Inspection on 29/06/06 for Lowdell Close, 186-188

This inspection was carried out on 29th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lowdell Close, 186-188 14/12/06

Lowdell Close, 186-188 04/02/06

Lowdell Close, 186-188 24/08/05

Lowdell Close, 186-188 17/11/04

Lowdell Close, 186-188 22/07/04

Lowdell Close, 186-188 14/10/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Lowdell Close, 186-188 Yiewsley West Drayton Middlesex UB7 8RA Lead Inspector Mrs Rekha Bhardwa Unannounced Inspection 29th June 2006 10:30 Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 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 Lowdell Close, 186-188 DS0000027064.V288613.R01.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 Adults 18-65. 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. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lowdell Close, 186-188 Address Yiewsley West Drayton Middlesex UB7 8RA 01895 434697 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) www.lifeopportunitiestrust.co.uk Life Opportunities Trust Mr Paul Jeremy Witter Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th February 2006 Brief Description of the Service: This is a home for four adults with learning and physical disabilities. Two have profound disabilities. Although the home is not purpose built it has all the aids and adaptations the service users need. It is on two floors and there is a lift. All the bedrooms are single rooms and they are an adequate size for wheel chair users. The home is owned by Ealing Family Housing Association and managed by Life Opportunities Trust. It is on a housing estate and is a long walk to shops and other local amenities. There is a minibus for taking service users out of the home. There is a Sensory Room for the provision of stimulation to the service users. Activities are provided in house and outings are arranged. Two service users are taken to a weekly club for people with learning disabilities. The service users socialise with service users who live in homes managed by Life Opportunities Trust nearby. There were no vacancies on the day of inspection. Lowdell Close, 186-188 DS0000027064.V288613.R01.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 undertaken as part of the regulatory process. The Inspector spent a total 6 of hours on the inspection process. The Inspector undertook a tour of the premises, examined service user records, staff records, maintenance records and medication records. The purpose of this inspection was to follow up the requirements of the last inspection and to assess all key National Minimum Standards for Younger Adults. The Inspector did not meet any of the service users during the course of the inspection as three service users were at day care and the service user who was at home had been taken out by the staff on duty. The pre-inspection questionnaire completed by the home has also been used to inform this report. What the service does well: What has improved since the last inspection? What they could do better: Some requirements have been repeated and these must be addressed. Action must be taken to address the shortfalls within the environment with the responsible Housing Association. Minor shortfalls in relation to staff records should be easy to address. No progress has been made with introducing Induction and Foundation training to meet Skills for Care requirements. Regulation 26 Visits must be undertaken monthly. The home must have in place an annual development plan. Health and safety shortfalls identified must be addressed. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 6 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. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The service users in the home are provided with information about the home and the services provided, so as to be clear about the services the home provides to meet their needs. Systems are in place for the service users needs to be assessed prior to admission to ensure that the home can meet their needs. EVIDENCE: The Statement of Purpose and the Service User Guide have been updated and a copy of both documents have been sent to the Commission. There have been no new admissions to the home for a number of years. The Manager designate stated that referrals would be received from the Community Team for Physical Learning Disabilities along with a completed Needs Led Assessment. If the home is suitable the potential service user would be encouraged to visit the home, meet staff and other service users. Day visits and weekend visits would be planned. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is a clear care planning system in place, which provides the staff with the information they need to meet the needs of the service users. The home has good risk management systems in place, which promotes the safety of the service users. EVIDENCE: All service users have a care plan. The Manager designate stated that all the care plans have been reviewed and have been streamlined. Individual health action plans were available and these detailed the service user’s health care needs and how these needs were to be met. Care plans are reviewed every three months or sooner if the needs of the service user change. The staff working in the home have a good understanding of the service users needs. Service users are encouraged to make decisions within their capabilities. Two of the service users are unable to communicate verbally, Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 10 however they are encouraged to indicate their choices through facial expressions. Advocacy services are available however at the time of the inspection no service users required this service. Individual risk assessments were available and had been reviewed. None of the service users are able to go out unaccompanied. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users participate in a range of activities that meet their individual needs. The home promotes individuality, positive relationships between service users and their families and supports service users to have a lifestyle that suits there individual needs and preferences. EVIDENCE: All four service users attend a range of day care. Each service user also has a day off during the week where they spend time at home and undertaking one to one activities. Two service users also attend an evening club. Within the home service users listen to music, undertake light exercise, massage and manicure. One service user is able to participate in small chores within the kitchen. None of the service users are able to take up opportunities for employment, education or voluntary work due to the nature of their learning disability. