Inspection on 27/10/06 for Queen Elizabeth House

This inspection was carried out on 27th October 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Queen Elizabeth House 10/10/08

Queen Elizabeth House 20/02/06

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Queen Elizabeth House National Society for Epilepsy Chesham Lane Chalfont St Peter Bucks SL9 0RJ Lead Inspector Christine Sidwell Unannounced Inspection 27th October 2006 10:00 DS0000065482.V309587.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 DS0000065482.V309587.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. DS0000065482.V309587.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queen Elizabeth House Address National Society for Epilepsy Chesham Lane Chalfont St Peter Bucks SL9 0RJ 01494 601300 01494 601300 andrew.ferguson@epilepsynse.org.uk Hampshire@epilepsynse.org.uk The National Society for Epilepsy 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) Andrew Ferguson Care Home 12 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places DS0000065482.V309587.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th February 2006 Brief Description of the Service: Queen Elizabeth House is a purpose built home providing care for people who have epilepsy and physical or learning disabilities. It is one of a number of homes on one site at Chalfont St Peter and is managed by the National Society for Epilepsy. There are 12 rooms, which have been designed to meet the needs of the disabled, and also have ensuite facilities. There are lounges and dining rooms and residents can use the facilities of the site, which include a therapy service and small shop. The village of Chalfont St Peter is a bus or taxi ride away as are the nearest shopping centres. The home is staffed by qualified nurses and carers and residents have the support of a multidisciplinary team including specialist consultant neurologists, psychologists and other therapists. Fees range from £2004.00 to £3700.00 per week. Information about the home can be obtained by visiting or telephoning the home. DS0000065482.V309587.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of three days and included an unannounced one-day visit to the home. Prior to the visit all previous information about the home was reviewed. Comment cards were sent to residents and their families and to other professionals who have contact with the home. Seven family members, two health and social care professionals and a care manager returned the comment cards sent out before the visit. The care of four residents was case tracked. Residents, staff and the manager were spoken to on the day of the unannounced visit. The home’s approach to equality and diversity was observed. What the service does well: The assessment procedures work well, giving residents and staff the confidence that residents’ needs could be met if they choose to move to the home on a permanent basis. Residents and their families are supported by the multidisciplinary team to make as many decisions as is possible about their care and lifestyle, within the constraints of communal living and their disabilities. The staff are supportive of residents and handle discrimination in the community well. The staff team supports residents to undertake activities commensurate with their abilities and wishes, in the home and on the NSE campus, and to participate in the wider community. Meals are prepared in the home and are taken at times suited to the resident and the activities of the day. There is good multi-disciplinary healthcare working giving residents access to the services that they require to maximise their abilities. Medication is managed well. The complaints and safeguarding procedures work well and residents and families feel that their concerns are listened to and acted upon. There are good training programmes in place to give staff the skills they need to meet residents’ health and behavioural management needs. The staff feel supported by the management team in the home. DS0000065482.V309587.R01.S.doc Version 5.2 Page 6 The home is well managed in the interests of residents. There is an experienced manager and deputy manager in post. The manager has set up a quality assurance system and has put the necessary health and safety policies and procedures in place. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000065482.V309587.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000065482.V309587.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. The assessment procedures work well giving residents and staff the confidence that residents’ needs could be met if they chose to move to the home on a permanent basis. EVIDENCE: Residents are admitted to the home by way of a multi-disciplinary team assessment and assessment by the manager of the home. Records were seen to confirm that the last resident to move to the home had been visited by the home manager before he came to the home for a period of six weeks assessment. A full assessment of his needs had been undertaken and his needs continued to be assessed by the multi-disciplinary team during his initial stay in the home. Their local Primary Care Trust (PCT) or social service departments fund most residents. There was evidence in the files that those residents who have a care manager had a care needs assessment. Potential residents stay at the home for a six-week trial period, to enable a full assessment of their needs. This is followed by a multi-disciplinary team review, which includes the resident and their family. Evidence to confirm this was seen in the care records of the four residents whose care was tracked. The assessment documentation takes account of potential residents’ cultural and faith issues. DS0000065482.V309587.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7and 9 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. Residents and their families are supported by the multi-disciplinary team to make as many decisions as is possible about their care and lifestyle, within the constraints of communal living and their disabilities. EVIDENCE: The care of two residents was case tracked and their care plans were looked at in detail. They are comprehensive and contain evidence of multi-disciplinary working. They had been reviewed monthly and the daily entries were signed and dated. There was evidence in the plans seen that residents had risk assessments appropriate to their needs. The plans also held a suggested daily guide as to when medication and other interventions were to be undertaken. This was to prevent residents being disturbed frequently and to allow them the opportunity for activity and relaxation in between necessary clinical interventions. Each resident has a named nurse and key worker. The key workers spoken to were knowledgeable about their resident and showed empathy with them. DS0000065482.V309587.R01.S.doc Version 5.2 Page 10 There was evidence in the plans that families have been involved in drawing up residents’ plans. The staff spoken to said that they tried to help residents to make their own decisions but that residents may need guidance because of their disability. There was evidence in the multi-disciplinary care plan that some decisions are made by the team, which the resident may not agree with. The deputy manager was clear that she always put the residents’ views forward if the resident was unable to do so themselves and ensured that they were heard. This was evident in the record of the multi-disciplinary meeting. There was evidence that residents are treated as individuals and the days routine is flexible to meet their wishes. Risk assessments are undertaken to support residents when they go out or participate on activities on the National Society for Epilepsy campus. There are written policies to govern unexplained absences and staff were aware of what to do if they lost someone on an outing. DS0000065482.V309587.