Inspection on 10/05/07 for Link House

This inspection was carried out on 10th May 2007.

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

Link House 10/03/09

Link House 20/05/08

Link House 04/05/06

Link House 30/11/05

Link House 24/05/05

Link House 19/10/04

Link House 25/05/04

Link House 09/01/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Link House 15 Blenheim Road Raynes Park London SW20 9BA Lead Inspector Emma Dove Unannounced Inspection 10th and 11th May 2007 10:30 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 Link House DS0000019135.V338904.R01.S.doc Version 5.2 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. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Link House Address 15 Blenheim Road Raynes Park London SW20 9BA 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) 020 8545 4920 020 8332 1044 tessa.atkinson@ccht.org.uk Central & Cecil Housing Trust Care Home 52 Category(ies) of Dementia (18), Old age, not falling within any registration, with number other category (34) of places Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Nursing Places To include no more than twenty service users requiring nursing care at any one time. Nursing Unit 1st Floor - Qualified Staff A qualified 1st level nurse must be available on the nursing unit at all times. This person must not have any management responsibilities for the home other than within the nursing unit. Nursing Unit 1st Floor - Care Staff 7.30am to 3pm three care staff must be available on the unit. 2.45pm to 9.30pm two care staff must be available on the unit. 9.30pm to 7.30am one care assistant must be available on the unit. Dementia Care Unit 2nd Floor - Care Staff 7.30am to 3pm three care staff must be available. 2.45pm to 9.30pm three care staff must be available. 9.30pm to 7.30am two care staff must be available, one of which will be the designated senior carer in charge of the home, in the absence of the Manager or Deputy Manager and able to offer assistance and guidance for carers throughout the home. Residential Unit Ground Floor - Care Staff 7.30am to 3pm two care staff must be available. 2.45pm to 9.30pm two care staff must be available. 9.30pm to 7.30am one care assistant must be available. Management One full time Manager 40 hours per week. One full time Deputy Manager 40 hours per week. A member of the management team to be available seven days each week. Ancillary Staff Administrative Staff 37.5 hours per week. Domestic Staff 136.5 hours per week. Cook 49 hours per week. Kitchen Assistants 102 hours per week. Laundry Staff 70 hours per week. Reviews The organisation must ensure that the above minimum staffing levels remain under review and that at all times suitably qualified, competent and experienced persons are working in the home in such numbers as are appropriate for the health and welfare of service users. Distribution of Staff The number and distribution of nurses, care staff and ancillary staff must be reviewed at regular intervals. If at any time, the evidence indicates that there are insufficient staff of any category available to meet the assessed needs of service users, the NCSC will require DS0000019135.V338904.R01.S.doc Version 5.2 Page 5 3. 4. 5. 6. 7. 8. 9. Link House additional staffing as appropriate. Date of last inspection 12th September 2006 Brief Description of the Service: Link House is a purpose built care home which has the capacity to provide nursing care for twenty older people and residential care for thirty two older people, eighteen of whom may have dementia. Fifty residents are currently living there. The home is owned and managed by Central and Cecil (CC) a charitable organisation who own and manage four other similar services in the Merton and Richmond area. Accommodation is provided over three floors with a lounge, dining room, kitchenette, bathrooms and single bedrooms available on all three floors. Residents have access to enclosed gardens to the rear and side of the home. Each floor is serviced by a lift. Link House is situated in a residential area of Raynes Park, close to the main A3 road, local bus services, churches of a number of denominations and local shops. The home is staffed twenty-four hours a day by trained nurse staff and care assistants. Three meals are provided each day with drinks and snacks available between meal times. The Statement of Purpose and Service Users Guide include contact details of the CSCI. The current range of fees for this home are £427 to £745 per week. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six hours on the 10th and eight hours on the 11th May 2007. One inspector visited the home, spoke with residents, relatives, staff and the temporary manager. Records were looked at and the communal areas and six bedrooms were seen. Eighteen questionnaires were sent to residents, relatives, health professionals and social workers. Eight questionnaires have been received by the CSCI and comments from these are included in the relevant sections of this report. What the service does well: What has improved since the last inspection? What they could do better: Update the Statement of Purpose and Service User Guide to ensure people have information about staff and services currently provided. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 7 Care plans must be more person centred and include all details to ensure peoples needs are fully met. Reviews must be more person centred and include details of the person being reviewed. A review of the mealtimes should take place to ensure residents receive a good service. More activities must be available to ensure all residents have the opportunity to do be involved in something they enjoy. All complaints must be recorded and include any actions taken and the outcome. Questionnaires noted that the laundry arrangements could be improved to ensure clothing is worn by the individual rather than other people. Staff levels must be kept under review to ensure peoples needs are met. The organisation must ensure that ongoing staff issues are concluded quickly to ensure consistency of care for people. A permanent manager must be appointed to provide good leadership. The portable electrical appliances must be tested every year to ensure peoples health and safety is protected. The lift must be serviced at the required intervals to protect people from harm The fire alarm must be tested weekly for safety reasons. A copy of monthly visit carried out must be sent to the CSCI to comply with Regulations. 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. The summary of this inspection report can be made available in other formats on request. Link House DS0000019135.V338904.R01.S.doc Version 5.2 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 Link House DS0000019135.V338904.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service Users Guide provided on each floor do not give up to date information about the home. Assessments are completed prior to admission. EVIDENCE: The Statement of Purpose and Service Users Guides which were provided on each floor were not up to date and do not reflect the staff and services currently provided. Five people noted that they had received enough information before they moved in. One person said that their relatives chose the home for them. One questionnaire quoted ‘looking around makes it easier to decide’. Another person said ‘I’m happy at Link House’. One person said that they didn’t receive any information about routines and contact numbers which would have been useful at the time of admission. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 10 Questionnaires indicated that people have a contract of residence with the home. Assessments were seen to have been completed by placing social workers and by staff prior to someone moving in. Link House DS0000019135.V338904.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Every person has a care plan which includes basic information needed to deliver care but it is not detailed or person centred. Health needs are monitored with some gaps in information. People who use the service have access to health care professionals who visit the home. EVIDENCE: Care plans are in place and have been reviewed monthly, except in two of the eight looked at. One care plan included lots of detail about the individuals preferences and how their care needs should be met by staff. Two care plans did not include details of the person’s religious persuasion. On one unit, staff complete regular reviews of individuals. This is a good practice, however on two reviews seen, the information was regarding a different person. This indicates that the review is a paper exercise and is not person centred. Two Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 12 files directed the reader to other areas for information, this is quite confusing when the information is stored in a different place. One questionnaire indicated that they are kept informed of their relatives progress and condition and that the home usually meets their relatives needs. Three questionnaires said that the person always receives the care and support they need while four questionnaires said that they usually get the care they need. Health information is clearly recorded in case files. People are all registered with a GP who visits once a week and as necessary. The dentist, optician and chiropodist visit at regular intervals throughout the year and some people attend community facilities of their choice. Six people said their medical needs are always met and one person said their medical needs are usually met. One relative noted that the GP was supposed to visit when the person had a cold and cough although this didn’t happen. Medication is securely stored and records were up to date with three exceptions. One gap in the signing of an external cream for two people. One external medication was not applied when prescribed. One persons medication was signed, however some medication remained in the monitored dosage system. Staff reported that this was due to not receiving medication from the pharmacist on time and using medication from a packet rather than the monitored dosage system for a few days. All other medication seen was signed and up to date. The signing of medication has improved since the last inspection with regular checks carried out by senior staff. Peoples wishes regarding end of life care are noted, however some noted ‘observe religious beliefs’ which were not all clearly stated and did not include what the religious beliefs are. Link House DS0000019135.V338904.R01.S.doc Version 5.2 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. 