Inspection on 03/05/05 for Lakeview House

This inspection was carried out on 3rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lakeview House 10/10/08

Lakeview House 31/08/06

Lakeview House 20/10/05

Lakeview House 23/08/04

Lakeview House 19/05/04

Lakeview House 28/01/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE LAKEVIEW HOUSE 88 Churchill Avenue Northampton Northants NN3 6PG Lead Inspector Pat Harte Unannounced 3rd May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lakeview House Address 88 Churchill Avenue Northampton NN3 6PG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01604 678810 01604 642307 Mr Philip Jones, Northants County Council, Oxford House, West Villa Road, Wellingborough, Northants NN8 4JR Miss Michelle Mullen CRH 41 Category(ies) of DE(E) Dementia over 65yrs - 15 places registration, with number PD(E) Physical Disability over 65yrs - 3 places of places OP Old Age - 41 places LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No person falling within the OP category can be admitted where there are already 41 people of OP category already in the home. No person falling within the DE(E) category can be admitted where there are already 15 people of DE(E) category already in the home. No person falling within the PD(E) category can be admitted where there are already 3 people of PD(E) category already in the home. To be able to accommodate one named service user who has needs within the LD(E) category. Total number of service users in the home must not exceed 41 Date of last inspection 23.8.2004 Brief Description of the Service: Lakeview House is a residential care home providing personal care for up to 41 Elderly Residents, including 15 people with Dementia and 3 people with Physical Disabilities. The Home has a specific condition to provide care for 1 existing named Resident with Learning Disabilities. The Home is owned by Northamptonshire County Council.The Manager is Mrs. M. Mullen. The Home is situated in a residential suburb of Northampton adjacent to nearby shops. The Premises consist of a 2 storey building providing lounge/dinning areas on both floors. The first floor is accessible by a lift. Single bedrooms are provided for all Residents. The Home provides pemanent care only. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 3 Residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. 5 staff and 8 Residents were spoken with. Mostly positive written comments were also received from 34 Residents but there were some concerns expressed about the effects on Residents from the behaviour of one Resident suffering from Dementia. 9 Relatives provided written comments again mostly positive but 4 felt there were insufficient staffing levels. A partial tour of the premises took place and a selection of records was inspected. The Inspection took place during the late morning and afternoon over a period of 5 hours and was carried out on an unannounced basis What the service does well: What has improved since the last inspection? What they could do better: Care planning for Residents must be improved to ensure that staff know what to do for each Resident and how to support them. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 6 The activities programme must be improved especially for Residents with Dementia. Consideration must be given to the layout of the building to ensure that Residents with Dementia are appropriately supervised and monitored and to ensure the premises are appropriately secure to prevent the risk of a Resident going missing. Consideration must be given to providing sufficient adequate and safe garden areas for Residents with Dementia. The Local Authority must ensure good maintenance of the building ensuring easy access to showers for disabled residents and give attention to deteriorating woodwork. The Manager must ensure maintenance checks are carried out regularly to identify broken furniture with prompt action taken to ensure repair or replacement where necessary. Staffing levels must be improved to ensure the needs of Residents are met in full. Attention must be paid to good record keeping including staff and training records. The systems for the safekeeping of Residents money must be reviewed to ensure that moneys are promptly transferred to Residents or into their own individual bank accounts. The testing of the Fire alarm systems is to be increased to weekly to ensure the system is safely maintained. Both the Northamptonshire County Council and the Manager must demonstrate prompt compliance, within the set timescales, to requirements made. Please contact the provider for advice of actions taken in response to this LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 Documentation provided to Prospective Residents is in need of revision to provide accurate information to enable them to make informed choice regarding their placement and the pre-admission assessment process needs to be more detailed to provide accurate information on needs. EVIDENCE: Information given to Residents, including the Home’s Statement of Purpose, is currently being revised to accurately reflect the Home’s services, facilities and Aims and Objectives. The admission process ensures that all prospective Residents are visited and assessed by staff from the Home. Individual records are kept for each of the Residents and inspection of the records showed that the pre-assessment documentation was somewhat limited and did not provide detailed information and risk assessments on all the needs to be met, particularly in the area of Dementia needs. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 10 Residents are provided with contracts, these are currently under revision. Residents and their relatives have opportunities to visit the Home before admission. Residents spoken with felt that staff were aware of their general needs and the care to be provided at the point of their admission to the Home. Staff spoken with felt that they were given information on new Residents needs, routines and wishes. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 Little progress has been made in the development of Care plans to adequately provide staff with detailed information they need to fully met the Residents needs, the Medication system was not safely managed. EVIDENCE: Individual plans of care are available for all Residents. The plans inspected showed that account is taken of Residents wishes and preferred routines. References to personal care needs remained limited. Instructions and guidance for staff on how the care was to be provided was not fully detailed. Risk assessments had not been updated. The approach to Dementia care is still fragmented, as the Home only has one dedicated Dementia care, which is insufficient to provide for up to 15 People with Dementia needs. Information gathering on Life histories, to aid understanding of the conditions and behaviours of Residents with Dementia, was limited and not crossreferenced to the care plans. Strategies for the management of behaviours and anxieties were not detailed. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 12 The documentation of Health care needs was also limited in detail though staff showed that they responded quickly to any changes to their Residents’ health and made referrals to medical professionals. Staff handovers at the start of each shift ensure that staff are updated of any changes. Stock rotation of some Medication such as creams and liquids was poor with medication not used in date order. Some creams did not have the receiving date written on the packaging. A medication cabinet was left open and unattended by the administering staff member during the medication round. Residents felt that they were treated as individuals and were respected by staff. Staff ensured that their privacy and dignity was protected when personal care was carried out. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Residents are enabled to maintain their independence as much as possible and exercise choice in the way they wish to lead their lives. Whilst group activities are provided there is little provision for individual, meaningful activities for people with dementia EVIDENCE: A number of Residents were spoken to and everyone who commented on the food said it was good, they had choice and their special and likes and dislikes were catered for and respected. The midday meal was efficiently served and nicely presented. Staff helped Residents with their meals where necessary. Residents felt routines were relaxed and flexible and that their preferences on rising and going to bed times were respected. They felt that they were free to decide on how and where they wished to spend their time. The Home has an activities programme activities but is limited to group activities and Residents commented that staff had little time to provide for individual interests or just sit and talk with them. There is little in the way of meaningful individual activities for Residents with dementia. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 14 The Home has an open visiting policy. A visiting Relative commented that she was always made welcome, extended hospitality and that staff made time to discuss their Residents needs, health and progress with them. Residents confirmed that they were enabled to receive their visitors in private if they wished. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18 Systems are in place to ensure that complaints are listened to and acted upon and that Residents are protected and their rights are upheld. EVIDENCE: Residents confirmed that they had been given the Home’s complaints procedure which is also displayed in the Home. Those spoken with felt confident and able to raise any issues or concerns with staff. A complaints record is maintained showing that any issues raised are taken seriously, investigated with action taken to improve the service where necessary. No complaints have been received by the CSCI in the last year. Staff have received training in Protection of Vulnerable Adult and records confirmed that the necessary notifications have been made. Residents are supported to vote and postal votes are obtained. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 - 26 The layout of the Home does not provide sufficient secure and dedicated areas and gardens for Residents with Dementia; general maintenance checks have failed to identify broken furniture and the Local Authority has not responded to recommendations made by the Occupational Therapist. EVIDENCE: Since the last Inspection there has been considerable renewal of furniture and carpets and some redecoration work. The requirement to guard radiators and pipe work was not met within the timescale of August 2004 but is now in progress. The Home is comfortably furnished, domestic and hygiene maintenance was good. The Home has only one dedicated Dementia Care Unit and one small secure garden suitable for Residents with Dementia, which is insufficient for the overall number of Residents within this category. Whilst the front door is secure Residents can access stairwells and some staff areas leading to doors opening to the outside, the doors are not alarmed. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 17 There is the potential risk that Residents with Dementia could go missing or gain access to the busy main road through these areas. The woodwork to the external service area by the Boiler room is rotting and in need of replacement. The arms of four dining chairs were found to be loose and lifted if pulled on, the failure to identify this maintenance issue resulted in a potential risk to Residents using the chairs. The chairs were subsequently removed from use. The flooring in the Residents Kitchen by the Treetops lounge is uneven and a potential trip hazard. Action has not been taken to the recommendations made by the Occupational Therapist to remove the lips from shower trays for ease of access. Residents stated their satisfaction in the facilities. They are enabled to personalise their rooms and have their furnishings and belongings about them. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 The maintenance of staff files and training records was poor and failed to confirm thorough procedures and training for staff, the deployment and number of staff was insufficient to provide monitoring and supervision for Residents with Dementia needs. EVIDENCE: Residents spoken with said that the staff were very kind, committed and caring. Residents and Relatives comments indicated that they felt the Home was short staffed and that there were delays in meeting their needs. Staff rotas showed that 6 care staff are on duty in the mornings with the level dropping to 4 in the afternoons. On the morning of the Inspection only 5 Care staff were on duty, a sixth was deployed on a one to one basis. There are six lounge areas, which cannot be appropriately supervised and monitored as staff are frequently called away to assist in other areas. 