Inspection on 23/06/05 for Redclyffe

This inspection was carried out on 23rd June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Redclyffe 20/04/07

Redclyffe 14/06/06

Redclyffe 13/12/05

Redclyffe 28/01/05

Redclyffe 26/04/04

Redclyffe 22/12/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Redclyffe 6/8 Aldrington Road London SW16 1TP Lead Inspector Davina McLaverty Unannounced 23 June 2005 8.40 am rd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Redclyffe Address 6/8 Aldrington Road London SW16 1TP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020-8769 6200 020-8769 6200 Richard Cusden Homes Mrs Yvonne Wallace CRH Care Home 22 Category(ies) of OP Old age (22) registration, with number DE Dementia (6) of places Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28TH January 2005 Brief Description of the Service: Redclyffe, is a residential care home for older people that is owned and operated by the voluntary organisation, Richard Cusden Homes ( non profit provider) and is located in a leafy, residential area of Streatham. The property comprises of two attached, but formally detached, large Victorian houses in their own grounds. A small car park is available. Public transport and local shops are nearby. The home is registered for twenty-two service users, six of whom may suffer with dementia. Sixteen of the bedrooms have en-suite facilities. The atmosphere is homely and relatives are encouraged to visit and take part in the life of the home. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out unannounced, by one inspector. The inspection commenced at 8.50 and concluded at 3.15pm. A variety of records, including care plans, staff files and health and safety documents, were looked at. A tour of the communal areas of the home was undertaken. During the course of the inspection, the inspector spoke to the manager, deputy manager, two support staff, and ten of the residents. What the service does well: What has improved since the last inspection? What they could do better: Monthly reviews of residents care plans must take place and risk assessments regularly updated. Staff supervision needs to take place on a one – to - one basis six times a year. This is to ensure that staff have the support and direction to carry out their jobs safely and efficiently. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 6 Staff must not be recruited without all the required checks being received. A quality assurance programme must be implemented which seeks the views of residents, relatives and other stakeholders regarding the current service being provided. All communal areas require redecorating to enhance the environment for residents. Carpets in the lounge and hallways require replacing which must be treated as a priority. 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. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4 & 5 Service users assessments are thorough and allow for detailed care planning process, to develop from the documentation. Good information is provided about the home in the Statement of Purpose and Service User Guide, which allows residents to make decisions about their care. EVIDENCE: Both the Statement of Purpose, and Service User Guide were available in the home. One resident, who had lived in the home for two week stated that she, had not received a copy of the guide. In discussion with the manager she stated that she was in the process of updating the guide and that the resident would be given a copy shortly. Consideration must be given to providing the guide at an earlier stage, as this will enable residents to decide if Redclyffe is the home they wish to live in. This resident stated that she had visited the home prior to agreeing to be admitted and found it very helpful. Four files were examined and details of the assessments were in place. Assessments are carried out prior to admission to the home by the manager, to ensure that the home can meet prospective residents needs. Copies of Care Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 9 Managers assessments and other involved professionals are also sought. Care plans are developed from the assessments. All ten residents spoken to were positive about the home and the care they received. Residents said, “ it’s alright living here”, “you can’t fault the girls, they are so kind, nothing is too much trouble for them”. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 Care plans are in place and have improved since the last inspection. The health needs of residents are adequately met and there is evidence on files of good multi disciplinary working with health care professionals. The privacy and dignity of residents is respected. EVIDENCE: Four care plans were examined. Progress has been made in developing the care plan. However there is still room for improvement, as monthly updates was only seen on one of the four files. Individual risk assessments were seen but the staff member, resident or their representative did not always sign these documents. A key worker system is in place and the manager stated she intends to introduce a system of monitoring care plans, to ensure that care plans and risk assessments are regularly updated. Personal profiles were seen, which included likes and dislikes, and these should be expanded upon, as they were very brief. There is evidence of multidisciplinary input from health and social care professionals including GPs, chiropodists, opticians and dentist. Residents did not raise issues regarding privacy and dignity with the inspector when Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 11 questioned. Residents said that staff will knock before entering their rooms and encouraged them to choose their own clothes. Staff support residents with personal care in their bedrooms and bathrooms with doors being locked. The doctor visited during the inspection and two service users had their blood pressure taken in the lounge area. Neither was asked if they wanted to go somewhere more private. This was raised with the manager who will discuss the issue with the doctor. Interactions between staff members and residents on the day of the inspection was observed to be appropriate with a relaxed and happy atmosphere being apparent. