Inspection on 17/10/07 for Wellesley Road

This inspection was carried out on 17th October 2007.

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

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

Other inspections for this house

Wellesley Road 23/08/06

Wellesley Road 14/11/05

Wellesley Road 30/07/05

Wellesley Road 22/11/04

Wellesley Road 27/05/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

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

CARE HOMES FOR OLDER PEOPLE Wellesley Road Wellesley Road 1 Wellesley Road London NW5 4PN Lead Inspector Pippa Canter Unannounced Inspection 17th October 2007 10:00 X10015.doc Version 1.40 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 Wellesley Road DS0000037326.V353612.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 Older People. 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. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wellesley Road Address Wellesley Road 1 Wellesley Road London NW5 4PN 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) 020 7267 0856 020 7424 0999 katherine.williams@camden.gov.uk/rupy.virdee @camden.gov.uk London Borough of Camden Miss Katherine Williams Care Home 48 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (48), Mental disorder, excluding learning of places disability or dementia (2), Mental Disorder, excluding learning disability or dementia - over 65 years of age (48), Old age, not falling within any other category (48), Physical disability (2), Physical disability over 65 years of age (48) Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 beds in short stay unit registered for adults under the age of 65. Date of last inspection 23rd August 2006 Brief Description of the Service: Wellesley Road is a care home providing personal care for up to 48 older people. The home caters for both male and female service users who are aged 65 years and older. The certificate of registration reflects that the staff are caring for people within the categories of dementia, mental disorder, old age and physical disability. The home not only provides long-term residential care but also three separate units for emergency admissions, respite and interim care. The current level of fee is £866 per week for long stay residents and £66.85 flat rate fee per week for up to 8 weeks in the interim or respite unit. The permanent service users are accommodated on the ground floor and the three other services are on the first floor. The units are self contained and staffed separately. They are organised so as not to impact on the lives of the long stay service users. The owned is operated by Camden Council and has been registered under The Care Standards Act 2000. It is situated with good access to public transport, shops and community facilities. The home was purpose built about thirty years ago therefore not all the rooms sizes and corridor widths meet with the national minimum space standards. All the bedrooms are single occupancy however forty of them are slightly below the national minimum space standard and eight of them measure over twelve square meters. The home is three storeys high although accommodation for service users is on the first two floors only. A shaft lift gives access to the second floor; the third floor is not registered. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this key inspection was unannounced, and took place on a weekday from 10.00 to 15.00. One inspector carried it out. An expert by experience accompanied the inspector on the site visit. Her role was to talk to the people who had been admitted to the home on a short-term basis, either for respite care, in an emergency or to the interim unit. Prior to the site visit all information held at our office had been reviewed. This included reports that had been sent to us on a monthly basis, and about any incidents/changes that had occurred since our last visit. The manager had completed an Annual Quality Assurance Assessment (AQAA), which gave us information about the people living and working in the home as well as the home’s compliance with the key standards. Based on the above we developed an inspection plan. This concentrated on those key standards that we could not make a full judgement on without a site visit. Questionnaires had been sent to the home prior to the visit for people who live there, for staff, relatives and professionals who visit the home. Because of the impact of the postal strike. A limited number of surveys have been returned in time for the completion of the draft report. Any further feedback can be included in the final report. During the visit we spoke to people living in the home, and examined five case files in depth. The expert by experience talked to three of these people on an individual basis and spoke generally to other residents during lunchtime, meal. We compared the planned care with the care they were actually receiving. We carried out a small sample audit of medication on each floor. We went round the home speaking to other people living in the home, to some staff and checking bathrooms and bedrooms. We directly observed the interaction between the care staff and people living in the service. We have used the information collected from all sources to reach the judgments made in this report. At the end of the visit we discussed our findings with the manager, and a form will be sent with the draft report so they can let us know how they felt we had conducted the inspection. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? A requirement had been set at the last inspection regarding the overall repair and appearance of the premises. The expert by experience recorded in her report: “My overall observations are that Wellesley Road, although an old building in bad need of refurbishment is a relaxed and efficient place, where staff are Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 7 friendly and responsive to residents and visitors. However there is evidence some refurbishment is about to be undertaken.” Working is progressing to introduce social profiles, which will usefully inform staff about the backgrounds of the people using the service and should feed into the activities programme. There has been a marked improvement in the accurate recording of the medication administration records What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home in order to make an informed decision about the whether the service is right for them. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. EVIDENCE: The case tracking process confirmed good practice. Written admission documentation was available and included a copy of the care manager assessment. Basic information was available to staff to ensure they could meet the social, emotional and care needs of new service users. The home is responsive to referrals whether they are planned or unplanned. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 10 There is a written contract and terms and conditions of residence were on each service users’ file. The newest service users had a copy. This means that service users have the information they need about the service they will receive and how much it will cost. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All arrangements are in place in order to meet the health care needs of the people moving into the home. EVIDENCE: A total of five care plans were looked at, and nine residents were asked for their views. The expert by experience spoke to three of these on an individual basis. Managers and care staff were observed interacting with residents and relatives, whilst carrying out their duties. The daily records and district nurse records were looked at. A requirement had been set at the last inspection to improve social profiles of the people admitted into the home. There has been an improvement and further development is planned. Managers and care staff are able to demonstrate an ability to balance meeting the health and personal care needs whilst retaining independence as a core value along with dignity, respect, and privacy. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 12 People living in the home described the care as ‘very good’ and ‘excellent’, and the care staff as ‘all very nice’, ‘attentive’, and “superb”. A small audit of the medication systems and medication administration charts was carried out. The procedures, and training, were discussed with one of the assistant managers. The medication policies, procedures, and practices are of a good standard, and residents are supported to control their own medication where possible. The General Practitioner holds a weekly surgery in the home. Residents confirmed that the medical support is very good. The whole ethos of this home is on residents retaining as much independence as possible. Staff respect their wishes and right to privacy. Observation of staff and resident interaction during this visit showed a very high level of mutual respect. In discussion with staff they demonstrated obvious warmth and affection for residents, and concern for their well-being. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities is available within the home and in the community. Staff would like to expand these to make them more stimulating and motivating. Meals and mealtimes are social occasions and people living in the care home find the food enjoyable. EVIDENCE: The care records showed some good practice and clearly identified personal choices. The development of the social care histories will enable a broader and more individual range of activities. Staff said that this is an area that they would like to see expanded. A programme of activities is available and people living in the care home are clear about their right to choose to take part in activities or not. Community involvement is encouraged. The expert by experience spoke to three people in the short stay and emergency units. Feedback from this was: “The environment in this area was relaxed and happy. Some residents were in their rooms, others in groups chatting; a small group of men were playing dominoes in the lounge. All of the people I chatted to seemed to be at ease Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 14 and liked the relaxed atmosphere and agreed the staff were not pushy; but there when you wanted. One person found the home accommodation better than he expected. The other quests as he referred to the residents seemed a nice bunch and as they all seem to come from the surrounding area had something in common. The food was perfectly all right and you had a choice. He found the staff approachable, friendly and unobtrusive. On the whole he seemed quite content with his surroundings, did not find residential care as intimidating as he thought it would be and was prepared to come again to Wellesley Road should his main carer need or want a short break.” The menus are varied with plenty of fresh vegetables and includes healthy options. The quality of the food was described as “excellent”. The expert by experience was invited to join residents for the lunchtime meal. The feedback was “The main meal was served in the middle of the day and a lighter tea in the evening. I had lunch in the dining room and spoke to several residents on respite care. The tables were well presented and there was a choice of fruit juice and fresh fruit on the table. The food was wholesome with a choice of fish in a white sauce with spinach and potatoes, or shepherds pie and peas. A choice of puddings, more fresh fruit, coffee or tea was served afterwards.” The care home caters for personal likes and dislikes, as well as cultural needs. A requirement was set at the last inspection for menus to be accessible to the residents. During this visit it was clear that people living in the care home are able to look at the menus and clearly knew what was for lunch. Visitors are made welcome to the care home. There have been changes to the lay out of the front foyer, which has been remarked upon by people coming into the home. The main entrance area is now a welcoming and inviting place and it looks more homely. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel safe and listen to and are supported by the policies and procedures of the care home in this. EVIDENCE: Complaints records were looked at and staff were asked about their responsibilities in relation to potential abuse. It is clear from the preinspection information that the home had implemented a recommendation from a complaint’s investigation. Evidence shows that complaint’s investigations are thorough and carried out by experienced officers. Remedial action is always taken. Relatives and people living in the care home are confident to report any concerns to the manager or their key workers. Since the last inspection there was one notification made which was investigated under the adult protection procedures. It was clear that the staff in the home had acted responsibly towards the resident concerned and the staff member. The staff training records did include information about recent training on adult protection. In discussions, staff were very clear about their responsibilities to report any suspicions to their managers. They were also clear that they could contact social services and the Commission. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and clean environment for people who live and work in the home. Improvements are planned that will benefit the people using the service. EVIDENCE: The manager and staff recognise that the building is outdated therefore they must capitalise on any assets. The location of the Home is excellent for accessing local shops and other facilities, including public transport. The location of the home enables two relatives to visit daily, and other relatives have commented on the ease of access. The expert by experience reported about Wellesley Road: “The home was very pleasant and had a relaxed and friendly atmosphere with a garden to the rear and sides. The planting of pots and troughs chosen by Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 17 the residents with the help of family and staff made it a pleasant spot for residents. The manager had attempted to make the home less institutional by the use of furniture and plants not normally found in residential homes. Giving it a more family and [personal appearance. Residents were encouraged to be involved in the redecoration plans for the large sitting room. This was one with residents and staff putting together a story board of cuttings from magazines of colours, furniture, curtains and carpets they would like to see used in the refurbishment.” One relative did comment that the bedrooms are small and her mother is unable to display much of her personal items although this is encouraged. This has not been an issue but it means that the communal spaces need to be more attractive. The home has been succesful in securing a £45,000 Capital Grant to make improvements this year. It is earmarked to improve the ground floor lounge and kitchenettes. People living in th ecare home will be actively involved on making changes and improvements. An example of this is the mood & swatch board that has been put together with their input. This is on display in the room for refurbishment. The home is extremely clean, and the domestic staff were observed to be very diligent in carrying out their duties. The home will continue to use the DOH essential steps guidance to assess their current infection control measures. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team, who are trained and competent to do their jobs, meets residents’ needs EVIDENCE: Residents were asked for their views, staff were observed carrying out their duties, and training records were examined. A hand over meeting was observed and individual discussions were held with the manager and staff. Staff rotas were checked. Staff very clearly know the needs, and wishes, of each resident. This includes the level of independence and privacy that each person wants. There is a stable staff team, and those spoken to show a clear commitment to their work. Comments about the calibre of the staff included: “The kindness of the staff in the interim unit is unbelievable” “Staff give superb and professional care to all residents”. “Staff show infinite patience under quite stressful conditions”. There is a rolling rota, so that staff know what shifts they will be doing and residents will know who will be on shift on any date, plus there is a Senior member of the team on shift at all times. The Home has a Duty Manager system. There are Domestics on shift, plus Cooks to ensure the smooth Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 19 running of the home. There is a clear management structure in place. A relative commented, “Most of the carers are extremely kind and caring. Luckily they seem to be on regular shifts so they know the residents quite well.” “I did not expect the amazing standard of care that my aunt receives. I admire the carers so much.” One area raised in a survey related to the agency staff engaged to fill gaps in the rota. A relative commented, “Most staff have the right skills and experience. But it is hard for the temps to have the knowledge of the residents’ ways, likes and dislikes. Generally the regular staff are superb.” This is an area that the management team should look at to ensure that agency staff have access to the correct information.” Wellesley Road is registered to accept a range of categories because of the role that it has as a community-based service. A training plan is in place and individual training needs are identified through regular supervision and annual appraisals. A high percentage of the staff have achieved an NVQ level 2 or higher. Staff have also received training in respect of dementia. A comment received was that staff show, “Acute understanding of patients with dementia and always show amazing kindness to them all.” One staff member did comment that they would like more advanced training in order to meet the diverse needs of the people being admitted on a short term basis e.g on oxygen therapy, leg ulcers and MRSA. Residents spoke highly of staff, and the interactions observed during the visits were professional and caring. Recruitment files were not checked as part of this inspection as HR is centralised, so staff files are no longer kept in the home. Feedback from surveys showed that staff had found their recruitment and selection to be thorough and robust. The Commission is satisfied that there continues to be a robust recruitment procedure. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The temporary management arrangements are meeting the needs of the service and the quality of the service is reviewed in order to make improvements. EVIDENCE: The registered manager was on maternity leave and in the mean time there have been two interim managers. The current manager has a relevant management qualification and a background in people management in Learning Disabilities. This experience and skills is transferable to the present situation and has proved in some instances to be beneficial e.g. supporting staff to take a more person centred approach. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 21 The manager completed and returned an Annual Quality Assurance Assessment (AQAA) prior to the inspection. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The information within the AQAA and further discussions with the manager during the site visit demonstrated a good level of awareness of the strengths of the service and the areas where improvements are necessary. Just as important, staff reported that the current manager had involved them in gathering the information for the AQAA, which they had found to be very useful. The judgements in preceding sections of this report have contributed to the judgement in this outcome area. The care home has a welcoming environment and promotes an open and transparent style of management. Both staff and relatives praised the skills and approachability of the current manager. One comment from a relative was “ The new manager has made such a welcoming atmosphere at Wellesley Road”. People using the service are protected by the policies and procedures. The quality assurance systems are effective and the manager is proactive in addressing quality issues within the home. All incidents and concerns are reported fully to the Commission for Social Care Inspection. The manager has demonstrated competence in dealing with untoward situations. The manager is committed to promoting equality and diversity in the service and meeting service users individual needs. There are effective systems in place to manage financial arrangements within the home. The home’s Public Liability Insurance certificate is on display and is current. A sample of health and safety records were looked at. These confirmed that the home is being managed responsibly with essential checks being made. The provider monitors health and safety in the home. There are robust procedures in place to monitor compliance. Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Wellesley Road DS0000037326.V353612.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!