Inspection on 01/02/07 for Perryn Road 23

This inspection was carried out on 1st February 2007.

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

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

Other inspections for this house

Perryn Road 23 05/12/05

Perryn Road 23 01/06/05

Perryn Road 23 10/01/05

Perryn Road 23 17/05/04

Perryn Road 23 01/07/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Perryn Road, 23 Acton London W3 7LS Lead Inspector Simon Smith Unannounced Inspection 1st February 2007 2:00pm Perryn Road, 23 DS0000027747.V324808.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 Perryn Road, 23 DS0000027747.V324808.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. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Perryn Road, 23 Address Acton London W3 7LS 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) 0208 749 8273 0208 944 8900 www.caremanagementgroup.com Care Management Group Ltd (trading as CMG Homes Ltd) Mr Rennie Lee Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th December 2005 Brief Description of the Service: 23 Perryn Road is home to a maximum of eight adults with learning disabilities. Some of the service users have additional mental health needs. The service is managed by the Care Management Group. The home is a detached property in a residential area close to Acton High Street, which provides good shopping and public transport facilities. The property has an enclosed rear garden and off street parking for two cars. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector used evidence from a wide range of sources when making judgements about the home. These included visiting the home and talking to service users, staff and the manager. A sample of records was checked, including staff and service users’ files. The inspector was made welcome during the visit and wishes to thank service users, staff and all those who gave their views about the home. The home met 19 of 26 National Minimum Standards assessed at this visit. One Standard was exceeded, 5 Standards were almost met and one Standard was not met. Surveys were given to service users, their relatives and professionals who visit the home. Surveys were returned by three service users, two relatives and two professionals. All service users had support from staff to complete their surveys. Service users said that staff treat them well and listen to what they say. Service users also that that they are able to choose what they do with their time. Service users said that the home is ‘usually’ fresh and clean. Relatives said they are made welcome when they visit and that there are always enough staff on duty to meet service users’ needs. One healthcare professional said, “The individual carers seem to be genuinely concerned about the well-being of the clients and treat them as individuals”. Another professional said, “The client I see is well supported by the home”. Service users are involved in their local community. Acton High Street is nearby and service users use local shops, cafes, pubs and public transport. Several service users go to resource centres and two service users go to college. Some service users have supported employment. Several service users said that they visit their families at weekends. Staff have done some excellent work in supporting service users to develop relationships with their families. Service users are able to give their views about the home. The Care Management Group gives surveys to service users, their relatives and staff every year. One complaint has been made about the home since the last inspection but there is no evidence that the Care Management Group has responded properly to the complaint. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 6 Some areas of the home have been improved since the last inspection but the kitchen looks rather shabby. The manager said that a new kitchen would be fitted soon. Other areas of the home also need attention. The ground floor shower room smelled damp and there was mildew on some of the tiles. One service user said that the lock on his bedroom door was broken and that he wanted it to be repaired. Most staff have worked at the home for some time. No new staff have joined the home since the last inspection. The manager said that the home does not use agency staff. Several staff training sessions have been cancelled since the last inspection. The Care Management Group must make sure that staff have the training they need to do their jobs well. What the service does well: What has improved since the last inspection? What they could do better: Improve the response to complaints. Improve the response to maintenance issues when these arise. Ensure that all areas of the home are clean, fresh and homely. Ensure that staff have access to training appropriate to their roles. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 7 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. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 8 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 Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 9 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): Standards 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are effectively assessed at the time of admission. Each service user has an individual contract with the home. EVIDENCE: Service users’ care plans contained thorough assessments performed at the time of admission. Assessments identified skills and needs in areas including daily living and self care skills, communication, community presence, employment, education, cultural and sexual needs. Each service user’s file also contained a ‘Resident Agreement’ and a ‘Resident Information Handbook’. Perryn Road, 23 DS0000027747.V324808.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): Standards 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans contain good information about service users’ needs, strengths and preferences. Residents receive good support to make informed choices about their lives. The home supports service users in taking appropriate risks as part of an independent lifestyle. EVIDENCE: A sample of service users’ care plans was examined. All the plans seen contained good information about service users’ individual needs, strengths and preferences. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 11 Care plans contained evidence of annual review with the input of all relevant people including the service user, their family, care manager and healthcare professionals where appropriate. Each service user has monthly keywork sessions with their keyworker, which are also used to review care plans. The manager and staff demonstrated a good knowledge of residents’ individual needs and a commitment to supporting residents in making informed decisions about their lives. Observation during the visit confirmed that service users are able to choose the way in which they spend their time at the home and that service users’ programmes reflect their individual needs and interests. The home has a good, organised approach to appropriate risk taking and managing risk. Guidelines are in place for staff when completing risk assessments. Risk assessments identify risk factors and appropriate control measures. Risk assessments are in place to maintain a safe environment and to address areas such as managing money, food preparation and accessing the community independently. Perryn Road, 23 DS0000027747.V324808.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): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users access day opportunities that meet their needs and preferences. Service users are involved in their local community. Service users receive excellent support to develop and maintain relationships with their families. Service users’ rights and responsibilities are promoted. Service users are involved in planning the home’s menu and preparing meals. EVIDENCE: Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 13 Service users access a range of day opportunities appropriate to their needs and preferences and are involved in their community. Several service users attend local resource centres daily and two service users attend college. Some service users have supported employment. The home does not have a computer. The Care Management Group should consider providing access to the internet, as both service users and staff would benefit from access to information and email. Acton High Street is nearby and service users make use of local shops, cafes, banks and pubs. Public transport networks are good and two service users travel independently. Several service users said that they visit their families at weekends. Staff have done some excellent work in developing service users’ relationships with family members. Service users spoke highly of the support they have received from staff to maintain contact with their relatives. Interaction between staff on duty and service users was positive during the inspection. Service users’ needs and preferences are clearly identified in their individual plans. Service users have their own bank accounts, into which their benefits are paid. Staff used appropriate forms of address when speaking to residents. Service users are consulted about the home’s menu and are encouraged to involve themselves in food shopping and cooking the evening meal. Service users spoke to during the inspection said that they usually enjoy the food provided by the home. The advertised menu indicated that the home provides a varied and well-balanced diet. Perryn Road, 23 DS0000027747.V324808.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): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to access community and specialist healthcare resources where necessary. Changes in need are effectively identified and receive an appropriate response. The home works co-operatively with other professionals in delivering care. Service users’ medication is appropriately stored and accurately recorded. EVIDENCE: The inspection provided evidence that the home has provides good support to service users who become unwell. One service user is currently having regular medical treatment and is supported by staff to attend appointments. The manager said that the home has a good relationship with the local community team for people with learning disabilities (CTPLD) and has Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 15 benefited from their input on a number of occasions. Visiting professionals who returned surveys to the CSCI said that the home communicates well with them about service users’ care. There is an appropriate system for the storage and administration of medication. All medication coming into or leaving the home is recorded. There are clear protocols governing the administration of medication. Staff files contained a competency assessment for the administration of medication. Inspection of medication records for three residents revealed no omissions or errors. Perryn Road, 23 DS0000027747.V324808.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): Standards 22 and 23 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There is no evidence that the Care Management Group has responded to a complaint made about the home. Residents feel confident about raising concerns with staff. Appropriate guidance is provided for staff in the recognition, prevention and reporting of abuse. EVIDENCE: One complaint has been made about the home since the last inspection. Records demonstrated that the complaint was passed to a senior manager for response but there was no evidence that the organisation had taken appropriate action to resolve the issue or responded appropriately to the complainant. See Requirement 1. Service users spoken to during the inspection said they would feel comfortable raising any concerns they had with a member of staff or the manager. The manager said that all staff have had training in the Protection of Vulnerable Adults. The manager also said that he has explained the organisation’s whistle-blowing procedure to the staff team. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 26, 27 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some areas of the home have been improved since the last inspection. The dining room door must not be propped open. The home must ensure that service users’ bedrooms are homely. The response to maintenance issues should be improved. The ground floor shower room and the kitchen must be properly cleaned. EVIDENCE: Several areas of the home have been improved since the last inspection. The office and the vacant room have been repainted. The flooring has been replaced in the sleep-in room, the office and two service users’ rooms. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 18 The home’s kitchen looks shabby in some areas and there is some minor damage to base level units, especially the unit by the sink. The manager said that a new kitchen would be installed in the near future. The home has a communal kitchen, lounge and separate dining room. Each service user has a single bedroom, which they are able to decorate and personalise as they wish. One service user showed the inspector her bedroom and said she enjoyed being able to choose how the room looked. The last inspection report made a Requirement that the home stop propping the dining room door open, as it is a fire door. The door was again propped open during this visit and the Requirement is reinstated. See Requirement 2. Staff said that service users like to keep the dining room easily accessible from the lounge and use a chair to keep the door open. The home should consider the best means of addressing this issue, such as installing a self-closing fire door, which would enable the dining room door to be left open. One service user chooses not to have curtains in his bedroom. To ensure the service user’s privacy, the home has installed privacy glass in the window. The surface has become worn and would benefit from replacement. To prevent objects from being thrown from one service user’s window, the home has placed wire across the window frame. The home should seek an alternative to this arrangement as it detracts from the homeliness of the room. See Requirement 3. The manager said that maintenance issues were not always addressed quickly. One service user told the inspector that the lock his bedroom door had been broken for some time and that he wanted it to be repaired. Requirement 4. The ground floor shower room smelled damp and there was mildew on some of the tiles. This must be addressed by the home. See Requirement 5. The extractor fan in the shower room must be cleaned, as it was too dirty to work effectively at the time of inspection. See Requirement 6. The tops of the eye level kitchen units were greasy and need cleaning. See Requirement 7. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a stable staff team who know service users’ needs. Staff have good support when they start work and ongoing supervision. Service users are protected by the home’s recruitment procedures. Staff access to training has been disrupted by cancellations. EVIDENCE: The home has a clear staffing and management structure. Job descriptions and contracts of employment are in place for all posts within the staff team. The home benefits from a stable staff team, which results in good continuity of care for service users. No new staff have joined the home since the last inspection. The manager said that permanent staff cover any vacant shifts and Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 20 that the home does not use agency staff. There was a vacancy for a deputy manager at the time of inspection. Staff said that they had a thorough induction when they started work at the home. Staff also said that the manager provides good support to the staff team. Each member of staff has supervision with the manager once a month. The manager said that team meetings are held monthly. The manager said that all staff have now achieved at least NVQ level 2 and that three members of staff have gained NVQ level 3. The manager said that he has yet to register for NVQ level 4 and that he and some other staff are awaiting registration for NVQ training. The Care Management Group has a training department that distributes a monthly training programme. Whilst the content of the programme is good, there was evidence that a number of training sessions had been cancelled shortly before they were due to take place. Training records indicated that this had occurred on six occasions since September 2006. The Care Management Group must ensure that staff have access to training appropriate to their roles. See Requirement 8. Records for three members of staff were examined. All provided evidence of a robust recruitment procedure and confirmed that the home carries out appropriate pre-employment checks on staff, including Criminal Records Bureau disclosures. Staff files also provided evidence of induction and regular supervision. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an experienced and enthusiastic manager. There is an effective quality monitoring system in place. Service users have opportunities to give their views about the home. The health and safety of service users and staff is maintained. EVIDENCE: The manager has a good deal of experience in his role and has a commitment to the continuous improvement of the service. Staff reported that the manager Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 22 is approachable and provides good support and leadership to the team. The manager said that he has a new line manager and that this has improved the support available to him. There is a Quality Assurance system in place, which includes surveys for service users and their relatives, and staff. The manager said that surveys will be distributed annually and that results from across the organisation will be collated. There is also a service user forum, which service users can attend if they wish. Staff said that service users’ meetings are held monthly at the home. The fire service last inspected the home in July 2005. The home’s fire fighting equipment was checked in June 2006 and the fire alarm system was serviced in November 2006. Staff check fire call points and the emergency lighting system weekly. A fire risk assessment for the home is in place. Staff files contained evidence of fire training. The last fire drill was in November 2006. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 1 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 24 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 YA22 Regulation 22(3) Requirement Provide evidence that the Care Management Group has addressed the recent complaint about the home. The home must refrain from using a chair to prop the dining room door open. This Requirement was also made following the last inspection. Seek an alternative to the wire placed across the window frame in one service user’s bedroom. Repair the lock on one service user’s bedroom door. Eliminate the unpleasant odours in the ground floor shower room and remove the mildew on the tiles. Clean the extractor fan in the ground floor shower room. Clean the kitchen units. Ensure that staff have access to training appropriate to their roles. Timescale for action 30/03/07 2 YA24 23(4)(b) 28/02/07 3 4 5 YA26 YA26 YA27 23(2) 23(2) 23(2) 30/03/07 30/03/07 30/03/07 6 7 8 YA30 YA30 YA35 23(2) 23(2) 18(1) 30/03/07 30/03/07 30/03/07 Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 25 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 2 Refer to Standard YA12 YA26 Good Practice Recommendations Provide access to the internet for service users and staff. Replace the privacy glass in one service user’s bedroom. Perryn Road, 23 DS0000027747.V324808.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Perryn Road, 23 DS0000027747.V324808.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. 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