Inspection on 23/05/06 for Oakdale Residential Home

This inspection was carried out on 23rd May 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 but made no statutory requirements on the home.

Other inspections for this house

Oakdale Residential Home 13/06/07

Oakdale Residential Home 31/10/05

Oakdale Residential Home 12/05/05

Oakdale Residential Home 14/12/04

Oakdale Residential Home 03/06/04

Oakdale Residential Home 02/12/03

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

CARE HOMES FOR OLDER PEOPLE Oakdale Residential Home 123 Kiln Road Benfleet Essex SS7 1TG Lead Inspector Jacqueline Graves Key Unannounced Inspection 23rd May, 2006 09:45 X10015.doc Version 1.40 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 Oakdale Residential Home DS0000018087.V296601.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakdale Residential Home Address 123 Kiln Road Benfleet Essex SS7 1TG 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) 01702 553734 01702 556836 Mr Kanagaratnam Rajamenon Mr Kanagaratnam Rajaseelan Manager post vacant Care Home 27 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (27) of places Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Personal care to be provided to no more than 27 people over the age of 65 years (OP). Number of service users to whom personal care is to be provided shall not exceed twenty seven (27). Personal care to be provided to 15 service users over the age of 65 years with Dementia. 31st October, 2005 Date of last inspection Brief Description of the Service: Oakdale is a large, detached, private home, which offers accommodation with personal care for twenty-seven older people. The home is situated in a residential area of Thundersley. It is relatively close to the main shopping areas of Southend, Rayleigh and Benfleet. Bus routes are close to the home. The homes facilities are situated on two floors and include two lounges, one with a dining area, twenty-three single bedrooms and two shared bedrooms. A shaft lift provides access to all areas used by service users. Some of the bedrooms have en-suite facilities. The home has off road parking facilities to the rear of the building. There is a well-maintained rear garden. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over five hours. The inspection was planned with the deputy and the inspector spoke to the manager when they came in at lunchtime. The inspector spoke to residents individually and in a small group, to some staff and the acting manager. The care of two residents was case tracked. The inspector observed everyday life in the home as carers went about their tasks and residents sat in the lounge. Lunch was also observed. A pre-inspection questionnaire was sent to the home, to gain information to include in the report, but this was not returned. Some records and care plans were checked. Since the last inspection, when concerns were raised about the administration of medication, a specialist pharmacist inspector has twice visited the home, making requirements and recommendations. The home had partly complied with some requirements made but timescales were extended after a follow up visit by the pharmacist inspector on 9th May, 2006 to allow full compliance. Since the last inspection, the registered manager has left the home. The acting manager has applied to be registered with the Commission. The inspector would like to thank the residents, staff, acting manager and the deputy for their help with this inspection. What the service does well: What has improved since the last inspection? The home has taken steps to respond to some of the requirements made by the pharmacist inspection which looked at how drugs are stored and administered in the home. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 6 The premises are cleaner and more hygienic than at the last inspection. Those bedrooms seen, communal areas, toilets and bathrooms were cleaned to a higher standard. 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. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,4,6 Updating the statement of purpose will help prospective residents have a realistic picture of the home EVIDENCE: The inspector noticed that the home’s statement of purpose needs to be updated to reflect changes to the service, for example, the manager vacancy, staff qualifications and to reflect the actual activities, which are on offer. The views of existing residents are not included. A resident felt they had been misled over the number of residents living in the home who had dementia and felt if this information had been made clear to them they would have been able to make a more informed choice about moving in. Some residents said they find it hard to live with other residents who are confused and whose behaviour may be loud and repetitive. The home’s brochure and the statement of purpose do not make clear that fifteen residents out of twenty-seven may be admitted with a diagnosis of dementia. A sample contract is included in the statement of purpose. This does not detail the overall care and services to be provided or the rights and obligations of service users and who is liable if there is a breach of contract. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 9 The inspector was advised that Oakdale does not admit people for intermediate care. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,11 Full, recorded information on the last wishes of residents and training for staff to deal with resident’s passing would ensure that people’s last wishes are observed and staff can deal calmly and confidently with the situation. EVIDENCE: After the inspection, reports of the deaths of some residents were received by CSCI. These did not contain sufficient information and in discussion with the staff, it emerged that last wishes had not been recorded for one resident and that staff on duty at the time were not clear about what to do following the deaths of residents. Records showed that hospital, doctor and other health appointments had been facilitated by the home. One resident said staff had not arranged a doctor’s appointment when they had requested this, and they had not received the results of medical tests, but it was not possible to follow-through this alleged omission at the time of inspection. Residents said they had received chiropody treatment when requested. The acting manager advised that a new chiropodist was being sought because the Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 11 home did not like how people’s privacy was compromised by the treatment being given in communal areas. Staff advised that reflexology was now offered to residents and that the qualifications of the practitioner had been checked. Two care plans were checked. They had been based on assessments of the residents prior to their entering the home. Some statements about their care made no sense and these were pointed out to staff. On one resident’s plan, risk assessments had not been completed and there was no risk reduction plan. The resident’s weight on admission, and subsequently was not recorded. Carers record daily care largely by ticking boxes, with some records showing a short statement. Although the staff feel the records record sufficient detail, the inspector found it difficult to get a picture of how the residents had been cared for by reading this format. Medication was not fully inspected because time is being allowed for the home to meet all the requirements of the pharmacist’s inspection. However, residents raised the possibility of managing their own medication as they said this was automatically handed over to staff for them to dispense. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 Listening and acting on residents request regarding food, menus, exercise activities and opportunities to go out and meet other people would give them control and choice. EVIDENCE: A menu was handwritten on a whiteboard but residents said they couldn’t see what was written on it. Some residents felt the food was ‘Not bad’. Some residents made a number of complaints about the food, such as pureed food not being smooth enough, having the same options for tea, not having full fat yoghurts, not having enough variety, sometimes insufficient portions, having tough meat and having what they regard as ‘rubbish’ foods such as chicken nuggets and meatballs. Discussion with residents about food highlights the need for residents and their relatives to meet with staff on a regular basis and contribute their views on how the home runs. Some residents said they were asked individually what they liked in the way of food. The mid-day meal was observed. The inspector realised the residents had been seated at tables waiting for some time, and then timed a further wait of twenty Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 13 minutes. Some residents expressed frustration at having to wait so long but said this was not a usual occurrence. Some residents said they would like tables to be laid correctly, with cutlery and glasses in the correct positions and cruet sets on tables. It was also mentioned that they would prefer staff not to reach across them when they are eating. The inspector observed one resident whose tea was placed out of their reach and which had become cool. The person had been given biscuits that they said they didn’t like. No activities were observed on the day of the inspection. In the afternoon, most residents were moved after lunch to sit around the T.V. In discussion, those residents without dementia found their days long and boring. They wanted more stimulation to keep their brains active. Some expressed frustration at having no opportunities to go out regularly or to meet other people or to take sufficient exercise when they were used to this. Some residents advised that a person comes to do activities twice a week, but the activities are always the same and they no longer enjoy them. Some residents wanted reading material but needed large print. The acting manager advised that the library service used to call at the home but no longer did. She agreed to explore the possibility of resuming this service for the residents. The acting manager advised that some new equipment for activities, such as a dartboard and bowling alley, had been purchased but that space in the home to carry out such activities presented a problem. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Reviewing the format of the complaints policy would ensure it is accessible to all residents. EVIDENCE: The complaints policy is displayed in the home and included in the statement of purpose. The present format would not be suitable for people with visual impairments to read (see standard 22). Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,22,23,24,26 Considering noise levels and the possibility of a loop system might help those people with hearing difficulties. . Further adaptations would help people with dementia find their way around the home and enhance the lives of those with other impairments. EVIDENCE: When the inspector sat in the lounge to observe every day life, rock music was playing on the radio and the T.V. was also on at a loud volume; the inspector found the noise quite distracting. Some of the residents have hearing difficulties and wear hearing aids so considerable noise could be quite disturbing to them. Staff have put a few photos on the doors of some residents to help them locate their rooms. In discussion with residents, the inspector was advised that adapted items, such as large keypads for the phone or large print books were not available in the home to help those residents with visual difficulties and Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 16 none were observed. Residents expressed frustration at not being able to read the handwritten menu to find out what they were having for meals. The complaint’s policy was in small print. Some residents’ rooms and all communal areas were seen and found to be clean and tidy. There were no unpleasant odours in the home. Residents spoken to said they were happy with their rooms and had been able to make them personal with their own possessions. They said they had been consulted about how their rooms were decorated. It was noticed that in one bedroom there was no bedside lighting. Bathrooms/ toilets were clean. One resident said they liked the layout of the home except for the toilet that is opposite the lounge/dining room. They found the odour from bathroom use and the spray staff use to be quite off putting when they are sitting in the dining room. Staff said they find the communal lounge/dining room space to be quite limited for activities. One resident only used a further lounge on the day of inspection. There is no room where residents may entertain visitors in private. The garden was quite well maintained but there were some items awaiting disposal. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 Monitoring how residents’ needs are met at peak times of day would help to ensure that there is sufficient staff. Having more staff with NVQ level 2 qualifications would help ensure residents are in safe hands. EVIDENCE: A resident said that staff were not so readily available in the mornings. Staff agreed there is a lot of demand on them at peak times of activity during the day. It was reported that sometimes staff have ignored resident’s requests. The acting manager advised that one member of staff has achieved NVQ 2 and two are working towards it. She also advised that four staff had nursing qualifications, which she believed were equivalent to NVQ 2. The home was advised to verify such qualifications as equivalent to NVQ 2 with a training provider. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,37,38 Regular fire drills for all staff and residents where capable, would improve the safety of the home. EVIDENCE: Records which homes should keep, such as insurance, admissions and death, fire drills and fire equipment maintenance, register and visitors book, were available. It was observed that one visitor entered and left the home without signing the visitor’s book and this was pointed out to the acting manager. Some residents said they had never taken part in fire drills and felt that they should in order to know what to do. The acting manager said this had happened, although records did not corroborate this. The last recorded fire drill was in June, 2005. Records showed that testing of emergency lighting was not frequent enough. It was noticed that a fire door on the first floor landing did not quite close which could be problematic in holding back fire. Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X X 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 3 2 3 2 X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 1 X X X 2 2 Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 4(1bc) Sch16(a)( b) Requirement Include the address of the registered provider and manager and update the statement of purpose to include the new condition of registration, current activities available. Timescale 01/02/06 not met Update the statement of purpose to accurately reflect the services and facilities to be provided and keep under review. Provide a copy to CSCI. The register person must ensure that records of medicines prescribed and administered are accurate and up to date. Timescale 31/03/06 not inspected The register person must ensure that all facilities used for the storage of medicines are locked when not in use. Timescale 31/03/06 not inspected The register person must ensure that records of the results of GP and other health contacts are complete and meaningful. Timescale 31/03/06 not inspected DS0000018087.V296601.R01.S.doc Timescale for action 01/08/06 2. OP9 13(2)17(1 a)Sch3(3i ) 31/07/06 3. OP9 13(2) 31/07/06 4. OP9 13(2)17(1 a)Sch3(3 m) 31/07/06 Oakdale Residential Home Version 5.2 Page 21 5. OP9 13(2) 6. OP9 13(2) 7. OP9 13(6) 8. 