Inspection on 14/08/06 for Queens Road, 14

This inspection was carried out on 14th August 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Queens Road, 14 22/02/06

Queens Road, 14 22/09/05

Queens Road, 14 06/01/05

Queens Road, 14 25/08/04

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 Queens Road, 14 Cowley Uxbridge Middlesex UB8 2NN Lead Inspector Key Unannounced Inspection 14th August 2006 11:30 Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 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 Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 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. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Queens Road, 14 Address Cowley Uxbridge Middlesex UB8 2NN 01895 254925 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) Ealing Consortium Limited Miss Charlotte Barbara Dawson Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: 14 Queens Road is a large detached two storey house situated in a quiet residential road in Cowley which is close to Uxbridge town centre. There are local shops and access to public transport close by. There is a front driveway with parking for several cars and a spacious enclosed garden at the rear, which is attractively laid to lawn with patio seating. The ground floor has a large communal lounge/dining room with doors leading to the garden. There is one bedroom on the ground floor, which has ensuite facilities. The kitchen, laundry, offices and cloakroom are also on the ground floor. There are four bedrooms on the first floor and two of these have en suite facilities. There is a further bedroom for staff to sleep-over and there is also an assisted bathroom and a further toilet on the first floor. The Deputy Manager is supported by a team of one Senior and 7 Careworkers. There are 12 vacant hours that are used for flexibility. The staff team comprises 2 male and 5 female Careworkers and the Service User group consists of 3 males and 2 females and this combination provides good gender choice for the Service Users. The home is registered to care for five adults with learning disabilities whose ages vary from 23-57. The home is currently using one waking and one sleeping night Staff due to the needs of one of the Service Users who suffers seizures, mobility problems and insomnia and, therefore, needs constant attention both day and night. A new Manager has been appointed for the home and is due to commence duties early in September 2006. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. The inspection was carried out over the course of one day for a total of about 5 hours. The Deputy Manager was not on duty at the time of the inspection and the Shift Leader (Senior) assisted in her place. Interviews were conducted with the Senior on duty and a Care Worker. Other members of Staff were spoken to who were on duty during the course of the inspection. An examination was made of recording systems, two Service User files (chosen at random) and a tour of the premises. Personnel files were not available for examination on this occasion as the Senior on duty did not have authority to hold the keys to the confidential file cabinet. Two of the Service Users were out with two Staff when the inspection began but returned after lunch having enjoyed a pub lunch together. The other three Service Users were at day centres and returned in the late afternoon. The atmosphere in the home was relaxed and Staff worked efficiently as a team. What the service does well: The home provides a high standard of care to the Service Users. Staff are identified as key workers to individual Service Users and are able to demonstrate their knowledge and understanding of them. The Deputy Manager has run the home very well for the past four months and has coped with some challenging management decisions. Staff work well as a team. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Arrangements for the provision of safety measures for one of the Service Users are not yet in place. Equipment identified by an Occupational Therapist in a risk assessment has not been installed. Agreed safe staffing levels to ensure safety of the Service User at night have not been clarified. The dietary needs of Service Users on restricted diets are still having an impact on the choices of those who are not. The laundry and garage storage area is cluttered with miscellaneous items, making it a hazard for Staff or the Service Users who use the area. The quality assurance programme has not yet been finalised. An overview based on the findings of annual surveys/questionnaires carried out to monitor and develop the service has not yet been produced. Risk assessments must be carried out to ensure the safety of both Service Users, Staff and any person who is exposed to risk. When a risk has been identified, measures must be put in place to reduce or eliminate it. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 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. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 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 Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 & 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective Service Users are admitted only after a full assessment to ensure that the home can meet their needs. The home has experienced difficulties in meeting the needs of a Service User due to the limitations of the premises. Service Users have individual contracts giving details of the terms and conditions of the home. EVIDENCE: Prospective Service Users are admitted only after a full assessments to ensure that the home can meet their needs. The home has not admitted a new Service User for several years but formats are in place to make thorough assessments of needs including any specialist needs of prospective Service Users. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 10 The home has recently experienced difficulties in fulfilling the needs of one Service User whose health and mobility has been fluctuating. These difficulties have been mainly due to limited accommodation on the ground floor and lack of passenger lift connecting the ground and first floor. It was noted that the Service Users’ files included individual contracts giving details of the terms and conditions of the home. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 11 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): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Service User plans/assessments examined were comprehensive and up to date. Care Plans showed that individual reviews had taken place and that goals and choices were included. The plans/assessments included evidence that choice was only restricted by health and safety risk assessments. EVIDENCE: Two Service User plans chosen at random were examined and found to be up to date and comprehensive. The records showed careful monitoring of each Service User’s health with details of things like an emergency list for hospitalisation, medical consultations, medication, diet and a weight chart. There was also evidence that the Service Users had contributed to develop a plan and their individual assessments included their personal goals and choices. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 12 One Service User’s plan included procedures for dealing with aggressive behaviour and violence as well as mobility and moving and handling issues. The assessments of risk and mobility were completed on the basis of the risk to the Service User and did not include the consideration of risk to other Service Users and members of Staff. The Service Users files included details of the activities they favour outside the home and the holidays they have chosen. One Service User is assisted to choose the food he likes by pointing to the things he likes from a selection of pictures of food. Other choices like having the key to their own bedroom, how personal care is carried out and the gender of the person who assists them with it were included in the Care Plans. Limitations on choice were only effected by safety considerations and were agreed and recorded. At the time of the inspection none of the Service Users were able to manage their own finances. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 13 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): 11, 13, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are facilitated to choose from a range of social, cultural and spiritual opportunities in the community. The home has a good record of encouraging Service User to develop within their individual capabilities. The dietary needs of Service Users on restricted diets still have an impact on the choice of those who are not. EVIDENCE: The Service Users have the choice of a range of things they enjoy and these Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 14 are documented in their individual Care Plans. Staff regularly accompany Service Users on holidays both at home and abroad. Service Users are also regularly accompanied on shopping trips and to pubs/restaurants. When the inspection took place, two Service Users arrived back with the two Staff that had accompanied them for a pub lunch. None of the Service Users are able to go out unaccompanied but the home ensures that there are enough Staff on duty to enable them to go out with Service Users frequently throughout the week to places they enjoy like the cinema, pub, shopping or a restaurant. The home has links with two other homes run by Ealing Consortium in the area and this gives the opportunity for Service Users to meet with Staff teams for bar be cues and parties. The arrangement provides the opportunity for the Service Users to mix and familiarise themselves with the wider group and also gives the chance for Staff to do the same. This has the advantage when Staff need to transfer or facilities need to be shared. Staff were observed interacting with the Service Users in a professional but respectful manner. Staff were observed to be skilled at interpreting the Service Users needs and wishes. Staff said that choice of food is affected by dietary restrictions for health reasons and several of the Service Users need a strictly regulated diet. Puddings still consist of mostly a choice between fresh fruit and yogurt. The dietary needs of Service Users on restricted diets still have an impact on the choice of those who are not. The evening meal being prepared was spaghetti bolognaise by a member of Staff who had made the bolognaise sauce himself without the use of a jar or packet. The sauce was sampled and considered very tasty indeed. The evening meal corresponded to the one on the printed weekly menu. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 15 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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users receive personal support in a sensitive way that takes into account of their needs and preferences. The Service Users files showed evidence of regular and detailed assessment of healthcare needs. The administration of medication in the home is well managed. EVIDENCE: Service Users receive personal support in a sensitive way that takes into account their needs and preferences. Each Service User has a personal care needs assessment and each area of personal care is clearly identified and the level of support required is recorded. The Service User’s wish for gender choice is also noted. Occupational therapy assessments are made to establish if aids and equipment are required. Each Service User has a key worker identified for them from the Staff team who works individually with them. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 16 Records viewed showed that the Service Users receive input from the Consultant Psychiatrist at the local hospital and that their General Practitioners an other healthcare professionals are involved in their health programme. The files showed that each Service User receives individual health monitoring and records detailed the range of regular medical appointments and logs of diet and weight. Medication records were well maintained and the storage of drugs was satisfactory. The first aid box was open and in an untidy condition. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 17 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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users and their representatives have access to a clear and effective complaints procedure to ensure their concerns or complaints are dealt with effectively. The home has systems in place for the protection of vulnerable adults to ensure the safety of Service Users. EVIDENCE: Service Users and their representatives have access to a clear and effective complaints procedure to ensure their concerns or complaints are dealt with effectively. The home uses the complaints policy of Ealing Consortium which is reviewed at regular intervals. All Staff have received training in the Protection of Vulnerable Adults. Most of the Staff team have received training in the management of challenging behaviour due incidents involving physical aggression towards them. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has benefited from re-decoration and refurbishments. Shared space in the home is spacious, fully accessible and well furnished to ensure it is comfortable and safe for the Service Users. The home is maintained to a satisfactory level of hygiene. EVIDENCE: The inspection included a tour of the premises. The home was clean and hygienic throughout. The home has received a programme of re-decoration and the rooms looked fresh and attractive. New furniture had been purchased for the lounge which consisted of a range of comfortable leather chairs. The garden patio area has received repair work and now offers an even surface for Service Users to use. The repair work now also provides safe access to the laundry room in the garage extension. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 19 The laundry room was in an untidy condition. The area is being used for storage and miscellaneous items are strewn around in an unsightly and unsafe manner. The garage area where Staff go to use the freezer is also in the same unsafe condition. The home still does not employ a cook or cleaner and these duties are performed by the Staff team. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment process used by the home are satisfactory and designed to safeguard the Service Users. Staff receive good training facilities through Ealing Consortium who provide a range of accredited courses including a comprehensive induction programme for new recruits Staff receive regular formal supervision to ensure their work is monitored and that they are supported. EVIDENCE: Staff files were not available for inspection. An interview with a newly recruited Staff member confirmed that his selection and induction training had been conducted in an appropriate manner. The induction process described by him showed that the course covers a wide range of subjects over a two week period plus experience in the workplace setting before placement is agreed. The Staff member thought that his induction training combined good quality practical and ideological courses in Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 21 subjects covering subjects like food hygiene, first aid, fire safety, protection of vulnerable adults, moving and handling, de-escalation of aggression and a range of health areas. Induction also includes Learning Disability Award Framework training units which form the basis for the underpinning knowledge for the NVQ. Over 50 of the Staff team have either achieved an NVQ qualification at an appropriate level or are working towards it. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,41 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has commenced quality monitoring structure but the monitoring process to ensure performance is progress is reviewed. Records examined were up to date and comprehensive. Risk assessment and management of health and safety issues concentrate on the safety of Service Users and risks to Staff are not being assessed. EVIDENCE: Work was commenced on a quality monitoring system but it has not completed. The home has produced quality questionnaires for Service Users/their representatives but the results were not collated. The home has received regular monthly review visits under Regulation 26 of the NMS from a Senior Manager of Ealing Consortium and these have been satisfactory. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 23 When the quality monitoring system has been completed, it should include all areas where feedback can be obtained on the service. An overview of the outcomes must produced annually with details of conclusions and measures that will be taken to improve or develop the service. This must be sent to the CSCI each year. Records examined during the course of the inspection were found to be well maintained and up to date. Risk assessments examined on a Service User’s file were carried out by professionals concerned with the health and social care of the Service User. The risk assessments did not include the risk to Staff and others. The Deputy Manager must carry out risk assessments that fully cover risks to Staff, other Service Users and people in close contact with the Service User. The Deputy Manager must seek support in the management of the situation where the assessed safety measures in terms of Staffing levels is being overridden by the placing authority. Where professional assessment of the Service User’s needs has indicated the need for grab rails and other equipment, the Deputy Manager must ensure that this is installed as a matter or priority. Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 1 4 x 5 3 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 2 25 x 26 x 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 3 12 x 13 3 14 x 15 x 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x X X 2 x 3 2 x Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 25 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, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA3 YA6 Regulation 12(1)(a)(b) 13(4) 23(2)(n) 12(1)(a)(b) 13(4) 23(2)(n) 23(1)(a) 24 Requirement The home must ensure that the needs of individual Service Users can be provided. Care Plans must include the changing needs of individuals and detail measures taken to ensure that the home can meet assessed needs. The laundry area and store room must be kept clean, tidy and made safe for Staff to use. A system of quality monitoring must be devised that includes feedback from a variety of relevant sources and uses the information to produce an overview with performance indicators. A copy of these outcomes must be sent to the CSCI each year. (This Standard has been partially addressed - previous timescale of 01/11/05 & 30/04/06 partially met). Timescale for action 29/09/06 29/09/06 3. 4. YA30 YA39 18/09/06 01/04/07 Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 26 5. YA42 13(4) 18(1)(a) Risks must be fully assessed to 18/09/06 ensure that all areas have been considered. When a risk has been identified all measures must be implemented to ensure the health, safety and welfare of both the Service User(s) and the Staff. 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 YA17 Good Practice Recommendations Limitations of diet are made for the whole group because some Service Users require a restricted diet and the right of choice for Service Users who do not need a restricted diet should be considered. The first aid box should be well maintained. 2 YA20 Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST 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 Queens Road, 14 DS0000027067.V294217.R01.S.doc Version 5.1 Page 28 - 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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