Inspection on 04/09/06 for St Quintin Avenue, 1

This inspection was carried out on 4th September 2006.

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

St Quintin Avenue, 1 11/04/05

St Quintin Avenue, 1 04/11/04

St Quintin Avenue, 1 10/05/04

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 St Quintin Avenue, 1 1 St Quintin Avenue North Kensington London W10 6NX Lead Inspector Sheila Lycholit Unannounced Inspection 4th September 2006 10:15 St Quintin Avenue, 1 DS0000010848.V310512.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 St Quintin Avenue, 1 DS0000010848.V310512.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. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Quintin Avenue, 1 Address 1 St Quintin Avenue North Kensington London W10 6NX 020 8968 3438 020 8968 3246 bimbososanya@lookahead.org.uk 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) Look Ahead Housing & Care Mr Bimbo Abiodun Sosanya Care Home 6 Category(ies) of Learning disability (6) registration, with number of places St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22 August 2005 Brief Description of the Service: The service is run by Look Ahead Housing and Care for 6 people with a learning disability. There are currently 5 service users living at 1 St Quintin Avenue, all of whom have been resident for a number of years. The house, which is arranged over 4 floors, is spacious, with a pleasant garden leading off the lower ground floor. Most of the bedrooms, which are all single, are of above average size. The house is in a tree-lined avenue in North Kensington, close to shops, services and public transport. The service users, who have high needs, attend day services in Kensington and Chelsea or Westminster. The building is not suitable for wheel-chair use, though the front entrance is ramped and one service user, who has restricted mobility, is able to manage the stairs to the lower ground floor. There is currently 1 vacant place. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection visit took place on Monday 4th September 2006 from 10.15AM until 3.15PM. Three service users were at home and two were attending day services. Two of the service users left with staff to go to Paddington Arts Centre and one to keep an appointment with the Dietician. Two of the service users later went out to lunch. The Manager and Deputy Manager were on duty and made themselves available throughout the visit. In addition to speaking with senior staff, the Inspector also met with one Support Worker in private and attended the handover meeting. A tour of the building was carried out with the Manager. What the service does well: What has improved since the last inspection? What they could do better: Visits on behalf of the provider have not taken place regularly and few reports for 2006 are available in the home. The Manager has not been provided with confirmation of satisfactory CRB checks by Look Ahead Housing’s HR Department who retain the information. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 6 Staff vacancies and sickness have resulted in some service users’ support plans not being reviewed regularly, though the Manager has taken steps to prevent further omissions by reallocating key working responsibilities. 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. St Quintin Avenue, 1 DS0000010848.V310512.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 St Quintin Avenue, 1 DS0000010848.V310512.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 The quality of outcomes for these standards is good. Accessible information has been developed for prospective service users. An individualised service is provided for each service user and staff work closely with the multi-professional team to regularly reassess needs. EVIDENCE: Information about the service is available in a variety of formats, including a video. Staff have produced a welcome pack which is used for open days and a more accessible version of the home’s brochure is being developed with the help of Look Ahead Housing’s publications officer. An accessible assessment form is available and is being used for each service user. None of the forms have been completed but assessments for 2 service users seen on the PC showed that staff are using photos as well as text to support service users’ involvement in the process. No new admissions have taken place for a number of years. There is a sound admissions procedure, involving the assessment and introduction of a prospective service user, which will be followed when the current vacancy is filled. St Quintin Avenue, 1 DS0000010848.V310512.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 The quality of outcomes for these standards is good. Service users are involved in developing their individual plans and are supported by staff to make choices and to take part in the life of the home. EVIDENCE: As discussed under standard 2, a new accessible assessment format is being piloted at the home. Three service users files were looked at. Each contained a detailed support plan, monthly summaries and copies of reviews and risk assessments. Support plans and risk assessments for two of the service users had been recently reviewed and updated. The support plan and risk assessment for one service user had not been reviewed since January this year, though it was clear from correspondence on file that her needs had been regularly reviewed and action taken regarding concerns about her health. The Manager said that he had recently re-allocated key workers for 2 service users as they were being affected by staff sickness and absences. Senior staff attend the RBKC person centred planning facilitator forum and the consultant appointed by Look Ahead Housing is helping staff with implementing PCPs and with setting up a family forum. Although 3 service users were without a Care Manager for a number of months, records show that staff at the home ensured that relevant referrals and meetings took place. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 10 Staff have continued to develop the use of multi-media, in particular digital photography, to improve communication with service users and to ascertain their wishes, likes and dislikes. St Quintin Avenue, 1 DS0000010848.V310512.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 The quality of outcomes for these standards is assessed as good. Staff have made progress in further developing the range of opportunities for service users to engage in activities and make friends identified as a result of the Quality Network. Generally, good relationships have been established with families and friends, many of whom visit regularly. Concerns about weight have been successfully addressed with the support of the dietician. EVIDENCE: All service users have a communication passport developed by the Speech and Language Team that enables staff to help establish service users wishes and to involve them in day to day decisions. Records and discussion with staff show that the unpredictable behaviour displayed by one service user, which had resulted in her being stopped from attending the day centre, had significantly reduced. Plans for her to return to the day centre were in hand. On the day of the inspection she appeared calm and relaxed. Records, discussion with staff and photos displayed in the house show that service users are taking part in a wide range of activities, including swimming, attending the local Fitness Centre, discos, dance group, attending church and days out. Four service users attend day services on 2 to 5 days a week. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 12 Service users are also supported in taking part in activities arranged at short notice such as visiting the cinema, having meals out and going for walks in the area. A record of activities is kept for each service user. One service user who enjoyed horse riding has had to stop this activity because of an allergic reaction. All service users have an annual holiday. This year the home closed for a week allowing staff to take 4 service users away. One person went on holiday with her family during this period. Records and discussion with staff show that good relationships have been established with families and friends. A number of families visit frequently and contact with her family has been significantly improved for one service user. Staff also maintain contact with families and friends who live some distance away by regular phone calls and letters. Unfortunately relationships with one family member continue to be strained. A family forum to involve families and carers in the development of the service has been planned. Some restrictions are placed on service users where identified in risk assessments. The front door is kept locked as no service user is able to safely go out alone. An assessment of the use of the kitchen has recently been undertaken by the Occupational Therapist at the request of the Advocacy Service. The OT’s assessment supports the current practice of keeping the kitchen locked when staff are not present in the area because of the risks to service users. The kitchen was clean and the fridge in good order. A cleaning schedule has ensured that a higher level of cleanliness has been maintained. An insect trap has been installed on the advice of the EHO who visited in December 2006 and other recommendations made by the EHO have been implemented. Records show that fridge and freezer temperatures are checked daily. A weekly menu for the evening meal is available. In addition staff record what each service user actually has at each meal during the day. Staff check the weight of service users regularly and referrals for assessment are made. One service user whose low weight was causing concern has put on weight. A visit on the day of the inspection to the dietician by another service user showed that she had lost weight as recommended. St Quintin Avenue, 1 DS0000010848.V310512.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 The quality of outcomes for these standards is assessed as good. Care guidelines are well written showing that staff have a detailed understanding of service users’ needs. Steps have been taken to improve the administration of medication. Health care is given a high priority and staff ensure that prompt referrals to GPs and health care colleagues are made. EVIDENCE: Each service user requires help with personal care and detailed guidelines are available. The health of two service users has caused concern to staff and referrals to Consultants have been made via the GP. Records show that health concerns are followed up and other colleagues, including the Learning Disability Specialist Nurse, are consulted. Regular appointments are made with Dentists, Opticians and Podiatrists. None of the service users is able to hold their own medication. The home has recently transferred to the Boots system, which the Deputy Manager, who takes responsibility for medication, reports is working well. Pre-printed MAR sheets are now used and these were seen to be fully completed. All staff have recently attended a 3 hour medication workshop. Medication is stored in a locked cupboard in a locked room/walk-in cupboard. Creams and lotions are St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 14 also kept in this room and are placed in locked cabinets in service users’ bedrooms as needed. The temperature of the medication room is taken daily. One service user died last year after a serious illness. He was cared for in the home with the support of staff, the Palliative Care Team and the Learning Disability Nurse. Staff received training in bereavement and loss. The Manager said that an event to mark the anniversary of his death is being planned. St Quintin Avenue, 1 DS0000010848.V310512.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The quality of outcomes for these standards is assessed as good. Steps are being taken to increase user involvement accessible documentation and regular meetings with service users, their families and other stakeholders. There is a well designed complaints procedure and staff demonstrate n awareness of the vulnerability of service users. EVIDENCE: There have been no complaints or adult protection investigations since the last inspection. Information about making a complaint is available in the main entrance and a copy of the detailed procedure is available in the office. St Quintin’s has a programme of increasing user involvement, including regular meetings with service users, families and carers and the development of more accessible documents. All staff receive training in adult protection and a copy of the local multiagency policy and procedures is available in the office. A number of service users can bruise themselves through self-injury. Any marks are recorded using body charts. Records show that staff have taken action to investigate any unexplained bruising, including in one instance discussion with the Care Manager and the service user’s family. Service users finances are audited by Look Ahead Housing and regularly checked by the Manager. The Service Manager also checked a number of accounts at her last visit. Two service users’ account books were looked at. Each was in good order, with all transactions noted and a running balance kept. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 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, 25, 26, 27, 28, 29 and 30 The quality of outcomes for these standards is assessed as good. Service users live in a spacious house that is indistinguishable from its neighbours. The building is in a good state of repair and provides a pleasant domestic environment. EVIDENCE: A tour of the building with the Manager found the home clean and tidy and in a good state of repair. All of the bedrooms were seen, including the vacant room. Service users’ bedrooms are all personalised, reflecting their interests. Displays of photos show service users taking part in a range of daily activities, as well as on holiday and on days out. Most of the bedrooms are of above average size. The sitting room on the ground floor contains a PC, which is adapted for use by service users. The Manager said that the sensory room leading off the sitting room is less well used nowadays and staff are looking at ways of making it more interesting and useful to service users. The building is generally in a good state of repair. The carpet in the hallway has been replaced. Some other floor coverings still need attention. The stair carpet remains stained in spite of attempts by staff to clean it and the hard floor in the dining room on the lower ground floor is very worn and needs to be repaired or replaced. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 17 Staff sleep-in in the office on the top floor. This is a very cramped area, with a sofa bed. Staff report that the bed is so uncomfortable that they are having to sleep on the floor. The Manager said that plans are in hand to move some of the office equipment to the loft room to create more space. The laundry room was in good order. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 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, 33, 34, 35 and 36 The quality of outcomes for these standards is assessed as good. Although there are a number of vacant posts, the staff team has continued to make progress in developing a person centred service. Staff are well supported by weekly team meetings, regular supervision and annual appraisal and have good access to NVQ training. EVIDENCE: Three staff, including the Deputy Manager have completed NVQ3. Two staff are undertaking NVQ2 and three NVQ3, either through Look Ahead’s programme or with RBKC. Discussion with a member of staff who has worked at the home for 11 months confirmed that he had undertaken an induction to the service both within the home and at Look Ahead Housing. He felt well supported at the home and commented on the relevance to the work of all the training provided, including the health and safety training, which he felt was geared to working with people with a learning disability. There are currently 3 staff vacancies. One member of staff has recently returned from maternity leave. Steps are being taken to fill the vacancies. Two staff files were looked at. These were in good order, with completed induction checklists, probationary reports, appraisals and supervision notes. The annual appraisal system is linked to pay. New staff are recruited with the help of Look Ahead’s HR Team who carry out all checks. The Manager is not provided with evidence of CRB checks, which the HR team obtain. The Registered Manager must be provided with St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 19 confirmation of CRB checks for all staff working in the home, including CRB disclosure numbers and date of check. In the case of agency staff the Manager receives evidence of CRB checks and references directly from the agency. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 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): 37, 38, 39, 41, 42 and 43 The quality of outcomes for these standards is assessed as good. Senior staff at the home know the service users well and have shown commitment to service improvement. Look Ahead Housing has a published programme of service user involvement, which is being gradually introduced at St Quintin’s. Record keeping is of a good standard. Steps are taken to ensure the health and safety of service users and staff. The absence of a Service Manager for the home until recently has led to insufficient visits on behalf of the provider taking place. EVIDENCE: The Manager and Deputy Manager, who was appointed at the beginning of the year, have both worked at St Quintin’s for a number of years and know the service users well. The Manager has completed NVQ4/RMA and is studying for a degree in Learning Disability. Records show that staff meetings take place regularly, normally weekly, and are recorded. It is recommended that all staff sign to confirm that they have read the notes of staff meetings. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 21 A programme of user involvement is being implemented, including the development of more accessible documents and the setting up of a regular family and user forum. Recording is of a good standard and service users’ files have been reviewed since the last inspection with a number of documents archived. A summary of the annual business plan for St Quintin’s is displayed in the home. All staff receive health and safety training, including refresher training. The accident/incident book showed a reduction in the number of accidents and incidents. All were recorded in detail. A fire risk assessment and general risk assessment for the building are available and are up to date. Records show that the fire alarm is tested weekly at different points. Fire drills take place 4 times a year and are recorded. Three drill have taken place in 2006 to date. The fire detection and emergency lighting systems are serviced quarterly and were last checked on 29th June 2006. Fire fighting equipment is serviced annually. The temperature of the hot water is tested at all outlets monthly. Water quality is checked annually by a specialist contractor. A new Service Manager has been appointed to the home. A detailed report of her visit in August is available. Following the departure of the previous Service Manager in March this year, no other reports on behalf of the provider are available. The Manager said that various staff from Look Ahead had visited in the absence of a Service Manager but reports of their visits had not been made. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 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 CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 2 29 3 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 2 3 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 x 3 3 2 St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 23 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 2 3 Standard YA6 YA28 YA34 Regulation 15 23 19, Schedule 2 26 Requirement Service users’ plans must be reviewed at least every 6 months. Staff sleeping-in must be provided with a bed in good condition. The Registered Manager must be provided with written confirmation of CRB checks including the disclosure number and date of check. Visits on behalf of the provider must take place at least monthly and a report made available in the home. Timescale for action 30/09/06 31/10/06 30/09/06 4 YA43 30/09/06 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 YA33 Good Practice Recommendations It is recommended that all staff sign to confirm that they have read the notes of staff meetings. St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 St Quintin Avenue, 1 DS0000010848.V310512.R01.S.doc Version 5.2 Page 25 - 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. 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