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 and 16 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. The home has made significant improvements in supporting residents to live a fulfilled life and to participate in community activities. EVIDENCE: The staff team have made enormous improvements in the support they are now able to give to residents to enable them to participate in community activities as well as those offered on the NSE campus. Two residents are now enrolled at a local college, one undertaking a National Vocational Qualification at Level 2. There was evidence that all residents had daily activity plans suited to their needs. The carers were enthusiastic about supporting residents to fulfil their social aspirations. One took a resident regularly to football matches. The resident needed protective headgear because of his epilepsy and some discrimination was experienced. The carer described how he handled this to protect the resident. The resident said that he enjoyed the outing and could remember his teams goal. DS0000065482.V309587.R01.S.doc Version 5.2 Page 12 There are community activities on site and residents can go to the local shops and town centres on the site bus or in a taxi. There is a choice of entertainment in the home and residents were proud to show the inspector their rooms, which were clearly personalised with their own belongings and equipment, related to their hobbies. The families who returned the comment cards said that they were made welcome at any time. One family was visiting on the day of the inspection and was observed to be made very welcome and participated in the daily life of the home. The staff were observed to be conversing with residents. The finance office of the National Society for Epilepsy and their care managers help residents and their families with benefits. Meals are prepared in the home by the care team. This gives the residents the opportunity to help and also allows for a flexible approach to meal times. On the day of the inspection the residents had a choice of cereals and toast for breakfast with a full cooked brunch for those wishing to eat a little later. Lunch was a choice of sandwiches, cake or yogurt. A selection of fresh fruit was also on offer. A curry was being prepared for the evening. One resident was helping in this and had looked forward to his cooking session throughout the day. In addition to this drinks and snacks are available around the clock. The day’s menu is on display in the dining room. Special diets are catered for. Meals were observed to be relaxed and sociable occasions. DS0000065482.V309587.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. Residents personal, healthcare and medication needs are met, maximising their abilities. EVIDENCE: The care plans had evidence that staff have considered how residents like to be moved. Some residents are mobile and some have multiple disabilities requiring careful attention to their position in a chair and in bed. One resident had very good positional photographs taken when he was in another rehabilitation unit to guide staff as to the best way to make him comfortable and to protect him from further damage due to poor positioning. The organisation should consider developing the expertise in-house in order to use this approach for other residents, where appropriate. There is a named nurse and key worker system in place and staff said that this was reviewed to ensure that both the resident and the staff member were happy and felt that the relationship was productive. The home is newly built and had the necessary aids and equipment to maximise residents’ abilities. There is a multi disciplinary team on site and there was evidence in the file that residents are reviewed by the team on a regular basis and that the appropriate interventions are put in place. DS0000065482.V309587.R01.S.doc Version 5.2 Page 14 Residents have access to local general practitioner services and to the specialist epilepsy services on site. There was evidence in the care plans that residents had access to routine outpatient appointments. The health professionals who returned the comment cards distributed as part of the inspection said that they were able to see residents in private and that there was good multi-professional working between visiting professionals and the homes care team. Residents’ consent to medication was recorded in the care plans. No residents self-administer medication at present. Residents’ medication is stored in locked boxes in their rooms and the medication record administration charts were seen to be completed correctly. The nurses spoken to said that no medicine was administered covertly. The controlled drugs were stored and administered correctly and the correct records kept. There is an on-site pharmacist from whom medication advice may be sought. The pharmacist reviews individual medication records but does not undertake regular audit of medication management in the home. The organisation should consider implementing this. DS0000065482.V309587.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. The complaints and safeguarding procedures work well and residents and families feel that their concerns are listened to and acted upon. EVIDENCE: There is a complaints policy and procedure in place. No one has complained directly to the Commission for Social Care Inspection (CSCI) although the manager has notified the CSCI of any complaints that he has received and is investigating in line with the organisations procedures. Of the eight family members who returned the comment cards, all said that they were aware of the complaints procedure and four said that they had made a complaint although gave no further details. One family who had had concerns about their sons care was visiting on the day of the unannounced visit and said that the home had responded to them and had made changes to meet their concerns. They were happy with the way in which the complaint had been handled. There are safeguarding policies and procedures in place and the staff spoken to were aware of these. The training records show that most staff had had training in this topic and regular training sessions are arranged. A case conference has been held recently under the auspices of the Buckinghamshire County Council Safeguarding Vulnerable Adults procedures. The organisation participated in and took action in response to the allegations. DS0000065482.V309587.