Inspection on 21/09/05 for Westwood Avenue, 20

This inspection was carried out on 21st September 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westwood Avenue, 20 30/06/08

Westwood Avenue, 20 09/08/07

Westwood Avenue, 20 21/04/06

Westwood Avenue, 20 27/04/05

Westwood Avenue, 20 30/11/04

Westwood Avenue, 20 15/04/04

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 20 Westwood Avenue Monpekson Care Limited 20 Westwood Avenue South Harrow Middlesex HA2 8NS Lead Inspector Judith Brindle Unannounced Inspection 10:15 21 September 2005 st 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 20 Westwood Avenue Address Monpekson Care Limited 20 Westwood Avenue South Harrow Middlesex HA2 8NS 020 8422 4176 020 8422 4176 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 Pek Enthwhistle Ms Monica Doreen Pryme Jean Page-Defour Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th April 2005 Brief Description of the Service: 20 Westwood Avenue is a care home providing personal care, and accommodation for 3 residents with learning disabilities Monpekson Care Limited owns the care home. The home is located in south Harrow close to shops, pubs, a post office, restaurants, banks, and other amenities. There are train and bus services within a few minutes walk from the care home. The home consists of a three bedroom semi- detached house that is in keeping with other houses in the area. All the home’s bedrooms are single. Two bedrooms are located on the first floor, and the third bedroom is situated on the ground floor of the home. The home has an enclosed, accessible well-maintained garden. There is parking for two cars on the forecourt of the house. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place during the 3.25 hours during a day in September 2005. During the inspection the inspector focused on spending time talking with residents, observation of interaction between staff and residents, and assessment as to whether previous inspection requirements had been met. The inspector was pleased to meet, and speak to all the residents. One resident with verbal communication needs used some signs and gestures to communicate. Both the other residents spoke at length with the inspector, and one resident kindly showed the inspector around the premises. Care records, were among a variety of records inspected. All the requirements from the previous inspection except for one were met. 15 National Minimum Standards Care Homes for Adults were assessed during this unannounced inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered person needs to ensure that all staff have full knowledge and understanding of required incident reporting procedures. Development, and review in regard to some records including risk assessments, resident’s individual goals, and also some procedures should take place. Dates of the review of records should be clearly documented. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 6 Staff guidance in regard to the management of behaviour from residents that might challenge the service needs to be in place and accessible. Quality assurance monitoring systems, which include regular recorded views from residents of the service, and an annual development plan, need to be in place 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. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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): Standard 1 (partially inspected) 2 Arrangements are in place for residents to have information they need to make an informed choice about where to live. Some information needs to be added to the documentation. Arrangements are in place to ensure that all residents have their needs assessed prior to moving into the care home. EVIDENCE: Following the unannounced inspection the registered manager supplied the Commission for Social Care Inspection with a reviewed service user guide document. This guide is an attractive document in pictorial and written format, and includes required information about the service provided. The registered person needs to ensure that the service user guide includes the address and telephone number of the Commission, and information in regard to accessing the inspection report if not able to include it in the service user guide documentation. The service user guide should be dated. All the residents have lived in the care home for sometime. There are no vacancies. The care home has an admission procedure, which records the arrangements in place to ensure that residents have a comprehensive assessment of their needs prior to their admission to the care home. During a previous inspection staff informed the inspector that the local purchasing authority also assesses prospective resident’s needs. All the care plans that were inspected confirmed that resident’s needs are assessed, and reviewed by 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 9 the service. A care plan inspected recorded confirmation that the purchasing authority reviews the resident’s assessed needs. The care home does not accept emergency admissions. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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): Standards 6, 7(partially inspected) and 9 Arrangements are in place to ensure that residents have an individual plan of care, in which their assessed needs are recorded, and reviewed. Arrangements in regard to choice are generally in place, but where there are restrictions on choice, recorded staff guidance (with residents involvement) needs to be in place. Arrangements are in place to ensure that residents are supported to take risks as part of supporting their independent lifestyle. Further development of risk assessment documentation needs to take place. EVIDENCE: All the care plans were inspected. Each care plan included a photograph of the resident. The care plans all included information, and documentation in regard to assessment of the resident’s individual needs, and review of those assessed needs. Records confirmed that residents and their relatives/significant others and care manager attend care plan review meetings. Documentation confirmed that residents participate in regard to their service user plan. Residents have signed care plan records. An assessment, and care plan summary from the local authority was recorded in a care plan inspected. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 11 Individual resident’s goals/objectives were recorded. These need evidence of recent review. There were goals dated January 2004. A resident’s manual handling assessment was not complete, and dated 5/9/03. There was some recorded staff guidance in regard to meeting behaviour needs of a resident. This staff guidance recorded ‘staff to set boundaries and parameters’. This guidance needs to clearly record what is meant by ‘boundaries’, and there needs to be clear steps in regard to staff action to be taken to meet residents behaviour needs. So that all staff are consistent in regard to how they manage behaviour that might challenge the service. There was a record of an incident in regards to challenging behaviour from another resident, but there was no accessible recorded staff guidance in their care plan. This must be in place, and advice should be sought from a specialist healthcare professional, such as a psychologist in the development of these guidelines. There needs to be clarity in regard to recording, and reporting incidents in regard to episodes of behaviour from residents that challenge the service. There needs to be clear recorded staff/resident guidance in regard to any restrictions on resident’s choice. This includes if residents do not have full access to any communal part of the care home during part of the day. This was discussed with the registered manager following the unannounced inspection. Risk assessments were available for inspection. These included some health, and safety risk assessments, such as travelling on public transport. These need review, and to be further developed if needed. A risk management issue document record in regard to one service user had not been completed, but was signed by the resident and staff. This needs to be reviewed and completed. The care home has a missing persons procedure. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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): Standard 14, 15 and 17 Arrangements are in place to ensure that residents have the opportunity and choice in regard to participating in a variety of preferred activities. EVIDENCE: Records, residents, and staff confirmed that residents participate in a range of activities, which include ‘in house’ activities such as regular in house art sessions with an activity worker, and a variety of community based activities. Shopping, attendance at clubs, pubs, outings to parks, and meals out are some of the activities recorded. During the inspection a resident spent some time with a staff member doing some drawing/colouring. A resident freely accessed the garden during the inspection. Another resident spoke of a computer course at Harrow College, and a writing course that he had commenced, and which he said he enjoyed. Records, and residents confirmed that residents access public transport facilities. Residents spoke very positively of recent holidays abroad. All the residents have had at least one holiday abroad this year. This is commendable. Residents spoke of their participation in household chores. A resident organized, and tidied his bedroom with staff support during the inspection. The visitor’s record book was among records that informed the inspector that residents had close contact with family and friends. A resident spoke of going 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 13 to visit his mother on a weekly basis. Another resident spoke of shopping trips with a friend. Records informed the inspector that family/friends attend care plan reviews. Records of meals eaten were available for inspection, and recorded varied wholesome meals. Residents who kindly spoke with the inspector reported that they enjoyed the meals provided. Residents helped choose and prepare their lunch during the inspection. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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): Standard 19 Arrangements are in place to ensure that resident’s healthcare needs are generally met, but development in the monitoring of an aspect of healthcare is needed. EVIDENCE: Residents spoke of attending appointments with healthcare professionals, including the GP. Records informed the inspector that resident’s have received dental care services, chiropody services, and specialist healthcare services. A resident attended a specialist appointment during the inspection. Two residents attended the GP surgery during the inspection. Care plans inspected included an individual recorded health action plan. Records informed the inspector that the residents had had their weight monitored on the 4/9/04. It was recorded in the health action plan of one resident that his weight be ‘monitored and reviewed’. The registered person needs to ensure that resident’s weight is regularly monitored, and that there is recorded staff guidance in place in regard to how frequently this needs to be. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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): Standard 23 The care home has recorded procedures in regard to protecting residents from abuse, which need to be fully understood and followed appropriately by all staff. EVIDENCE: This standard was inspected during the previous inspection. Adult protection procedures including the local authority protection of vulnerable adult procedures were available for inspection during that inspection. A staff member who spoke with the inspector during the inspection had some understanding of procedures in regard to protecting residents from abuse. Incidents were recorded, but records of one incident were not accessible during the inspection. The registered manager following the inspection supplied documentation concerning this incident to the Commission for Social Care Inspection. This confirmed that the protection of vulnerable adults procedure, including not informing the CSCI, had not been adhered to. This was discussed with the registered manager following the unannounced inspection. All staff must have knowledge and understanding of adult protection procedures. There needs to be evidence that the registered manager and staff receive protection of vulnerable adults training. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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): Standard 24 and 30 The environment for residents is clean, warm, and homely EVIDENCE: The home offers access to local amenities, and including public transport facilities. The premises is in keeping with other houses in the area. The home is well maintained. The garden is accessible, maintained and enclosed. A resident accessed the garden freely during the unannounced inspection. The registered person should have weeds removed from the front forecourt area of the care home. Residents spoke of regularly accessing community facilities, and of being familiar with, and liking the location of the care home. A resident kindly showed the inspector around the care home. The home was very clean and has homely features. Furnishings are of good quality. The laundry facilities are located away from food storage and food preparation areas. A resident spoke of his participation in regard to the care of his laundry. There should be evidence that staff have received training in regard to infection control. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 17 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): Standard 35 Arrangements are in place for staff to receive appropriate training to meet individual resident’s care and support needs. EVIDENCE: A staff training programme was available for inspection. Records in regard to training completed by individual staff were available for inspection. Each staff member should have an individual training, and development assessment and profile. Records informed the inspector that appropriate staff training had been carried out, which included fire training, first aid, safe handling of medication, manual-handling training. Several staff had recently completed manual handling, and also health and safety refresher training. Records confirmed that a staff member had completed a staff induction plan, and that a staff member had completed NVQ level 2 in care training. A staff member informed the inspector of the variety of training courses that she had received. The registered person needs to ensure that the particular communication needs of a staff member are assessed, in regards to telephone access. The needs of the service need to be included in this assessment. The implications in regards to resident’s welfare of staff not being able to access the telephone was discussed with the registered manager following the unannounced inspection. Recorded staff guidance needs to be in place. It is recommended that advice be sought from appropriate organisations in regard to specialist telephones. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 18 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): Standard 39 and 42 Arrangements are in place in regards of the monitoring of some systems within the care home, but these need to be further developed to ensure that the quality of the service provided to residents is effectively monitored. The health, safety and welfare of residents are generally met. EVIDENCE: The registered manager supplied the Commission for Social Care Inspection a format of a ‘personal development review’ plan, which included information in regard to key service priorities and objectives 2005-2007. She reported that this documentation will be used with staff and with residents to assist in meeting resident’s needs and to assist in the monitoring and improving the quality of the service provided by the care home. There was accessible information in regard to quality assurance, but an annual development plan was not available for inspection. This was a previous requirement, which needs to be met. Records inspected confirmed that proprietor’s reports of the care home are completed. The last recorded visit was May 2005. Visits need to take place at least once a month. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 19 Records confirmed that there was a monthly health, and safety check of the environment. Risk assessments of the environment, and kitchen were dated April 2004 and need evidence of having been reviewed. (See Standard 9). Records informed the inspector that fire drills take place monthly. This is good practice. COSHH information was displayed. Portable appliance testing was recorded as having last taken place 04/06/04. This check needs to take place annually. The registered person needs to supply the CSCI with evidence that this electrical check has been completed. The certificate of employers liability insurance was displayed and up to date. 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 X X X Standard No 22 23 Score X 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 20 Westwood Avenue Score X 2 X X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 2 X DS0000017580.V252203.R01.S.doc Version 5.0 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 5(1)(d)(f) • Requirement Timescale for action 01/12/05 2 YA6 3 YA6 4 YA6 The registered person needs to ensure that the service user guide includes the address and telephone number of the Commission for Social Care Inspection. • And information in regard to accessing the inspection report. 15(2) Care plan documentation including recorded individual goals need evidence of regular review. 12, 13(4)(5) 15 All resident’s manual handling/mobility documentation needs evidence of having been completed, and reviewed regularly. 12,13(4)(6)14(2)18• There needs to be 1 recorded staff guidance in regard to staff action to meet resident’s DS0000017580.V252203.R01.S.doc 01/12/05 01/12/05 01/12/05 20 Westwood Avenue Version 5.0 Page 22 5 YA7 12(1)(2) 13(7) 14 6 YA9 12,13(4) 18(1) 7 YA19 12 8 9 YA23 YA23 13(4)(6) 18 13(4)(6) 18(c) 10 YA35 12 needs when they challenge the service. • There needs to be evidence that all staff are aware of the recording and reporting procedures in regard to incidents. There needs to be clear staff guidance in regard to any restrictions in regard to resident’s choice. The ‘risk management issue’ document record in regard to one service user needs to be completed, and reviewed. All risk assessments need evidence of regular review. The registered person needs to ensure that resident’s weight is monitored and that there is staff guidance in regard the frequency of this monitoring according to resident’s assessed needs. All staff must follow Protection of Vulnerable Adult procedures. There needs to be evidence that the registered manager and staff receive protection of vulnerable adults training, which includes reporting and recording procedures. The registered person needs to ensure that she assesses the particular communication needs of a staff member, (and the service) in regard to 01/11/05 01/12/05 01/12/05 01/11/05 01/12/05 01/12/05 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 Page 23 11 YA39 24(1)(2) 12 13 YA39 YA42 26(3) 12,13 access of the service telephone. Recorded staff guidance needs to be in place. A quality assurance annual development plan needs to be supplied to the CSCI It needs to include evidence of feedback/comments from service users and significant others in regard to the service provided. (Previous timescale 01/04/05 not met). Visits need to take place at least once a month. The registered person needs to supply the CSCI with evidence that a portable appliance test check has been completed. 01/03/06 01/12/05 01/12/05 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 YA1 YA6 YA24 YA30 YA35 YA35 Good Practice Recommendations The service user guide should be dated. Advice should be sought from a specialist healthcare professional, such as a psychologist in the development of behaviour management guidelines. The registered person should have weeds removed from the front forecourt area of the care home. There should be evidence that staff have received training in regard to infection control. Each staff member should have an individual training and development assessment and profile. It is recommended that advice be sought from appropriate organisations in regard to specialist telephones. DS0000017580.V252203.R01.S.doc Version 5.0 Page 24 20 Westwood Avenue Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 20 Westwood Avenue DS0000017580.V252203.R01.S.doc Version 5.0 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. 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