Inspection on 22/11/05 for Strathleven Road, 94

This inspection was carried out on 22nd November 2005.

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

The inspector found 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Strathleven Road, 94 23/08/07

Strathleven Road, 94 15/05/06

Strathleven Road, 94 08/07/05

Strathleven Road, 94 02/03/05

Strathleven Road, 94 19/11/04

Strathleven Road, 94 06/03/04

Strathleven Road, 94 12/02/04

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 Strathleven Road, 94 Brixton London SW2 5JF Lead Inspector Ms Rehema Russell Unannounced Inspection 22nd November 2005 14:00 Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Strathleven Road, 94 Address Brixton London SW2 5JF 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) 0207-738 4004 Southside Partnership Mr Mark Wallis Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 places - one of which is used for respite care Date of last inspection 8th July 2005 Brief Description of the Service: 94 Strathleven Road is purpose built home that is fully wheelchair accessible and situated in a residential area close to a major shopping centre. It is managed by a voluntary organisation called Southside Partnership. The home is close to local shops and buses, and is a short walk from a large shopping centre with full community and public transport facilities. There is metered on street parking around the home. There is a paved area at the front of the house and a good-sized garden at the rear of the property. The accommodation is all on the ground floor with six single bedrooms, each with an en suite toilet and wash hand basin. One of the bedrooms is used by two clients on a shared care basis for different days of the week. At the time of inspection there were no vacancies at the home. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out during an afternoon and early evening in late November 2005. The inspector spoke with the acting deputy and several support workers, observed service users, toured the building and looked at documentation and records. A lot of improvements had been made since the previous inspection and the acting deputy and staff facilitated the inspection well. What the service does well: What has improved since the last inspection? 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. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 6 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 Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 7 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 and 3 An up to date Statement of Purpose is available at the home. The home obtains full pre-assessment details from relevant professionals but does not have its own internal assessment on file. Service users are able to benefit from an independent advocacy service. EVIDENCE: The previous inspection report required that an up to date Statement of Purpose be made available at the home and this had been implemented with the Statement of Purpose seen at this inspection. The previous report also recommended that the home ensured that residents had access to the services of an independent advocate. This recommendation had been implemented. An independent advocate who specialises in advocacy for this client group had been contacted and was due to meet with the manager, and advocacy training had been made available for early 2006. Two service users files were examined to ascertain whether prospective service users’ individual aspirations and needs are assessed. All service users have been at the home for several years and so there were no new admissions that had been undertaken by the current staff group and the files looked at referred to admissions from the past. It was found that full and detailed information about prospective service users’ needs had been obtained from all relevant professionals and previous placements, including guidelines and risk assessments, but that neither file had an assessment carried out by Strathleven Road. However the acting deputy has undertaken assessment Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 8 training and devised an assessment form and this will be used in the future for any prospective new placements. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 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 and 9 Service users’ assessed and changing needs are reflected in their individual plan. Service users make decisions about their lives, with assistance as needed, within the limits of their cognitive impairments. Risk assessments are present and reviewed. EVIDENCE: Care plans were checked at the previous inspection and a requirement was made for all care plans to be regularly reviewed and to be organised and well kept. At this inspection it was found that care plans had been put in order and that they were being reviewed every six weeks by key workers. This was evidenced by written key worker meeting notes, which were very thorough. A requirement was also made for handover notes to be sufficiently informative. Progress had been made on this, with a new form devised which refers to the daily notes, but on three files there were still handover notes on several shifts or even whole days that were missing. A recommendation has therefore been made in regard to this. It was found at this inspection that the local authority had failed to carry out the annual statutory reviews of service users’ placements. It is recommended therefore that the manager writes to the local authority requesting that the annual reviews are carried out, retaining a copy of the letter and any response received. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 10 The previous inspection report also required that all risk assessments were present on file and that the existing ones were reviewed and brought up to date where necessary. The inspector was told that this had been done and evidence of updated risk assessments, signed and dated by key workers, was seen. All service users at the home have limited cognitive abilities and only one can verbalise more than a few simple words. Staff therefore assist service users to make choices/decisions by interpreting their behaviours. Staff have gained as much information about service users likes and dislikes from their families and as a team have planned how to distinguish whether service users are happy or sad, primarily by their behaviours. Examples were given of this and were observed during the inspection. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 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): 13, 14 and 17 Service users are part of the local community and engage in appropriate leisure activities but their access to the community and to activities is limited in evenings and holidays by staffing levels. EVIDENCE: Service users are encouraged and supported to be part of the local community by visits to the cinema, pubs, restaurants, recreation centres, shops, churches and local events. The previous inspection report also noted that service users are supported to engage appropriate leisure activities. However, at times when all service users are in the home, such as in the evening and during college half-terms and holidays, current staffing levels only permit the accompaniment out of one resident at a time and this therefore restricts service users’ choice and freedom in regard to access to the community and to outside leisure activities. This will be referred to in the Staffing section later in the report. The previous inspection report made a requirement that accurate records of daily menus were to be kept. This had been temporarily implemented by a record of each service users’ daily meals being kept in handover notes, and the Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 12 acting deputy had devised a new form that would be used for this purpose from December 2005. Standards 11, 12, 15 and 16 were assessed at the previous inspection and were all found to be met. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 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): 19 Service users’ health care needs are met. EVIDENCE: All service users are registered with a local General Practitioner with the exception of the two shared-care service users who each have their own GP. Each service user has a record of health appointments in the handover file and these evidenced that service users are supported to access the full range of healthcare professionals such as the dentist, district nurse, optician, chiropodist, speech therapist and physiotherapist. In addition, all service users are supported to see an aromatherapist, which their reactions indicate that they enjoy. Standards 18 and 20 were assessed at the previous inspection and were both found to be met. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 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 and 23 The home has a thorough complaints system. EVIDENCE: The previous inspection report required that a central complaints book be kept at the home and this had been done. All other aspects of the complaints procedure and practice at the home had been assessed at the previous inspection and found to be met. The home has an effective abuse policy and all staff have undertaken relevant training. Staff spoken with were aware of the different types of abuse and how to respond to any suspicions. The home has a copy of the recently published Adult Protection procedure of the local authority in which it is situated, and the whole team recently attended a talk by the local authority’s adult protection officer. At the time of the inspection there had been two allegations made at the home, which are in the process of being investigated. The correct procedures were being instigated and followed by the Registered Provider. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 15 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, 26,27,28,29 and 30 Residents live in a homely, comfortable and safe environment, with bedrooms that suit their needs and lifestyles. The home is generally clean and hygienic but there are some maintenance and re-decoration issues and the kitchen remains in need of refurbishment. EVIDENCE: The previous inspection report found that although the home was generally safe, comfortable and homely, and bedrooms were personalised and suitable to individual service user’s lifestyles, there were several repair and maintenance issues. Requirements were therefore made in regard to certain bedrooms, bathrooms and the lounge. At this inspection it was found that the majority of these requirements had been implemented, with only one requirement still outstanding (ventilation in the second bathroom) which was in the process of implementation. The previous inspection report also made a requirement that all environmental adaptations and disability equipment at the home be brought up to date to meet the current assessed needs of service users. This had been Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 16 implemented, with equipment serviced or replaced and with two service users in the process of having their wheelchairs replaced or improved. A further requirement made at the previous inspection was for the kitchen to be refurbished. The revised target date of 31st July 2005 had not been met but the kitchen units had eventually been refurbished by the Housing Association. Unfortunately however the unit drawers are not well made and one has already broken. A new requirement has been made for this to be repaired. Another requirement has been made for the freezer to be repaired/replaced as the door jams once it has been opened and there are several internal compartment covers broken and missing. A new requirement has also been made in regard to one of the bathrooms. This bathroom is the main one used for service users as it has special adaptations and a bath that could be moved up and down. Unfortunately, maintenance carried out by contractors working for the Housing Association has resulted in the wrong pipes being installed so that the bath can no longer be moved up and down. This therefore puts the health and safety of support workers assisting service users to bath at risk and must be rectified as a matter of urgency. Although the home was found to be generally clean and hygienic throughout, at the last inspection a recommendation was made for a spring clean of the whole home to be undertaken by external cleaners. The Registered Person had attempted to implement this but the agency cleaner employed for this purpose had not carried out the work fully, and so the recommendation is repeated. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 17 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 and 35 Service users are supported by competent and qualified staff but staffing levels are not sufficient to give service users choice in regard to evening, and some day, activities. Service users are supported and protected by the home’s recruitment policy and practices and their needs are met by well trained staff. EVIDENCE: The home has met the 2005 NVQ training standard as half of the current staff, including the acting manager, have NVQ Level 2 or above. Staff spoken with also evidenced a good understanding of the physical and cognitive impairments of the service users and a strong commitment to their rights and independence. The previous inspection report made two requirements in regard to an effective staff team. The first was that the Registered Provider review staffing levels to ensure there is always sufficient staffing at the home to implement both safe working practices and appropriate flexibility to allow service users to undertake individual day and evening activities. The Registered Provider had identified the need for greater staffing numbers and was negotiating with the placing authority in regard to finance. As this situation has continued for over a year, the Registered Provider must write to the Commission to outline the timetable for increasing staffing levels. The second requirement was repeated from the March 2005 inspection report and required the Registered Provider to ensure that staff undertaking the eleven hour 1:1 