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 12 The service users access local pubs, cafes, restaurants and theatre. Plans were in progress for three service users to have a summer holiday. One service user attends a local Church every Sunday. The Vicar from this Church also visits the home monthly. Two service users had a day trip to the London Eye. A visiting policy is available. The home has an open visiting policy. Service users can see visitors in their own bedrooms or in the communal areas. The service users can also visit family and friends outside of the home. None of the service users are able to manage a key to their bedrooms. Service users can choose whether they spend time in the lounge or in their bedrooms. Staff working in the home eat their meals with the service users. Meals are chosen on a daily basis. A record of food partaken by the service users is kept. Pureed diets are provided. Snacks and drinks are available throughout the day. The kitchen was clean and food was appropriately stored. Fridge freezer temperatures were being recorded daily. Staff training records evidenced that care staff working in the home have received Food Hygiene training. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Personal support is offered in such a way as to promote service users’ privacy, dignity and independence. Overall the health care needs of service users are well met with evidence of good multi disciplinary working. The systems for the management of medication were in place and well managed. EVIDENCE: Individual personal care needs are identified in the service users care plan. This also details the level of support and guidance required. None of the service users in the home are fully mobile. Two service users require support with all aspects of their personal care. Suitable adaptations are available throughout the home. This included wheelchairs, grab rails, tracking hoists and mobile hoists. Moving and handling risk assessments were available on the files viewed. The service users in the home have access to all healthcare professionals. Evidence of this was seen in the files viewed and included the dietician, speech Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 14 therapist, District Nurse, GP, Optician and Dentist. All service users have an annual health check. The home uses the Boots Monitored Dosage system. The Medication Administration Records viewed were well completed and all medication received into the home had been recorded. Liquid medications had the dates of opening recorded. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The systems for managing complaints and adult protection matters are robust, thus safeguarding service users. EVIDENCE: The home has a clear complaints procedure in place. A simplified pictorial version of the procedure has been given to all the service users. The Manager designate stated that the home has received no complaints since the last inspection. No complaints have been received by the Commission. No service users are able to manage their own finances. Small amounts of personal allowance is managed by the home. The records viewed were up to date and receipts were available regular checks are undertaken on the balances of money held by the Manager designate and at Regulation 26 Visits. All staff have received training in the protection of vulnerable adults. Further training has been planned with the Safeguarding Adults Co-ordinator at Hillingdon. The homes adult protection policy has been amended to dovetail with the local authority safeguarding adult’s policy. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The standard of the environment is generally good and provides service users with an attractive and homely place to live. EVIDENCE: A tour of the premises was undertaken during the course of the inspection. There has been little progress with the redecoration and repair of the corridor areas. The Manager designate reported that the property had been surveyed by the Housing Association on the 16/06/06. The Manager designate was still awaiting the report. The Inspector requested that a copy of the report be sent to the Commission. Service users bedrooms viewed were well maintained, homely and the furniture and fittings were of a good standard. Each bedroom is individually personalised, with photographs, equipment and personal items. There is a large garden to the rear of the property which can be accessed via the lounge and the kitchen. Since the last inspection the patio area has been extended. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 17 A new shower trolley has been purchased for the first floor shower room. The manager designate stated that there were problems with the drainage, but this has been reported to the Housing Association. The home does not employ a domestic, all the cleaning is undertaken by the staff on duty. The home was clean and odour free throughout. Gloves, aprons, paper towels and were available in the toilets and bathrooms. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home was adequately staffed to meet the assessed needs of the service users. The service users are well supported by a well established staff team which is well managed, supported, supervised and effective in meeting the individual and joint needs of the service users. Overall staff training in the home provides staff with the skills and knowledge to meet service users needs. No progress has been made with the introduction of Induction and Foundation training. Robust systems are in place for the recruitment of staff, thus safeguarding service users. The minor shortfall identified in this Standard should be easy to address. EVIDENCE: The pre-inspection questionnaire detailed that four care staff had completed their NVQ Level 2 or equivalent. The staff working at the home have prior experience of working with people with learning disabilities. Two new staff members were in the process of being recruited. The Inspector discussed with Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 19 the Manager designate the need to ensure that these staff undertake the Learning Disabilities Award Framework accredited training (LDAF). No progress has been made with the introduction of