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13,14 & 15 Residents have access to three regular weekly, one hour activities arranged by the home. Residents, especially those with more specialised needs, do not benefit as fully as they might, due to the limited time given to the activities. Residents are encouraged to maintain contact with family and friends and the home has an open visiting policy. Residents are encouraged to retain their independence through the care planning and risk assessment process. Dietary needs are catered for and food is well prepared and nutritious. EVIDENCE: The home has three regular weekly activities, which are carried out by individuals from outside of the home. One person does reminiscence one day and music and movement another day. A pianist plays the piano and leads a ‘sing – a- long’ once a week. The inspector saw this activity in progress and observed that the majority of residents were clearly enjoying it and several spoke warmly of this activity. One resident told the inspector of the balls and dresses she use to wear and how she looked forward to the piano man coming as it evoked so many memories of her earlier life. In addition, television and music equipment are also available in the lounge and several residents have such equipment in their rooms. Residents were observed to be watching the television or reading a paper/ books during the inspection. One resident spoke of activities which staff involves residents in e.g. quizzes, games, sing-a –longs and light exercise. Another resident spoke of the summer outing to Brighton, Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 13 which took place last year and was being planned again for this year. Resident’s artwork was seen to be displayed in the dinning room. The activities book seen however, did not reflect the activities taking place and records must be maintained. Staff must be encouraged to record activities organised and resident’s participation. The manager stated that some residents have telephones in their rooms. A pay phone is available in the hallway on the ground floor. Visitors are welcomed although none were seen on the day of the inspection. One resident goes out on her own to the corner shops every day. Two residents attend a day centre one day a week, and one goes to the local church. A representative of the Catholic Church visits weekly to administer communion. The menu seen demonstrated that residents have a choice of two hot meals and two deserts at lunchtime. On the day of the inspection the cook was off sick, resulting in the deputy cooking lunch. The inspector had lunch with the residents who complimented the meal and food served. Condiments were available on the table as were jugs of water/squash to which residents could help themselves. Tea and coffee is served mid morning, mid afternoon, after tea or when requested. A pantry area is available off the kitchen where residents /relatives can help themselves to drinks/biscuits. A record is kept of meals served. Residents who smoke can do so, in part of the dining area, away from where food is served or go outside. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a complaints procedure is in place, which is accessible to residents. Systems for recording and monitoring of complaints are in place. Organisational policies and procedures are available to protect service users from abuse. However, training in adult protection must be put in place to ensure that appropriate action would be taken if the need arose. EVIDENCE: The home has a complaint policy, which is included in the Statement of Purpose and Service user guide to the home. Five residents said that they were aware of the procedure but that they had no cause to complain. Since the last inspection two complaints had been made. One was not pursued as the complainant failed to make further contact following a letter being sent out. The second involved rough handing of a resident who was dismissed. The manager was reminded of the adult protection procedure and advised of the appropriate action she should have taken. Training in adult protection must take place for all staff. The Local Authorities Protection of Vulnerable policy was available in the home. An organisational policy on abuse and whistle blowing is also available. One staff member spoken to demonstrated a clear understanding of adult protection and whistle blowing. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,25 & 26 There has been no significant change to the décor or furnishings since the previous inspection. The environment requires immediate attention to enhance it for the residents living there. Decoration of the communal areas and replacement of the carpets in the communal areas and lounge is still outstanding. Lack of funds prohibits, much needed work to take place, and places services users at some risk. EVIDENCE: Many areas of the home present as requiring re-decoration, in particular the lounge, communal hallways and staff office. The manager stated that finances are an issue. The home is run by a registered charity which is non-profit making and the organisation has to fund raise, to obtain additional funds as it receives insufficient funds from purchasers of the service. Large expenditures have to go through the management committee, which meets monthly. The manager expressed her concern at not being able to make decisions about Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 16 expenditures, which involved large sums of money and the delay in obtaining decisions. However decisions are made as quickly as possible. In the homes newsletter 2004/5 the Chair of the management committee has said, “ it is clear that whilst we are able to break even on a day to day basis, capital projects, including larger maintenance work as well as the critical upgrading of the Redclyffe building, cannot be financed from income. Richard Cusden Homes will therefore be launching a major fundraising initiative, to be a central focus during the coming year. The Commission has received following the previous inspection, a maintenance and essential upgrading audit, which identify areas for refurbishment and decoration e.g. replacement of carpets in the lounge and hallways, and decorating the communal areas. No timescales are included, as much will depend on fund-raising. This is a serious cause of concern. The manager stated that the replacement of carpets in the hallway had been identified as a priority for this year, which will result in other areas having to wait. Sixteen of the bedrooms have en suite facilities, although not all ensuite baths are suitable for the needs of service users. Several require support and their personal needs are carried out in the assisted bathroom on the first floor. The remaining rooms have wash hand basins. As stated above, there is one assisted bath and one shower in the home. Additionally, there are five communal toilets, two with disabled access. The home was advised at the last inspection to consider installing another assisted bath, particularly if dependency levels increase. Lack of funds however prevents this from being immediately addressed although it is being pursued. The inspector observed that grab rails are available throughout the home. Raised toilet seats and grab rails were seen in some of the toilets. The home continues to use the services and expertise of occupational therapists when new residents are admitted. The inspector was concerned that carpet on the ground floor which was grubby, worn in places and where one of the “ carpet joins” had come away. The manager stated that tape only exacerbated the problem, as it tended to come away and stick to resident’s zimmer frames. Risk assessments and putting up a sign to inform residents/staff and visitors of the hazard were required to be put in place. Following, the inspection the inspector was informed that the committee had agreed to replace the carpet in the ground floor hallway and the carpet will be in place within two weeks of the inspectors visit. The garden area was tidy although there are many hazardous areas towards the back of the garden. The manager stated that service users do not go into the garden area without staff. Residents stay on the patio area, which has garden furniture on it and is free from hazards. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 17 The home was seen to be clean on the day of the inspection. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Staff showed they had a very good knowledge of residents needs and displayed a conscientious attitude to their work. The recruitment practice in the home does not ensure that all necessary checks are carried out before staff employment, thereby putting residents at risk. Residents benefit from a mix of long- standing staff, however improvements must be made in respect of staff training to ensure that all staff have up to date knowledge in areas such as manual handling, first aid, food hygiene and health and safety. EVIDENCE: A good deal of positive feedback about the staff at the home was received from the residents. Staff were described as “kind”, “good” and “ helpful”. As a result the residents experience of the home, is of a caring environment where they feel they will be looked after. One resident over lunch said that she liked to spend time on her own in her room as she enjoyed reading and doing the crosswords. The majority of the staff have worked in the home for a number of years and display a strong loyalty to the home and demonstrated a conscientious approach to the residents. During the day there are a minimum of three staff per shift. The manager is supernumerary and ancillary staff are employed. Shifts were described, as busy and staffing levels must be kept under review to ensure that residents needs can be met. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 19 Staff files examined did not evidence that all staff had done training in essential areas, such as food hygiene, health and safety, medication, moving and handling, dementia awareness and first aid. No training and development plan was in place for individual staff. Two staff had completed their NVQ level 2 and two staff is due to start the training in September & October respectively. Five staff files were examined and none were found to contain all the required information. This is a cause of concern as recruitment practice does not protect resident’s welfare and is not in line with the Care Home Regulations 2001. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 & 36 The registered manager provides clear direction and leadership within this home. There have been improvements in record keeping, specifically relating to care planning since the last inspection. There is no quality assurance system in place, although staff seeks views of residents informally. Staff supervision must be more frequent, and staff appraisals must take place to ensure good quality of care and to enable staff to continue to develop. EVIDENCE: Since the last inspection the manager has completed and passed her NVQ Level 4 in Management and Care. Feedback about the manager was very positive from staff and residents. Typical comments from residents were as follows “ the manager is kind” and “She listens to me”. Staff stated that the manager is fair and approachable and keeps you informed about things. However, staff meetings were found not to be occurring monthly, which the Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 21 manager stated, was partly due to the high level of sickness currently in the home. She also stated that she was and her deputy have not been able to carry out one- to -one staff supervision as required in regulation and attributed this to staff shortages and her own training, which had resulted in less time in the home. However, she was confident that this would improve now that she had completed her course. No progress has been made in regard to the organisation developing an effective assurance and quality monitoring system, based on seeking the views of residents in measuring success in meeting the aims, objectives and statement of purpose. Service users meetings must be resurrected and appropriate records maintained. This area requires urgent action. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 3 x x 2 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 3 2 x x 2 x x Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 23 Yes 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. Standard OP 7 Regulation 15(2) (b) Requirement The Registered Person must ensure that all care plans are reviewed on a monthly basis. The Registered Person must ensure that risk asessment are regulary updated Previous timescale of the 30th June 05 not reached by the inspection. The Registered Persons must ensure that the plan of activities stated take place or a record kept as to why it did not. The Registered Persons must ensure that all staff receive training in adult protection. The Registered Person must resubmit the programme of works to the Commission and provide dates as to when the works identified will be addressed. The Registered Persons must ensure that staff files contain all the information as set out in Schedule 2 of the Care Homes Regulations. The Registered Person must ensure that core training is up to date. Refresher training must be provided for staff . The Registered Provider must ensure that visits are conducted Timescale for action 30/06/05 & ongoing 2. OP 12 16(2) (n) 23/06/05 & ongoing 30/10/05 30/08/05 3. 4. OP 18 OP 19 18 (1) (a) 18( 1) 5. OP 29 Schedule 2 30/08/05 6. OP 30 18(1) 30/10/05 7. Redclyffe OP 33 25(2) (e) 15/06/05 & on going. Page 24 G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 8. OP 33 25(2) (e) 9. OP 36 18(2) to the home in accordance with Regulation 26 and any reports generated from these visits be sent to the Commission. Previous timescale of the 30/04/05 not met. The Registered Person must develop a quality assurance monitoring system which seeks the views of service user, relatives and stakeholders. The Registered Person must ensure that care staff receive formal supervision at least six times a year. 30/10/05 23/06/05 10. 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 1 21 Good Practice Recommendations The Registered Person should give considertion to producing the Service user Guide in different formats to meet service users individual needs. The Registered Person should give consideration to purchasing a second hoist for the home following advice from an occupational therapist. Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Ground Floor - CSCI 41-47 Hartfield Road Wimbledon SW19 3RG 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 Redclyffe G54 G04 S10220 Redclyffe V234990 230605 stage 4.doc Version 1.40 Page 26 - 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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