Inspection on 25/01/06 for Tewin Road (1)

This inspection was carried out on 25th January 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 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

Tewin Road (1) 19/01/09

Tewin Road (1) 24/01/07

Tewin Road (1) 02/06/05

Tewin Road (1) 14/03/05

Tewin Road (1) 18/11/04

Tewin Road (1) 11/03/04

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Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Tewin Road (1) 1 Tewin Road Leverstock Green Hemel Hempstead Hertfordshire HP2 4NU Lead Inspector Mr Tom Cooper Unannounced Inspection 25th January 2006 12:40 Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tewin Road (1) Address 1 Tewin Road Leverstock Green Hemel Hempstead Hertfordshire HP2 4NU 01442 214796 10442 244250 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) Caretech Community Service Limited Natalie Jayne Gordelier Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate 6 people with learning disability or physical disability (when associated with learning disability). 2nd June 2005 Date of last inspection Brief Description of the Service: 1Tewin Road is a respite care unit for up to six adults with learning disabilities and associated physical disabilities. In addition, two further clients may be offered day care at any one time. Service users are allotted specific numbers of nights per year, as specified by Hertfordshire County Council Adult Care Services and generally come for repeated short stays thus becoming familiar with the home and staff. Approximately sixty-five clients use the service. There are two ‘shared care’ beds provided for service users with physical disabilities. The building is an ordinary two-storey detached house in a residential neighbourhood, adjacent to parkland. Ground floor accommodation comprises the two shared care beds, a lounge, dining room, small office, laundry room and kitchen. Upstairs there are four bedrooms, two bathrooms, the staff sleep-in room and the main office. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection for the year 2005/6 under the National Minimum Standards for Care Homes for Younger Adults and the Care Homes Regulations 2001. The inspection took place on a weekday in the late afternoon and early evening. The main focus of the inspection was to check compliance with the requirements made at the last inspection and to evaluate the service users’ experience of staying the home. In addition to observing and talking with the two service users present, discussions were held with the registered manager and members of staff on duty. Documentation checked included six service users’ care plans, risk assessments, the complaints procedure and records. A tour was also made of the premises. The inspection indicated that the home was well managed with the service users enjoying their stays in the home and receiving consistent support from highly motivated staff. This is reflected in the absence of statutory requirements in this report. What the service does well: The home provides an invaluable local resource to service users and their relatives who benefit from periods of respite. The service is able to cater for the needs of a diverse and challenging group of clients. The service users continue to attend their day care placements from the home or if necessary staff provide appropriate and meaningful daytime activities for those who have no external day care provision. Staff have drawn up detailed service plans for each individual containing clear assessments of needs and the actions determined to meet them while staying at the home. Therefore staff are well informed of the varying needs and aspirations of each person. Files sampled were completed to a consistent standard and contained up to date risk assessments of relevant issues of concern. The two service users present during the inspection looked very content in the home and both said that they liked coming to stay. Staff evidently relate well to them and are sensitive to their particular needs, abilities and aspirations. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 6 The house is well decorated, furnished and equipped to a high standard and provides a safe, comfortable and homely domestic environment where service users can feel relaxed and secure. The home has an effective complaints procedure and suitable policies to protect service users from abuse, including rigorous recruitment and induction procedures. The home is effectively managed and has a well trained and committed staff team. Standards are bolstered by the company’s quality monitoring system that involves regular quality audits made by an outside contractor, monthly visits from the Service Manager and the canvassing of the views of service users and their relatives. What has improved since the last inspection? What they could do better: On the basis of this inspection, there is little the team needs to do to improve the care provided. Both staff and service users commented favourably on the home. Although the manager indicated that maintenance matters were being attended to more promptly than had been the case in the past, the introduction of a planned maintenance programme would be desirable to ensure standards in the home remain consistently high. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 7 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. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 8 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 Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 9 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 Adequate information is available to prospective service users and their representatives to facilitate an informed decision about staying at the home. Prospective service users’ individual aspirations and needs are assessed and reviewed regularly so that staff know how to work effectively to meet them. EVIDENCE: The home has a detailed statement of purpose setting out the ethos of the service, the standards of care promised and the arrangements to deliver them. This is made available to all service users and their relatives. Copies were seen in individual bedrooms. Senior members of staff carry out full assessments of the needs and personal characteristics and circumstances of each prospective service user prior to admission. This information is used when drawing up the initial care plan. Staff re-evaluate the assessments monthly and make any adjustments deemed necessary and this is recorded. Staff also seek external support from specialists or health professionals as appropriate. Service users have keyworkers in the staff team and they attend and contribute to whole life reviews, coordinated by the designated adult care services care manager. All the assessments checked on this occasion had been recently reviewed. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9, 10 Each service user’s needs are documented in individual care plan files that contain clear details of their needs and aspirations. Staff consult service users over the content of their care plans and empower them to make decisions and choices for themselves, participating in activities and taking risks that are evaluated and documented. Therefore service users can lead reasonably independent lives during their stays, with staff support provided as necessary. The home has policies that ensure confidential information is handled appropriately. EVIDENCE: Every service user has an individual care plan and a designated keyworker to provide extra individual support in the home. Six examples examined all contained clear descriptions of the major needs and personal preferences of the individual and the actions agreed to meet them to be taken by staff. Daily progress notes were on each file, relating to particular stay periods. The philosophy of the home is that the care plan belongs to the service user. The company’s policy is for the care plans to be reviewed monthly and this had taken place for all examples seen. However this seems unnecessary for those Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 11 service users who only stay infrequently. For such service users their care plans should be reviewed shortly before their next stays to free staff time for more productive tasks. Relevant risk assessments were on file, for example in respect of eating and going out into the community. Those seen were up to date. The risk assessment practice enables staff to provide appropriate support for service users to make decisions for themselves and lead reasonably independent lives when staying at the home. The company has a policy on handling confidential information. Staff are aware of the need to handle personal information about clients cautiously and only share details with outside agencies when necessary. All care documentation is held securely in the main office on the first floor. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 14, 15, 16, 17 Personal development opportunities are encouraged for all service users. Staff assist and encourage service users to make decisions for themselves and choose their activities. Service users use community services and amenities. Staff support service users to enjoy positive relationships with each other. Staff also respect and promote individual rights and encourage service users to take responsibilities in some areas. Service users have well balanced diets with any special requirements catered for appropriately. EVIDENCE: Whilst at Tewin Road service users continue to attend their outside day care placements as part of their agreed packages of care. These include attending Butterwick and Jarmans day centres, courses at local colleges or work experience placements depending on the individual. During their stays staff work with service users to encourage them to develop and maintain social, emotional, communication and independent living skills to enhance their life experiences. When they go out, service users use community facilities in the ordinary way, supported by staff as necessary. The aim is to allow them to enjoy different experiences during their stays and to act relatively independently so that the respite situation adds genuine value to their lives. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 13 There are no rigid rules in the home, however staff endeavour to follow sensible routines and encourage service users to assist them with some tasks in the home to promote independence and a sense of responsibility. Service users have unrestricted access to all parts of the home, although for health and safety reasons staff supervise activities in the kitchen and laundry. Staff devise menus each day, taking into account the known preferences and requirements of the service users currently staying. Records of food provided are maintained. Both service users said they liked the food at Tewin Road. The home caters for a variety of special diets, including halal meat diets, soft/palatable meals etc. Healthy eating habits are encouraged for all during their respite stays. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Service users’ personal, physical and emotional needs are met by reference to regularly reviewed care plans. The home has thorough procedures for ensuring the safe handling, storage and recording of medication that protect service users’ interests. EVIDENCE: All care provided is by reference to detailed individual care plans based on full needs assessments. As indicated earlier in this report these are regularly reviewed and updated. One service user spoken with said that he was satisfied with the way staff looked after him. Staff spoken with had good knowledge of the service users’ needs and were very familiar with the care planning system. They support service users with all aspects of their personal, health and emotional care as identified in the care plans, with appropriate input sought from specialists such as community nurses, GPs, dentists, opticians and dieticians as necessary. Staff provide service users with information and advice regarding general health issues. However, as the service users normally only stay in the home for short periods their medical needs are generally dealt with by the main carers/relatives and Tewin Road staff would only intervene in cases of emergency. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 15 The home has a written medication policy and follows sound procedures for the safe receipt, storage, administration and recording of drugs. Medication received into the home is securely stored in a locked cabinet in the staff sleepin room. Only trained staff may handle medication. Service users may selfadminister medication subject to risk assessments. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Service users and their relatives/representatives are encouraged and enabled to make their concerns and complaints known. Adequate policies and procedures are in place to ensure that service users are protected from abuse. EVIDENCE: There is a comprehensive complaints procedure in place, produced in an effective user-friendly format that commits the home to making a response to any complaint within 28 days. Two complaints had been received by the home since the last inspection. Documentation was available to demonstrate that appropriate and timely responses had been made to each. The two service users present declined to discuss the issue of complaints, however there was sufficient evidence to conclude that the system was operated well and the manager understood the need for effective communication with complainants and to learn from any mistakes that might be made. Therefore service users and their representatives should feel confident that their concerns would be taken seriously and dealt with appropriately to improve practice. The home has robust procedures to protect service users from abuse and harm. Staff spoken with were aware of the company’s ‘Responsible Reporting of Concerns’ policy and had a fair grasp of their obligations to respond to any suspicion or allegation of abuse. The issue of abuse awareness is covered during the induction of new staff and some staff have received formal adult protection training. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 17 Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The home provides a safe, comfortable, homely and well equipped domestic environment suitable for meeting the aims of the home set out in the statement of purpose. Service users’ single bedrooms are spacious and well appointed. Adequate toilets and bathrooms are provided for six residents. . Staff maintain a good standard of cleanliness and hygiene, involving service users in cleaning tasks as appropriate. EVIDENCE: On the evidence of this inspection the premises had been noticeably improved since the last inspection in June 2005. Several bedrooms had been redecorated and looked very smart and the lounge and dining room were in good order, with décor and flooring in good condition. Several new beds had been purchased, also a new dishwasher for the kitchen. The garden was tidy, accessible and safe, with recent repairs carried out to the fencing. The manager said that essential repairs and maintenance were currently occurring more promptly than had historically been the case but there is still a need for a Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 19 planned programme of renewal and refurbishment to ensure standards remain consistently high. A recommendation has been made. Overall the premises provide a suitably equipped domestic environment for service users to feel comfortable and at home in and there is sufficient variety of space for individuals to spend time on their own if desired. The lounge has modern television and audio equipment and all furniture is of good quality, comfortable and in good condition. Kitchen and laundry facilities are adequate to cater for six residents. Each service user has a spacious single bedroom. There are two ground floor bedrooms for physically disabled service users. Several mobility aids are provided to assist such service users during their stays, including hoists, grabrails in the bathroom and assisted beds. All areas seen were clean, tidy and hygienic. Staff were aware of good infection control procedures. The two service users present said they liked the home. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 20 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): 31, 33, 34, 36 The home is staffed by adequate numbers of experienced and competent support workers who are appropriately trained to meet the service users’ complex and changing needs. The home employs experienced support workers who have access to regular relevant training that equips them to support and care for the service users. Staff feel well supported and are regularly supervised by senior colleagues. This ensures effective staff support for service users. The home has rigorous recruitment procedures that ensure staff are fit to work at the home and protect service users’ interests. EVIDENCE: Detailed job descriptions are in place. Staff spoken with and observed at work during the inspection had a clear understanding of the aims of the home and their roles in helping to achieve them. Three staff were on duty during the inspection. The manager stated that the minimum number was two. Rotas were available to confirm adequate staffing levels. The deputy manager was away on maternity leave and one part time night post was vacant. Any potential staffing shortfalls were normally covered Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 21 by permanent staff working additional hours or by regular bank staff. Agency staff are rarely used. They undergo a basic induction before starting work. This ensures that staff on duty are always familiar with the way the home works. The home follows the company’s rigorous recruitment policies and procedures. The file of the latest recruit was examined. This contained two positive references, application form, CRB disclosure evidence and identity evidence, demonstrating that suitable vetting of staff takes place to ensure their fitness to work at the home. Staff on duty said they felt well supported by senior colleagues and received regular individual supervision, monthly for full time staff and bi-monthly for part timers. In addition, all staff have annual appraisals. Regular minuted staff meetings are held. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 22 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, 42 The home is well run in accordance with its stated aims and provides a friendly and supportive environment for service users. The manager is experienced and qualified. The company’s quality monitoring processes are used to assess the service and promote improvements in the operation of the home to the benefit of service users. Appropriate health and safety measures and safe working practices are followed to ensure that the home is a safe place in which to live and work. EVIDENCE: The registered manager has many years’ relevant experience of working with adults with learning disabilities and has obtained the NVQ4 and Registered Manager’s Award. She provides strong leadership to the team and ensures that the aims out in the statement of purpose are achieved. Staff spoken with said they felt the manager provided effective leadership and was approachable. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 23 They rated teamwork and communications as good. Handovers always take place between shifts and written communications materials seen were detailed and objective. CareTech operates effective quality monitoring systems, including regular monitoring visits by the Service Manager, and annual assessments by an outside quality assurance contractor. The home also canvasses the views of service users and their families. The information obtained from these sources is used to assist in improving the quality of the service provided. The home is a safe place in which to live and work. Staff have completed a wide range of generic and specific risk assessments; COSHH assessments are made annually and hazardous substances are kept locked away; equipment such as fire extinguishers and hoists is serviced regularly. Records showed that the fire alarm and emergency lighting had been tested frequently. Fire drills take place quarterly. No health and safety hazards were noted on touring the premises, although replacement bulb protectors should be fitted to some of the external patio lights. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 24 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 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 3 32 X 33 3 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 X X 3 x Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 25 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. 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. 2. Refer to Standard YA24 YA42 Good Practice Recommendations The home should have a planned maintenance and renewal programme to ensure standards remain consistently high. Replacement bulb protectors should be fitted to some of the external patio lights. Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Tewin Road (1) DS0000019564.V274778.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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