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. People using the service are given the opportunity to take part in a variety of activities within the home and some in the community. The food is generally of good quality, well presented and meets people’s dietary needs, however the meal experience needs to improve to ensure peoples needs are fully met. EVIDENCE: An aromatherapist visits once a week and spends time with a few people on one floor each visit, using smells, touch and massage with individuals. One person was very positive about the aromatherapists visit and how helpful it was for them. An artist continues to attend once a week, spending time on a different unit each visit. Questionnaires noted that two people ‘always’, one person ‘usually’, two people ‘sometimes’ and one person ‘never’ has enough activities provided. One person noted that there is only a weekly art class and another person said they had been on one trip with not much else provided. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 14 People were seen to be reading the paper, talking with staff, watching their television, spending time with visitors and playing skittles during the visits. One person noted that they are not supported to maintain contact with relatives. Other visitors confirmed that they are made welcome. Visitors were seen throughout the visits. Visitors and residents confirmed that representatives from the churches of their choice visit. Comments regarding the food provided ranged from its ‘always good’ to it’s ‘sometimes good’. A mealtime was seen to be unhurried and well managed on one unit. Tables are laid with cloths, place mats, serviettes and flowers. In one unit, ten people were seen to remain in their wheelchair. One person had a serviette and four people were seen to have a ‘bib’, this practice should stop and people should be offered a serviette. This practice does not maintain peoples dignity. If people choose to wear an apron this should be recorded in their care plan. For people who take meals in their bedrooms the service was seen to be a less positive experience, with some people receiving their main course and hot dessert at the same time and one person not receiving the help they require to meet their needs as noted in their care plan. Staff must be made aware of peoples needs and mealtimes should be reviewed to ensure that all peoples’ needs are met. Link House DS0000019135.V338904.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A complaints procedure is in place which is available to residents and their relatives and representatives. People are aware of how to make a complaint. Records are kept but do not contain all actions taken and the outcome of the complaint. EVIDENCE: People were aware how to make a complaint and knew who they could speak with to raise concerns. One person noted that they should speak to a carer, although they had a different carer every day. One person reported that their family would deal with any concerns or complaints. No issues or concerns were raised during the visits. Seven complaints have been received since the last inspection, four were regarding care practices. The records did not clearly indicate the actions taken and the outcome of the complaints. One complaint was not recorded and one complaint was recorded in the persons file, not in the complaints record. One complaint has been received by the local social services department, which is still being investigated. The CSCI has not received any complaints since the last inspection. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 16 The organisation takes a long time to investigate complaints and concerns involving staff and the policies followed do not always protect residents. Link House DS0000019135.V338904.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides an environment that meets the needs of people who live there. People are encouraged to personalise their bedrooms. A choice of communal areas is available in two units and people can meet with visitors in private in their bedrooms if they wish. The home is well lit, clean and tidy and generally smells fresh. EVIDENCE: The home is separated into three units with single bedrooms, a bathroom and shower room, a lounge on the ground floor and a lounge and dining room on the other two floors. People have access to two enclosed gardens. Staff reported that residents are supported to maintain the flowerbeds and pots in the garden. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 18 Bedrooms are all single with an ensuite toilet and wash hand basin. Bedrooms were seen to have been personalised with the individual’s belongings, pictures and ornaments. People made positive comments about their rooms and the home. Six questionnaires noted that the home is ‘always’ clean. All areas of the home were seen to be clean and tidy, one odour was noted on one unit on first arriving. Communal areas are starting to show signs of wear and a redecoration schedule must be in place. Link House DS0000019135.V338904.