Inspection on 11/04/07 for Tavistock Avenue (12)

This inspection was carried out on 11th April 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tavistock Avenue (12) 26/04/06

Tavistock Avenue (12) 25/01/06

Tavistock Avenue (12) 18/08/05

Tavistock Avenue (12) 21/01/05

Tavistock Avenue (12) 20/10/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Tavistock Avenue (12) 12 Tavistock Avenue St Albans Hertfordshire AL1 2NH Lead Inspector Mrs Jan Sheppard Unannounced Inspection 11th April 2007 10:00 Tavistock Avenue (12) DS0000019562.V336007.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 Tavistock Avenue (12) DS0000019562.V336007.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. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tavistock Avenue (12) Address 12 Tavistock Avenue St Albans Hertfordshire AL1 2NH 01727 850 215 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) Cherry Tree Housing Association Miss Janet Winsett Deane Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2006 Brief Description of the Service: The home, known as 12 Tavistock Avenue is a semi-detached house in a quiet residential area of St. Albans. It is situated close to local amenities and provides personal care and accommodation for three people. These residents each have their own individual single bedrooms and share the lounge, dining room, bathroom and laundry room. There is a pleasant domestic style kitchen that overlooks the secluded rear garden and patio area. Staff have a small office and sleeping accommodation on the first floor. There are small gardens with off street parking to the front of the property. The home, which is run by Cherry Tree Housing Association, offers homely and safe accommodation and full care services for its residents who all have learning disabilities. The current fee for the residents who are all sponsored by Hertfordshire County Council is £780.44 per week. Information regarding the service is available from the Statement of Purpose and Service User Guide. The current CSCI inspection reports are available in the entrance hallway for interested parties to read. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon and early evening, all three residents were spoken with as were all the staff on duty along with the recently appointed Housing Associations new Area Manager who was visiting the home at that time. The comments in this report reflect the findings made by the inspector during that visit and also take account of information gathered over the past months from the homes manager and by way of the pre inspection questionnaires completed by all three residents and their relatives. This was a positive inspection with the entire key standards examined met. There were no outstanding requirements from the last inspection. One recommendation to further improve practice has been made following this inspection. Since the last inspection the recently appointed Manager Ms. Janet Dean has successfully completed the registration process with the Commission. The senior support worker who was in charge of the home at the time of this inspection has attained the NVQ qualification at level 3. At the time of this inspection the home had a calm, peaceful and very homely atmosphere where staff and residents were seen to be interacting very positively. All the residents told the inspector that they were very happy living there and that they had good choices about their varied interesting and enjoyable life styles. What the service does well: What has improved since the last inspection? Since the last inspection various works of redecoration, renewal and improvements to the furnishings and fabric of the home have been completed these ensuring the good and homely maintenance of the environment for the benefit of the people who use the service. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 6 A new medication storage and administration system - MDS, (monitored dosage system) has been introduced in the home. This provides greater safety and is much easier for the staff to ensure accurate administration. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Tavistock Avenue (12) DS0000019562.V336007.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 Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Admissions are not agreed until a full needs assessment has been carried out and the home is satisfied that it can meet these needs. Sufficient information is provided for prospective residents and their families to enable them to make an informed choice about admission. EVIDENCE: One new resident has been admitted to this home since the last inspection. He told the inspector that he had been given good opportunities for a gradual introduction to the home where he said that he now felt very comfortable. He said that he made several introductory visits, which enabled him to meet the other residents, one of whom he had already known for some years. He commented that he was very pleased that he was able to bring his cat with him and that he liked his room. The homes paper work pertaining to his admission evidenced that the home had followed its policies and procedures and had taken time in assessing the compatibility of the new person with the existing residents. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 9 The existing residents have the required information about the home including a Tenancy Contract, a Statement of Terms and Conditions and the Service Users Guide. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The home maintains good quality care plans for each resident. Appropriate procedures are in place to ensure the safety of the people using this service both inside and outside of the home. People using this service are given every encouragement to make as many decisions about their own lives as it is safely possible for them to do. EVIDENCE: All the care plans were examined and were found to be very well maintained with good detail as to the manner in which care needs should be met to best meet the wishes of the individuals concerned. Changes in care needs were carefully recorded and regular reviews were planned ahead and also appropriately recorded. Although there was evidence (this confirmed by the residents to the inspector), that they were always involved with their care plan reviews this could not be formally evidenced as they did not sign the review. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 11 Risk assessments for activities both external and internal to the home were regularly updated. These activities were focusing on the promotion of independence for the resident always within safe limits. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. Residents in this home are able to make individual choices about the good quality food that is freshly cooked for and by them each day. Their diverse social and activity interests and needs are very well supported. EVIDENCE: The residents all have individually planned day activity programmes, which offer them the opportunity for personal development alongside peers of a similar age and ability. These activities encompass three or four weekdays and several evenings. In addition there is a regular pattern of weekend outings and one resident enjoys regular weekend visit staying with his family. Another resident is able to make their own bus journey to college to attend classes whilst another is able to make unaccompanied visits to the city centre for shopping and to attend a church social club. The third resident is assisted by Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 13 the staff to access the city facilities and shops and one such visit was made during the time of this inspection. Two residents told the inspector of their recent visit to the Hendon RAF museum (taken by a staff member in their car) and anther spoke very positively about the golf and tennis activities that he now participates in. The residents spoke in an empowered manner as to how these visits are decided upon and planned by them. They shared with the inspector their current discussions about choices for a summer holiday and staff confirmed that so as to adequately meet individual wishes and needs it was likely that three separate holidays would be taken with staff accompanying each individual. One resident talked to the inspector about his continuing involvement with two local churches where he enjoys attending services and social events amongst many friends and acquaintances. Another resident explained to the inspector his involvement with the care of the homes pet rabbit and two residents talked of their plans for summer gardening their tomatoes in pots having been very successful last year. Over the past year staff have worked very hard at increasing the range variety and times of activities that the residents access this to adequately meet their changing needs and interests in an individually stimulating way. The residents plan their weekly menus and usually one resident will accompany a staff member to the local supermarket to do the weekly shop. Good attention is paid to a healthy eating regime and residents confirmed that they continue to keep on track with their weight reduction and maintenance programme commenced last year. Following suggestions and preferences expressed by the new resident a number of new dishes have been introduced and residents confirmed to the inspector that they are able to make changes to the planned dish choices for the day if they wished and that the timing of their meals was arranged to suit their particular day activities and they were not restricted to a set meal time. The residents freely accessed bowls of fresh fruit and yogurts kept in the fridge during this inspection without any reference to staff. A kitchen cooking and cleaning rota is compiled weekly by the residents this also involving the staff. The residents told the inspector that they enjoyed eating out as a group and that they sometimes did this with the residents from the associations other near by home. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. The residents receive effective personal and healthcare support following a person centred care planning approach. Robust and safe medication administration and storage procedures are in place to protect the people who use the service. EVIDENCE: The residents all told the inspector that they were happy with the manner in which they received help and care. Staff were observed to be offering care only when it was needed allowing the residents to do as much for themselves as was safely possible and thereby meeting both physical and emotional needs in a safe manner. One said, “ carer X is very kind and understanding I can talk to her and ask her anything”; another said, “If I didn’t like anything I would say”; and another “ Carer X has helped to make my unaccompanied journeys to college which I do like doing”. Staff always accompanies residents to visit their doctor in his surgery rather than asking the doctor to make a home visit. The care records reviewed Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 15 showed that the residents have regular access to chiropodists, opticians and dentists. One resident told the inspector of the general improvement he felt to his wellbeing following the fitting of his hearing aid. The home is well supported by District Nurses and by the Community Mental Health Nursing Service when needed. Staff discussed with the inspector the provisions that had been made to prevent an existing pressure area suffered when the resident was admitted to the home did not further deteriorate. These measures which included regular input from the District Nursing service and the provision of specialist equipment led to a quick improvement. A new medication system, the MDS monitored dosage system has been introduced into the home since the last inspection. All the staff spoke entirely positively about these new arrangements for which the whole team received the appropriate training from the supplying chemist who also makes regular follow up check visits. The systems for ensuring that the residents receive their prescribed medication safely and on time were found to be in order. The medication storage facilities meet the current needs of the service and comply with the requirements of the royal pharmaceutical society. The management must ensure that the required storage facilities for any controlled medication, which may be prescribed, could be quickly accessed and properly installed in the home to ensure safety and compliance with the requirements concerning the storage of this level of medication. The staff discussed with the inspector the arrangements that they had made to enable one resident to self administer some of his medication; these were seen to be satisfactory with appropriate risk assessments in place and have enabled the resident to further develop his independence and self caring abilities. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The complaints policy and procedures are known and understood by the people who live there. The policies and procedures concerning Adult Protection and Whistle Blowing follow the guidelines given in the Hertfordshire County Council Adult Protection Joint Agency procedures. EVIDENCE: There have been no complaints since the last inspection. Residents spoken with confirmed to the inspector what actions they would take if they had any concerns or complaints about anything. One said “ I would just tell my carer and I know that she would sort it out”. Questionnaires received from the residents relatives stated that they understood how to access the homes complaints procedures if they ever needed to do so. One incident that has occurred since the last inspection and that arose outside of the home, concerning Adult Protection was dealt with promptly and professionally by the staff following the joint agency guidelines. Continuing support is being offered to those concerned in an appropriate manner. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The home provides a homely, safe and comfortable environment where the accommodation meets the residents physical and social needs and the facilities provided are suitable to enable the appropriate care to meet their assessed needs to be given. EVIDENCE: This home benefits from an ongoing and planned maintenance and refurbishment programme so that it continues to have the appearance of a homely lived in domestic environment for the benefit of the people who use the service. The standard of decoration throughout the home is good and well maintained with scuff marks in some areas being attended to on an on going basis. The residents are always involved in the choices of new colours soft furnishings and curtains etc. The residents were all happy to show the inspector their individual bedrooms, which have been all individually personalised by them to reflect their tastes and interests hobbies etc. One Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 18 resident has a large Video collection another has many sports posters in his room whilst the third has musical instruments and various items concerning the care of his cat. All the bedrooms meet or exceed the required space size, one south facing room is fitted with an air conditioning unit, and none have fitted washbasins. The recently refurbished bathroom with new power shower is much liked by the residents who told the inspector appreciatively of the effectiveness they get from this shower and the great improvement it is on the previous one. The shared spaces of the lounge and dining room are comfortably furnished and contained evidence of individual items belonging to each of the residents. On the day of this inspection the home was found to be clean and hygienic and appropriate risk assessments are in place to ensure the safety of the building. The Fire Service has recently carried out an inspection from which no requirements were made. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The service continues to retain a stable experienced and well-qualified staff group who work well together as a team. People who use this service are protected by the homes safe recruitment policy and practices. EVIDENCE: The main staff group has remained entirely stable since the last inspection and many have worked at the home for many years. These staff are all very experienced workers who all hold an NVQ qualification at either levels 2 or 3. They know the residents very well and have a through understanding of their care needs and how these should best be met to suit each individual. All staff have over the past year attended a variety of training courses including medication storage and administration, Food hygiene, Health and Safety, First Aid, Moving and Handling, Fire Awareness and Macketon training. Since the last inspection a younger male carer has successfully recruited, this was being done to meet the specific needs of this male group of residents. The paperwork and records relating to this recruitment evidenced that the Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 20 procedures were followed correctly to ensure the safety of the residents. This new member of staff had clearly made a great hit with the residents one of whom told the inspector of all the new activities that his appointment had enabled to be introduced. The new worker described himself as working very happily at the home was delighted with the fact that he had already completed an induction training and was thereby able to commence his NVQ level 2 course and said that he was very well supported by all the staff but particularly by his training mentor. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The management and administration of this home is based on openness and respect. The managers are qualified and have appropriate experience. EVIDENCE: On the day of this inspection the home was found to be running calmly and smoothly according to its policies and procedures and the aims and objectives as set out in its statement of purpose and service users guide. A number of the homes records were examined including weekly random water temperature checks, records of the fire alarm testing, monthly health and safety checks and monitoring of the food storage arrangements in the kitchen fridge freezer. This record keeping was found to be of a consistently high Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 22 standard thereby promoting the health safety and welfare of the people who use the service. Appropriate records of money kept on behalf of individual residents are maintained so that residents are confident it is being kept securely. Accidents to residents and staff are recorded and reported to the Commission under the health and safety legislation as required. The homes new manager has since the last inspection been registered by the Commission. She is studying for the NVQ level 4 and the Registered Managers Award. The senior carer at this home, who is usually responsible for its day to day running, has already obtained her NVQ at level 3 and is now completing the Assessors Award. Since the last inspection she has also attended training on staff supervision and appraisal writing. The records examined evidenced that staff all receive regular supervision and an annual appraisal. Regular staff meetings are held of which adequate records are kept. Monthly unannounced visits by the Associations managers / directors, these to comply with regulation 26, are made and properly recorded. A Quality Assurance programme is in place whereby residents, relatives and stakeholders in the home are regularly asked for their views and evidence of the programme for 2007, which has just commenced, was shown to the inspector. The Association compiled a report of the findings of the previous quality survey and a copy sent to the Commission. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 YA6 Good Practice Recommendations Having been involved with the compiling and review of their own care plans residents should be encouraged to sign them. Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Tavistock Avenue (12) DS0000019562.V336007.R01.S.doc Version 5.2 Page 26 - 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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