Inspection on 11/08/05 for Peddars Way

This inspection was carried out on 11th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Peddars Way 24/08/09

Peddars Way 18/09/07

Peddars Way 19/09/06

Peddars Way 09/02/06

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CHILDREN’S HOME Peddars Way 5a Peddars Court Peddars Way Lowestoft Suffolk, NR32 4TT Lead Inspector Anna Rogers Announced 11 August 2005 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 Children’s Homes. 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 Every Child Matters, outlined the government’s vision for children’s services and formed the basis of the Children Act 2004. It provides a framework for inspection so that children’s services should be judged on their contribution to the outcomes considered essential to wellbeing in childhood and later life. Those outcomes are: • Being healthy • Staying safe • Enjoying and achieving • Making a contribution; and • Achieving economic wellbeing. In response, the Commission for Social Care Inspection has re-ordered the national minimum standards for children’s services under the five outcomes, for reporting purposes. A further section has been created under ‘Management’ to cover those issues that will potentially impact on all the outcomes above. Copies of Every Child Matters and The Children Act 2004 are available from The Stationary Office as above. This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Peddars Way Address 5a Peddars Court Peddars Way Lowestoft Suffolk NR32 4TT 01502 538746 01502 538746 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) Royal Society of Mentally Handicapped Children and Adults Michael Ullah Childrens Home 3 Category(ies) of PD Children with Physical Disabilities (3) registration, with number LD Children with Learning Disabilities (3) of places Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 2005 Brief Description of the Service: 5a Peddars Court is a children’s home, registered to provide care, accommodation and support for three young people with profound learning and physical disabilities. Due to the complex nature of their disabilities, these young people are unable to be cared for at their family home and will eventually move onto adult services. Each young person requires very significant care staff input in relation to meet their health, physical, and emotional and social care needs. The families of the three young persons have unrestricted contact. Two of the three young people have now reached the age of eighteen and although one is continuing their education alternative day care provision is being investigated for the other one. The third reisdent continues to receive full-time education at a local Special School. An application for a variation on the registration has been received by The Commission for Social Care Inspection(CSCI) to enable the three residents to remain together. 5a Peddars Court is a bungalow, built as part of a residential housing development in North Lowestoft. As such, it is attached to neighbouring properties, and the small development has been built in courtyard style, with neighbours on three sides. The home is located close to a range of community services including local shops and public transport. Due to the very significant levels of disability, the young people living at this home are transported using the home’s own adapted minibus.The home is run by Mencap, a Voluntary Agency specialising in services for people with learning disabilities. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and started at 10am. It took place over 6 hours during a weekday. Time was spent with four staff on duty including the registered manager. A tour of the premises was made. A number of records were examined including those relating to the care of residents, staff records and a selection of policies and procedures. Two of the three residents were at home during the day. It was not possible because of their level of disability to gain their views but the working practices were observed. What the service does well: What has improved since the last inspection? What they could do better: The showering and bathing facilities need to improve to ensure that as the residents become older the facilities will still meet their needs. The shower room requires cosmetic changes but the bathroom layout will need to be Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 6 reviewed to ensure the residents and staff can use the facilities safely. There is also a need to explore the feasibility of providing adequate storage space for equipment so the communal areas are not encroached upon. 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. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Being Healthy Staying Safe Enjoying and Achieving Making a Positive Contribution Achieving Economic Wellbeing Management Scoring of Standards Statutory Requirements Identified During the Inspection Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 8 Being Healthy The intended outcomes for these Standards are: • • • Children enjoy healthy, nutritious meals that meet their dietary needs. They have opportunities to plan, shop for and prepare meals. (NMS 10) Children live in a healthy environment and their health needs are identified and services are provided to meet them, and their good health is promoted. (NMS 12) Children’s health needs are met and their welfare is safeguarded by the home’s policies and procedures for administering medicines and providing treatment. (NMS 13) The Commission considers Standards 12 and 13 