Inspection on 02/08/06 for Webb Road (1a)

This inspection was carried out on 2nd August 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Webb Road (1a) 08/12/08

Webb Road (1a) 23/08/07

Webb Road (1a) 16/02/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Webb Road (1a) 1a Webb Road Blackheath London SE3 7PL Lead Inspector Lorraine Pumford Unannounced Inspection 2nd August 2006 13.00P Webb Road (1a) DS0000066976.V306515.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 Webb Road (1a) DS0000066976.V306515.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. Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Webb Road (1a) Address 1a Webb Road Blackheath London SE3 7PL 020 8858 8918 020 858 8918 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) The Avenues Trust Limited Mr Olugbenga Olaose Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 Brief Description of the Service: 1a Webb Road is a residential care home for six younger adults with both physical and learning disabilities. It is a modern chalet style detached building near to Greenwich Park and Blackheath Village. Since the last inspection the registered provider has changed and the new care provider is Avenues Trust Limited. The home currently provides care and accommodation for three female and two male residents. Accommodation is provided on two floors. Bedrooms are on the first floor and communal areas on the ground floor. A passenger lift enables residents to access all areas of the home. To the rear of the property is a raised garden. This has steps with support rails leading to a gazebo. French windows open from the lounge onto the rear garden. Parking space is provided to the front of the property. Residents are supported to attend day centres, to access local leisure facilities and maintain family contacts. A mini bus is provided to enable residents to access external services and activities. Staff have established links with the local Community Learning Disability Team, the local Speech and Language Therapists and Occupational Therapists who support them to meet the needs of the residents. Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first inspection since the change of ownership of the home. One inspector was in the home for approximately 3.5 hours. During that time the staff on duty assisted with the inspection. The manager returned briefly from another home he is managing on a temporary basis for the Avenues Trust. The Service users accommodated have profound learning disabilities and therefore their ability to verbally contribute to this inspection was limited. A number of documents and records were examined, some specifically relating to the care of two service users and two members of staff, one of whom has been recently employed. Additionally parts of the premises were inspected. Prior to this inspection taking place service users representatives were given the opportunity to complete questionnaires; at the time of writing this report none had been returned. Fees for the home are currently £ 1329 to £1391 per week. What the service does well: Risk assessments are in place that safeguard service users and promote their independence. Residents are provided with relevant social and leisure activities and a varied nutritional diet. There are sound procedures in place regarding the storage, recording and administration of medication to service users. Service users are enabled to maintain contact with family and friends. The home operates a key worker system and staff clearly understand the additional responsibility of this role. Staff were seen to assist service users in a calm unrushed manner, which respected service users’ privacy and dignity. It was evident that care staff Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 6 provide support to service users to enable them to attain an individual and personal identity. Service users are provided with appropriate community health care support. Staff are offered good training opportunities to develop the skills required to care for the service user group accommodated. What has improved since the last inspection? What they could do better: The care plan format needs to be reviewed to provide clear guidance for staff on how to meet individual service users’ assessed needs. The responsible person needs to ensure they can provide evidence that robust recruitment procedures are in place in order to protect service users in the home. The provider needs to take responsibility for maintaining good standard of furniture and furnishings in service users’ bedrooms and to ensure appropriate action is taken to eradicate the smell of urine in the lounge and first floor landing. The manager needs to ensure that the staff rota maintained is an accurate reflection of staff working in the home. The provider needs to ensure that staff records kept in the home comply with Schedule 2 of The Care Standards Act 2000. Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 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. Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 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 Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 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): 1,2,4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are given the opportunity testdrive the home. Service users’ advocates should also be provided with information regarding the Avenues Trust who have recently taken over the operation of the home. EVIDENCE: The Avenues Trust has prepared a new Statement of Purpose and Service User Guide and copies of these have been given to service users. Staff confirmed that none of the service users residing at Webb Rd would be able to understand these documents Therefore a copy of these documents should also be given to relatives or service users’ advocates. Generally the service user group has remained stable for a number of years so it has not been necessary for staff working in the home to complete a preadmission assessment. However staff confirmed that this would be undertaken when required and any admission would be phased over a number of weeks, with opportunities for the prospective service user to meet other residents and staff before being offered a place on a trial basis. Webb Road (1a) DS0000066976.V306515.