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,29 and 30 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. The home is a safe and comfortable place for those living there. EVIDENCE: Queen Elizabeth House is a new purpose built home designed to accommodate adults with complex epilepsy and a range of physical disabilities. The home is in two halves, each virtually mirroring the other. Bedrooms are spacious and all have en suite shower and toilet facilities. Tracking is fitted in both the bedroom and en suite areas to assist movement and handling. Additional disabled toilets and two Arjo baths have been provided should the residents prefer to use them. Each dining area has a kitchen where snacks and hot drinks can be prepared. The main meals of the day are prepared in the home’s main kitchen, which is again spacious and domestic in style. Doorways and corridors have been designed with a wheelchair user in mind. The maintenance schedules were up to date and showed that a planned maintenance schedule is in place. All rooms are single and it was evident that residents are encouraged to personalise them with their own belongings. DS0000065482.V309587.R01.S.doc Version 5.2 Page 17 The home has been adapted to meet the needs of those with severe disabilities. There are specialist physiotherapy and occupational provision on the site for those who move to the home for short periods of rehabilitation. There are infection control policies and procedures in place which staff were observed to be following. There is a modern laundry with sluicing facilities. The staff were aware of the correct way to manage soiled laundry. Special tabards are worm when preparing food. Protective clothing is provided. DS0000065482.V309587.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. The staff team have the qualities, training and support needed to support residents with complex needs. EVIDENCE: The staff spoken to and observed on the day of the visit were empathetic to residents’ needs and were observed to be patient and supportive. The healthcare professionals and the families who returned the comment cards were all satisfied with the overall care provided. The training records seen showed that a range of training opportunities are available to staff and staff had recently undertaken training in epilepsy, basic life support, safe behaviour management, safeguarding vulnerable adults, infection control and care principles. Some had undertaken equality and diversity training. The training offered is focussed on meeting the care and behavioural needs of residents and could be further developed with more input related to techniques for communicating with people with learning difficulties, rehabilitation and giving carers the skills to develop residents’ ability to self care and to participate in community life. DS0000065482.V309587.R01.S.doc Version 5.2 Page 19 Four staff recruitment files were checked at random and all had the required documentation to show that a thorough process to check the suitability of staff had been undertaken before the staff member commenced work. Supervision is in place and records were seen to confirm this. The staff spoken to said that they felt that the supervision process was supportive. DS0000065482.V309587.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. The organisation has a strategy and business plan in place to meet the future needs of residents. The home is well managed in the interests of residents. EVIDENCE: The registered manager is a registered general nurse and holds the National Vocational Qualification in Management at Level 4. He has had four years experience of managing a care home. He has qualifications and experience in caring for people with learning disabilities and epilepsy. The home has been open for a year and the work in the first year was to establish the home, recruit the staff team and develop the home’s approach to its dual role of providing an opportunity for a longer period of assessment for residents with complex epilepsy management needs and to provide a home for those who live there permanently. During that period the National Society for Epilepsy has revised its corporate strategy and states that it will, over the next five years, focus on research towards seizure freedom for all, focus its services to support those with very complex needs, increase offsite support DS0000065482.V309587.R01.S.doc Version 5.2 Page 21 and increase its charitable income. The home plays an important part in that strategy as its focus is on the care of those with very complex needs. The manager has established a quality assurance system. Evidence was seen to show that the manager undertakes a regular environmental, medication, care plan and health and safety audits. A survey of residents, their families and other stakeholders has been undertaken. The results have been collated and an action plan developed. Action has been taken to address the requirements of the first inspection, undertaken last year. There are health and safety policies and procedures in place. Training records showed that staff had received manual handling training. Most but not all staff had had food hygiene training. There are infection control policies and procedures in place and staff were observed to be adhering to this. Staff were observed to wash their hands and encourage residents to do the same. Alcohol hand gel is available to help prevent the spread of infection. There are COSHH data sheets available and generic risk assessments have been undertaken. The maintenance schedule showed that the necessary maintenance checks had been undertaken with the exception of the emergency lighting test. The fire log was up to date and there was evidence that staff have received fire training. An individual risk assessment has been drawn up describing individual resident’s responses to the noise of the fire alarm and the best staff response. A fire drill had been held in the last year and action plans had been developed to deal with an unexpected resident response. The staff were aware of their responsibilities to report serious incidents. The organisation also has a clinical incident reporting system. DS0000065482.V309587.R01.S.doc Version 5.2 Page 22 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 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 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 DS0000065482.V309587.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA18 Good Practice Recommendations The organisation could consider implementing individualised photographic guidance as to how to position residents with complex needs as is demonstrated by the guidance provided by another organisation when a resident transferred to the home. Medication management could be improved if a qualified pharmacist were to undertake a medication management audit in the home on a regular basis in line with Royal Pharmaceutical Society guidelines. The training programmes could be further developed with more input related to techniques for communicating with people with learning difficulties, rehabilitation and giving carers the skills to develop residents’ ability to self care and to participate in community life. 2 YA20 3 YA32 DS0000065482.V309587.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Area Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 DS0000065482.V309587.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. 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