Inspection on 20/12/05 for Samuel Close (1, 2 & 3)

This inspection was carried out on 20th December 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Samuel Close (1, 2 & 3) 15/11/06

Samuel Close (1, 2 & 3) 25/05/05

Samuel Close (1, 2 & 3) 30/12/04

Samuel Close (1, 2 & 3) 26/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Samuel Close (1, 2 & 3) Samuel St Woolwich London SE18 5LR Lead Inspector Keith Izzard Unannounced Inspection 20th December 2005 10:00 Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Samuel Close (1, 2 & 3) Address Samuel St Woolwich London SE18 5LR 020 8855 0322 020 8855 6261 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) londonroad@tiscali.co.uk Milbury Care Services Limited Mr Jimmy Lendor Care Home 17 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (1) of places Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 place registered for LD(E) in respect of named service user only. Date of last inspection 25th May 2005 Brief Description of the Service: Numbers 1, 2 and 3 Samuel Close are three linked bungalows situated in a residential close in Woolwich. Each house provides board and nursing care for between five and seven adults with learning disabilities. The three houses provide services for different needs. House one is for people with learning disabilities who have challenging behaviour, house two for people with physical disabilities as well as learning disabilities and house 3 for people with learning disabilities who may also have other needs. Each house functions as a distinct group with its own front door, house leader, staff group, and communal facilities. Service users in each house eat together and share a communal lounge. There is an overall registered manager for the three houses, and some service users socialise with or visit other service users in different houses. The home is one of a group of six homes for adults with learning disabilities in the London Borough of Greenwich managed by Milbury Community Services a National Organisation. The home has strong links with the Greenwich Community Learning Disabilities Team (C.L.D.T) a service for people with learning disability in Greenwich. The CLDT are involved in placements in the home, and the service users life plan reviews. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over 6 hours in total on 20th December 2005. Within this inspection year this followed an unannounced inspection on 25th and 31st May 2005 and a subsequent unannounced inspection on 16th June 2005 as the result of an anonymous complaint regarding medication received by CSCI. At that visit an immediate requirement was made and this was complied with immediately. All the core Standards and most of the other Standards were covered in the previous report, some have been updated within this report reflecting developments within the home., This inspection included talking to residents, staff and management. Inspecting records, safety systems and the premises. What the service does well: What has improved since the last inspection? Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 6 Other than matters to do with the building fittings and furnishings previous requirements and recommendations were complied with including relocation of two fire call points. 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. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 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 Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 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): These Standards were assessed at the previous inspection on 25/05/05 and remain met, please refer to the previous report. EVIDENCE: Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 8 Standards 6- 10 were assessed at the previous inspection on 25/05/05 and remain met, please refer to the previous report. Standards 6, 7 & 8 were reassessed and remain met. Service users know their assessed needs are reflected in their individual plans and are enabled to make decisions with assistance as needed. EVIDENCE: The care files and associated daily notes were examined in respect of two residents, as there had been significant changes. One resident has been identified as needing a different placement. The Inspector had been appropriately, notified by the manager prior to the inspection. It was noted that the appropriate consultation had taken place both with the resident parents and Community Learning Disability Team and that a review had been set up for all involved to progress this. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 10 Sadly, one of the older residents was in very poor health and not expected to live much longer. The Inspector examined the care files and interviewed two members of staff. It was very evident that the resident was being cared for with appropriate sensitivity and that medical advice had supported the decision for the resident to spend her last days in the home rather than be admitted to hospital. Only the day after the inspection the Inspector was contacted by the manager and informed that the resident had suddenly died. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 These Standards were assessed at the previous inspection on 25/05/05 and remain met, please refer to the previous report. Standard 17 was reassessed following an anonymous complaint received at CSCI and the Inspector found that service users are offered a healthy diet. EVIDENCE: These Standards were assessed at the previous inspection on 25/05/05 and remain met. Following an anonymous complaint received at CSCI the Inspector reassessed Standard 17. In relation to this Standard the rotas of menus were examined covering a period of three weeks that showed a varied and nutritious diet was provided. Six staff members were interviewed who each confirmed that the diet for residents was adequate and that they were satisfied with the budget available to them for the purchase of food. Fridges, freezers and food cupboards were examined and showed that there were adequate stocks of fresh, frozen and packaged food. See Recommendation1 Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 12 Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 &21 The ageing, illness and death of a service user was handled with respect and as the individual would have wished. Medicines were assessed as safely managed. EVIDENCE: These Standards were assessed at the previous inspection on 25/05/05 and remain met. Subsequent to that inspection an additional visit was undertaken in response to an anonymous complaint on 16/06/05 and an immediate requirement was made in relation to medication. In view of this medication was again assessed at this inspection on all three units and, overall, the Standard was met in relation to recording storage intake and disposal of medication. Following the immediate requirement made on 16th June written instructions had been provided for the home restating that all medication must only be signed for, when it had been observed to have been taken, by the person administering the medication. No errors were found on this occasion and the manager reported no further incidents. As stated in previous Standards 7 & 8, staff members of the home experienced the sad loss of a resident and the Inspector had noted that staff members had responded to this expected death with appropriate sensitivity and care. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 14 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 Adequate procedures were in place to ensure complaints were managed and to protect residents from abuse. EVIDENCE: An anonymous complaint comprising three separate components was received by CSCI. Firstly, that service users were not receiving enough food and the food budget had been cut. Complaints were also made that only one washing machine was working and there were problems with ageing tumble driers. A third complaint was to do with the poor state of carpets and the inadequacy of the in house carpet cleaner. The Inspector investigated all of these complaints during the course of the inspection. The complaint regarding food has already been commented on Please see Standard 17 and was only substantiated in that the budget has been cut, this was acknowledged by the manager following a directive from the management of Milbury, but the evidence was that this had not resulted in a lack of food. See Recommendation 1 The complaints received, in respect of the washing machines and tumble driers was substantiated and six members of staff were interviewed in relation to this and confirmed the situation. The Inspector issued an immediate Requirement notice to replace and or repair the machines. The Inspector can confirm that these matters were attended to immediately as subsequently reported by the manager to the Inspector. The complaint received in respect of the carpets was substantiated and this represents part of a number of concerns previously identified by the Inspector in two previous inspections that resulted in requirements being made about Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 15 the standard of the building and furnishings and fittings. To date these requirements are still outstanding and, therefore, again the subject of requirements arising from this inspection of the home. Please see Standard 24 in the following section and the related requirements. The manager reported a recent incident when an agency staff member allegedly flashed a lighter in front of a resident’s face, this occurred at a day centre. This matter has been dealt with appropriately and the manager agreed to inform the CSCI of the outcome. No incidents of an adult protection nature have occurred within the home itself since the previous inspection in May 2005. A recommendation made at the previous inspection that staff be updated in adult protection was complied with. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 &30. One requirement and four restated requirements have not been complied with in response to previous inspections in relation to Standard 24. This is unacceptable. The CSCI will be seeking an explanation from the provider in respect of non- compliance. In relation to Standards 25-30 the home met these Standards. EVIDENCE: Carpeting in house 1 had not been replaced; three previous timescales of 1/12/04 and 1/05/05 and 1/10/05 were not met. A general requirement to ensure that shower rooms and toilets are refurbished, previous timescales of 1/01/05 and 1/5/05 and 1/10/05 were not met. A previous requirement that the state of internal decorations and furnishings must be reviewed and the results submitted in writing to the CSCI, had not been complied with, timescale given 1/06/05.and 1/10/05. A previous requirement that the kitchen units and extractor fan be repaired or replaced in house 2 was not complied with, timescale 1/06/05 and 1/10/05. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 17 A previous restated requirement that the paved area to the rear of the houses must be levelled for the safety of service user was not complied with, timescales given 1/01/05 and 1/06/05 and 1/11/05. Additionally at this inspection it was noted that the carpet by the kitchen door was ill fitting and therefore hazardous and the shower is not working in House three. Also the Parker Bath in House 1 needs repair as staff members are reduced to filling it with buckets of water. These matters must be attended to as soon as possible. Restated Requirements 1,2,3,4,5 and Requirement 6. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32-36 Service users are supported and cared for by competent and qualified staff members who act as a team to meet their needs. Staff members are well supervised and supported and this benefits service users. Recruitment practice was satisfactory and service users protected by the recruitment policies and procedures excepting receipt always of company stamps on references. EVIDENCE: Training records for individual staff members were seen and this showed that a good level of training had been provided and was being planned for the future. Induction training had been provided for all new staff and foundation training following this. The Inspector noted that a number of staff were overdue for the required annual update in moving and handling training, the manager agreed to remedy this. See Recommendation2 From observations made of care worker practice and the evidence of training provided for staff the Inspector felt that, overall, there was a good level of skills and experience and that those staff observed had the requisite attitudes and characteristics necessary to adequately support service users. Staff members were observed to be respectful and caring in the way they were relating to service users. It was equally evident that service users were content within their environment and responding positively to any staff interventions, such as assistance with eating or engagement in activities. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 19 Three personnel files were examined for the new staff recruited since the previous inspection and recruitment practice was found to be almost in accordance with the requirements of Regulation 19 and Schedule 2 of the National Minimum Standards. The only shortfall noted was that in three instances a company stamp had not been received on reference letters. See Requirement 7 A number of personnel files were examined that showed that the required level and regularity of staff formal supervision had taken place. It was also noted that team meetings were held regularly and several staff members interviewed stated that they received agendas and minutes of meetings and felt able to raise any items they wished within these meetings. Staff members receive an annual appraisal. The required number of staff qualified to NVQ Level 2 had been achieved for 2005. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The management approach to the home benefits residents and provides good leadership. However, there are a number of issues regarding non compliance that need to be discussed with Milbury. Also a recommendation has been made to asesss the confidence of staff members to register complaints through their line management rather than CSCI direct. Policies and procedures were in place and records examined showed residents’ rights were both promoted and safeguarded and good attention paid to health and safety matters. EVIDENCE: The Registered Manager is very experienced and meets the requirements of this Standard although will not have completed the Level 4 NVQ until later this year 2006. Otherwise, the requirements of Standard 37 were met. The management approach of the home benefits service users and staff members interviewed were positive in their comments regarding the manager and stated that they felt he was approachable and would have no hesitation in Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 21 reporting any concerns to home either in respect of service users or regarding the running of the home. In the past year there have been two episodes of anonymous reporting of complaints regarding the home. The Inspector has been assured by several staff members in relation to the complaints investigated under Standard 22 that there is no implied criticism of the manager in relation to the budget for food or refurbishment of the home and that this has been as a result of higher management/budgetary decisions within the organisation Milbury. The Inspector is concerned that two staff members have felt it necessary to make anonymous complaints direct to the CSCI as this might suggest that there is a lack of confidence in reporting through line management and it is recommended that the Responsible Person should investigate the possible reasons for this. See Recommendation 3 The home has a comprehensive set of policies and procedures that are up to date and are easily accessible to all staff members. Records examined were up to date and apart from the accidents file were well organised. See Recommendation 4 An annual survey of residents’ views has been conducted and this will be sent when published to the CSCI and generally made available. The Inspector examined a number of documents to do with health and safety matters and routine inspections of equipment and the building and these were found to be satisfactory, comprehensive and up to date. However the home must implement the advice received from the Fire Officer to install two electronic door alarms. Service users generally benefit from an accountable management of the service but the inspector has some concerns regarding the lack of response to requirements made under Standard 24 and also the reason why two staff members have complained to direct to CSCI, please see Recommendation3. Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 23 CHOICE OF HOME Standard No Score 1 X 2 X 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 1 25 X 26 X 27 X 28 X 29 X 30 3 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 X 3 3 X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 3 2 2 3 3 3 3 2 Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 24 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 YA24 Regulation 23 Requirement The Registered Person must ensure that the carpeting in house 1 is replaced as soon as possible. Restated Requirement (timescale of 1.10.05 not met) The Registered Person must ensure that shower rooms, toilets and associated fittings are in a good state of repair and specifically one shower and toilet repaired and another the floor and wall re-sealed in house 3.Restated Requirement timescale 1.10.05 not met) The Registered Person must ensure that the internal furnishings and decoration throughout is reviewed and the outcomes submitted in writing to the CSCI. Restated requirement, timescale 1.10.05 not met. The Registered Person must ensure that the kitchen units and extractor fan are adequately repaired or replaced in House 2 restated requirement previous timescale 1.06.06 not met. The Registered Person must ensure that the paved area to the rear of the houses is levelled DS0000006770.V276209.R01.S.doc Timescale for action 01/03/06 2. YA24 23 01/04/06 3. YA24 23 01/03/06 4. YA24 23 01/04/06 5. YA24 23 01/05/06 Samuel Close (1, 2 & 3) Version 5.1 Page 25 6. YA24 23 7 YA34 18 8. YA42 23 to ensure the safety of service users. Restated Requirement. (timescale of 1.06.05 not met) The Registered Person must ensure that the kitchen door carpet is made safe and the shower in House 3 made effective so residents can have a proper shower. The Parker Bath is repaired in House 2 The Registered Person must ensure that company stamps or letterheads are available on all references submitted The Registered Person must ensure that recommendations recently made by the fire officer in respect of fitting electric locking mechanisms in House 1 are implemented as soon as possible. 01/03/06 01/03/06 01/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA17 Good Practice Recommendations The Registered person should clarify the rationale for the recent reduction in the budget for food and confirm in writing to the CSCI, as soon as possible, whether the budget is now considered adequate, or in need of further revision. The Registered Person should ensure that all staff are annually updated with moving and handling training The Responsible Person should consider the reasons for two members of staff making complaints to CSCI direct rather than through line management. Accident records should be kept in chronological order to facilitate easier reference. 2 3 4 YA32 YA38 YA41 Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Samuel Close (1, 2 & 3) DS0000006770.V276209.R01.S.doc Version 5.1 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!