Inspection on 02/05/06 for Waymead Short Term Care

This inspection was carried out on 2nd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Waymead Short Term Care 08/08/07

Waymead Short Term Care 10/10/06

Waymead Short Term Care 07/12/05

Waymead Short Term Care 02/05/05

Waymead Short Term Care 15/12/04

Waymead Short Term Care 27/07/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Waymead Short Term Care St Anthonys Close Off Binfield Road Bracknell Berkshire RG42 2EB Lead Inspector Robert Dawes Unannounced Inspection 2 and 5th May 2006 11.40 nd Waymead Short Term Care DS0000031646.V293447.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 Waymead Short Term Care DS0000031646.V293447.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. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Waymead Short Term Care Address St Anthonys Close Off Binfield Road Bracknell Berkshire RG42 2EB 01344 424642 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) Bracknell Forest Borough Council Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2005 Brief Description of the Service: Waymead Short Term Care Unit provides respite care, for adults with a learning disability. The home can accommodate up to 10 service users per night. The home is registered to take service users who are male or female between the ages of 18-65 years. The service is owned and operated by Bracknell Forest Borough Council. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place over two days. Two service users, three members of staff, the assistant unit manager and the acting manager were interviewed. A tour of the premises was undertaken and records seen. Two questionnaires from service users were returned. Thirteen requirements (three carried over from previous inspections) and five recommendations were made. What the service does well: What has improved since the last inspection? Service users are more involved in the preparation of food and benefit from more flexible meal times. Service users now have the use of an accessible downstairs shower. The statement of purpose, admissions policy and medication procedures have been revised. Staff have received refresher training in key areas of their work and the quality of care plans has improved. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 6 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. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose is being amended to bring the information up to date. Records showed service users are admitted only on the basis of a full assessment. The admission procedures are currently being revised. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service user plans have improved but more detail is required in key area, including risk assessments. Service users are given a degree of choice and take some risks but there is an element of care practice which restricts their right to make decisions about their lives EVIDENCE: Records showed that the quality of care plans has improved but there is still a need for them to contain more detailed description of such areas as; service users’ emotional needs and how best to respond; what they would like to achieve; activities; individual needs; how to undertake personal care tasks; and management of identified risks. New care plan formats and risk assessments will be introduced after staff have attended person centred planning training. Regular reviews of the care plans are not taking place. Every service user has a link worker. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 10 The inspector was informed that service users contribute to the menu, have a choice of meals, helped choose how the home should be decorated and what new purchases should be made. A service user informed the inspector that he would like to go the garage/local shop on his own but is not allowed to go. In the questionnaires service users said they can do what they want to do most of the time but at weekends they have wanted to go out but it didn’t happen. The inspector was informed that a service user wanted to phone home at 9.30pm but was not allowed. Staff informed the inspector that some staff are ‘too caring’, not allowing service users to take risks or make their own decisions. For service users who do not look after their own personal money a system is in place for recording transactions and securely storing their money. The inspector was informed a regular audit takes place. The inspector was informed that staff, on occasions, do not allow service users to take risks i.e. a service user said he wanted to go to the local shop on his own but was not allowed. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 12, 13, 14, 15, 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users enjoy their meals, maintain family links and friendships, and have their rights respected. However, participation in the local community and engaging in appropriate leisure activities must be significantly improved. EVIDENCE: All the service users attend day centres during the weekdays. Questionnaires from service users said they would like to be taken out more, particularly at weekends. A service user said he complained of being kept indoors for a whole weekend. Staff said service users go to a social club on a Wednesday evening, out to town and the occasional outings. The management team said the level of staffing at weekends makes it very difficult to take service users out unless the group has similar interests and they are compatible. They are trying to develop a system where service users who are admitted are more compatible than they used to be so shared activities and Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 12 outings can be arranged and they can make friendships and have people in common to relate with. Questionnaires from service users said they would like more activities; ‘sometimes it is a bit boring’. A service user said he used to play snooker when he came but the table is now broken. Activities listed in the pre inspection questionnaire are very limited and basic, i.e. cooking, videos, play station, karaoke etc. The management team said they want to develop greater variety in and out of the home, particularly for the younger age group. There are more activities going on than in the past but they are still not meeting individual needs. There is also no planning of activities before a service user comes in for respite. Relatives and friends can visit the home at any reasonable time. Two service users who are boyfriend and girlfriend are allowed to spend time in each other’s rooms. Service users were observed freely moving about the home as they wish and choose whether to mix with other service users. A service user said he helps with food preparation. There are clear rules on smoking and alcohol consumption in the home. Service users said they enjoy the food, they have a choice and can help with the preparation. Staff were observed to assist service users appropriately with their meals. The management have made meal times more flexible. Service users, if they are able, now go into the kitchen to choose what food is put on their plates and they can choose where to eat their meals. Service users can help themselves to soft drinks, and now use glass and china cups/mugs instead of plastic ones. The menus showed a variety of nutricious meals were on offer. Service users said they contribute to the menu. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users said they enjoy coming to the home. They can sleep in as long as they want at weekends. Staff are kind, patient, helpful and respectful. Service users in the questionnaires said staff usually treat them well and act on what they say. Staff were observed to treat service users in a caring manner. As service users are only resident for short periods of time the main responsibility for their healthcare needs rests with their relatives/carers. Should they need outside medical support it is arranged or relatives are contacted. Service users’ health needs are discussed at hand over meetings and staff meetings. A visit by the pharmacist inspector in January 2006 concluded the medication process was satisfactory and no requirements needed to be made. The majority of staff have received medication training. There has been one recent medication error which management has addressed. The medication records Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 14 were in order. Photos of service users still need to be attached to all individual records. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users know how to voice their concerns and make a complaint. Staff know how to respond to possible abuse. Recently, service users have not been protected from abuse. EVIDENCE: There is a complaints procedure in place. Service users said they would talk to a member of staff or the manager if they had a complaint. ‘Complaints leaflets’ explaining how to make a complaint and complaints forms in a picture format are in the foyer. They are also given to service users and their relatives when first admitted. Procedures for responding to suspicion or evidence of abuse are in place. Staff have received ‘protection of vulnerable adult’ training. Staff know how to respond to allegations and suspected incidents of abuse. In the last few weeks there have been two incidents of abuse and one alleged abuse. Management have responded according to the procedures. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 24, 26, 27 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Much needed decoration and refurbishment of the home is taking place. All bedrooms must have the equipment to promote their independence. EVIDENCE: Many areas of the home are shortly to be decorated and refurbished. The management team want to take the opportunity of making the home less institutional and more flexibly used. In some of the bedrooms there were no bedside lights, none had a portable TV and insufficient fans were available in hot weather. A service user said his bed was comfortable. In response to an Occupational Therapist’s recommendations one bathroom now has an appropriate shower facility and the other downstairs bathroom is to be refurbished shortly The home was clean and hygienic. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 17 Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 32, 33, 34, 35 and 36. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home has a core of experienced and knowledgeable care staff and all the permanent care staff have attended the necessary basic training courses. The organisation is operating a thorough recruitment procedure. However; only two care staff have a NVQ2 in care or above; there is too high a reliance on agency staff; there is insufficient staff on duty at weekends; staff morale is low; LDAF has not been incorporated into the training programme; and regular supervision of all staff does not take place. EVIDENCE: Staff interviewed demonstrated a good understanding of service users’ needs. The management team considers the care practices and attitude towards the service users is old fashioned. It needs to move forward to an ‘enabling’ rather than a ‘being cared for’ service in order that service users’ needs are better met. One member of the care staff has a NVQ 4 in management and the Registered Manager’s award and another has a NVQ 2 in care. There was no evidence that any relief staff or agency staff had a NVQ in care. Records show the home has an acting manager, 2 assistant unit managers, 4 care officers, 1 care assistant, 2 night staff, a driver/handyman, an administrative assistant and 3-4 relief care staff. The permanent care staff have worked at the home for between three and eighteen years. When 10 service users are resident in the home 3 care staff are on duty. One service user has his own member of staff when he is a guest at the home, so there is Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 19 then 3 staff for 9 service users. Staff said there are not sufficient staff at weekends to respond to the service users’ individual needs. Questionnaires from service users said they could not go out some weekends and spent the whole time in the home. There is a high reliance on agency staff which the inspector was informed is not satisfactory because; some work well while others do not; time has to be taken inducting them; they don’t know routines or the service users; and service users do not see familiar faces. Staff informed the inspector that morale has not been good for at least 18 months. Some of the reasons given were; agency staff being paid more than permanent staff; the difference in pay between RCO 1 and 2 grades with no difference in responsibilities; uncertainty about the future; the manager being on long term sick leave; poor communication and lack of permanent staff. There is a high level of sick leave. Staff records seen demonstrated the organisation is operating a thorough recruitment procedure. To ensure the home employs the agency worker allocated to them the inspector recommended all agency workers produce photo identification when they start