Inspection on 21/09/06 for Westcliff House

This inspection was carried out on 21st September 2006.

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

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

Other inspections for this house

Westcliff House 05/11/07

Westcliff House 09/02/06

Westcliff House 02/09/05

Westcliff House 24/11/04

Westcliff House 26/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Westcliff House 24/26 Westcliff Dawlish Devon EX7 9DN Lead Inspector Sam Sly Unannounced Inspection 20th September 2006 9.45 Westcliff House DS0000003801.V298683.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 Westcliff House DS0000003801.V298683.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. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westcliff House Address 24/26 Westcliff Dawlish Devon EX7 9DN 01626 862260 NONE 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) Mrs Christine Ann Dodge Christopher Hardwidge Care Home 29 Category(ies) of Learning disability (29), Learning disability over registration, with number 65 years of age (10) of places Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered only for the 10 named residents with a learning disability over the age of 65 10th February 2006 Date of last inspection Brief Description of the Service: Westcliff House cares for up to 29 residents with learning disabilities, 10 named residents whom are aged over 65 years old. The home is situated on the main road into Dawlish town centre, with patio areas to the front, and a small garden across the main road, which is tended by a resident. There is only a short walk to the local shops, amenities, and bus and train routes. The premises are made up of two terraced houses that were initially two separated residential homes but now function as one. The Roborough wing has six single bedrooms within an annexe to the main building having a separate entrance but also linked to the main house. Each bedroom is large and has kitchen as well as sleeping and sitting facilities. In this part of the premises there is a shower/toilet for every 2 residents. In the main part of the premises there are a further 5 fully self-contained flats each having a living room with cooking facilities, a bedroom, and a bathroom. Two of these flats have two bedrooms and are shared at present. There is also a communal lounge, dining room and kitchen. The homes office is situated in the Roborough wing. The Sidborough wing is a more traditional style care setting with single, and one double bedrooms of which five are en-suite, communal toilets and bath/shower facilities, lounges, dining rooms and kitchen. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit was unannounced and took place during a weekday in September. It included discussion with fourteen residents and observation of others during the day including a shared lunch. Interviews and discussion also took place with some of the staff on duty and the registered manager Chris Hardwidge. The care of three residents was tracked, which included talking to the residents and looking at records. Care records, and health and safety records were examined and Westcliff’s Quality Assurance system was examined and discussed. Staff records were also examined. A tour of the all the communal areas and about half the bedrooms was carried out during the site visit. The inspection process also included a review of contact the Commission has had with Westcliff House since the last key inspection, information contained in a pre-inspection questionnaire sent by the registered manager, and comment cards received by the Commission from four residents, five staff, six relatives, and five care managers. The weekly fee at Westcliff House is £449.40. All the required key standards were assessed during the inspection process. What the service does well: What has improved since the last inspection? The registered manager is starting to implement a person-centred life planning system with residents that will ensure residents are supported to be as independent as possible and achieve their goals in life. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 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. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are assessed before admission ensuring Westcliff House can provide appropriate care. . EVIDENCE: Residents who sent in comments to the Commission said that they had been given enough information to make a decision about moving to Westcliff House. Four resident’s care was case tracked, and each person had an assessment carried out by the registered manager before admission to Westcliff House, however these assessments were not always particularly in depth and there was not always a placing authority assessment either. The registered manager discussed plans, and showed a format that was just being introduced that would greatly improve the current care planning system at Westcliff based on the person-centred principles of maximising the person’s independence and skills. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 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): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs and goals are documented, understood by staff and action is taken to make them as independent as possible. EVIDENCE: Residents all had care plans and risk assessments. Some of these care plans included some goals, but due to a lack of depth to the assessment and risk assessment processes, plans were not always comprehensive. The registered manager talked knowledgably about the needs of residents and what action was taken to meet residents needs, however this was not always recorded in plans, and there was not always clear guidance for staff on what action to take with regard to needs and risks. The registered manager was clear that he wanted to further develop the care planning systems at Westcliff and had actively involved himself in local initiatives to promote a citizenship and person centred planning. The registered manager was initially working with one resident to trial the new ways of working, and was planning how to get staff involved in the process. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 10 Residents spoken with said they had been involved in their care planning process and knew what was written about them. The format used was a written format that would not be accessible to all residents, however the new format being introduced was much more user-friendly. Residents meetings are held monthly, and well attended, and questionnaires were given out annually. Records showed that issues raised in meetings and in the questionnaires were dealt with by the manager with feedback given to the residents. Residents are encouraged and supported to be as independent as possible in managing their own finances. Money handled by the registered manager is suitably accounted for and residents spoken with said they were happy with the way their money was handled. Some residents attended selfadvocacy groups in the community. Resident comments to the Commission showed that they felt able to make decisions about what to do during their day. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 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): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lead active interesting lives as part of the wider community. EVIDENCE: Fourteen residents were spoken with during the site visit and these conversations, plus other written evidence like resident meetings, evening class programmes and relative feedback showed that residents were involved in lots of activities, educational development, and work experience. Some residents were able to access the community unsupported and said they shopped for themselves, buying food for their breakfast and lunches with money provided by the registered provider. During the site visit two residents proudly showed the gardens that they planted and attended to, and residents sitting on the front patio were regularly spoken with and waved to by passing motorists and pedestrians. Residents spoke animatedly about their recent holidays and involvement in community festivities like the town carnival. Regular use is made of evening Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 12 classes and clubs locally run for people with learning disabilities. Hobbies are encouraged and a resident proudly showed the needlework they worked on, and another resident was working on a jigsaw in their bedroom. Some residents are encouraged to cook their own breakfast and snack lunches and help with cleaning their bedrooms and stripping their beds, however laundry is done by staff. There was feedback from a staff member that they would like to ‘spend less time cleaning and more time interacting with residents’ and it was observed during the site visit that, particularly in the wing of the Home where more independent residents live the staff member did spend much of the day cleaning and preparing and serving meals. The registered manager said the comment and observation would be acted on. Family contact is encouraged and supported at Westcliff and all six relatives that returned comment cards to the Commission said they were made welcome at the Home at any time, kept informed of important matters concerning their relative and satisfied with the overall care provided. Relatives commented that residents were ‘settled and happy and well looked after’ and ‘the owner in my opinion runs a very caring and efficient home, when visiting the staff are always welcoming, cheerful and helpful.’ Relationships are encouraged and supported as well, with partners able to share facilities, and advise and guidance given appropriately and sensitively about relationships. All residents have locks on their bedroom doors and keys provided. The flatlets have doorbells too. A lunchtime meal of soup was shared with some of the residents, others had cheese on toast and residents said they had a choice. A four-week menu is in operation and residents were asked for their views on the menu during meetings. Resident’s weight was regularly monitored, but it was evident in care plans that risk factors like obesity were not always being acted on. If assessed as safe residents had drink-making facilities in their bedrooms. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive support with personal and health care in ways they prefer and require and medication is administered safely. EVIDENCE: During case tracking the registered manager was able to give several examples of how input from doctors, psychiatrists, community nurses and other professionals was appropriately sort. Care plans indicated how personal support was given to those residents that needed it, and residents spoken with confirmed that staff support was given in ways they prefer. Comment cards received by the Commission from professionals showed mostly positive, but a few less positive views. Of the five responses four were that staff demonstrated a clear understanding of the needs of residents, one was that information was not always volunteered ‘especially if something unusual has occurred’. When asked if there was always a senior member of staff available to talk to, four responses were positive, and one was that ‘more involvement of care staff would be welcome’. All respondents were satisfied with the overall care provided to the resident that they had placed in the home. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 14 The procedures for administering medication were observed, and records examined. Two residents currently self-administer medication. Medication is stored securely in a purpose built cabinet, with controlled drugs also stored appropriately. A Lloyds Pharmacy MDS system is in place, and the Home gets regular visits from these. It was noted that although two staff were witnessing the administration of controlled drugs, the recording system for stock checking and administration was loose-leaf, and not in a bound book and required. Other administration records were kept appropriately and all staff administering drugs had received rigorous training. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and benefit from knowing that concerns are listened to and acted on. EVIDENCE: Residents who were spoken with, or who returned comment cards said that they were clear about whom to go to if they had a concern. They said they would either go to the registered provider, the registered manager or staff. They also said that they were listened to, and action was taken if they were not happy. The complaints book recorded that concerns raised with the registered manager were dealt with in a timely fashion. Concerns raised with the Inspector during the site visit by residents were already known by the registered manager, with action being taken. The Commission has not received any complaints about Westcliff House since the last Inspection. The registered manager is a Protection of Vulnerable Adult trainer, and records showed that all staff had received training. Staff interviewed or who returned comment cards were able to demonstrate they understood the adult protection procedures. The registered manager was able to demonstrate that adult protection issues are dealt with appropriately. Throughout the year the registered manager and registered provider have diligently reported significant incidents to the Commission, however records and discussion revealed that a few additional incidents should have been reported. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 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): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment at Westcliff House is homely, clean and safe for residents. EVIDENCE: A partial tour of the premises was made, this included all the communal rooms, kitchens and laundry and those bedrooms that the Inspectors was invited into. Westcliff House is a large old building requiring regular maintenance and renewal to keep it up to scratch. The registered provider does this through an on-going maintenance programme, including regular environmental checks and a yearly renewal programme where carpets and wall decorations are regularly replaced. Those areas of maintenance identified during the site visit had either already been identified by the registered manager or were added to the renewal programme, which would be taking place in October 2006. A cleaner and care staff carry out the cleaning, with residents encouraged to be involved too. All of the bedrooms and flatlets that were entered were clean, tastefully decorated and full of personal possessions that reflected the personality, hobbies and interests of the inhabitant. Residents spoken with were very happy with, and often proud of, their bedrooms and flatlets. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 17 The laundry was fairly tidy and clean but unfortunately access problems meant some residents were unable to use it independently. The registered manager said he was thinking of ways around this. A COSHH policy was in operation and information sheets were available for all toxic products. Toxic products were found in a cupboard in the kitchen instead of being locked away in the correct cupboard in the laundry. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 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): 32, 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient numbers of staff with the qualities, skills, and qualifications to meet the needs of residents. EVIDENCE: There is four care staff on duty during each day, and the team is split so that one staff member works in the part of the house where the more independent residents live, and three work in the other side. The registered manager is also in the house every weekday. The team are about to loss two staff members so a recruitment drive in place. Four staff files were examined, and information gathered from the preinspection information sent by the registered manager and from staff feedback. Staff reported that the correct recruitment procedures were carried out with them, and files showed this to be right, with fitness checks including an application form, health form, POVA First and CRB checks and ID checks being carried out before employment. In the files examined a written interview format was not being used and this meant decision-making with regard to issues around staff fitness were not being recorded. Staff reported that the training they received was good and helped them with the residents they cared for. A training development plan for the staff team Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 19 was available and showed that training included health & safety, an induction and foundation course, first aid, risk assessment, moving and handling, medication administration, food hygiene, infection control, POVA, fire awareness and epilepsy training. Staff attended specialist learning disabilities training when it was available. Some staff were doing NVQ training, but as yet not 50 . The registered manager was open about not considering that the Home provided training or guidance for staff on the promotion of equality and diversity. Staff were observed, when interacting with residents to be respectful and courteous, as well as showing a genuine respect and interest in their wellbeing. There was a lot of laughter at the dining table with one particular staff member demonstrating a good rapport with residents. Residents spoken with said the staff were kind and approachable, as was the registered manager. Comments from professionals stated that they were satisfied with the overall care provided by the home, but that they would ‘appreciate more input from care staff, when talking about/with clients.’ and ‘more involvement of care staff would be appreciated’. The registered manager said he was planning to get staff much more involved in the planning of residents care. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well run home, with the quality of care continually monitored and improved by the registered manager and registered provider. EVIDENCE: Throughout the site visit, and in all dealing with Westcliff House since the last inspection the registered manager has shown integrity, honesty and a genuine enthusiasm for the residents at Westcliff House. He and the registered provider demonstrated a clear determination to continue to improve the service with innovative ideas for the future. All comments received from staff, relatives and residents about the registered manager and registered provider were positive. Comments were received such as: ‘the owner in my opinion runs a very caring and efficient home, when visiting the staff are always welcoming, cheerful and helpful’. ‘[My relative] is settled and happy and is well looked after’ and ‘the manager is very helpful’. Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 21 The registered provider and registered manager have implemented a comprehensive Quality Assurance system, which include the views of resident and their relatives. A summary report had been produced in May 2006, and it was recommended that an annual development plan be distributed more widely as feedback to those who contributed, and to the Commission. It was also recommended that the registered provider formalise her contact with the Home into a monthly audit as required in the Care Homes Regulations. The pre-inspection questionnaire and records at the site visit showed that staff undertook a range of health and safety training including first aid, food hygiene, fire awareness, manual handling and infection control. The fire records examined were up to date and accurate. A fire officer had visited in April 2006 and he was satisfied with the fire precautions at Westcliff House. The pre-inspection questionnaire also indicated that required checks on gas, heating, water, wiring and adaptations were being carried out appropriately. The registered provider employs an external company to audit the health & safety aspects of the service, and action was taken on any shortfalls. There were information sheets available for all toxic substances used in the house, but some of these cleaning substances were not locked away safely. Westcliff House DS0000003801.V298683.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard YA2 YA17 YA7 YA35 YA20 YA34 YA23 YA39 Good Practice Recommendations Risk assessments should cover all areas of risk, including obesity and diabetes, and stipulate clearly what action staff will take to minimise risks Training and polices should be in place to ensure equality and diversity issues are understood and acted on. There should be a controlled drugs book in use. A written record should be kept of the staff interview process so that decision-making about employment where there are issues of fitness is recorded. All incidents that adversely affect the welfare of residents should be reported to the Commission. The registered provider should consider instating monthly visits to the Home as part of the Quality Assurance system. The annual development plan should be forwarded to the Commission each time it is produced. All toxic cleaning products should be locked away when not in immediate use. 7. YA42 Westcliff House DS0000003801.V298683.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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