9. OP11 OP12 37(1)(a) 16(2)(m)( n) 10. OP22 23(2)(n) 16(2)(a)( 1) 11. 12. OP24 OP29 23(2)(p) 19(1)(C) The register person must ensure that medication that is no longer prescribed is disposed of promptly and not retained for future use. Timescale 31/03/06 not inspected The register person must ensure that the temperature of medicines storage facilities is monitored and recorded to ensure a suitable environment exists. Timescale 31/03/06 not inspected The register person must ensure that staff authorised to administer medicines must be trained and assessed as competent to do so. Timescale 31/04/06 not inspected When advising the Commission of the death of a resident, include the circumstances. Make arrangements for residents to engage in local, social and community activities. Consult residents about the programme of activities. Suitably engage and occupy residents who have developed dementia. Previous timescales 1/8/05, 01/02/06 partly met) Provide facilities for recreation, fitness and exercise. That the possibility of a loop system to assist those residents with hearing difficulties is explored. Provide appropriate telephone facilities. This relates to large keypads for those residents with visual impairments. Provide bedside lighting where this is required and suitable for the resident. Ensure authenticity or references by making sure they are addressed to the home, are on headed paper or accompanied by DS0000018087.V296601.R01.S.doc 31/07/06 31/07/06 30/07/06 01/07/06 01/09/06 01/10/06 01/09/06 01/07/06 Oakdale Residential Home Version 5.2 Page 22 13. OP33 24(1-3) 26 (1-5) 14. 15. OP37 OP38 17(2)(3)( a) Sch 4 23 c (i)(v) e a company stamp. Ensure a full employment history is taken and any gaps questioned and noted, schools and training recorded (this relates to one staff file with an incomplete application form). Timescale 01/12/05 not inspected Reports of reviews of the quality of care, providing for consultation with residents and their representatives, must be supplied to CSCI. Timescale 01/06/05 not met The registered provider must carry out regular monitoring visits, unannounced, at least monthly, write a report and supply it to the Commission and manager. Ensure that the visitor’s book is kept up to date. Conduct and record regular fire drills so that all staff and, so far as practicable, residents, are aware of procedures to be followed in the event of a fire. Ensure that emergency lighting is regularly tested and record this. Make arrangements to adequately contain fire; this is with reference to the fire door which did not completely close. 01/08/06 01/07/06 01/07/06 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 OP1 Good Practice Recommendations Include resident’s views of the home in the statement of purpose. Make sure it is clear that all residents may be DS0000018087.V296601.R01.S.doc Version 5.2 Page 23 Oakdale Residential Home 2. OP4 admitted with a diagnosis of dementia. Consider current good practice regarding the care of people with dementia when decorating / maintaining the building, for example to help them find their way around the building and to identify their own rooms. Ensure that instructions for staff are clear on care plans. Medicines controlled under the Misuse of Drugs Act 1971 should be stored and recorded in accordance with the Act and associated Regulations. Promote independence if people are risk assessed as being able to self-administer medication. Arrangements regarding terminal care and arrangements after death are recorded. Advise the date of death, cause, if known, and full circumstances on notices of deaths of residents to CSCI. Policies and procedures for handling death and dying are understood and observed by all staff. Resident’s wishes regarding terminal care and arrangements after death are recorded and carried out. That forums such as resident’s meetings are held to ask residents their views on all aspects of life in the home. Menus should be displayed so that visitors, residents and staff know what is being served. Ensure people are able to reach their food / drinks and can select their own biscuits. Consult residents about how laying tables, how staff serve and the actual food served could make meal times more pleasant occasions. Consider the impact of noise levels on residents. Arrange for the library to visit for those residents who would like this service and ensure that large print reading materials/tapes are available to those with visual impairment. Ensure that signs / policies are in a suitable format for those with visual impairments. Achieve a minimum of 50 of staff trained to NVQ Level 2 or equivalent. Verify nursing qualifications of staff to see if they equate to NVQ 2. 3. 4. OP7 OP9 5. OP11 6. 7. OP12 OP15 8. OP22 9. OP28 Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Oakdale Residential Home DS0000018087.V296601.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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