Inspection on 05/04/06 for Lincoln House

This inspection was carried out on 5th April 2006.

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

Lincoln House 28/10/08

Lincoln House 31/10/07

Lincoln House 18/12/06

Lincoln House 29/11/05

Lincoln House 23/06/05

Lincoln House 07/01/05

Lincoln House 23/06/04

Lincoln House 05/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Lincoln House Lincoln Close, Off Gillett Road Wood Green Banbury Oxfordshire OX16 0EF Lead Inspector Jane Handscombe Unannounced Inspection 5th April 2006 10:00 X10015.doc Version 1.40 Page 1 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 Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 2 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. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lincoln House Address Lincoln Close, Off Gillett Road Wood Green Banbury Oxfordshire OX16 0EF 01295 257471 01295 266285 manager.lincolnhouse@osjctoxon.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Orders Of St John Care Trust Care Home 44 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (44), of places Physical disability over 65 years of age (6) Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The total number of persons that may be accommodated at any one time must not exceed 44 As vacancies arise the numbers in the PDE categories will be reduced to 3. The continued registration of this service past April 2007 is dependent upon the physical environment meeting standards. Admittance of one named under age resident effective from 3rd April 2006 29th November 2005 Date of last inspection Brief Description of the Service: Lincoln House is one of a number of care homes run by The Orders of St John Care Trust and provides care and accommodation for older people who may be suffering some dementia related illness, and/or physical disability. Local psychiatric services are available for guidance on treatment and support for staff. The home is due to be rebuilt in order to bring the building up to current spatial requirements and will remain close to the centre of Banbury. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on the 5th April 2006. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The visit involved speaking to residents in order to ascertain their views upon the care and the services they receive at the home, staff members and the trainee manager of the home, viewing care plans and assessments and case tracking these, whilst observing the general day to day operations of the home. Comment cards were received by the Commission for Social Care Inspection, giving feedback from relatives and visitors who visit residents in the home. The home presented as one, which was clean and tidy throughout. Residents were going about their daily activities in a calm relaxed manner. Staff were seen to provide care and support in an unhurried manner whilst addressing their needs appropriately. Comments received from residents during the inspection included: ‘I am very impressed on the carers knowledge’ ‘The food is very good’ ‘It is very good here’ ‘My son and daughter come regularly to visit’ ‘I came for half a day to see if I liked it’ Comments received from relatives comment cards included: ‘Lincoln House is a lovely little care home. My mother is as happy as she can be anywhere’. ‘I find all the care staff kind and helpful’ ‘Staff levels have always seemed lacking, however in recent months this has improved’ A comment regarding a complaint received by the home: ‘…….I commend the way the incident was dealt with at the time by the duty manager’. The inspector would like to thank the residents, staff and relatives/visitors for their warm welcome and their assistance during the inspection process. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The responsible individual for Lincoln House needs to ensure that requirements, when made, are addressed within the stated time given, failure to do so is a breach of the regulations and could lead to the Commission questioning their fitness as a responsible individual. Requirements made during the last 3 inspections, over a spate of 18 months have clearly not been addressed and this leads the inspector to question as to whether the residents’ health, safety and welfare are perhaps being compromised. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 7 Care planning and assessment procedures were lacking in detail and need to give comprehensive details, in order that the care staff are informed of the resident’s full care needs that need addressing and how to minimise the risks associated with these needs. Furthermore, regular reviewing of these needs must be undertaken in order that any changes in the resident’s needs are recognised and addressed appropriately. It is vital that the procedures around the recording of medication are adhered to, since the poor practices being undertaken are placing the residents at risk. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 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 the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with good clear information about the home and the services it offers and undergo an assessment of their care needs before moving into the home, to ensure that both parties are confident that these needs may be met. EVIDENCE: All prospective service users undergo an assessment of needs and are provided with the opportunity to spend a day at the home to meet with fellow residents and the staff, in order that they are able to make an informed choice when choosing where to live. The assessment is undertaken in collaboration with the individual and/or their representative, although this was not apparent in one resident’s case, since there was no resident/representative signature to evidence this. Information about the home is contained in a brochure, which contains a summary of the Statement of Purpose and Service Users Guide and was on Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 10 view within the home; it was very informative, written in plain English and easily understood. It was mentioned to the inspector that the residents handbook, which includes information about the home, the staff working at the home, activities, meal times and the complaints procedure, was being withdrawn from production. With this in view, the responsible individual must ensure to provide every resident with a written copy of the complaints procedure. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 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 the following standard(s): 7,8,9 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is providing a poor service when addressing the residents’ health and personal care. Residents are treated with respect and their right to privacy is upheld at all times. EVIDENCE: The inspector sampled five residents’ care plans during the inspection which were found to be of poor quality. Admission details were found to be incomplete, monthly reviews of care plans were not always being undertaken. All five files viewed, informed the inspector that there were risks involved in parts of the care to be delivered, however these risks were not highlighted on any of the five risk assessments to inform staff how to deal with and minimise the risks entailed to ensure the residents’ health, safety and welfare. Of the five viewed, two residents’ care plans informed the inspector that there were emotional needs, however there was no plan to address these needs nor that of the residents’ health needs. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 12 The inspector viewed a sample of medication administration records and very poor practices around the recording of medication were found, placing the residents at possible risk. There was one incidence in which signatures had been crossed out and no coding or explanation as to the reason was included. Likewise, upon viewing the controlled drugs register one resident’s records informed the inspector that medication had been administered as required, and should leave a remaining 15 tablets to be administered, however there was a higher number of tablets remaining, for which the staff member spoken to and the trainee manager were unable to explain. A further incidence was apparent in which the medication in the controlled drugs register failed to be clearly named for that individual. Any medication recording pertinent to an individual must be clearly named for that individual. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Daily life and social activities provided at Lincoln House are adequate; although the lack of activities during the afternoons does not take into consideration the needs of all residents. The home supports residents to maintain contact with their family and friends and the local community and they are assisted to exercise choice over their day. EVIDENCE: Residents spoken to informed the inspector that they were able to choose how they wished to spend their day and were not made to feel uncomfortable if they chose to stay in their own room, and not join fellow residents. Daily activities are offered to residents, although during the inspection the inspector noted no activities taking place during the afternoon. Upon enquiry with the trainee manager, it was mentioned that activities generally take place in the mornings, as attendance was higher in the mornings than that of the afternoons, because many tend to take their afternoons quietly. This was confirmed by one resident, who spoke with the inspector, and stated; ‘in the Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 14 mornings we have activities, we have a lovely lady who sings and it is a lovely morning’. Another resident who spoke with the inspector was disappointed with the provision of activities and said ‘ there are not many activities.’ The inspector was informed that activities take place in the activities room on the second floor. With this in view, the delivery of activities are not as individualised as they could be and therefore the inspector has made a recommendation to include individualised person centred activities for those who require them and deliver these on a one to one basis or in small groups, during the quieter afternoons, so as to address everyone’s individual needs. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 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 the following standard(s): 16,17 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the home is addressing complaints and protecting the residents in their care adequately, although there are important areas for improvement to ensure that service users are safe at all times. The home has good policies and procedures in place along with relevant training, however it was apparent that staff need to be made aware about their responsibilities in relation to “whistle blowing” should they have any concerns. Residents are confident that any complaints or concerns they may have will be acted upon appropriately. EVIDENCE: Speaking with residents on the day, it was apparent that they were aware of the complaints procedure and were confident that any concerns they may have would be acted upon appropriately. All residents spoken to were aware of who to take any concerns to if the need should arise. The inspector viewed 5 complaints received since the last inspection 4 of which were dealt with appropriately. The remaining complaint highlighted that whilst the matter had been dealt with, the home failed to notify the Commission for Social Care Inspection under Regulation 37 as is required by the Care Homes Regulations 2001. The home must ensure that The Commission for Social Care Inspection (CSCI) is notified without delay of any occurrence affecting the welfare of service users Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 16 An independent advocacy service is available for residents to access if the need arises. Residents can approach any member of staff who will assist them to access the service, or if preferred they can self refer. There are regular residents meetings held in the home to which all residents and their families are invited. These meetings are an open discussion in which residents and their families can voice any concerns and make any suggestions and the management can address their issues and discuss points of interest relating to the home. The meetings are minuted and displayed within the home to keep all residents informed. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 17 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 the following standard(s): 19, 22, 24 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Ongoing redecoration and routine maintenance are undertaken and create a comfortable and safe environment for the residents and their visitors to enjoy. Overall residents generally live in a comfortable, well maintained environment with safe access to all parts of the home and grounds. EVIDENCE: The home encourages residents to bring small items of furniture and memorabilia to personalise their rooms to their own liking, which was evident on touring the home. Each bedroom has an alarm near to the bed in order that assistance may be sought when required. Residents spoken to on the day informed the inspector that they were very happy with their rooms and found them to suit their needs. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 18 All parts of the home are accessible to the service users, with the use of grab rails and a lift to facilitate mobility around the home. There is adequate provision of toilets, washing and bathing facilities throughout the home, however it was noted that one bathroom failed to provide liquid soap, paper towels and disposable gloves, for which a recommendation has been made to ensure these are provided at all times. The home has had problems with the emergency lighting on some units, although this has now been addressed. Further work is scheduled to take place at the end of April which will entail closing one corridor at a time, contingency plans have been addressed in order to ensure the residents’ health and safety whilst this is undertaken. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 19 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s policies and procedures around recruitment and selection of staff are of good quality. Staff are provided with the necessary training. The home’s recruitment and selection of staff operates in line with equal opportunities and is non-discriminatory. Checks are undertaken on staff to ensure their suitability and residents’ protection EVIDENCE: On the day of inspection there was sufficient staff to meet the residents’ overall needs. The recruitment procedures at the home were generally good with clear monitoring systems in place to promote the protection of service users including application form, interview notes, references and Criminal Records Bureau (CRB) check being sought. All new staff undergo an induction period in which all mandatory training is undertaken and shadow senior carers in order to provide them with the skills required to provide the care efficiently and competently. The inspector was informed that recent training had included medication training and dates have been arranged to provide staff with further training in Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 20 the awareness of abuse, infection control, fire training and dementia, during April and May. Discussions with the trainee manager informed the inspector that all staff undergo an appraisal once a year and regular supervision takes place both formally and informally. However when sampling personnel files it was apparent that one member of staff had not undergone an appraisal since May 2004. A recommendation has been made within this report to address this matter. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 21 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33.35 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Excellent financial systems are in place within the home, and adhered to. The management of the home is poor, with failings around key national minimum standards related to the residents’ safety and well being, requirements from previous inspections have not been addressed and key national minimum standards related to safety and well being are not being met. EVIDENCE: Management and leadership within the home has been inconsistent, requirements from previous inspections have not been addressed and key national minimum standards related to safety and well being are not being met. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 22 There are shortfalls around the residents’ health, safety and welfare (see section headed Health and Personal Care) which were also evident during the last two inspections and for which requirements were made. The home must ensure that assessments, individual plans of care and reviews are comprehensive and address the needs of the residents appropriately. Continued failure to comply with this could result in further action. Regular residents meetings are held, which keep residents informed and allow for any concerns to be discussed. The meetings are minuted and distributed around the home. The inspector met with the administrator and discussed the management of the residents’ finances. Systems and records were seen to be in place and provide a clear audit trail to safeguard the residents’ financial interests. The Commission for Social Care Inspection (CSCI) is notified under Regulation 37 of The Care Homes Regulations 2001 of any occurrence affecting the welfare of service users, and the trainee manager showed an awareness of what events need reporting, although there was one such incidence where notification had not been forwarded to CSCI (See section headed Complaints and Protection) for which a requirement has been made. Lincoln House has been without a manager during the last 3 inspections, however a trainee manager was recruited in March 2006, who is familiar with the staff and residents since she was previously head of care. The trainee manager has been undergoing relevant training and updating of her skills including the Registered Managers Award and the NVQ level 4 in care. It has been strongly recommended, in previous inspections, that a manager be sought to manage the home and to become registered with CSCI as a matter of urgency, since the lack of a manager is unsettling for both the residents and staff members. A requirement has been made to ensure that an application be put forward to CSCI in order that there be stable leadership and continuity for both the residents and staff members, which has not been the case for some time. Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 23 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 x x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 2 Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 24(1)a Requirement Timescale for action 07/04/06 2. OP7 24(1)a 14 The home must update all the risk assessments highlighted during the inspection and forward copies to CSCI. The home must ensure that all 30/04/06 remaining assessments of needs, risk assessments and reviews of care plans are undertaken, kept under review and up to date to reflect the needs of the service users, and to provide staff with clear information as to the management of those needs. This is an outstanding requirement from previous inspections in June and November 2005. The home must review and update the care plans highlighted during the inspection and forward copies to CSCI. The home must ensure to gain the signature of a family member/advocate, where the service user is unable to do so themselves, to evidence that appropriate consultation with the service user or their DS0000035671.V288028.R02.S.doc 3 OP7 14 07/04/06 4. OP7 14 31/05/06 Lincoln House Version 5.1 Page 25 representative regarding the care planning and assessment takes place. This is an outstanding requirement from previous inspections in June and November 2005. The home must ensure to discuss the medication errors found during the inspection, with staff and ensure staff adhere to the home’s policies and procedures. Any medication recording pertinent to an individual must be clearly named for that individual. The home must ensure that The Commission for Social Care Inspection (CSCI) is notified without delay of any occurrence affecting the welfare of service users. The home must ensure to contact the fire officer and seek advice to the storage of wheelchairs and hoists under the stairway. A copy to be forwarded to CSCI. The responsible individual must ensure to have a manager registered with CSCI to ensure leadership and continuity for residents and staff. This was recommended during previous inspections in June and November 2005. 5. OP9 13(2) 07/04/06 6. OP38 37 05/04/06 7. OP38 13 10/04/06 8. OP31 8 31/05/06 Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 26 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. Refer to Standard OP21 Good Practice Recommendations It is a good practice recommendation to ensure the provision of liquid soap, paper towels and gloves in communal bathing facilities and that these remain available at all times. It is a good practice recommendation to include individualised person centred activities on a one to one basis or in small groups, at varying times of the day, so as to address everyone’s individual needs. Appraisals for all staff to take place on an annual basis. 2. OP12 3. OP30 Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South, Cowley Oxford OX4 2SU 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 Lincoln House DS0000035671.V288028.R02.S.doc Version 5.1 Page 28 - 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. 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