Inspection on 20/04/05 for Myrtle Cottage

This inspection was carried out on 20th April 2005.

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 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

Myrtle Cottage 19/02/07

Myrtle Cottage 25/10/05

Myrtle Cottage 01/12/04

Myrtle Cottage 24/06/04

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Fairways

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

CARE HOME ADULTS 18-65 Myrtle Cottage 123 New Brighton Road Emsworth Hampshire PO10 7QS Lead Inspector Drew Gurney Unannounced 20/04/05 Time: 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Myrtle Cottage Address 123 New Brighton Road, Emsworth, Hampshire, PO10 7QS 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) 01243 370500 Dolphin Homes Limited Mrs Julia Spriggs CRH 6 Category(ies) of LD registration, with number of places Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to six male or female service users in the category of learning disabilities may be accommodated at the home. 2. All service users accommodated must be between 18 and 65 years of age. Date of last inspection 01/12/04 Brief Description of the Service: Myrtle Cottage is a large, detached older style property set within the residential area of Emsworth, Hampshire. The property blends suitably in style with the surrounding properties and has been tastefully converted to provide a suitable home for six younger adults with learning disabilities. There is a large lawned area to the front of the property, surrounded by fencing to ensure privacy and a smaller rear garden. Adequate car parking is provided to the front of the property. Bedrooms have been installed with en-suite facilities and are tastefully decorated and furnished and personalised by residents. There is a spacious, family feeling throughout the home. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Myrtle Cottage was undertaken on 20th April 2005. For a considerable period during the inspection, residents were not present and were attending educational or social courses arranged as part of their care provision. At a later stage, the inspector spoke directly with two residents and one member of staff and observed favourable interaction between both residents and staff. The atmosphere was relaxed and residents were involved in activities generated by the staff. The condition of the home was favourable and residents’ personal accommodation was personalised and reflected their particular interests. Records were viewed for both residents and staff and were found to be very full and descriptive of the care provided and those referring to staff contained appropriate information with regard to recruitment practices and general required administrative and training information. The inspection was very productive and no requirements were placed. What the service does well: The service provides well for service users who require one to one care support and especially for high dependency requirements. Because of this, the manager is very positive in negotiations prior to admission and on an ongoing basis, to ensure that the correct level of support is provided for service users and staff alike. The team is very focused in activity-based care and each service user has a very detailed programme directed towards individual needs. Risk assessments are very specific and fully describe and support all activities, both on a care and social basis. The recruitment process is very positive and the ongoing training needs of care staff, receives a high priority. New admissions are vetted thoroughly by the management team, who attend appropriate care meetings and reviews prior to decisions being reached, to ensure that any new resident being admitted to Myrtle Cottage, will both fit in with the existing residents and with the abilities of care staff to provide care and support. Some residents spoken with, appeared to be happy in their surroundings. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: 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. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 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 standard(s) 2, 3 and 4 The home’s management team undertakes full needs assessments prior to admission to the home. The abilities of the home to provide supportive care are discussed with prospective residents, relatives and funding agencies represented by care management, prior to admission. The home has shown their ability to provide effective care and support for new admissions since their registration was approved and continue to do so. Introductory visits are undertaken to ensure compatibility with other residents and the appropriateness of new placements. EVIDENCE: The inspector viewed the needs assessment that was undertaken for the most recently admitted resident. The assessment was undertaken following an application received from care management and meetings were held with all individuals involved in the enquiry to ensure that the home was appropriate for the prospective resident’s needs. A summary of the care management assessment was received and was available on the resident’s file. This was supported by the home’s assessment paperwork and covered sufficient information to provide the management team to reach decisions about the suitability of the home for the person involved. This included the suitability of the accommodation available on the ground floor; the ongoing day care and educational facilities available locally; that the specific specialist input and condition-related needs could be supported and that in general, the needs of the applicant could be met in a safe and suitable manner. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 9 New residents, relatives and enquiries made on their behalf are provided with information describing the staff’s ability to deliver care and support for residents. This information includes their Statement of Purpose and Service User’s Guide. The manager is very positive in stating that a place would not be offered to a prospective resident whose needs could not be met by the current staff, or with whom the established residents find difficulty in responding to. The admission procedure is conducted by the manager visiting a prospective resident where the applicant is currently living and establishing as much information as possible, and then following this by a structured introduction to Myrtle Cottage. Introductions to the home vary, according to individuals but the most recent admission, included the applicant visiting the home for differing periods of time and meeting with other residents. It was helpful that the applicant knew one of the established residents and this led to a very settled and quick admission transition for all the new person and current residents. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 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 standard(s) 6, 7, 8, and 9. All residents have individual care plans on file that they or their representatives know about. Residents are encouraged to participate in decisions made within the home and are consulted about specific choices. Risk assessments are very full and explanatory. Residents are supported to take risks as part of an independent lifestyle and this is very clearly documented. EVIDENCE: Care plans viewed by the inspector included all information such as assessment information, name and addresses of individuals involved, date of admission to the home, the name and address of any authority or organisation arranging admission, a photograph of the resident, contractual agreements, and detailed risk assessments and care plans. All care plans are currently being reviewed and focusing on person centred care plans. These will focus on goals towards which both resident and staff are aiming to achieve. Information on files was full and contained satisfactory information for staff to provide supportive care. Care plans had been signed by either resident or a supporting relative. Decisions made by residents are sought regarding their choice of bedrooms colour schemes, involvement in daily activities, residents’ choice with regard to Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 11 likes and dislikes in menus and in choice of clothes. Residents are encouraged to attend the open forum style joint staff and resident meetings and to have a say in the general running of the home wherever possible. All inspection reports are read to residents and supporting relatives are also encouraged to read these. Staff read minutes of all meetings to residents or these are provided in Makaton communication format, which most residents understand, using basic symbols and objects of reference. Risk assessments are broken down to every aspect of daily living for all residents, are very full and explanatory and include social activities and daily routines, hobbies and behaviour. The inspector read several very detailed and explanatory risk assessments. Residents are given training about personal safety both inside and outside the home’s environment and all staff have been trained in SCIP (strategic crisis intervention prevention) training, having undertaken a three-day course. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 15 and 16. Residents have programmes that include independent living skills, makaton skill based communication and social skills that are appropriate. Residents are well accepted by the local community. Leisure activities are well organised, and include arranged holidays that are popular with the residents. Regular contact is encouraged and maintained with families and friends. Individual choice is respected by the home and staff. EVIDENCE: All residents have programmes that include independent living skills, communication and social skills. This information is recorded within care plans and are being transferred into person centred care plans. Communication is focused on makaton skills and evidence of this was viewed in various notices viewed by the inspector and other paperwork within files. Other methods of communication also includes other symbols of communication that have been found successful as a means of communication with residents such as small sized versions to indicate bedtime, personal hygiene aspects and meal times in picture format. An activity chart is available for all to view and this indicates the activities for the week for every resident in written and symbolic style. Spiritual needs are respected and currently two residents are supported to attend gospel sessions at their request and enjoy the singing and the visit. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 13 Residents are encouraged to participate in any educational or occupational activity that they did before they entered Myrtle Cottage and some continue to attend the local college. Currently, one of the residents is employed at an older person’s home, where she assists staff with providing cups of tea and having a chat with residents. The home residents have a very positive relationship with the local community and attend local events. All residents are registered to participate in postal electoral votes and staff endeavour to explain the process. Social and leisure activities at day services include music, dance, Internet involvement and coffee mornings. Regular holidays are taken at a local holiday camp which offers theme weeks at an excellent affordable rate and which many of the residents enjoy. Residents are encouraged to have two annual holidays. Holidays have also included trips abroad to Disneyworld in France. Relationships with residents’ families are encouraged and families visit at regular intervals and are welcomed at Myrtle Cottage. Photographs were very evident and on display in various parts of the home, showing visits from family or friends. Privacy is upheld when residents consult a G.P. or whilst having personal care. Residents can hold meetings with visitors in their bedrooms. There are locks on all doors, with access via a master key if necessary. Some residents have been advised to lock their rooms due to behaviour problems being experienced currently and have chosen to follow this arrangement. Residents do not hold a key to the front door of the home and entry to the home is open to all during daylight hours. A key entry system has to be observed when leaving the property for safety reasons but the number is clearly available for those able to access in this manner. Mail is given directly to all residents and read upon request. Residents are encouraged to keep their rooms neat and tidy and to participate in household chores where this is appropriate and where this is specified in care plans. The home has a no smoking policy indoors and anyone involved in this activity would be risk assessed and would be requested to smoke outside. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 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 standard(s) 18, 19, 20 and 21 Personal support and health care is provided for residents, directly by staff or by input from professional sources requested on their behalf. Appropriate medication administration procedures are carried out. Ageing, illness and death procedures are observed by the home. EVIDENCE: All files viewed by the inspector, contained manual handling assessments appropriate to the abilities of residents. Personal care is assessed and the gender of care staff providing care is part of the assessment procedure, for protective reasons for both resident and staff members. All residents make personal choices about their wishes in all aspects and these decisions are documented in care plans. Professional advice is sought from various sources as required to provide for the needs of residents. The major source of support apart from the primary health care team, is from the learning disability team based at Raebarn House in Waterlooville, from care managers or currently, the services of a physiotherapist have been sought for one resident. Records are available which document that residents have been visited or have access to G.P.’s, six monthly visits to dentists, or annual visits to opticians. Medication administration and storage was viewed by the inspector and found to be recorded and stored appropriately. All staff have received training in the administration of medication. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 15 The home has a policy on ageing, terminal illness and death. This issue has been discussed and recorded for all residents and arrangements have been made with the local disability team to provide some input on bereavement counselling for residents. In all instances, residents have clearly identified their wishes with regard to their demise. In one instance, the inspector recommended that the input is sought from an experienced advocate with regard to the terms of a will. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 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 standard(s) 22 and 23 Complaint and adult protection issues are dealt with in an appropriate manner. EVIDENCE: There is a complaint procedure at Myrtle Cottage and residents, their supporting relatives and anyone who requests information is provided with details on how their concerns would be addressed. Staff provide explanations to residents to the best of their ability in the format of makaton and relatives are provided with the prepared information for the purpose. No complaints had been received since the previous inspection was held on 1st December 2004. All staff are provided with training on adult protection issues. The Hampshire adult protection procedure and the Department of Health document ‘No Secrets’ are used as a basis for training and any issues of concerns would be brought to the attention of the appropriate professionals, including the Commission for Social Care Inspection (CSCI) Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 17 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 standard(s) 24, 26 and 30 All rooms were found to be well presented, clean and hygienic and appropriate for the residents living at Myrtle Cottage. Furniture and fittings were satisfactory. Safety equipment has been installed that meets the needs of residents. EVIDENCE: The home consists of six single bedrooms, two bathrooms, a communal sitting room, kitchen and laundry. The inspector looked around the home throughout the course of the inspection. All rooms were entered, including bathrooms, and with the exception of those bedrooms that had been locked by residents. All rooms were found to be in good decorative order. The colour schemes were chosen by their owners and reflected individual tastes, hobbies and interests of the residents. Each room is provided with adequate drawer and hanging space and is appropriately lit. All rooms were bright, well ventilated, safe and free from offensive odours. All radiators are covered throughout the home and windows have safety restrictors in place. The laundry has outdoor access, to avoid soiled laundry being taken through the kitchen area and appropriate infection control measures appear to be Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 18 undertaken by the home. The laundry room floor is impermeable and floors and walls are readily cleanable. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 35 and 36 Job descriptions are provided for staff that cover all aspects of their role and reflect how residents will benefit from staff complying with their roles and responsibilities. The home has appropriate staffing levels, has robust recruitment practices and training procedures for staff and provides regular supervision. EVIDENCE: The staffing structure consists of the manager, deputy manager, two shift leaders and eight care staff. Night cover consists of one wake and one sleep-in member of staff. Staffing levels on duty vary according to the needs of residents, which varies from time to time. The manager is very clear when negotiating care packages with funding authorities, what level of support is required for residents either at the point of admission, or when needs change and reviews are held and reflect the need for further support. The existing staff normally responds to additional working requirements and this ensures that residents are familiar with the team. Procedures are followed for recruitment. Appropriate health checks, references, outside United Kingdom documentation and CRB/POVA clearance. were present on files viewed by the inspector. Interviews are recorded. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 20 Work rotas were available and a graphic notice is available for ready access for both staff and residents to check who is actually on duty at any given point during the week. This notice includes photographs of staff so that residents are left in no doubt as to who will be available and on which days. National Vocational Qualifications (NVQs) held are as follows :• • • • 2 1 1 4 staff have level 3, and both commence level 4 in September 2005 member of staff has level 2, is currently taking level 2 are being enrolled for level 2 training in September 2005 All staff have undertaken fire safety training. All fire policies were recently reviewed, risk assessed and the fire safety file contains a risk assessment for each bedroom and for the building in general. The staff are currently completing a fire safety awareness work book exercise and when completed, will be issued a certificate by the recognised company that is being employed to update the training systems at Myrtle Cottage. All staff have undertaken first aid training, and this topic is updated annually, with appropriate certification being provided. Food hygiene safety and infection control measures are currently being reviewed via Highbury Technical College. Medication administration training has been achieved by all staff via Chichester Technical College. All staff have done full SCIP training as previously stated. Epilepsy training is provided by the a member of the learning disability team who has nursing qualifications. Currently all staff are doing risk assessment training towards evaluating and writing risk assessments. All staff receive supervision every six weeks. A new member of staff, would receive supervision on a monthly basis for a period of time. Supervision is recorded. All staff are provided with grievance and disciplinary procedures. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Systems are in place to ensure the safety and well being of both residents and staff. EVIDENCE: The inspector viewed service documentation that established that equipment is regularly serviced. The following fire procedures were in place :• annual servicing of the fire alarm system, • weekly test of break glass points and discharge of emergency lighting • weekly alarm tests are conducted in different parts of the building • a weekly visual inspection of the fire extinguisher equipment is undertaken Documentation was viewed for other equipment, including gas, central heating, electrical wiring. Temperature checks are undertaken for refrigerators and meal temperature probe tests are conducted. Tests are undertaken for all electrical equipment. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 22 Information was available stating the shower test samples indicating water bacterial level had been sent to Southampton University and that Environmental Health had undertaken drain tests. Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Myrtle Cottage Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score x x x x x x x H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 24 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 Regulation Requirement Timescale for action 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 21 Good Practice Recommendations That the services of an advocate be involved in resolving residents wishes Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 25 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire, 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 Myrtle Cottage H54 S58347 Myrtle Cottage V222603 200405.doc Version 1.30 Page 26 - 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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