at the home. Records showed all the permanent care staff have received basic training i.e. first aid, adult protection, manual handling, food hygiene. The majority of staff have also received training on dementia care, medication and physical intervention. Fire training and person centred planning training has been arranged. LDAF has not been incorporated into the training programme. No staff had attended training on communication techniques. The extent of training undertaken by agency staff is not known. It was recommended the profile of agency workers show the training they have received. Relief staff have undertaken basic training but records did not show they have received the necessary refresher training. Some staff said they had received epilepsy and diabetes training but this could not be confirmed on the training profiles. One member of staff said she ‘had not been supervised for ages’. Another member of staff said it was a long time since she had had supervision. Another member of staff said she was receiving supervision at least every two weeks. Relief staff rarely have supervision and regular agency staff never. Team meetings take place every Wednesday but only those on duty attend. Minutes of the meetings are taken and can be read by all the staff. The management team reviewed the supervision policy in April 2006 and when the second assistant unit manager returns from sick leave regular supervision of all staff will start. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 37, 38, 39, 41 and 42. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The acting manager has tried to introduce new working practices but has not been able to effect all the necessary changes. Staff say that communication is poor and they do not feel involved in the processes of running the home. There is no quality assurance and quality monitoring system in place. The standard of record keeping has improved but requires further improvement, i.e. photographs of the service user on the individual files. The necessary health and safety checks have taken place except for the required frequency of fire drills. EVIDENCE: The home has experienced a long period without a registered manager in post. The current acting manager has moved from his job as day centre manager on two occasions to manage the home and has currently been acting manager for 6 months. The organisation is in the process of trying to recruit a new manager. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 21 Staff interviewed said they were not clear about the changes that management want to bring in. They have been told about specific changes such as more activities and meal times being more flexible but not the broader picture or the reasons why. They have also had no formal discussion about the long-term plans for the home and community care. They said, ‘there is a them and us split’; ‘directions are issued from above’; ‘feel unimportant’; ‘morale poor’; ‘loose interest’; ‘just a pawn’; ‘not given any guidelines about what to do’; ‘know the service needs updating but not why and how’; ‘would like to be more involved’; and ‘have more of a say’. The acting manager said he has experienced great difficulty in bringing in more modern care practices that respond to the individual needs of the service users. Annual financial and safety audits take place by an outside individual. There is no quality assurance and quality monitoring system in place. No annual development plan has been produced. Regulation 26 visits take place. The acting manager tried to start a relatives group but lack of interest resulted in it not taking place. The management team is in the process of improving the standard of recording in care plans, risk assessments and handover records. Individual files did not have a photograph of the service user. The majority of health and safety checks and inspections are taking place as required except for fire drills which are not taking place twice a year. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 2 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 1 34 3 35 2 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 1 14 1 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 1 1 1 X 2 2 X Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 23 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 YA6 Regulation 15 Requirement Care plans and risk assessments must contain more detail in key areas of a service user’s care. (Outstanding from 02/08/05 inspection) Care plans must be reviewed at least every six months. (Outstanding from 02/08/05 inspection) Service users must be enabled to make more decisions about their care. Service users must be consulted about their social interests and enabled to engage in local and community activities. Service users must be consulted about the programme of activities arranged for them. More care staff must be enabled to achieve a NVQ 2 in care or above. To consider the future capacity and resourcing of the service at weekends. LDAF to be incorporated in the staffs’ training programme. Regular supervision of all staff to take place Effective communication DS0000031646.V293447.R01.S.doc Timescale for action 31/08/06 2. YA6 15 30/09/06 3. 4. YA7 YA13 12 16 31/08/06 31/08/06 5. 6 7 8 9 10 YA14 YA32 YA33 YA35 YA36 YA38 16 18 18 18 18 10 31/08/06 31/12/06 30/09/06 30/09/06 31/08/06 31/08/06 Page 24 Waymead Short Term Care Version 5.1 11 12 13 YA39 YA42 YA41 24 23 17 between management and care staff to be developed to enable staff to feel involved and carry out their responsibilities and the necessary changes. A quality assurance and quality monitoring system to be developed. Fire drills to take place at least twice a year. Individual files must have a photograph of the service user. (Outstanding from the 07/12/05 inspection) 30/09/06 31/07/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA14 YA20 YA26 YA34 YA35 Good Practice Recommendations Repair the pool table. Photos of service users to be attached to all individual medication records. All the bedrooms should have bedside lights, fans available to offer service users in hot weather and portable TVs if service users are unable to bring their own. All agency workers produce photo identification when they start at the home. The profile of agency workers includes the training they have received. Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Waymead Short Term Care DS0000031646.V293447.R01.S.doc Version 5.1 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. 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!