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Inspection on 15/01/08 for Norbury Crescent (30)

Also see our care home review for Norbury Crescent (30) for more information

This inspection was carried out on 15th January 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People are provided with good quality care. The service is very person centred and a professional commented that the service is "tailored" to meet the needs of the person". A person`s individuality is promoted and respected. Staff believe promoting dignity and respect as an essential element of their work, recognising a person`s rights and responsibilities. A professional reported "My experience of working with the home to date has been a positive one" People at the home were happy to sit with and some to talk. A professional said the home "offers choice and excellent facilities to all that live there. A resident spoke about being "happy here".

What has improved since the last inspection?

Eight requirements were set on the last inspection. Six of these related to outstanding maintenance issues, which have now been attended to. Another requirement concerned the need to complete six monthly reviews of the care plan and risk assessments. This is now an ongoing practice of the home. The final requirement concerning an annual development plan has not been attending to and is outstanding. Two recommendations were made and both issues have progressed.

What the care home could do better:

The service meets the key standards set for inspection with one exception the development plan. Currents Standards concerning maintenance and cleanliness of the house hold must be maintained.

CARE HOME ADULTS 18-65 Norbury Crescent (30) 30 Norbury Crescent Norbury London SW16 4LA Lead Inspector Jean Stuart Key Unannounced Inspection 16th January 2008 2:10 Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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 Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norbury Crescent (30) Address 30 Norbury Crescent Norbury London SW16 4LA 020 8765 0431 F/P 020 8765 0431 larysa_khmurych@hotmail.com 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) Norcrest 2000 home Limited Mr John Samuel Care Home 11 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (1) of places Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. As agreed on the 29th September 2006, one (1) named service user over the age of 65 can be accommodated. The CSCI must be informed when this service user no longer resides at the home 7th September 2006 Date of last inspection Brief Description of the Service: 30 Norbury Crescent is owned and staffed by Norcrest 2000 homes Ltd, a specialist provider of residential care homes for adults with learning disabilities and challenging behaviours. The home is registered with the Commission for Social Care Inspection to provide personal support and accommodation for up to eleven younger adults. The Registered Manager, John Samuel, remains in operational day-to-day control of the home. Situated in a residential area of Norbury, close to the centre of town, the home is well placed for accessing a wide variety of local shops, eating establishments and public transport links. Built over three storeys the main house comprises of eleven single bedrooms, three are located on the ground floor, a main lounge, a large open plan kitchen and dining area, two ground floor offices, and a laundry room. Toilet and bathing facilities are located near to peoples’ bedrooms and communal areas. Outdoor space is adequate. The Statement of Purpose and Service User Guide can be obtained on request from the Registered Manager. Fees for the home are £952.00 per week to £1773.00 for special care. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and completed over one day. The site visit lasted five and half hours. Four people, three members of staff, and the manager were spoken with. The views of various professionals from various health and care services were sought. Records relating to care plans, staff recruitment and medication were seen. A tour of the premises was undertaken. Information from the home’s Annual Quality Assurance Assessment has also been included in this report. Returned survey forms included seven from people living in the home, six from staff, five from relatives, and three from care and health professionals. One person said “ I am happy here here”, another person said they feel “so,so” about living here and then explained the positive things in their life. Comments from health care professionals included “they are a very good and caring provider”. , “They meet the needs of service users”. A relative reported that there “is a close family feeling”. Assessments and care plans are comprehensive and record good quality information about the support needed by each person and how this should be given. Risk assessments are up to date and protect the person from harm. Individuals take part in activities and are part of the local community. Families have regular communication with the staff. Individuals take on responsibility for their own bedroom, a person reported putting dishes away in the dishwasher ,other place their washing in the machine. Meals are balanced and varied and meet cultural needs. There is a pictorial menu, which people can view. Staff receive good training and provide good support to individuals. A professional on a survey form indicated that “Staff are well trained” and the manager “ensures that relevant training is accessed when necessary” The complaint procedure is accessible to people. The procedure has been used in a satisfactory manner. The environment is comfortable and homely ,clean and hygienic. The manager is competent and ensures people are kept safe. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 6 What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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 Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using the service are fully assessed to make sure that their needs can be met. EVIDENCE: 30 Norbury Crescent before the person comes to stay develops an assessment of need. This is to an excellent standard. Assessments are always completed with the individual, their representatives, and any other professionals involved with their care. People on survey forms demonstrated that they received information before moving in to help them make an informed choices. Staff were able to understand people by using signs and Makaton to speak with people. A relative reported that they have “very good communication with Nocrest” (the providers of the home). A health professional stated that “Norcrest has worked closely with the person, the family and other professionals involved to support the move working “in the best interests of the person throughout”. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 9 In line with current CSCI practice the categories of Registration will be revised. The home will be register solely for people with learning disability with no age restrictions. The Statement of Purpose should be amended to accommodate this. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans in place have good information on peoples needs. Individuality is recognised and people make their own daily living decisions. Risk assessments are in place to make sure individuals are independent but remain as safe as possible. EVIDENCE: The key principal of the service is that people lives are as purposeful and fulfilling as possible. One professional reported that they “help client to move forward with personal care, and paid sheltered work. Excellent progress.” Another professional said any care plans “are jointly negotiated with the service user’s input”. To help with communication visual aids, pictures and symbols and Makaton are used. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 11 Day care services are provided on site, with activity in the community each afternoon. People are able to do things of their own choosing. A professional commented that “they follow through care plans (with the person) as agreed”. A member of staff was seen supervising a person carrying out an everyday activity. Ensuring safety but leaving the person alone to achieve the task. Risk assessments are in use for daily activities such as showering. As stated in the AQAA risk assessments cover not only known risks to a person’s safety but also to other people around them. Evidence of staff handling potential risk situations was seen on the day. An assessment must also be available for activities outside the home such a person using a wheelchair in the community. Care plans are revised every six months and the required paperwork completed. Key workers supported the manager in his explanation of the homes practice. Relatives and carers who returned survey forms all agreed that the home always or usually meets the needs of their relative. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are able to enjoy a good range of activities, both at home and in the community, meeting with friends and family, visiting clubs and restaurants, activities of their own choosing. Meal times are viewed very positively and are seen as an enjoyable time. EVIDENCE: People reported that they decide on what they want to, documents show that people go to Debbie’s club, a club for people with a learning disability. One individual stated that they like going to the pub “for beer”. A survey form returned by a professional said one of the things the home does well is “take people out” Another person visits the family on a regular basis. A relative reported that a visit to their home is “made every two weeks”. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 13 People are free to spend their time as they wish, one person went straight to their room, coming out later for the evening meal. Other people chose to sit in the lounge. A professional reported that “they try very hard on this aspect of care (giving choices) and are usually successful”. People spoke of how they help in the kitchen, and one person reported that they put washing in the machine. The kitchen was a hive of activity some people enjoyed the busy atmosphere, checking what was happening for dinner. From talking with people and observing reactions to staff it could be seen that people are aware of the routines of the home and of what was happening that evening. The group was calm and comfortable. The one exception to this was a new person who moved to the home a few weeks ago who was still adjusting to the new environment. The staff demonstrated how the new individul’s care needs are to be met, alongside the more settled people. People enjoyed the meal. When asked what they enjoyed one person said “lots of things”. The menu is available in the kitchen and all information is presented in pictorial style to help people see want is being served and also the alternatives available. Staff spoke of different people’s dietary needs. Staff were aware of people’s diverse cultural needs, evidence of this was seen in the care plans. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People receive effective personal and health care support based on individual needs and preferences. Knowledgeable staff deliver good care recognising physical and emotional needs. The home’s medication policies and procedures protect from harm. EVIDENCE: The AQAA states that the aim of care is to promote independence , choice and inclusion. This statement was supported by care observed on the day. Individual plans clearly record peoples needs and how care can be delivered. Personal support is responsive to the preferences of the individual. Staff are aware of changes in mood, and behaviour of individuals and understand the action they should take. A health care professional reported that the home works well with people “they help them move forward rather that just stagnate, deskill, institutionalise them” Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 15 People’s health care needs are documented in their support plan. As seen on the paperwork regular medical treatment and appointments with the psychologist are arranged with the key worker. A relative said on the survey form “any appointment with the G.P, dentist, hospital is always informed to us. Sometimes we attend together”. Staff are trained in health care matters, and arrangements are made on specialist areas as required. Training in the needs of people with epilepsy has recently been given to staff. The files reflect medication training and staff confirmed this. Training ensures medication is given safely and that the well being of service users is protected. Systems are in place to ensure medication is properly administered. All staff administering medication are competent and appropriate training has been given. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People feel safe and secure in the service provided. There is a clear complaints procedure with timescales for actions. People are protected from harm by the home providing appropriate training for staff. EVIDENCE: Individuals feel safe and well supported and are able to state their ongoing daily concerns to staff. As seen during this visit all staff know the importance of taking peoples view seriously and responding to the issues raised. Access to advocacy is actively promoted and is used for people. Posters are available detailing the complaint procedure. No one expressed any concerns about staying at 30 Norbury Cresent. One person said if “I’m not happy I would speak to family”. Survey forms returned by people all indicated an awareness of the complaint procedure. This is in a pictorial format. Survey forms from people showed that people would speak to their keyworker, the manager or staff if they had a Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 17 complaint. Staff spoke of the procedure to be followed if anyone wished to complain. Five survey forms were returned from relatives/carers all reported that they now how to make a complaint. Three complaints have been received since the last inspection. A theme of misunderstanding between the community and the needs of people dominated the complaints. The manager is already working on this and has had an open day. Concerns received are recorded and the manager responds quickly and informs the appropriate people. It is a satisfactory complaint procedure. A review of the nature and number of complaints made should be used as a part of the quality assurance for the service Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is homely and clean, safe and comfortable. The accommodation meets the needs of people. EVIDENCE: The home is comfortable and well maintained. The home and carpets are clean and smell fresh There is a selection of communal areas, and people have a choice of where to sit. All people have single rooms. The kitchen and laundry are designed to enable the involvement of people in domestic tasks and to develop independent living skills. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 19 People’s rooms are individualised and reflect people’s personality. The changing physical needs of two people were accommodated by the home, and appropriate bathing facilities (walk in showers) have been provided. The ground floor is fully accessible to people with poor mobility. Maintenance and cleaning issues identified on the previous inspection have been dealt with. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. All recruitment checks are complete before a person starts work. Staff are appropriately trained to support people. Competent and experienced staff team ensure that people who use the service are well supported. EVIDENCE: During the inspection staff showed a good knowledge and understanding of the people who lived there. A survey form returned from a member of staff reported the “the service provides a very high standard of care”. Staff have the skills to communicate effectively with people. The roles and responsibilities of staff are clearly defined, and this view was supported by discussions with two members of staff. On the day of this inspection there were enough staff to meet the needs of people. Individuals were all calm and spending their time as they wished, with staff help as required. Staff reported in survey forms that in information about Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 21 people is shared in staff meeting and during handover. This was confirmed in discussions with staff. A relative reported that” sometimes there is not enough staff to care for everybody’s needs, especially during the weekend”. A health care professional stated “more one to one care would help the client move forward and this should be provided”. A new person has needs over and above the level of staffing generally provided. The manger has acted in a proactive manner and arranged with the local authority for adequate funding to be available. Staff assisted people to fill out the survey form. Five forms were completed. A question on the form asks “how do people treat you”. Four people said staff “always treat them well”. One person reported staff “never treat them well”. In response to do carers listen and act on what you say, four people said usually and one person said never. This form did not indicate the name of the person. There is wide diversity in the staff team. Staff spoke of receiving regular supervision and regular staff meetings. Records of supervision were seen. , One member of staff reported that there is`”always up to date information and training.” All staff agreed that they receive “lots of training” Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager is developing a clear vision for the home and what is to be achieved. Health, safety and welfare of people is promoted and protected. The views of people are listened to and valued. EVIDENCE: The manager has been in post for 11 years and was able to demonstrate a clear vision and a sense of direction as to how the home will achieve good care One relative spoken with felt that the home was working in partnership with families, a health care professional reported “they address needs and work in as collaboratively as possible”. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 23 The service is people focused, equality and diversity issues are given priority and all individuals are encouraged to achieve their goals with staff support if required. The service has an understanding of equal opportunity issues. Staff have regular team meetings and supervision. Records of supervision were seen meetings were seen. Working practices in the home are safe and up to date policies and procedures are in use. The home has achieved the investors in people award last year and once previously. An annual development for the home was not developed in the last year. This is outstanding. Once developed this will provide information on what the home wants to achieve. The AQAA contains excellent information. The manager has certain areas, which he would chose to improve the quality of care for people. Such as the availability of holidays for people and the use of the Hindu community centre. People in the home on the day were happy with how the service is delivered. A professional reported that “staff support and work well with very complex and demanding clients. Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 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 X 2 4 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 4 23 4 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 4 33 x 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 4 x 3 x x 4 x Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 25 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 YA39 Regulation 24 (1)(a)(b) Requirement The home must produce an annual development plan and make this available to the CSCI Timescale of 1/11/06 was not achieved. Timescale for action 30/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Norbury Crescent (30) DS0000025820.V341952.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!