Inspection on 25/05/05 for Lyle House

This inspection was carried out on 25th May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lyle House 16/06/06

Lyle House 31/10/05

Similar services:

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Henry Nihill House

Birchwood

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

CARE HOMES FOR OLDER PEOPLE Lyle House 207 Arabella Drive Roehampton London SW15 5LH Lead Inspector Jon Fry Unannounced 25 May & 8th June 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lyle House Address 207 Arabella Drive Roehampton London SW15 5LH 0208 481 7277 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) enquiries@rutcht.com Richmond upon Thames Churches Housing Trust Iqbal Musafer CRH Care Home 45 Category(ies) of DE (E) Dementia over 65 (30) registration, with number OP Old age (15) of places Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: Lyle House is a new purpose built care home for older people that opened on the 14th February 2005. The home is operated by Richmond Upon Thames Churches Housing Trust and was built to replace the now closed Chestnut Lodge care service situated immediately adjacent to this property. The home is registered to provide care and accommodation for 45 residents, 30 of whom may have dementia. It is organised on three floors with two units providing dementia care situated on the upper levels. The ground floor unit provides care for older people with lower dependency needs. All bedrooms are single with en-suite facilities. The home is situated near the East Sheen shopping area and is well placed for public transport. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector on 25th May and 8th June 2005. The inspector spent approximately ten hours in total at the home. The inspection included the examination of records, a tour of the premises and individual conversation with residents, staff and the three assistant managers in post at the home. The inspector had the opportunity to speak with twelve residents and four members of care staff. What the service does well: What has improved since the last inspection? What they could do better: A Requirement was made at the time of inspection for the home to review the staffing levels in place during afternoon shifts within the two upper floor units caring for residents with dementia. This was based on the inspector’s Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 6 observation of the needs of the residents currently accommodated and feedback from staff at the time of inspection. The report highlights areas such as care planning, key working and activities where the systems in place could be further developed in order to benefit residents. This is with particular reference to person centred care practices and ensuring that all areas of need are met. An activities co-ordinator has been appointed at the home for eighteen hours a week. It is recommended that this provision be extended to full-time weekly hours to allow for a more extensive programme of activities both internal and external to the home. It is essential that this staff member receives training in providing activities – this is with particular reference to the provision for residents with dementia. Two environmental issues were identified at the time of inspection. Staff members highlighted issues with the en-suite facilities provided in each bedroom. These have full-length shower curtains fitted that makes assistance with personal care by staff problematic. Hoist equipment was seen to be stored in the lounge area of each unit and a Requirement has been made for alternative storage areas to be identified. 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. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The needs of residents are assessed prior to moving into the home. Prospective residents and / or their relatives are given an opportunity to visit the service in order to assess the quality, facilities and suitability of the home. EVIDENCE: As stated within the summary of this report, the majority of residents in occupation at the home were moved from Chestnut Lodge. The organisation has existing procedures in place with regard to the assessment of prospective residents. The relatives of one resident reported that they had visited the home prior to their relative moving in. They stated were ‘very satisfied’ with the care being provided to their relative and that staff members were ‘very helpful’. Twelve residents were spoken to in total during the inspection visits. The majority of comments received were positive regarding the new home and included ‘lovely’, ‘very nice here’ and ‘quite happy’. One resident stated that they preferred living at the previous home as Lyle House was ‘too much like a hotel’ and was ‘too quiet’. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 9 Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 and 10. The care plans in place are fully completed and subject to a recorded process of monthly review. This ensures changing needs of residents are addressed by the home. The care documentation in place particularly for residents with dementia would benefit from further review to ensure that they are person centred and enable care staff to obtain more information regarding the individual’s life, experiences and preferences. Medication administration records are well maintained at the home. One shortfall was identified on the day of inspection with regard to staff practice that potentially could impact on individual health and welfare. EVIDENCE: Care plan documentation was examined for five residents on the day of inspection. These were all seen to be fully completed and monthly reviews had taken place for each individual. The home must ensure that the information within each care plan is kept up to date – the inspector identified two instances where good information was included within the monthly review notes but had not been included within the care plan itself. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 11 It is strongly recommended that the care plans in place reflect the person and their life history / experiences. This is particularly important for residents with dementia in order to help plan their care / support and to provide care staff with pertinent information to aid communication. The inspector identified that life histories had been developed for individual residents but these were not included within the main ‘working’ care plan document. The key worker system utilised at the home should be reviewed in order to further support a person centred approach. General care assistants (GCA’s) employed at the home currently do not have responsibility as key workers – the more senior staff assume this role and the ratio is approximately one key worker for five residents. Using general care assistants as key workers would reduce this ratio and therefore further individualise the support given. Personal care was seen to be given in private and staff were observed to knock on residents doors before entering. Preferred terms of address are included on each individual care plan. Three members of staff observed in the first and second floor units were seen to interact very positively with residents. The inspector was however concerned at the staff numbers deployed in these units accommodating residents with dementia. This was especially apparent during the afternoon shift and when staff were taking their breaks and impacts on privacy / dignity issues. Examples of this were a resident on the first floor entering another resident’s bedroom to use their en-suite toilet without their permission. Other residents were additionally observed to be wandering in and out of bedrooms on a regular basis. Two of the five care plans examined stated that the individual residents required supervision whilst mobilising. One resident concerned was seen to be moving around the unit without supervision on a number of occasions. Records maintained for the administration of medication were seen to be well maintained. One shortfall was identified where a member of staff was observed to be signing the administration record prior to actually administering the medication item itself. One other member of staff was observed to be following the correct procedure within a different unit. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15. A programme of activities is in place at the home with a dedicated part-time member of staff in post to co-ordinate this provision. There is however scope to both to extend and improve the activity provision at the home to ensure that individual social / recreational needs are fully met. Residents are able to maintain contact with relatives and friends. This contact is facilitated in private as required. The dietary needs of residents are well catered for with a balanced and varied menu available. EVIDENCE: An activities co-ordinator has recently been appointed at the home for 18 hours per week. This member of staff was observed to be talking to individual residents on both days of the inspection in order to inform a planned revision of the activities programme in place. This schedule in place includes board games, bingo, quizzes and a social evening each Wednesday. A dedicated activities room is available at the home and this was seen to contain resources such as games, books and a computer. As stated within the previous standards, care plan documentation should be developed to be more personalised to the individual. This should include input Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 13 from the activities co-ordinator as to individual likes & dislikes and opportunities for activities within the unit outside of the formal programme in place. The activities co-ordinator reported that they had received training regarding dementia but had not attended specific training on the provision of activities. This would be with particular reference to ensuring positive activities for residents with dementia. A recommendation has been made for additional hours to be made available for the activities co-ordinator. This increase in conjunction with an increase in the care staff provision within the two upper floor units would do much to ensure a person centred approach to care at the home. The revision of the activities programme should additionally allow for regular activities outside the home. One resident spoke of how they would like to access a local library and another reported that they would ‘like more trips out’. Other comments included ‘its boring here now’, ‘I would like to go out for a walk’ and ‘more occupation’. Two residents spoken to reported that they preferred not to join in activities at the home. Residents were observed to receive visitors in their own rooms on both days of the inspection. Feedback from visitors spoken to was very positive regarding the home and the staff working there. Menus were seen to be displayed in all three units. Comments from residents were uniformly positive regarding the food provided. These included ’very good’, ‘I enjoy the food I have’ and ‘its ok’. Each unit has its own dining area and small kitchen for preparation of drinks and snacks. Afternoon tea was observed to be served on both days of inspection with cake and biscuits provided. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 An organisational complaints procedure is in place at the home. A record of complaints is maintained but requires minor review to ensure that this is completed fully. This development will serve to further evidence that complaints are always responded to promptly and are taken very seriously. EVIDENCE: The record of complaints was examined and this evidenced that two complaints had been received since the home opened. One of these was a formal complaint whilst the other had been logged as ‘informal’. Both issues were seen to have been addressed by the home with outcomes recorded but not dated. It is recommended that each complaint be signed off by the registered manager when completed. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 to 24 and 26. The home is purpose built and provides a high standard of accommodation to the residents living there. Areas that require addressing include the suitability / practicality of the ensuite showers provided and an increase in storage space for equipment in use. EVIDENCE: The home was first opened on the 14th February 2005 and has been purposebuilt for use as a care home for older people. The premises present very well and provide comfortable and spacious accommodation for the residents. Each unit has a dining room, two communal lounges and a small kitchen for drinks and snacks. All areas of the home were seen be kept clean, hygienic and free from offensive odour on the day of inspection. Comments from residents included ‘its lovely’, ‘my room is beautiful’ and ‘very nice’. One resident stated that the home was ‘too much like a hotel’. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 16 Individual bedrooms were seen to be personalised and the inspector was informed that the residents who had moved in from Chestnut Lodge had been able to choose their individual colour schemes. This was confirmed on inspection of individual bedroom areas. Additional facilities provided at the home include another large ground floor lounge area, an activities room and an attractive landscaped garden. The inspector did not observe any residents being enabled to access the garden area on either day of inspection – it is essential that residents be provided with regular opportunities to access this area as is their preference. An en-suite bathroom is provided in each room with shower, washbasin and toilet facilities. Two members of staff reported difficulties in helping residents with their showers as a full-length shower curtain is fitted in each bathroom. The inspector was additionally informed that the bathrooms flood when the shower is used as there is just a corner drain provided with no base unit fitted. Hoists and chair scales were seen to be stored in the quiet lounges on each floor during both days of inspection. The inspector was informed that there were no available storage areas for this equipment. Residents accommodated within the units for persons with dementia were observed to have difficulty at times in locating their bedroom. It is recommended that further consideration be given to additional appropriate signage or colours of door surrounds in order to further facilitate an enabling environment. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30. Staffing levels within the two upper floor units of the home require immediate review. This is to ensure that appropriate numbers of staff are on duty at all times for the health and welfare of the residents accommodated. An organisational training programme is in place and care staff are able to access a wide range of available training courses. Residents accommodated would further benefit from increased opportunities for staff to access specialist courses particularly regarding dementia. EVIDENCE: As stated within previous Standards, the inspector was concerned at the staffing levels in place on the two units for residents with dementia. This was with particular reference to the afternoon shift and at times when other staff members were taking their breaks. An incident was found to have been recorded in early June 2005 where four residents were found to have fallen in a bedroom on one unit. The member of staff on duty at the time reported that they had been on their own in the unit and had been attending to another resident’s personal care when the incident occurred. Other instances were observed by the inspector where residents were routinely wandering around the unit and entering bedrooms of other residents. It is strongly recommended that three members of staff be consistently on duty within these units during daytime shifts. A minimum of two members of Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 18 staff should be present in the unit at all times whilst staff members take their breaks. Four members of staff spoken to at the time of inspection stated that they felt staffing levels were not sufficient in the two upper floor units. A Requirement was made at the time of inspection for the organisation to conduct an immediate review of the staffing levels in place. An organisational training programme is in place. This includes a wide range of courses such as food hygiene, IT training, equal opportunities and supervision. A mandatory one day course for staff regarding dementia is facilitated – it is recommended that this training provision is developed / extended to ensure staff expertise in this area. Two newly employed general care assistants were spoken to during the inspection visit. Both reported that they had received induction training with one person reporting that this provision was ‘very good’ and that the managers had been ‘supportive’. One resident stated the new staff were ‘very nice’. As stated previously, the activities co-ordinator must attend training regarding the provision of activities. This again would be with particular reference to ensuring positive activities for residents with dementia. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 38. A well organised management structure is in place at the home. Consideration should be given to the handover system in place in order to further ensure that all relevant / important information concerning residents is communicated to all care staff working on each unit. EVIDENCE: The management team at the home was previously in place at Chestnut Lodge prior to the relocation of the service. The registered manager was on scheduled leave during these inspection visits but the three assistant managers were providing management cover on a rota basis. Each assistant manager heads up a team that includes a team leader, key workers (senior carers) and general care assistants. Each team covers individual shifts at the home on a rotating basis. The registered manager’s hours are supernumerary. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 20 The inspector observed a comprehensive handover taking place on the second day of inspection. This meeting involved managers and senior staff with a secondary handover then taking place to general care assistants on each unit. The inspector discussed this practice with two assistant managers on the second day of inspection – a recommendation has been made for the home to consider holding single handover meetings that include all care staff working on each shift. This may serve to ensure good firsthand information is given to all care staff and help to underline the team ethos. The inspector identified that an organisational accident form is not routinely completed for every fall sustained by residents. A record was seen to be made within the resident’s individual notes. It is recommended that a separate record of falls be maintained for each unit that can be easily used for auditing purposes. Records pertaining to refrigerator and hot water temperatures were observed to be maintained. Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 4 4 2 2 4 4 x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x 3 x x x x x 3 Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 22 n/a 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 OP9 Regulation 13 (2) Requirement The Registered Persons must ensure that care staff only sign the administration record after administering the individual medication to the resident. The Registered Persons must ensure that the activities coordinator receives training appropriate to the work they have been asked to perform. This is with particular reference to ensuring positive activities for residents with dementia. The Registered Persons must ensure that suitable en-suite shower facilities are provided. This is with particular reference to ensuring that carers can give suitable assistance with personal care and that the drainage provided is sufficient. The Registered Persons must ensure that suitable storage is provided for equipment in use at the home. The registered Persons must conduct an immediate review of staffing levels for the afternoon shift on both dementia units. Timescale for action 01.07.05 2. OP12 OP30 18 (1) (c) 01.08.05 3. OP21 23 (2) (b) (c) (n) 01.09.05 4. OP22 23 (2) (l) 01.09.05 5. OP27 12 (1) 13 (4) 17.06.05 Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 23 18 (1) (Requirement issued 08.06.05) 6. 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 OP7 Good Practice Recommendations It is strongly recommended that the care plans in place be reviewed to ensure that they are person centred. Information such as the individual life history, experience and likes & dislikes should be included. It is recommended that general care assistants be utilised as key workers for individual residents. Full-time hours should be allocated for the activities coordinator. The programme of activities should be reviewed to include regular structured activities outside of the home. The record of complaints should include a completion date for each recorded complaint (formal / informal). It is recommended that further consideration be given to additional appropriate signage or other methods to ensure that the first and second floor units provide enabling environments for residents. It is strongly recommended that a minimum of three members of staff be on duty in the units providing dementia care during daytime hours. A minimum of two members of staff should be present in the units whilst staff take their breaks. It is recommended that consideration be given to a single handover process involving all care staff coming onto shift. It is recommended that a separate record of falls be maintained for each unit. These can then be utilised for auditing purposes. 2. 3. 4. 5. 6. OP10 OP12 OP12 OP16 OP22 7. OP27 8. 9. OP32 OP38 Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ground Floor - CSCI 41-47 Hartfield Road Wimbledon SW19 3RG 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 Lyle House G54-G04 S62953 Lyle House V226584 250505 Stage 4.doc Version 1.30 Page 25 - 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!