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using services are generally satisfied that they get the care they need to meet their needs, but there are times when they need to wait for staff support and attention. EVIDENCE: Staffing levels were seen to be sufficient, however three questionnaires identified that staff are always available and four questionnaires said staff are usually available with two additional comments that ‘often wait a long time’ and ‘wait, due to staff shortage’. Staff also reported that more staff would enable more time to be spent with residents doing activities. Two comments were also made about the difference between day and night staff, noting that night staff are ‘not so helpful’. A comment was also made that staff usually have the right skills but not necessarily the right attitude. Residents comments about staff included ‘the staff are good’, ‘staff help’, Staff were seen to have a good knowledge and understanding of peoples needs. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 20 Staff recruitment is in line with requirements, with application forms completed, interviews, references and Criminal Records Bureau checks completed prior to staff commencing employment. Staff reported that they have access to training courses and are supported to do their work. Staff training records continue to be quite confusing and it is quite difficult to see what courses staff have completed. The staff training programme must include training for working with people with dementia and challenging behaviours, to ensure staff are aware of people’s needs and how to meet them. Link House DS0000019135.V338904.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Checks show that records are generally up to date although some gaps are found. EVIDENCE: The registered manager left in March 2007. The organisation put in temporary management arrangements for a few weeks and a temporary manager is now at the home. This is the eighth change in manager since the home first opened. A permanent manager must be appointed and register with the CSCI. A senior staff meeting was held in April and May 2007 but it was not clear from records when the last staff meeting was held. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 22 Evidence was not available to confirm that residents are involved in the day to day running of the home. A representative from the organisation visits and carries out a monitoring visit and writes a report on the services provided. A copy of this report must be sent to the CSCI. Residents finances are well managed, records up to date and balances correct. If there are concerns about residents finances, these should be discussed with the placing authority to ensure people are protected from harm. Recording of health and safety is well ordered and up to date with the exception of the portable electrical appliances, the lift service and the weekly fire alarm test. Link House DS0000019135.V338904.R01.S.doc Version 5.2 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 3 3 3 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 X X 2 Link House DS0000019135.V338904.R01.S.doc Version 5.2 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 OP1 Regulation 4 Requirement The Statement of Purpose and Service Users Guide which are made available to people must be up to date and reflect staff and services currently provided. Care plans must be more person centred and include details of individuals care needs. (previous timescales of 16/12/04, 19/07/05, 07/07/06 and 10/11/06 not met) Failure to meet this requirement may result in enforcement action. More activities must be provided to meet all peoples needs. Medication must be signed for at the time of administration. (previous timescales of 23/06/06, 07/07/06 & 27/10/06 not met) Medication must be administered as directed. All complaints must be recorded with clear details of action taken and outcomes. A redecoration schedule must be in place. The handrails on the second floor DS0000019135.V338904.R01.S.doc Timescale for action 12/07/07 2. OP7 15 (1 & 2) 12/07/07 3. 4. OP12 OP9 12(1)&16 (2)n 13 (2) 12/07/07 28/06/07 5. 6. 7. OP16 OP19 OP19 22 (3) 23 (2) d 23 (2) b 12/07/07 12/07/07 26/07/07 Page 25 Link House Version 5.2 8. OP27 18 (1) a 9. 10. 11. 12. 13. OP31 OP33 8 (1) (a) & (b) 26 (5) a 12 (1) a 23 (4) c (iv) 13 (4) OP38 OP38 OP38 must be painted, (previous timescales of 23/06/06 & 10/11/06 not met) Staffing levels must be reviewed in consultation with residents and their representatives to ensure peoples needs are fully met. A manager must be appointed at the home and register with the CSCI. A copy of the monthly visit carried out at the home must be sent to the CSCI. The lift must be serviced at the required intervals. The fire alarm must be tested weekly. The portable electrical appliances must be tested every year. 12/07/07 12/07/07 12/07/07 12/07/07 12/07/07 12/07/07 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 OP30 Good Practice Recommendations Staff training records should be easily accessible and indicate training individuals have completed. Link House DS0000019135.V338904.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Link House DS0000019135.V338904.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!