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 The residents can expect that their physical, emotional and health needs are identified and appropriate action taken to secure the medical, dental and other specialist health services needed to meet them. EVIDENCE: The care plans for two residents provided detailed evidence that all aspects of their health care needs are addressed. The care staff team are clearly supported and liaise regularly with specialist clinicians. The young people had access to a wide range of medical, dental and other specialist services. There was evidence that specialist advice is available with clear written guidelines to support staff with peg feeding arrangements and managing epilepsy seizures. The training provided to staff is documented and the record shows that this training is updated to ensure staff involved, remain competent. One resident has a behaviour management plan relating to dislocating their jaw that has been developed by a multi disciplinary team. There is clear guidance together with a risk assessment about what staff will do in the event of this occurring. There was evidence that the plan is regularly reviewed and a detailed record kept of when the resident ‘s jaw becomes dislocated. Each young person has a wall-mounted lockable medication cabinet in their own room. There is a clear system in place for the administration and recording of medication after the medication has been administered. It was noted at the last inspection that there were gaps in an administration chart, which the member of staff had not signed. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 9 It was evident from inspection of the medication charts at this inspection that the requirement made has been actioned. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 10 Staying Safe The intended outcomes for these Standards are: • • • • • • • • • Children’s privacy is respected and information is confidentially handled (NMS 9) Any complaint will be addressed without delay and the complainant is kept informed of progress (NMS 16) The welfare of children is promoted, children are protected from abuse, and an appropriate response is made to any allegation or suspicion of abuse (NMS 17) Children are protected from bullying (NMS 18) Children who are absent without authority are protected in accordance with written guidance and responded to positively on return (NMS 19) All significant events relating to the protection of children accommodated in the home are notified by the registered person of the home to the appropriate authorities (NMS 20) Children are assisted to develop socially acceptable behaviour through encouragement of acceptable behaviour and constructive staff response to inappropriate behaviour (NMS 22) Children live in homes that provide physical safety and security (NMS 26) There is careful selection and vetting of all staff and volunteers working with children in the home and there is monitoring of visitors to prevent children being exposed to potential abusers (NMS 27) The Commission considers Standards 9, 16, 17, 18, 19, 22, 26 and 27 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18,22,26, 27 Residents can expect that any complaints will be taken seriously and investigated fully. The home has a clear policy and procedure in place for dealing with allegations or suspicions of abuse. Residents can be assured that the recruitment procedures are followed to protect their safety. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 11 EVIDENCE: The severe nature of each of the young person’s disabilities means they would not be able to understand or access the complaints procedure themselves, but would be reliant on persons advocating on their behalf. All three young people had contact with their families and staff said they would respond to any concerns expressed by family members. A pictorial leaflet for young people explaining what they should do if they were unhappy was available. Staff spoken with confirmed their understanding of what action they would take in the event of receiving an allegation of abuse or suspecting abuse. It was evident that they monitored unexplained bruising. Two of the residents have now reached the age of 18 and staff at the home will need to attend and familiarise themselves with the policy and procedure relating to adult protection. It was evident from discussion with the manager that there is a commitment to this training. There is a written policy on bullying which gives a clear message to staff that bullying will not be tolerated. Detail of this policy is also included in the Statement of Purpose. It is evident that staff recognise the vulnerability of the young people. It was evident during this inspection that staff provide choices to the residents and give time for the resident to consider and indicate their wishes. As noted in the previous section of this report one of the residents does have a behaviour management plan in place for suspected self-harm which results in the resident dislocating their jaw. A multi disciplinary team has devised this plan. There was evidence that this plan and the question as to whether it is attention seeking behaviour is regularly reviewed by the multi disciplinary team. There are good guidelines for staff to follow when the resident exhibits certain behaviour and this is supported by a detailed risk assessment. There is evidence to indicate that health and safety of the residents is paramount. The records confirm that fire checks are undertaken weekly and the servicing of equipment is maintained. Other