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are not provided with clear up-to-date written information on action to be taken by them to meet the health and care needs of service users. EVIDENCE: The sample of care plans seen were pictorial, staff stated this was the format used by the previous owners of the home. Staff stated that the format would be changing soon to that used by the Avenues Trust Ltd. Discussion took place regarding the need for the care plan to clearly identify the service users’ assessed needs, with clear guidance for staff on actions to be taken by them. Each service user has a diary which staff maintain on a daily basis recording health, activity and general demeanour. In addition staff are recording detailed information about service users in the shift leaders book; discussion took place with staff regarding this practise as they are spending additional time duplicating information. The practise also raises issues regarding Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 11 confidentiality, as information regarding a number of service users is recorded on the same page. Risk assessments were seen to be in place which promote independence and safety; for example, these had been completed for service users in relation to transport and activities outside the home. Staff stated that a key worker system operates. Staff spoken with were able to provide very clear evidence of the way in which they both support and promote service users independence on a daily basis. Discussion took place with staff regarding service users’ decision making in the home. It was apparent from meeting with some of the service users that they have very limited ability to make decisions for themselves. However the inspector was informed that in addition to televisions, videos, etc, service users had chosen to purchase a number of items of furniture such as beds and wardrobes as their personal savings had built up. Records seen indicated there were also instances when service users had also paid for pillows, carpet and a chest of draws. Discussion took place with the manager around the fact that standard furnishings should be paid for by the Avenues Trust unless service users or their advocates are able to express a wish to upgrade and purchase basic items for themselves. Staff stated that all service users residing in the home needed some support in managing their finances and personal allowance. Service users benefits are paid directly into individual named personal accounts. Service users personal allowances are held in individually named envelopes, the sample examined indicated that service users personal allowance tallied with the house records. Staff stated that to further safeguard service users’ money the signatures of two named members of staff are required to withdraw money from service users’ accounts. Webb Road (1a) DS0000066976.V306515.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 The overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. It was apparent that staff endeavour to promote service users’ independence on a day-to-day basis. Residents are provided with relevant social and leisure activities and a varied nutritional diet. EVIDENCE: None of the current service user group are able to participate in employment or formal education. All the service users attend day centres on a regular basis. It was evident from discussion with staff and from records seen that service users are assisted to participate in local community activities. Staff maintain a record of social activities service users have participated in. Service users have all had a summer holiday this year. Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 13 Records seen indicate that service users are supported to maintain links with family and friends on a regular basis. It was clear from observations made and through discussions with staff that whenever possible, residents’ independence is promoted and encouraged. Generally service users were seen to have ready access to all communal areas and their bedrooms. Service users were seen to wander freely around the home and when necessary staff provided assistance to less able service users who expressed a wish to go to their bedroom on the first floor via the lift. The home benefits from having a part time cook. The menu seen indicates service user have a varied nutritional diet. Staff use pictures of food to help ascertain service users likes and dislikes. The cook confirmed that she varied the menu if the planned evening meal was not appropriate for the weather on the day or if a service user indicated they preferred an alternative to the main meal being cooked. The inspector advised that on these occasions a record needed to be kept of the alternative provided. Webb Road (1a) DS0000066976.V306515.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to regular health care. There are sound medication procedures in place which protect service users health. EVIDENCE: Service users’ care plans indicated that they visit the GP when necessary and receive regular routine health checkups. Community health care professionals, such as dentists, chiropodists and opticians, are accessed as and when required. In addition service users have access to more specialised health care professionals when needed. The service users’ GP completed a CSCI Comment Card and he stated he feels staff communicate appropriately information to him and he has never felt the need to complain. Medication is stored in a locked trolley and housed securely in a locked cupboard. Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 15 MAR sheets were being appropriately maintained, Discussion took place with staff assisting with the inspection and confirmation was given by the inspector that current practise does not require staff to indicate PRN was not required by writing a X on the MAR sheet. A record of staff signatures was being maintained; this enables persons inspecting the records to undertake an effective audit. Staff maintain a record of medication received into the home and returned to the Pharmacist for save disposal. The Community Pharmacist also undertakes regular audits of medication being stored and administered by staff in the home and provided regular training up dates. The issue of training in relation to the administration of medication was discussed with the staff. Members of staff spoken with stated they had received formal training in relation to medication procedures and had been assessed as competent to administer medication. Good interaction was seen between staff and service users; staff assisted service users requiring assistance with personal care in a manner which respected their dignity and privacy. It was evident that care staff provide support to service users to enable them to attain an individual and personal identity. Webb Road (1a) DS0000066976.V306515.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their advocates can be confident that appropriate action will be taken to address any concerns they raise. EVIDENCE: Records seen indicate a record has been kept of complaints made by relatives when the home was managed by the previous company. Staff stated they have received no complaints since the Avenues Trust took over the day-to-day management of the home; however, in the event of this happening a record would be completed and action taken to address the concerns raised. The CSCI have received no complaints regarding the service since its registration with the CSCI. Information regarding the Avenues Trust complaints procedure is in the Statement of Purpose and additionally copies of this are available in pictorial and audio format. The homes policy on whistle blowing was seen. Staff spoken with stated they understood the term whistle blowing and felt they could go to the manager if they had any particular concerns. The manager stated that training has been arranged for all staff in relation to management of aggression, understanding challenging behaviour and breakaway techniques over the coming months. Webb Road (1a) DS0000066976.V306515.