3 care staff provide night cover. Residents with Dementia are accommodated throughout the Home and not in specific units. There were times when staff were occupied in other areas and the Residents were not supervised or monitored. The Commission has recently been involved in discussions with the Manager on the need for a specific one to one monitoring of a Resident with Dementia. As a result of the discussions one to one staffing has been deployed to alleviate concerns expressed by other Residents and ensure appropriate supervision. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 19 A sample of 2 staff files showed that the appropriate checks were undertaken though one record evidenced only one reference and not all the required details were maintained in full. Whilst staff training records were maintained there were no records available for one member of staff other than an incomplete induction. The Induction programme was limited and was not linked to the National Training Organisation for Social Care’s guidance. The induction for Agency staff was also limited and in one instance was incomplete. Training for staff in Dementia care needs is also limited. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 32, 33, 34, 35, 36, 37 & 38 The Manager has failed to ensure a full oversight of the running of the Home and has failed to take action to ensure the systems for the safekeeping of Residents moneys are maintained in their best interests. EVIDENCE: Staff spoken with felt that the Manager was accessible to them and was willing to discuss any issues and guide them in practice. Supervisions systems were in place to ensure that staff receive guidance and support. Residents felt the Manager was readily available to them. They commented that regular Residents meetings were held and that the Manager also sought their individual views. Residents felt that they had overall trust and confidence in the staff group. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 21 The systems for safekeeping of Residents moneys showed that their moneys are still held in a Local Authority bank account. A previous requirement to ensure moneys are promptly transferred directly to the Resident or paid into individual’s bank accounts has not been met. Records showed that the Home’s Fire Alarm system is not being tested on a weekly basis resulting in the potential for a systems failure. The Manager could not demonstrate a full oversight of the running of the Home and has not responded promptly and within set timescales to requirements made. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 3 2 3 3 2 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 2 2 2 2 3 2 2 LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15. (1) Requirement Care Plans must have sufficient and up to date information in order that care needs may be met. This is an outstanding requirement from the Inspection Report dated 23.8.2004, Timescale by 30.10.2004 An action plan must be submitted with proposals for appropriate accomodation for Residents with Dementia including the security arrangements to prevent a Resident going missing and the proposals for safe and secure garden areas. Attention must be given to providing suitable and meaningful activities for all Resident s including those with Dementia. The stock rotation of Medication must be appropritaely carried out and include the opening date recorded on items such as creams.This is an outstanding requirement from the Inspection Report dated 23.8.2004, Timescale by 30. 9. 2004 The flooring to the Kitchen near the Treetops Lounge must be Timescale for action 9.7. 2005 2. 19 23 (1) (a) & 2(a) 15.6.2005 3. 12. 2 16. (2) (n) 30.6.2005 4. 9 13 (2) 15.5.2005 5. 19 23 (2) (b) & 13 (4) 31.5.2005 Page 24 LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 (a) 6. 19 23 (2)(g) & 13 (4) (a) 7. 19 23 (2) (b) 8. 19 23(2)(j) 9. 27 18, (1)(a) & 12 (1) 10. 11. 29 30 18, (1)(a) & 12 (1) 18 (1)( c) (i) 12. 13. 30 31 18. (1)(1) ( c) 9 (2) (b) (i) made even or replaced if necessary.Written confirmation must be forwarded to the Commission confirming this work has been carried out. The Manager must ensure that effective maintenance checks are carried out throughout the home and that broken furniture is identified and promptly repaired or replaced. The woodwork to the external service area of the Home must be replaced. Written confirmation must be forwarded to the Commission confirming this work has been carried out. An action plan must be submitted to the Commission with proposals to alter shower trays to give easy access to the showers. Staffing levels must be increased to meet the needs of Residents and provide adequate supervision and monitoring.This is an outstanding requirement from the Inspection Report dated 23.8.2004, Timescale by 30. 9. 2004 Staff records must be maintained in line with the Regulations. The Induction programmes for the Homes staff and Agency staff must be reviewed in line with the TOPSS guidance and evidenced as fully carried through with every new member of staff. Staff training records must be maintained. The Manager must demonstrate her on going fitness for Registration including a full and thorough oversight of the running of the Home and prompt action taken to comply with requirements. 15.5.2005 30.6.2005 31.5.2005 15.6.2005 31.5.2005 31.5.2005 31.5.2005 31.5.2005 LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 25 14. 35 20 (1) (a) The Registered Person must ensure that money belonging to Service Users is paid into individual bank accounts.This is an outstanding requirement from the Inspection Report of 23. 8. 2004 Timescale by 30.10.2004 31.5.2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 3 12 Good Practice Recommendations The pre-admission assessment documentation should be detailed with written comments on areas of need to aid the development of the care plan. LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 26 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI LAKEVIEW HOUSE C51 S35736 Lakeview House V223450 030505 stage 4 .doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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