Induction and Foundation training that meets the Skills for Care requirements. The Manager designate reported that this requirement is being addressed by the training Manager. This is a repeat requirement. Staffing levels have been increased since the last inspection. The Manager designate stated that there are two care staff on duty at all times. When specific individual activities for service users are planned additional staff are on duty. The need to ensure that the staffing levels are kept under review in line with the service users dependency levels was discussed with the Manager designate at the inspection. The Manager designate stated that an audit of all the staff employment records had taken place since the last inspection. Where shortfalls had been identified in the information required the Human Resources department had been contacted. Two staff employment files were viewed by the Inspector. One file contained all the required information; the other file contained all the information required with the exception of one reference. The Manager designate at the time of the inspection contacted the Human resources department to request a copy of the reference. The pre-inspection questionnaire completed by the Manager designate detailed the training that had been undertaken and training that had been planned. This included abuse awareness, moving and handling, first aid, health and safety and Food Hygiene. A system of staff supervision is in place. Records viewed indicated that staff receive regular formal supervision. Staff receive ongoing supervision by the Manager designate as he also works alongside the care staff. The home also has in place an annual appraisal system Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Improvements have been made in the area of quality assurance, further improvements are required to ensure that the a programme of self-review is in place. Shortfalls in the systems for the management of health and safety do not always safeguard the service users. EVIDENCE: The Manager designate has applied to become the Registered Manager. The Manager designate is currently undertaking the Registered Managers Award and has several years experience of working with this resident group. This standard will be examined in detail at the next inspection. Records viewed at the time of the inspection indicated that the Manager designate was undertaking periodic training. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 21 Regulation 26 Visits were not taking place monthly. The last visit report received at the CSCI was dated 24/04/06. No further visits have taken place. Since the last inspection the home uses a in house quality assurance monitoring form. The home also has in place a quality monitoring plan, which is in a checklist format. An annual development plan has not been formulated. This is a repeat finding. Service user and their representatives have received feedback questionnaires. Stakeholder surveys are to be sent out in July by Head Office. The Manager designate agreed to send the collated results to the Commission and other interested parties. Maintenance records were viewed at random and those viewed were up to date. Fire drills and fire alarm tests were taking place. The fire drill records did not record the times of the drill and their was no evidence that night staff had undertaken a drill. The fire risk assessment viewed did not contain sufficient detail regarding the risks identified and there was no evidence that an emergency plan was in place. Regular health and safety audits are taking place. Hot water temperature readings are being undertaken periodically by the staff, on some occasions the readings were above 43◦c. in the bathroom on the first floor. It appeared that no action had been taken by the home to address this. Records viewed indicated that staff were receiving mandatory training. A business plan for the home was available. The Manager designate confirmed that the business was financially viable. Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 X x 2 3 Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 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 YA24 Regulation 23 (2) (b) Requirement Wear and tear to the structure of the home caused by wheel chairs must be remedied. (Previous timescales of 21/11/05 and 01/04/06 not met) Timescale for action 01/08/06 2 YA24 23(2)(b) A full environmental audit of the 01/08/06 home must be carried out. There must be in place a programme of redecoration and refurbishment with timescales for completion. A copy of this must be forwarded to the CSCI. (Previous timescale of 01/04/06 not met) Staff records must include all the information required under Schedule 2 of the Care Homes Regulations 2001. (Previous timescale of 01/04/06 partly met) Induction and Foundation training to meet the Skills for Care core standards must be in place and implemented. (Previous timescale of 01/05/06 not met) 01/08/06 3 YA34 17 4 YA35 18 01/08/06 Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 24 5 YA39 24 An annual development plan for 01/08/06 quality assurance, relevant to the size of the home, must be formulated and available in the home. A copy must be forwarded to the CSCI. (Previous timescale of 01/05/06 not met) Regulation 26 Visits must take place monthly. A copy of the report of the visit must be sent to the CSCI. (Previous timescale of 17/03/06 not met) The fire drill records must identify the staff attending each drill, the time of each drill, and what action, if any, was required. (Previous timescale of 10/03/06 partly met) Night staff drills must take place. These must be clearly recorded. 01/08/06 6 YA39 26 7 YA42 23(4) 01/08/06 8 YA42 13(4) Where hot water temperatures are found to be above recognised safe temperatures, there must be evidence recorded of the remedial action taken to address this. The fire risk assessment must contain sufficient detail to identify the risks and the actions to be taken to minimise the risks. Details of the emergency plan must also be included. 01/08/06 9 YA42 23(4) 01/08/06 Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection West London Area Office 11th Floor West Wing 26-28 Hammersmith Grove Hammersmith London W6 7SE 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 Lowdell Close, 186-188 DS0000027064.V288613.R01.S.doc Version 5.1 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. 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