shift had a significant break during Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 18 that period. The inspector was told that staff had been informed that they should take a break when the most appropriate cover staff was on duty. It is recommended that this situation is monitored for a three month period, by daily recording of the break, to ensure that the break becomes established practice. The Registered Provider has a thorough recruitment procedure but as it is a large organisation, recruitment is conducted from Head Office and records are maintained there. These will be assessed at a later time. However there was evidence of proper procedures being followed in regard to Criminal Records Bureau procedures at the inspection when a new member of staff explained that he was shadowing an established member of staff and was allowed to do only this until his CRB was received and accepted. The Registered Provider has a comprehensive and thorough staff training and development programme, with a dedicated training budget, structured induction training and individual training profile for each member of staff. In addition, the staff team as a whole are kept up to date by raising and being given information about current issues in team meetings and by having external speakers give talks at team meetings, for example recently by the adult protection office of the local authority. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 19 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, 39, 41 and 42 The home does not have a registered manager but the acting manager and acting deputy are making good improvements at the home. Service users views are sought within the limits of their cognitive disabilities. Record keeping is good and nearly up to standard. The health, safety and welfare of service users is promoted and protected. EVIDENCE: The home has not had a registered manager in post for over 8 months and a requirement was made in the previous inspection report that the Registered Provider rectify this situation by 31st October 2005. This timescale had not been met but since the previous inspection the acting manager and acting deputy had made very good progress in improving several standards at the home and the Registered Provider had ensured that two of the three support worker vacancies had been filled. The Registered Provider has informed the Commission that the Registered Manager post was subject to personnel issues but that they were confident that it would be resolved by early in 2006. The Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 20 requirement given at the last inspection, to appoint a manager and ensure that an application for registration is made to CSCI, is re-stated in this report. As previously mentioned, all service users at the home have limited cognitive abilities and only one can verbalise more than a few simple words. It is not therefore possible to canvass service users’ views on the running of the home and service provision in general but staff try to interpret this using their knowledge of service users’ preferences and needs and by interpreting their behaviours. Staff also seek the views of relatives and visitors and feed these back to management via staff and management meetings. The Registered Provider operates an externally verifiable quality monitoring and assurance system for the home, and has a Service Users’ Committee which service users can be supported to attend. The previous inspection report found that although documentation systems at the home were good they had not been maintained due to poor record keeping. It also found that the acting deputy manager had made good efforts to improve the situation, and a requirement was made for the Registered Provider to ensure that sufficient time was made available for the acting manager and deputy manager to bring all documentation and records to the required standard. This had been done and all records seen at this inspection, with the exception of handover notes referred to in Standard 6 above, were maintained and in good order. Health and safety maintenance and service records were seen. Emergency lighting, call points checking, fire drills, water temperature valves, accident and incident file, water hygiene, small electrical appliances, COSHH storage, fire extinguishers and Arjo bath services were all up to date and in good order. The annual gas safety check was overdue and the inspector was told that the Registered Provider’s housing section was aware of this. Gas safety checks must be carried out annually and a requirement has been made in regard to this. The Registered Provider must also ensure that the water temperature gauges are checked as the water in one bedroom en-suite was tepid and did not reach the required temperature. Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 1 2 2 2 LIFESTYLES Standard No Score 11 X 12 X 13 2 14 2 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 1 3 4 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Strathleven Road, 94 Score X 3 X X Standard No 37 38 39 40 41 42 43 Score 2 X 3 X 3 2 X DS0000022759.V257842.R01.S.doc Version 5.0 Page 22 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 YA27YA29 Regulation 23(2)(c) Requirement The Registered Provider must ensure that the moveable bath is in working order as a matter of urgency. The Registered Person must ensure that the drawer unit in the kitchen is repaired satisfactorily. The Registered Person must ensure that the freezer is repaired/replaced. The Registered Person must write to the Commission to outline the timetable for increasing staffing numbers. The Registered Person must ensure that there is an experienced and permanent manager in post and that an application for registration is made to CSCI. Previous timescale of 31/10/05 not met for personnel reasons. The Registered Person must provide evidence of the annual gas safety check for 2005 and must check that the water gauges in the home are all in good working order. Timescale for action 28/02/06 2 YA28 23(2)(b) 28/02/06 3 4 YA28 YA33 23(2)(b) 18(1)(a) 28/02/06 01/03/06 5 YA37 CSA 01/03/06 6 YA42 12(1)(a) 28/02/06 Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA2 YA6 YA6 Good Practice Recommendations The Registered Person should ensure that a full internal assessment of need is undertaken for all future new placements. The acting manager should ensure that handover notes are maintained for every shift. The acting manager should writes to the local authority requesting that the statutory annual reviews are carried out, retaining a copy of the letter and any response received. The Registered Person should ensure that a spring clean of the whole home by external cleaners is undertaken. The Registered Person should ensure that the break for the 11 hour 1:1 shift is monitored for three months to establish its practice. 4 5 YA30 YA33 Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 Strathleven Road, 94 DS0000022759.V257842.R01.S.doc Version 5.0 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. 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!