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are provided with a safe, comfortable, well-decorated and well-furnished environment. EVIDENCE: Staff stated they are still waiting for the Housing Association responsible for maintenance of the building to make good the damage to the shower room and staff room, which sustained considerable damage when the shower leaked some months ago. Service users’ bedrooms seen were individually personalised. Some service users had cases and boxes etc stored on top of wardrobes and discussion took place regarding the need for these to be appropriately stored to reduce the risk of accidents to service users or staff. Staff stated that service users were provided with appropriate beds and specialised equipment such as wheelchairs, hoists and safety rails to meet their needs. Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 18 Although staff stated carpets are cleaned on a regular basis, a smell of urine pervaded the lounge and upstairs landing. Action needs to be taken to eradicate this problem. The decor and furnishings are appropriate for the service users accommodated and provide a homelike environment. The manager stated that a new bath had been purchased to enable service users to have a choice between a bath or a shower. Staff stated that the laundry equipment provided meets the current needs of the service users accommodated. Webb Road (1a) DS0000066976.V306515.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are cared for by appropriately qualified staff. There is insufficient evidence that robust recruitment procedures have been followed to protect service users. EVIDENCE: The manager holds a NVQ4 qualification in care and management and all other care staff working in the home hold relevant Care qualifications or are currently undertaking training. The staff rota indicated the manager is working shifts in the home; however he is currently managing another establishment close by on a day-to-day basis and is not working any shifts at Webb Rd. He is available to support staff working in Webb Rd when required. Of the four week sample of rotas examined, the deputy was working only one weekend in four. Discussion took place with the manager regarding the need for the staff rota to accurately reflect staff working in the home and to ensure that there are some regular management hours after 5pm and at weekends to monitor staff practise. The manager stated the majority of staff had worked in the home for a number of years. The files for two members of staff working in the home were examined, one of whom had recently been recruited as a member of bank Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 20 staff. The files examined did not comply with Schedule 2 of The Care Homes Regulations 2001 for either member of staff, for example the only information regarding the recruitment of the bank member of staff was a letter to the manager advising him of the person’s employment by the Avenues Trust. An audit of these records should be undertaken to ensure that they meet with the requirements of The Care Homes Regulations 2001. Webb Road (1a) DS0000066976.V306515.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Regular safety and maintenance checks are carried out to ensure service users and staff are in a safe environment. There are sound quality assurance mechanisms in place that seek to monitor and improve the service. EVIDENCE: CSCI records indicate monitoring as required under Regulation 26 of the Care Homes Regulations 2001 takes place on a regular basis with the Service Manager undertaking monthly audits of the care and service provided by the home. The manager is aware of action to be taken by him to meet the requirements of regulation 24 of the Care Homes Regulations 2001; he stated that he was currently preparing a format to use for completing this task. Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 22 The Avenues Trust seeks the views of service users and their advocates or other relevant stakeholders in relation to the quality of service they provide. Record seen indicate that regular maintenance and safety checks are undertaken to equipment being used in the home. Webb Road (1a) DS0000066976.V306515.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 3 2 3 3 X 4 3 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 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 Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 24 N/A 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 The Registered Person must Develop a written Care plan for service users providing staff with clear guidance on how to meet service users assessed needs in respect of health and welfare. Timescale for action 01/11/06 2 YA24 16 3 YA30 4 YA31 5 YA34 The Registered Person must provide appropriate furniture and Furnishings in rooms occupied by service users. 30 The Registered Person must take action to eradicate the smell of urine apparent in the lounge and first floor landing on a permanent basis. 17(2)Sch4(7) The Registered Person must maintain an accurate rota of persons working in the home and whether the roster was actually worked. 19 Sch 2 The Registered Person must ensure that adequate recruitment checks are carried out on new members of staff employed and provide evidence to the CSCI. 15/10/06 02/10/06 29/09/06 27/10/06 Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 25 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 YA1 YA6 Good Practice Recommendations Service users representatives should be provided with a copy of the homes Statement of Purpose and Service User Guide. It is recommended that all information regarding service users, health, activities and demeanour be kept in one document to improve confidentiality and to cut down on reiteration and save staff time. Maintain a record of all meals provided to service users. Current Pharmaceutical Society Guidelines indicate it is not necessary to indicate PRM medication was not required by recording an X on the MAR sheet. It is recommended that some of the management hours worked in the home are outside of 9 to 5 Monday to Friday. 3 4 YA17 YA20 5 YA31 Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Webb Road (1a) DS0000066976.V306515.R01.S.doc Version 5.2 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. 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