Inspection on 24/11/05 for Roland Residential Care Home (Hampden Way)

This inspection was carried out on 24th November 2005.

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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roland Residential Care Home... 11/07/06

Roland Residential Care Home... 27/01/05

Roland Residential Care Home... 05/11/04

Roland Residential Care Home... 20/01/04

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

CARE HOME ADULTS 18-65 Roland Residential Care Home (Hampden Way) 163 Hampden Way Southgate London N14 7NB Lead Inspector Julie Schofield Unannounced Inspection 24th November 2005 09:00 Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 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 Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 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. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Roland Residential Care Home (Hampden Way) Address 163 Hampden Way Southgate London N14 7NB 020 8368 1323 020 8882 7973 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) Mr Dushmanthe Srikanthe Ranetunge Mrs N Ranetunge Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specific service user, who is over 65 years of age, may remain accommodated in the home. This condition must be reviewed at such time as the service user is discharged and the Commission of Social Care Inspection notified. One specific service user, who has a diagnosed enduring mental disorder and a mild learning disability, may remain accommodated in the home. This condition must be reviewed at such time as the user is discharged and the Commission for Social Care Inspection notified. 27th January 2005 2. Date of last inspection Brief Description of the Service: 163 Hampden Way is a home for younger adults with mental disorders. At the time of the inspection there were 7 service users accommodated in the home. The home was registered in September 1990. The home is one of three residential care homes owned by Mr and Mrs Ranetunge. The home is a twostorey semi - detached house, which has recently been extended. On the ground floor there is a kitchen, a lounge/dining room and two bedrooms. One of the bedrooms has an en suite toilet. On the first floor there are bedrooms, a toilet and a shower room. The second floor consists of a loft extension. There are two bedrooms and a bathroom on the second floor. There is a building in the garden at the rear of the premises, which contains an office, lounge (with kitchenette facilities, laundry room and toilet. The home is located in a quiet residential area, near Southgate. There are a variety of shops, restaurants and other community facilities within a quarter of a mile of the home. One of the residents brought their cat with them when they moved into the home and the cat is now the home’s pet. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Thursday morning in November 2005. It started at 9.00am and finished at 12.15pm. During the inspection a partial site visit, examination of records and discussions with manager, deputy manager, staff and residents took place. The Inspector would like to thank everyone who took part in the inspection. What the service does well: What has improved since the last inspection? There have been changes to the home, which have enabled the number of residents for which the home is registered to increase from 6 to 7. Within the home the office has been removed and a new bedroom has been created. The laundry room has been removed and a medication room has been created. In Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 6 the garden there is a new building which includes an office, lounge with kitchenette, laundry room and a toilet. 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. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 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 Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 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, 4 Carrying out an assessment of the resident, prior to their admission, ensures that the needs of the resident are identified and that the home is able to determine whether these can be met by the home. Residents are involved in the process of choosing a care home that can meet their needs and make their decision after introductory visits to the home. EVIDENCE: One resident has been admitted to the home since the last inspection. The case file was inspected. Information from the placing authority obtained prior to the admission included an Overview Assessment and there was a report by the psychologist. There was a form where the wishes of the resident were recorded in respect of the type of accommodation that the resident wanted. The manager of the home had visited the prospective resident in the resident’s previous accommodation and had carried out an assessment of need. This, and the supporting information, formed the basis on which the resident’s care plan had been developed. There was a record in the case file of a programme of trial visits to the home. The prospective resident had an opportunity to see the home and the room, which they would occupy. They had the chance to meet the staff team and the other residents, to have a meal and to decide whether the new home would meet their needs. The new resident said that they had formed a good Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 9 impression of the home and that they had settled in well. They said that staff had made them feel welcome. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 Evaluating care plans on a regular basis ensures that changes in the needs of residents are identified and can be addressed. Staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. EVIDENCE: Two case files were inspected. Each contained a care plan assessment, which includes an assessment of social, personal and health care needs and sets goals and records the action to be taken. The resident signs the care plan assessment. There was evidence of regular review meetings being held. On a six monthly basis an external review meeting is held, which includes the consultant psychiatrist and social worker and where family members are also invited, if the resident wishes. In between these meetings the home holds an internal review meeting. Case files contained risk assessments, which are tailored to the individual needs of residents. The risk assessment included risk management strategies. Risk assessments included the resident going out on their own, smoking, the use of knives in the kitchen, continence, carrying money, healthy eating and withholding the combination of the keypad attached to the front door. There Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 11 was evidence that the risk assessments were subject to review. The home has a procedure in the event of a resident going missing. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 14, 15 Access to college or day centre provides the resident with an opportunity to develop their social and communication skills. Residents’ independent living skills develop through participation in domestic routines within the house and help residents prepare for moving into more independent accommodation. Residents are knowledgeable about what facilities the community has to offer and they make decisions about what they want to do each day. The support of staff enables residents to maintain family contact, which contributes towards the wellbeing of residents. EVIDENCE: One of the residents attends college twice a week and the sessions include communication and assertiveness. Another resident attends a day centre once a week and said that they travelled there by bus. They said that staff had helped them to become familiar with the route before they travelled independently. Within the home there are opportunities for residents to develop independent living skills by undertaking domestic tasks. Each resident has an individual weekly activities programme, which may include shopping, cooking, laundry etc. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 13 Residents use public transport, taxis and dial a ride to access community facilities. Residents were aware of local shops, post office, supermarket and other facilities. Some residents like to go swimming at a local leisure centre. The names of residents are entered on the electoral roll but it is the residents’ choice whether they want to vote at elections. Some activities in the community take place with the support of staff, with staff undertaking escort duties as part of their role. Residents said that they had enjoyed a holiday arranged by the company for the residents of the company’s 3 care homes. Outings are also arranged by the home and there are photographs of visits on display in the lounge. Residents said that when friends or family members visited the home they were made welcome by the staff on duty. Visits can take place either in the resident’s room or in the lounge, according to the resident’s wishes. Some residents visit their families; including staying with them overnight and 2 of the residents will be staying for Christmas with relatives. Families keep in touch with residents both by visits and by telephone calls. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 Residents receive assistance in a manner, which preserves their self-esteem. Wearing appropriate clothing in communal areas protects the dignity and privacy of residents and staff must encourage residents to wear a dressing gown over nightclothes. In order to promote good health the residents are supported by staff to take their medication, at the times directed and in the doses prescribed by their GP. EVIDENCE: The level of personal support given varies according to the individual needs of the resident. The manager said that it could vary from prompting, supporting or encouraging to direct assistance. Residents are able to choose the time that they get up or go to bed, have a bath and have meals. However they are encouraged to develop regular routines during the day e.g. getting up, washing and dressing and having breakfast in the morning so that their day has structure and purpose. It was noted that at the start of the inspection a resident was sitting in the lounge dressed in a flimsy, short nightdress but not a dressing gown. It was warm in the room and the resident was aware of what they were wearing and had chosen to wear this. However, it compromised the dignity of the resident in front of other residents and visitors. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 15 Since the last inspection the laundry room in the home has been converted into a medication room and this was kept locked. Within the room medication was safely stored. Medication records were inspected and were up to date. The home uses a blister pack system for medication and the blisters had been appropriately opened prior to the inspection. However some blister packs start on a different day of the week to the majority of the others and it would be preferable for all of the packs to start on the same day of the week to avoid the possibility of any error occurring. On a case file there was a record of a medication review meeting taking place. There was also a letter on file from the hospital giving permission to crush tablets and administer these in an oral suspension for a named resident. The manager said that staff have undertaken a safe handling of medication training course. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Residents are aware of their right to complain if the care that they receive is not satisfactory and said that they were confident to do so, if the need arose. An adult protection policy, familiarity with the interagency guidelines and protection of vulnerable adults training for staff contribute towards the safety of residents. EVIDENCE: The complaints book was available for inspection. It was noted that 1 complaint had been recorded. An investigation concluded that the complaint had not been substantiated. The resident had signed the book acknowledging that they were satisfied with the outcome of the complaint. A copy of the complaints procedure is available in the office and there is a copy in the communal area for residents to refer to. The manager said that residents are provided with a copy during the admission process. The complaints procedure includes timescales for each stage of the process and details of the complainants right to contact other agencies e.g. the regulatory authority. Residents, including the new resident, said that if they had any concerns or complaints they would be able to talk to some one in the home. The home has a Protection of Vulnerable Adults policy in the event of an allegation or incident of abuse. The home has notified the CSCI of one incident, since the last inspection. The incident was in respect of behaviour, which did not preserve the dignity of the resident. The home carried out an investigation and appropriate action was taken. The home has a copy of the local authority’s interagency guidelines in the event of abuse. Ms Ranetunge has undertaken training in the role of investigating officer. The manager said that staff have received training in respect of vulnerable adults. There is a Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 17 policy in respect of staff supporting service users with challenging behaviour and a policy on restraint and these are discussed as part of the induction training process. The manager said that restraint is not practiced in the home. There is a policy in respect of the handling of service users’ monies etc. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 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 Residents were satisfied that the home provided comfortable and “homely” accommodation. Within the communal space in the home, residents have a choice of lounges, where they can relax or socialise. However there is a need to review the practice of walking through one lounge en route to the other lounge. Residents enjoy a home, which is clean and tidy and provides a hygienic environment. EVIDENCE: Since the last inspection changes have taken place in the home as a new building has been constructed in the garden at the rear of the premises. Access to this is by a ramped walk way and it is recommended that grit is used on this in icy conditions, to prevent accidents. There is a door at the back of this building, which allows visitors who use a wheelchair, access to the garden. The building contains an office, residents’ lounge where smoking is allowed, kitchenette facilities, toilet and laundry room. It was noted during the inspection that residents enjoyed using the new lounge and they said that it was a good part of the home. However, when residents or staff left the house to go to the new building or returned to the house from the new building this was done by coming in and out of the patio doors to the lounge. It was difficult to carry on a conversation with the distraction of people walking through the lounge and the home needs to consider the effect of this when Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 19 residents are relaxing in the lounge, particularly when the weather is very cold. Residents said that the home was comfortable and that they liked the way that it was furnished and decorated. With a new lounge in the building in the garden, in addition to the open plan dining/lounge area in the house, there are now 2 lounges for residents’ use. Smoking is allowed in the lounge in the new building so residents have a choice of environment. Residents said that they liked the new lounge and it was noted that it was used during the inspection. Both areas are comfortably furnished and decorated and both areas contain a television. The parts of the home inspected were clean and tidy and free from offensive odours. The new building that has opened in the garden contains a laundry room. The home services laundry for a resident who is incontinent and the home should review the need for a washing machine, which has a sluicing cycle. The manager said that all staff have received infection control training as part of their NVQ training. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 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): 32, 33 The quality of the support given to residents is enhanced when staff have the knowledge and understanding of the needs of the client group. The home continues to support staff undertaking NVQ training and to provide mental health training. The rota demonstrated that there were sufficient staff on duty to support the residents and to meet their needs. EVIDENCE: Members of staff work in one or more of the Roland care homes. The manager said that within the company 7 members of staff have already completed either NVQ level 2 or 3 training and other members of staff are currently undertaking NVQ training. Staff also have access to training in topics such as infection control, manual handling, medication, epilepsy, schizophrenia and personality disorders etc. During the inspection it was noted that staff and residents enjoyed a good rapport and that several residents enjoyed using the lounge area in the new building, where they were close to staff working in the office. Unless privacy is required, the door to the office is open. Residents said that staff were “kind” and “helpful” and the new resident said that the staff had made them feel welcome and helped them settle into the home. The rota was available and the home is maintaining the agreed minimum staffing levels, discussed as part of the application for a major variation, to increase the number of residents for which the home is registered from six to Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 21 seven. At the time of the inspection the manager, deputy manager and support staff were on duty. Staffing levels were sufficient to support residents inside and outside the home and to support residents on a 1 to 1 basis, if required. At night there is a member of staff asleep but on call in the home. The staff team consists of both male and female support workers. The rota also provided information about the on call management system. Staff confirmed that regular staff meetings took place and that regular individual supervision sessions were given. This support was in addition to the day-today supervision of staff. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 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): 37 The manager is experienced and competent and is able to encourage and develop good working practices in the home, which provides residents with a safe environment where their rights are respected. Now that she will be undertaking the role of a service manager for the company, an application for registration of a new manager is required. EVIDENCE: The manager said that she has completed her MSc – Psychiatry and is waiting for her dissertation to be approved. She said that she now undertakes a service manager’s role where she supports each of the care homes within the company. Her deputy is undertaking an acting manager role and the deputy manager confirmed that she would apply to the CSCI to be the registered manager. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 24 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA18 Regulation 12.4 Requirement Timescale for action 01/03/06 2 YA24 12.4 3 YA32 18.1 4 YA37 8.2&9.2 That staff encourage residents to wear a dressing gown over nightclothes when they are seated in communal areas. That a review of the use of the 01/03/06 lounge in the house as a route to the new building takes place with manager, staff and residents. That 50 of carers whose 01/07/06 names appear on the rota for Hampden Way achieve an NVQ level 2 or 3 qualification. That the current manager 01/03/06 informs the CSCI in writing of her new role within the company and that the acting manager forwards an application for registration to the CSCI. 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 YA20 Good Practice Recommendations That all blister packs start on the same day of the week to DS0000010540.V267867.R01.S.doc Version 5.0 Page 25 Roland Residential Care Home (Hampden Way) 2 3 YA24 YA30 avoid the possibility of an error occurring. That the ramped walk way is gritted in icy conditions to prevent accidents. That the home reviews the need for a washing machine with a sluicing cycle for servicing incontinent laundry. Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Roland Residential Care Home (Hampden Way) DS0000010540.V267867.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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