Inspection on 31/01/06 for Moss Cottage

This inspection was carried out on 31st January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Moss Cottage 12/05/06

Moss Cottage 21/10/05

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Moss Cottage 7 Western Road Liss Hampshire GU33 7AG Lead Inspector John Vaughan Unannounced Inspection 31st January 2006 10:00 Moss Cottage DS0000064988.V277474.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 Moss Cottage DS0000064988.V277474.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. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Moss Cottage Address 7 Western Road Liss Hampshire GU33 7AG 01730 894 242 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.c-i-c.co.uk Community Integrated Care Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4), Physical disability (1), of places Physical disability over 65 years of age (1) Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users admitted to the home must have a Learning Disability. Date of last inspection 21st October 2005 Brief Description of the Service: Moss Cottage is a small residential service providing care and support to four adults with a learning disability. Community Integrated Care provides the care and support and the building is owned by the health authority who are responsible for the maintenance of the property. The home is located in a residential street and is indistinguishable from the other houses in the street. The home is close to the shops in the small village of Liss in a rural part of Hampshire. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector met with service users and staff in the home and toured the building assisted at times by a service user. A sample of records was examined during the visit. This is the second inspection of the home since the new provider, Community Integrated Care took over on 1st July 2005. The inspector spoke to the manager and deputy manager of the home during this visit and looked at what they have done to improve the service since the last visit. What the service does well: What has improved since the last inspection? What they could do better: Although their have been some improvements to the information for service users much more work is needed and the manager has been asked to put better information in place about the home and what service users will be provided with if they live in the home. The home needs to put clear plans for how the support service users and put clear information in place on how they will keep people safe. The manager needs show how service users monies are being managed and that each person receives their personal allowances from their benefits. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 6 The inspector has asked that the manager makes sure staff have the right skills and abilities by putting training and development plan in place and that staff training is updated. The manager needs to get all the information on staff backgrounds and keep a record of this in the home to show that they can protect service users. The inspector has asked the manager to carry out a review of the home involving service users, their families and representatives to make sure they are providing the service people want and need. 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. Moss Cottage DS0000064988.V277474.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 Moss Cottage DS0000064988.V277474.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 Service users and their representatives do not have enough information to make informed choices about living in this home. Improved practices mean that the home can demonstrate service users needs are being assessed and documented. EVIDENCE: The home did not have a statement of purpose or service user guide at the last inspection and could not show how service users are given information about how Community Integrated Care intend to support them. Some improvement was seen at this inspection with the development of a statement of purpose. This needs more work to meet the standard and the manager was advised to add information on age ranges, how they will support service users to observe religious practices, maintain privacy and dignity and how service users will be consulted about the running of the home. The service user’s guide is not in place and the manager said they would develop and put this document in place. The inspector advised that this document must be in a format that is accessible to service users to demonstrate that service users have clear information about what the home can offer them. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 9 At the last visit to the home concerns were raised about the lack of assessment information for service users. At this visit care manager’s assessments were in the service users files to support statements on the needs of service users. The inspector was told that the staff members have been working with service users to develop a new care plan. One of these documents has been completed and the senior support worker printed out a copy. The plan has not been put in the file and or agreed yet. The document includes information on the person’s skills, abilities and areas where they need support. The home still needs to carry out a lot of work to complete the plans for three service users. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 10 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 The lack of fully completed service user’s plans mean that the home cannot demonstrate how service users needs are being responded to. The practice in the home supported service users to make decisions about their lives however this would be enhanced by fully documenting service users needs and wishes. Incomplete risk assessment strategies do not demonstrate that service users are supported to take risks. EVIDENCE: The inspector was able to see one plan for a service user once it was printed off the home’s computer. The deputy manager explained how further work is underway with the other three service users to develop a similar document however one blank plan was seen for another service user which has not been started yet. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 11 The deputy manager said that the staff member who was going to work on this was due to start this in the next few days. The document read by the inspector is a statement of the needs of the service user and information on the abilities and support requirements of the individual. There are no current goals or objectives in place for this person and the inspector was told that the staff team are going to work with each service user to develop this part of the plan. The inspector was told that the deputy intends to restart monthly one to one meetings between service users and their keyworker to look at and review goals. Risk assessments have also developed for this person. They cover community access, health, daily activities, eating and drinking, moving and handling and showering. The inspector advised that the details within the risk assessment include a strategy that staff have training on moving and handling to reduce risks. The assessments also need to demonstrate who has taken part in the decisionmaking and need to be signed and dated. Further work is required to put these strategies in place for all service users in the home. The inspector stated that they are concerned about the time it is taking to put essential information in place. These documents are needed to provide consistent and effective guidelines to support each service user. The inspector spoke to three service users and observed the interaction between staff and service users during the visit to the home. Staff offered service users choices throughout the visit. Service users were supported to choose when to have a drink and what activity to take part in. Staff members were clear on the wishes of service users, as they have built up this knowledge over time. A risk assessment seen supported the right on the service user to make decisions about the health care they receive and refuse treatment if this was the service users wish. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 12 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): 15, 16 and 17 The practices within the home support service users to maintain contact with families and friends. Staff practices promote the rights of the service user and support their individual wishes however the home must develop more detailed plans to demonstrate how this is consistently achieved. Service users benefit from a balanced and varied diet based on their likes and dislikes. EVIDENCE: The plan seen by the inspector included information on the service user’s important relationships and how to support the person to maintain the contact with these individuals. Another service user told the inspector that they were going to see their family and a member of staff supported them to travel to their parent’s home. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 13 Staff confirmed that they support service users to keep in touch with families and friends through regular visits, meals out and other recreational activities. Service users were observed moving freely around their home. Staff knocked on bedroom doors and waited for permission before entering. Information from surveys sent to service users by the inspector confirmed that service users have a lock on their door however at present no one has a key to lock their door. The inspector spoke to staff and was told that none of the service users choose to have their key. The inspector advised that the reasons for service users not having a key should be recorded within each person’s care plan. The inspector examined a menu plan. This indicated that a varied diet is offered to service users who help to choose, shop for and prepare these meals. Fresh vegetables and fruit are provided. Food likes and dislikes are recorded within the plan and alternative meals are noted on the menu. The inspector spoke to service users about the meals they have and he was told that they are happy with the menu and the meals choices they have. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 14 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 The home provides support for service users to access health care professionals to meet their needs. Personal support is given in a way that respects the privacy and dignity of the individual. Medication administration practice in the home demonstrates a suitable and safe system is in place to support service users needs however the lack of staff training in medication administration could undermine this practice. EVIDENCE: The inspector sampled records and confirmed that each service user is registered with a GP practice and the home keeps in contact with the doctor’s surgery to arrange suitable appointments to monitor health issues. Sections within the homes care plan document the service users health care support needs. This is completed for one service user including information on medication needed. Service users are able to meet visitors and attend medical appointments in private. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 15 Medication records are in place and are accurate. Medication is stored in a locked metal cupboard and records are kept of all medication received, administered and disposed of. When the inspector looked at staff records for training they did not have any information on medication administration training. The deputy manager stated that staff have not had this training. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 16 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): 22 and 23 Complaints procedures are in place demonstrating that the views and concerns of service users, their families and representatives would be recorded and responded to. The lack of full information on service users finances means that the home cannot demonstrate that the service is managing their finances appropriately EVIDENCE: The home has a clear complaints procedure, this included details on how to contact the commission. The complaints procedure is on display in the home. The inspector was able to confirm that no complaints have been made. At the last inspection the inspector confirmed that service users are supported with their finances and monies are held on behalf of service users. Each person has a building society account. The inspector noted that service users are not in receipt of their personal allowances at present. The manager stated that they are still waiting for monies to be sent from head office to the service users accounts. At the last visit the inspector required that detailed records of these monies need to be maintained and that the provider must demonstrate that service users are in receipt of their personal allowance entitlement. This has not been done. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 17 The manager did not have the Hampshire policy for the Protection of Vulnerable Adults. They were advised at the last inspection that a copy of this policy must be available in the home. The inspector stated that this document is the agreed strategy for responding to allegations of abuse across Hampshire and the home cannot demonstrate that they work within its guidelines if the staff team have no access to this. The staff training records did not contain evidence that staff have completed any training in protecting service users from abuse. The manager was advised that they must carry out training in this area. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 18 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 and 30 Service users benefit from a comfortable and well-maintained home. Documenting good hygiene practices will demonstrate the homes approach to maintaining the health and safety of service users. EVIDENCE: The inspector toured the home. The house was in a generally good state of repair, clean and tidy and free from any unpleasant smells. The home has a lounge and a separate kitchen/dining room. The communal areas were being redecorated during the visit to the home. The manager stated that they are requesting that the windows are replaced. Further work to decorate service users rooms is also planned and some rooms have already been completed. Service users confirmed that they participated in this by choosing the paint colours. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 19 The laundry is accessed through the kitchen and the staff were able to demonstrate good practice in relation to preventing contamination and cross infection. At the last visit the inspector recommended that the practices undertaken by staff to ensure the health and safety were documented. This has not been put in place however the deputy manager stated that they would complete a risk assessment and put guidelines in place. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 20 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, 33, 34 and 35 The home demonstrated that staff are supported to obtain suitable National Vocational Qualifications. A satisfactory level of staff is provided to meet the current needs of service users. The recruitment practices of the home are not sufficient to protect service users. The practices of the home do not demonstrate that staff are receiving training and development to meet the needs of service users. EVIDENCE: The home has two staff members with a NVQ 2 at present. The deputy manager said that they and another support worker are undertaking their NVQ level 3. Another staff member is due to start their NVQ 2 award in September 2006. The inspector examined the homes staffing rota and spoke to the staff member in charge of the home on the day. Two staff were on duty during the inspection and the rota indicated that this level of staff is maintained when all four service users are at home. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 21 A deputy manager has started since the last inspection and they are working on developing records in the home including the completion of care planning and risk assessment strategies. The manager confirmed that agency staff are not left in charge of the home without a full induction and suitable checks on their ability to take charge of the service. The inspector looked at the records for all staff and found information to confirm that staff have undertaken some mandatory training. Updates on food hygiene and first aid are required and there is no evidence of staff undertaking training on protecting service users from abuse. Four out of five staff records do not have evidence of fire training. The manager said that they discussed this a staff meeting but no formal training has taken place. An induction booklet is in place to demonstrate that staff are shown around the home, instructed in health and safety and general aspects of working with service users. The induction was dated 1999 and when asked the manager was unable to say if this document has been reviewed against the skills for care or previous Training of Personal Social Services (TOPSS) standards. The manager was unaware of the Learning Disability Awards (LDAF) Framework and did not know what the organisation’s approach is to this training standard. The manager stated that a wide range of training is available to the staff team and information is provided from the training department. Person Centred Planning training is currently being provided to staff. There was nothing available in the home to show what training is planned or when staff will have their mandatory training updates. The manager was required to ensure all staff have up to date training and additional training in areas that support service users needs such as medication administration, epilepsy and communication is provided. All staff records were examined to confirm the homes approach to recruiting staff. One file checked did not have any proof of identity for the member of staff and an email from the companies Human Resources department stated that this person had a Protection of Vulnerable Adults (POVA first) check. The manager was advised that this was not enough information as the details of the outcome of the check and unique reference number must be on file. Another file indicated that a member of staff did not have an updated Criminal Records Bureau (CRB) check when they transferred to the home after promotion. The staff member and manager told the inspector that an application was completed but it was lost in the post and they are completing a new one. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 22 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 Although there have been some improvements the manager must achieve much more in order to demonstrate that service users benefit from a well run home. The lack of a quality assurance system means that the home cannot demonstrate that the service is reviewed and developed involving service users and their representatives. The home is well maintained and all equipment is regularly serviced. EVIDENCE: The home has a manager who has applied to the commission for approval as the registered manager. They are also managing another small registered care home. The manager has experience of working in senior role within another registered home and have started their registered manager’s award at college. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 23 The inspector discussed quality assurance with the manager. The inspector was told that this is an area that needs to be worked on. A quality assurance policy is in place and this outlines the procedures to follow including service user and family consultation. This has not taken place. The manager said that regular contact is maintained with family members and representatives of service users and they welcome any comments on how the service can be improved. Regulation 26 visits take place each month and a copy of this report is sent to the inspector. The manager was required to put in place a system for reviewing and developing the service which included the views of service users, their representatives and other parties involved in the service. The inspector examined servicing and maintenance records, which demonstrated regular servicing of the electrical, heating and fire alarm systems, take place. Records indicate that weekly and monthly checks are carried out on the fire alarm systems. The last fire drill took place in November 2005. The manager told the inspector that they have completed a fire risk analysis of the home and this has been sent to their headquarters for approval by the Health and Safety Officer. Staff training is required in fire safety and health and safety. An induction booklet is in place to ensure staff are aware of health and safety in the home. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 24 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 2 2 2 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 1 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 2 X Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 25 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 YA1 Regulation 5 Requirement The registered person must ensure a service users guide is produced and made available to each service user. Repeated requirement previous timescale 21/01/06 not met. 2. YA2 14 The registered person must ensure that each service user has a full assessment of their needs in place Repeated requirement previous timescale 21/01/06 partly met. The registered person must ensure that each service user has a plan, which fully documents their assessed needs and includes clear methodologies for supporting these needs. Repeated requirement previous timescale 21/01/06 partly met. The registered person must ensure that service users are supported by clear risk assessments for daily activities. Repeated requirement previous Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 26 Timescale for action 31/03/06 31/03/06 3. YA6 15 31/03/06 4. YA9 13 31/03/06 timescale 21/12/05 partly met. 5. YA23 13 The registered person must ensure that service user’s monies are fully documented including personal allowances in the home. 31/03/06 6. YA34 19 7. YA35 18 8. YA39 22 Repeated requirement previous timescale 21/12/05 not met. The registered person must 31/03/06 ensure that proof of identity and evidence of completed CRB checks are in place and on file for all staff. The registered person must 30/04/06 ensure that staff have training to meet the needs of service users and the service. The registered person must 30/04/06 ensure that systems are put in place to carry out a review of the quality of care involving service users and their representatives. 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 YA30 Good Practice Recommendations The manager should document the current practices in the home related to Laundry and the prevention of cross infection. Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Moss Cottage DS0000064988.V277474.R01.S.doc Version 5.1 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!