Inspection on 05/11/07 for Rowan House

This inspection was carried out on 5th November 2007.

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

Rowan House 14/12/06

Rowan House 23/02/06

Rowan House 13/12/05

Rowan House 08/03/05

Rowan House 16/11/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Rowan House Church Lane Doddinghurst Brentwood Essex CM15 0NJ Lead Inspector Bernadette Little Unannounced Inspection 5th November 2007 10:40 Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rowan House Address Church Lane Doddinghurst Brentwood Essex CM15 0NJ 01277 823853 01277 822722 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) www.concensusupport.com Consensus Support Services Ltd Mrs Trudy Jane Hunter Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2006 Brief Description of the Service: Rowan House is owned and managed by Consensus Support Services Ltd. It provides care and accommodation for six service users who have a moderate to high level of learning disability. Rowan House is situated on the edge of a small village, with local shops and amenities nearby. Public transport does present some difficulty for staff and visitors. The home has its own transport to support service users to access community facilities. The building is a spacious mock Georgian family house. Residents’ bedrooms are provided on two floors in single accommodation. There is a separate lounge and dining room on the ground floor. Rowan House has developed two rooms, one as a music/art activity room and one as a sensory room. There is an enclosed garden at the rear of the property, which is mainly laid to patio and a gravel parking area at the front of the property. The Service User Guide and Statement of Purpose are up to date and available as required, in appropriate formats. A copy of the last inspection report is available in the manager’s office. This is discussed individually with relatives when it is published. Fees range between £1068.80 and £2030.00 per week. Extras not included in the fees include clothes, toiletries and haircuts. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine Key unannounced inspection. The site visit took place on over a seven and a half hour period. Prior to this, the manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to the commission. Information from this document was taken in account and is included in the report. A tour of the building took place, random records and policies were inspected and time was spent with the residents and staff, observing care practice and seeking their views. The manager was available at the site visit and feedback was given to her throughout the day. Following the site visit a random selection of relatives were contacted to seek their views on the home. The assistance of all those who participated in this inspection process is appreciated. What the service does well: What has improved since the last inspection? A bathroom has now been adapted so that it meets resident needs. The temperature that medicines were stored at is now recorded to show that it was correct. Two people now sign the handwritten medication records as a safer way of checking it. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People choosing to live at Rowan House can be confident they will receive detailed information about the home in a range of formats and their needs will be assessed before admission so the home can be sure it can meet their needs. EVIDENCE: A detailed statement of purpose and service user guide was readily available. These had already been updated to provide information on the Commission’s new contact details. The service user guide is available in written format, in picture format and also on DVD with spoken language. There have been no new admissions to Rowan House for some time. The AQQA confirms that the needs of all residents are assessed prior to admission. This is to ensure that the home know, and are sure they can meet, the person’s needs. This is considered and a care package and staffing ratio put in place accordingly. The manager confirmed that information would be gathered from a range of sources and the prospective residents would visit to Rowan House on a number of occasions as part of the assessment process. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Rowan House benefit from a well developed care-planning system, this ensures that they are supported to make decisions about their lives and to take risks within their individual abilities and capacity to understand. EVIDENCE: Care plans sampled were well organised and information was easy to find. They had photographs of the resident and the person’s key workers to support communication and identification. The care plans seen, had lots of different areas of need and had instructions for staff on how to meet these so that there was consistency for residents. They showed what the person liked and disliked, their preferred routines, what needs they had, the things that they could do and encouraged choice and Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 10 independence skills. A resident’s sensory need or reference to religious customs could have been clearer in the care plans. Risk assessments were in place on the files sampled that looked at individual issues for that person, for example bathing, use of crockery, restrictions on the water supply to the person’s room, and showed how staff were to support the person. Contingency plans were in place regarding positive behaviour management to ensure staff had clear instructions and residents received consistent and considered support. A risk assessment relating to moving and handling should now be considered where a progressing need indicates this. Care notes were written regularly and noted things like what times residents got up or went to bed, and other choices like where they spent their time in the house, at mealtimes, acceptance of personal care or community activities. The manager advised of difficulties in gaining reviews with funding authorities in some cases, with one having being considered as undertaken following a telephone call. A review for a resident who has increasing care and staffing needs was requested and arranged, but the reviewing officer did not attend. The manager is actively awaiting a further review appointment. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at Rowan House are well supported to participate in activities that are appropriate to their needs and to access facilities in the local community. They are assisted to maintain relationships with their families. The people living in Rowan House benefit from a well balanced, nutritional and varied diet. EVIDENCE: Each person has an identified weekly programme of activities, both at home and in the community, that include evenings and weekends. The home has its own sensory room and a craft/computer room for residents. Three residents were going out for a meal to a local pub on the evening of the site visit. Some residents had recently had a holiday. The AQAA states that all residents attend college. Residents have use of a vehicle supplied by the home. Care plans showed the residents are encouraged to participate in everyday tasks, for Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 12 example tidying their room. Resident meetings are held and recorded. The AQAA confirms that each resident has the support of an independent advocate. The manager and staff monitor residents responses to newly introduced activities. A relative explained that the number of college sessions attended by the resident each week has been decreased and increased according to the residents responses and need at different times. A staff member explained that a resident had enjoyed swimming while on holiday and they were now looking for a local facility to introduce this regularly for that person. Three staff surveys indicated that they would like to be able to have more opportunity/resources to give residents more one to one time and more outside activities. The manager confirmed that there are occasions when planned activities may not occur because staffing levels may not have happened as planned or also because the resident may not be able to accept the support to go, perhaps due to feeling tired after seizures etc. The team at Rowan House support residents to maintain links with family and friends. Relatives spoken with confirmed this and one advised of the support provided by the team in the past to bring the resident to visit their family. Relatives spoken with felt welcomed at Rowan House and that generally that they were kept appropriately informed of issues relevant to the resident. Staff plan the weeks menu on Sunday, taking into account their knowledge of resident likes and dislikes. Individual records of what residents have eaten are kept that show variety and choice, and include 3 main meals, snacks and supper. Records also show when residents eat out. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents received good support to meet their individual healthcare needs and to respect their dignity. Medication systems and practice protected residents. EVIDENCE: Each resident has an allocated key worker that oversees issues relating to the individual. Staff spoken with were aware of the needs of the different residents and of information specific to their plans of care. They were also observed to respect residents’ dignity and encourage a resident to close the bathroom door. An occupational therapist assessment is arranged to consider the needs for additional equipment to meet a resident’s needs where mobility is decreasing. The manager was advised to ensure that a moving and handling assessment and safe working practice plan was undertaken to safeguard both the resident and staff. The manager advised that all staff receive training in moving and handling and evidence was seen on the staff files sampled. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 14 There was evidence of routine health monitoring in the separate healthcare file for each resident. This records information on their current medication, when it was reviewed and, for example appointments with the optician and dentist, and also monitoring and investigation of individual health issues. Weight and seizure charts were maintained. Sampled records relating medication were well maintained with no omissions. Each resident had an individual file and an individual shelf for storage. Recommendations made at the last inspections had been actioned. Protocols were in place for staff to follow for ‘as required’ medications so they were used consistently. Temperatures were recorded of where medication was stored to make sure this was within safe limits to keep the medication in good condition. The management of the medication systems and records are audited routinely to support good practice. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Rowan House have access to a complaints procedure and relatives felt confident to raise concerns. People living at the home are safeguarded by the knowledge and skills of staff, who are supported by relevant training. EVIDENCE: The complaints procedure was readily available in a user friendly format. The full procedure had been updated to show the Commission’s new contact details. The manager was recommended to clarify the information so that people understood that the Commission do not investigate individual complaints but that these could be taken to the local/funding authority if felt appropriate. Relatives spoken with said they would feel able to raise any concerns. The Commission has not received any complaints regarding Rowan House. The manager advised that a complaint had been made to head office, discussion indicated that this was linked to a grievance/staffing issue. Two complaints from neighbours received directly by the home related to the garden had been logged and responded to, with actions recorded. Records showed that all staff had received training in protecting vulnerable adults and the manager advised that this is updated every three years. Staff spoken with were able recognise types of abuse and were aware of appropriate Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 16 actions to take in reporting. The manager had available the name and contact details for the adults safeguarding team. There had been one safeguarding issue referred in the past year. Staff had reported this appropriately and they and the manager worked with other professionals involved in taking appropriate actions. The manager confirmed that all staff had had training in managing behaviour that challenges/positive responses. This was a two day course that considered both theory and practical management. Please also refer to Standard 34, staff recruitment. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents at Rowan House live in a home that is generally clean and homely. They may not be best safeguarded by access arrangements and more effective maintenance input from the registered provider could offer them a safer and more pleasant environment. EVIDENCE: Internally, the premises were clean and pleasant although the lounge carpet was in need of cleaning. A headboard was not attached to one resident’s bed. The AQAA stated that the registered provider’s head office was evaluating the speed with which premises issues are dealt with at times. Outside, a wooden ramp to allow wheelchair access had been erected. It was not fitted with a handrail or anti- slip treads and the manager advised it has an incorrect gradient. She had evidence that she reported two accidents relating Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 18 to this ramp to the registered person and is awaiting prompt action. A fire risk assessment has been undertaken as there is no ramp to the back fire exit. A bathroom has been refurbished and adapted to meet the specific needs of an individual resident. The quality assurance surveys showed that more redecoration of residents’ bedrooms was needed and this has now been done. New furniture had been provided in a resident’s bedroom. The manager confirmed that labels stuck on drawers advising where socks etc were stored were not of any benefit to the resident. This did not demonstrate respect for the person’s dignity or present as homely. The premises was otherwise clean and tidy. COSHH items {Control of Substances Hazardous to Health} were safely stored. Staff spoken with were aware of appropriate infection control procedures. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at Rowan House benefit from a competent and well trained staff team, but can be adversley affected by occasional staff shortages. Some aspects of the recruitment procedure do not safeguard residents. EVIDENCE: The manager advised of minimum planned staffing levels of four staff each day and evening and two awake staff at night, with her fulltime hours being supernumerary. She confirmed that there have been occasions where planned staffing levels have not been met. A further two permanent staff are expected to leave soon and the manager advised that the lack of public transport and salaries not equal to other comparable homes are a difficulty in retaining staff. Staff also commented on the difficulties of being short staffed and not being able to take residents out to individual activities. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 20 Recent use of agency staff was noted on the rota. A sampled file for one agency staff was available that contained required information on identity, references and checks and a record of induction. This information was not available for two other agency staff on the rota. This did not safeguard residents. The manager arranged for their profiles to be faxed that day. Permanent staff had recently been appointed. One file sampled demonstrated a robust recruitment procedure and all required records, as well as evidence of ongoing induction. The second file for a staff member also on induction contained no photograph to support identity and no POVA first or criminal record bureau check in place. While the inductee was to be supervised by staff at all times, a POVA first check must in place to protect residents. Staff training at Rowan House is well planned and extensive. A matrix in the office displays the training undertaken by each staff member and when this needs to be updated. Staff files sampled confirmed that staff are provided with all basic training, with updates, as well as training specific to the needs of the residents at Rowan House, such as epilepsy, invasive procedures, autism and conflict management. The AQAA stated that all permanent staff have achieved levels of National Vocational Qualifications and there is a plan for Learning Disability Award Framework training to be introduced to all new staff. Staff surveys confirmed that staff feel well supported and with good access to training. There was evidence that staff are given regular support through supervision. Observed staff interaction with residents was friendly, skilled and respectful. One staff commented “I am happy and content in my workplace”. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from competent internal management that has shown commitment to improving standards of care for the people who live there, listening and acting on their views. The registered owner needs to put systems in place to ensure the safety and well being of residents, staff and visitors. EVIDENCE: The AQAA confirms that the manager had recently completed the Registered Managers Award. Mrs Hunter has been managing Rowan House for several years providing stability and effective management, and has kept other training up-to-date. Staff spoken with confirmed that the manager is approachable and supportive. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 22 The manager undertakes an annual quality review and provides surveys to relatives, other professionals, staff and those for residents are provided in a user-friendly version. The information is collated, a report written and an action plan in place. Positive comments regarding the service were included. The monthly visits and reports required to be arranged by the registered person to assess the care and conduct of the home were not occurring regularly. The most recent report was dated June 2007. Additionally, the manager has not been offered supervision, which is a support she feels is necessary and was recommended in the last inspection report. Records of residents’ finances sampled tallied and receipts were available to support records of transactions. Money, bank cards and records were securely stored and systems in place for staff signatures. A weekly audit system was in place. Regular health and safety audits are undertaken on the premises with weekly checks of equipment such as wheelchairs. There was evidence of regular fire drills, as well as checks of the fire safety equipment and hot and cold water temperatures. Safety inspections certificates were available in relation to gas and fixed electrical wiring. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 2 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 x 3 3 x Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 YA29 Regulation 23(2)c & n Requirement Timescale for action 15/12/07 2. YA34 19(1) (4) Sch 2 37 3. YA39 Residents must suitable access to the premises and have safe equipment to support this and so that the risk of accidents is reduced. Residents must be safeguarded 05/11/07 by robust recruitment procedures, this includes for agency staff. The quality of the service 15/12/07 provided to residents must be monitored by the registered provider and monthly visits and reports undertaken as required, to ensure that a quality service is provided. 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 YA24 Good Practice Recommendations The lounge carpet should be cleaned and systems put in place for prompt access to maintenance services. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 25 2. 3. YA30 YA36 The access to the laundry via the kitchen to be considered. Formal supervision should be arranged for the manager. Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rowan House DS0000018115.V349490.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!