records confirm that risk assessments are in place for legionella with a record of showerhead cleaning and descaling. Hot water temperatures are maintained to a safe level. Equipment such as the assisted bath and hoists are regularly serviced. The health and safety file contains good documentary evidence of the range of health and safety checks undertaken. It was noted during a tour of the premises that the non-slip flooring at the entrance of the shower room has been ripped and constitutes a health and safety hazard. It was also noticed that there is an odour from the shower drain. The shower has a grill with an uncovered drain underneath. However when this was lifted the surface around the drain is concrete. This area needs Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 12 to be reviewed at the time of repairing the non-slip flooring to ensure the surface can be cleaned and is fresh smelling. A seat attached to the wall in the shower should be removed, as it is not suitable for the resident using this area and could be a hazard for staff when assisting the resident with their shower. It is also rusted in places. The resident has been provided with an appropriate shower seat by an Occupational Therapist. (OT) During this inspection the files of five members of staff appointed since the last inspection were examined. There was evidence on all five files that Criminal Records Bureau (CRB) checks at enhanced level were being applied for and received prior to the person beginning their employment. There was evidence on all files of two references including the last employer. There was good evidence of questions asked with responses and evidence that the interviewing panel had explored any gaps in CVs. The only deficit on the files inspected was that none had a photo as required by Regulation. The Manager has on occasions needed to use agency staff. They have devised a form for completion by the agency to confirm that the worker has a satisfactory CRB disclosure with a requirement that the CRB check also included a POCA and POVA check. Advice was given to include the word enhanced to the CRB disclosure request. This is acknowledged as good practice to ensure the safety of the residents. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 13 Enjoying and Achieving The intended outcomes for these Standards are: • • • Children receive individual support when they need it (NMS 7) The education of children is actively promoted as valuable in itself and as part of their preparation for adulthood (NMS 14) Children are able to pursue their particular interests, develop confidence in their skills and are supported and encouraged by staff to engage in leisure activities (NMS 15) The Commission considers Standards 7 and 14 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 Residents can expect to be supported to complete their education that is appropriate to their needs. EVIDENCE: Two of the three residents continue to attend school. One of the residents has now completed their education and opportunities within day service provision are being investigated. The manager confirmed that although one placement has been identified although the staff team have expressed their concerns as it would involve the resident travelling to Norwich each day. Another option located within Lowestoft is also being investigated. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 14 Making a Positive Contribution The intended outcomes for these Standards are: • Children have their needs assessed effectively and comprehensively, and written placement plans outline how these needs will be met and are implemented. Children in the home are appropriately placed there (NMS 2) Children’s needs and development are reviewed regularly in the light of their care and progress at the home (NMS 3) Children are able to maintain constructive contact with their families, friends and other people who play a significant role in their lives (NMS 4) Children are able to move into and leave the home in a planned and sensitive manner (NMS 5) Children are encouraged and supported to make decisions about their lives and to influence the way the home is run. No child is assumed to be unable to communicate their views (NMS 8) Children enjoy sound relationships with staff based on honesty and mutual respect (NMS 21) • • • • • The Commission considers Standards 3, 4 and 8 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,8 Residents can expect their identified needs to be met. Residents can expect to be consulted and provided with choices about how they spend their time. EVIDENCE: It is not possible for the residents to express their views verbally to the review process and are reliant on their key workers to advocate on their behalf. However it was evident from observation that the staff team know the residents very well. One of the residents had a hospital appointment during this inspection and required a continence pad for their journey. It was evident from observation that this was not put on until the minimum time before they left the home as the member of staff felt it important that the resident had a choice about whether they used the toilet during the time before they needed to go for their appointment. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 15 There was evidence that reviews are held regularly and are multi agency spanning life in the home, health and medical care needs, education, and social aspects. The records support the fact that reviews are seen as important and are very thorough to ensure that the identified needs of the individual residents continue to be met and addressed. It was evident from discussion with staff and confirmed in records that contact with parents is encouraged. One of the young people spends a large proportion of their time at home with their family, and as such contact arrangements were effective and regular. On the day of this inspection the staff on duty were preparing to take the other two residents to collect the third resident from home where they had been for three days. Communication with relatives is enhanced with the use of a communication book, which ensures any concerns they or the staff team have are recorded and actioned. The three residents have very complex needs relating to their disabilities. As noted they are unable to communicate verbally to make their needs known, or comment about the care being provided and are reliant entirely on the staff team and other involved parties to advocate on their behalf. At the time of this inspection two residents were present. One had opted to watch television in their bedroom and from their facial expressions were clearly enjoying the programme. The other resident was in the lounge and following questions by a member of staff decided they wanted to listen to music in the garden room. The member of staff was then observed to identify which music the resident wanted. Both residents were smartly dressed and appropriately for the weather conditions and their age. There was also evidence of staff routinely checking with the residents that they were happy with what they were doing. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 16 Achieving Economic Wellbeing The intended outcomes for these Standards are: • • • • • Children receive care which helps to prepare them for and support them into adulthood (NMS 6) Children are encouraged and enabled to choose their own clothes and personal requisites and have these needs fully met (NMS 11) Children live in well designed and pleasant homes providing sufficient space to meet their needs (NMS 23) Children enjoy homely accommodation, decorated, furnished and maintained to a high standard, providing adequate facilities for their use (NMS 24) Children’s privacy is respected when washing (NMS 25) JUDGEMENT – we looked at outcomes for standard(s) 6,23,24,25 Residents can expect the organisation to support them into adulthood and a variation to the registration of the home is being applied for to ensure they can continue to live together. Residents can expect the home to be well cared for but residents cannot be assured that there is sufficient storage space. EVIDENCE: Two of the three residents have now reached 18 years of age. The third resident is 15½ years old. The Commission for Social Care Inspection (CSCI) have received an application to register Peddars Court as an Adult Service. There is evidence that the older residents have had their needs reassessed and services are in the process of being identified for example day service provision to support them in adult services. The staff team are also to undertake relevant training for example Protection of Vulnerable Adults (POVA). The home is located in a residential area, where other families including children, live in close proximity. The home is also located close to local facilities including shops. There continues to be a problem with parking. There is a mini bus used to take the residents out and is equipped with a tail gate lift to ensure the appropriate equipment can be taken with the residents. Some of the neighbours have made it difficult at times including boxing staff cars in. The Manager has written to the local council to express their concerns. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 17 The house is domestic in size. There is a lack of storage facilities and the home has recently purchased an outside storage facility for keeping continence pads in. The residents also require the assistance of mobile hoists, a standing frame and specialist chairs which clearly have to be available in the living areas. There is a small garden at the rear and side of the house and an area at the back of the house for parking one vehicle. It was envisaged that this area could be used for the mini bus but the access is very tight and leaves little room for manoeuvring the vehicle into position. Residents have their own bedrooms, which have been individually personalised and provide a welcoming atmosphere. All are of an acceptable size but not all will accommodate the additional aids the resident requires now and any additional aids in the future. There is one bathroom equipped with an assisted bath and a shower grid that fits over the bath and is used by two of the three residents when they have a shower. This area is compact (it also has a WC and a wash hand basin). The bath is situated against one wall, which makes it difficult for staff to support the resident. Discussion with staff also indicated that one of the residents has become taller and their feet hang over the shower mat. It was also felt that the shower mat would not be suitable as the residents become heavier. The bathroom facility needs to be reviewed to ensure it meets the on going needs of the residents. The shower room is situated in a separate room next to the bathroom and has a walk in facility. As noted in the section “Staying Safe” of this report the nonslip flooring at the entrance of the shower room has been ripped and constitutes a health and safety hazard. The area under the shower grill needs to be reviewed at the time of repairing the non-slip flooring to ensure the surface can be cleaned and fresh smelling. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 18 Management The intended outcomes for these Standards are: • Children and young people are guided through and know what services they can expect from the home, how they will be cared for and who they are likely to share with, and a clear statement on how the home operates is available for parents and others needing this information (NMS 1) Children are looked after by staff who are themselves supported and guided in safeguarding and promoting the children’s welfare (NMS 28) Children receive the care and services they need from competent staff (NMS 29) Staff are sufficient in number, experience and qualification to meet the needs of the children (NMS 30) Children are looked after by staff who are trained and competent to meet their needs (NMS 31) The person carrying on the home monitors the welfare of the children in the home (NMS 32) The care of children accommodated in the home is monitored and continually adapted in the light of information about how it is operating (NMS 33) Children enjoy the stability of efficiently run homes (NMS 34) Children’s needs, development and progress are recorded to reflect their individuality (NMS 35) Children living in secure units or refuges receive the same measures to safeguard and promote their welfare, as they should in other children’s homes (NMS 36) • • • • • • • • • The Commission considers Standards 29 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,29,31,33,35 Residents can expect to live in a homely and welcoming environment but the facilities for bathing and showering need to be reviewed to ensure they continue to be appropriate to meet the continuing needs of residents. Residents can expect to be cared for by a dedicated, well-supported staff team. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 19 EVIDENCE: The Statement of Purpose is being updated to identify how the home will continue to care for the three residents. Staffing levels are adequate and provide one to one care for each resident. There are occasions when a resident requires two to one care but staff spoken with said this was manageable. There is a positive commitment to training and currently 4 members of the care team hold NVQ level II training and above. There has been a significant change within the team and five new members of staff have recently joined the team. From discussion with two of them it is clear that they are having a detailed induction which both felt was excellent to assist them in their task. There is also evidence that staff are committed to undertaking relevant adult training to continue caring for the three existing residents. Records confirm that a representative of the Registered Provider is carrying out the required monthly-unannounced visits. The manager sends copies of the report to the Commission for Social Care Inspection (CSCI). There is evidence that action is taken on areas identified during the visit for example a recent report noticed the need for supervision to be regular for all staff. The standard of record keeping is excellent. The resident’s files enable easy reference and identification of the care plan and associated risks. The care plans are working files and provide good information as to how the residents need to care for. Daily notes are sufficiently detailed and the language used appropriate. There was evidence that policies and procedures are kept up to date. SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Children’s Homes have been met and uses the following scale. 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 Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 20 BEING HEALTHY Standard No 10 12 13 Score MAKING A POSITIVE x 3 3 STAYING SAFE Standard No 9 16 17 18 19 20 22 26 27 Score x 3 3 3 x x 3 x 2 CONTRIBUTION Standard No Score 2 x 3 3 4 3 5 x 8 3 21 x ACHIEVING ECONOMIC WELLBEING Standard No 6 11 23 24 25 Score 3 x 3 2 2 Score ENJOYING AND ACHIEVING MANAGEMENT Standard No 14 15 7 Score 3 x 3 Standard No 1 28 29 30 31 32 33 34 35 36 3 x 3 x 3 x 3 x 3 N/A Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 21 No 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, Children’s Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 27 Regulation Schedule 2 Requirement The registered persons must ensure that a photograph is available on each staff file as required by Regulation. The floor covering in the shower room must be repaired. A review of the floor covering and drain under the shower grill must be undertaken to ensure it can be kept clean and free from odours. The bathroom provision and layout must be reviewed to ensure it meets the needs of the resident group There must be adequate provision for storage of equipment and aids Timescale for action Immediate 2. 25 31 Provide action plan to CSCI by October 30 2005 Provide action plan to CSCI by October 30 2005 Provided action plan to CSCI by october 30 2005 3. 25 31 4. 24 31 (8) 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 Good Practice Recommendations I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 22 Peddars Way 1. Standard 25 The push down seat attached to the shower wall should be removed as it is not suitable for the resident using the area. Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ 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 Peddars Way I54 - I04 S24563 Peddars Way V231889 050811 Stage 4.doc Version 1.40 Page 24 - 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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