Setting

X10029.doc Version 1.40 Page 1 FOSTERING SERVICE

p.1

HU17 9BA

Lead Inspector Mike McCleave MBE Announced Inspection 9th January 2006 09:30 East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 2 The Commission for Social Care Inspection aims to:

p.1

HU17 9BA

• 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

p.2

HU17 9BA

Reader Information Document Purpose Inspection Report Author CSCI Audience General Public Further copies from 0870 240 7535 (telephone order line) Copyright 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 Internet address www.csci.org.uk East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 3 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 Fostering Services. 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

p.2

HU17 9BA

Every Child Matters, outlined the government’s vision for children’s services and formed the basis of the Children Act 2004. It provides a framework for inspection so that children’s services should be judged on their contribution to the outcomes considered essential to wellbeing in childhood and later life. Those outcomes are: • Being healthy • Staying safe • Enjoying and achieving • Making a contribution; and • Achieving economic wellbeing.

p.3

HU17 9BA

In response, the Commission for Social Care Inspection has re-ordered the national minimum standards for children’s services under the five outcomes, for reporting purposes. A further section has been created under ‘Management’ to cover those issues that will potentially impact on all the outcomes above.

p.3

HU17 9BA

Copies of Every Child Matters and The Children Act 2004 are available from The Stationery Office as above This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 4

p.3

Name of service

East Riding of Yorkshire Council Fostering Service

p.4

Name of service

Address County Hall Cross Street Beverley East Yorkshire HU17 9BA

p.4

Name of service

Email address helen.greenwood@eastriding.gov.uk

p.4

manager (if applicable)

Type of registration Local Auth Fostering Service

p.4

of places

East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 5

p.5

Brief Description of the Service:

The Fostering Service is run by the East Riding Of Yorkshire Council and is managed within the Social Service Directorate. The service is set up to provide foster care for children looked after by the Council. Foster carers are recruited and assessed by fostering social workers and are considered for approval by the Fostering Panel. Looked after children may also be placed with ‘friend and family’ carers who should also be assessed and approved. The Council’s stated aim for the service is to help Foster Carers to provide care that ensures the safety and well-being of children and maximises their life chances by valuing diversity and promoting equality and achievement.

p.5

Brief Description of the Service:

The East Riding Fostering Service is located a short distance from the town centre. The office itself is not suitable for disabled access and if required, an alternative venue can be arranged at the county offices nearby. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 6

p.5

SUMMARY

This is an overview of what the inspector found during the inspection.

p.6

SUMMARY

This inspection took place over five days and included a pre-inspection meeting prior to the actual inspection. The methodology used during the inspection was as follows:

p.6

SUMMARY

Group discussions were held with foster children and foster carers. A sample of foster carers and children were also seen separately. Interviews with the Resources Manager and Acting Team Manager and an interview with the Chair of the Fostering Panel took place. A sample of kinship carers were spoken to by telephone contact. In addition individual interviews took place with the following:

p.6

SUMMARY

The foster social work team, the Marketing Officer, Training Officer, members of the Panel, the social worker from the CAMHS team, the Complaints Officer, Independent Reviewing Officer, the Independent Support Worker for foster carers, the Participation Team Manager, the Children’s Consultation Group, the elected member with responsibility for the Fostering Portfolio and the Strategic Development Care Manager. Questionnaires were completed by a number of foster children, placing social workers and foster carers.

p.6

What the service does well:

The fostering service is highly regarded by the foster carers who are very complimentary about the support they receive from the fostering team.

p.6

What the service does well:

The fostering social workers are positively motivated and take pride in their work with the carers. The team demonstrate a positive enthusiasm for their work.

p.6

What the service does well:

Training provided for the social workers and foster carers is good and there is a varied training programme in place.

p.6

What the service does well:

The children’s records contain health assessments that are very clear and concise with all the relevant information to ensure that the foster carers are able to meet the health care needs of the children in their care.

p.6

What the service does well:

The Foster Carer’s Handbook has been designed to be user friendly and to enable foster carers to access information with the minimum of fuss. This publication has been well received.

p.6

What the service does well:

The majority of foster carers feel valued by the East Riding Fostering Service, and the organisation has invested financial resources to provide an independent worker to provide support to foster carers during any dispute or complaint. This is a message to foster carers that the organisation values their input and where difficulties occur the organisation will ensure that they are East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 7 supported. Kinship carers in particular are supported by a link social worker. This is a good use of scarce human resources and it has been a success among kinship carers who feel that they are valued and listened to.

p.6

What has improved since the last inspection?

The social workers have been successful in providing an extra thirty new foster placements. This has been achieved due to the investment by the authority in staff numbers and the hard work of the team.

p.7

What has improved since the last inspection?

The appointment of the Independent Support Worker albeit on a contractual basis, provides foster carers with a good support mechanism.

p.7

What has improved since the last inspection?

The six week timescale to process kinship carers applications is now being met.

p.7

What has improved since the last inspection?

Training in equality and diversity is now part of the annual training programme for staff and foster carers.

p.7

What has improved since the last inspection?

An independent Chair of the Panel has been appointed and the Panel is now developing a quality assurance function to identify good practice in reports and to make suggestions where required to improve on work coming to Panel.

p.7

What they could do better:

The Key Information section of the case file needs to be restructured. There is currently a variety of information filed and it is difficult to see if there are any trends in the Diary Sheets because these do not follow a numerical sequence. In addition many of these sheets did not have the signature of the author. It is important that each time an entry is made the author signs at the end of the record.

p.7

What they could do better:

Some foster carer review reports have very little narrative and therefore a sense of how the carers have progressed since the last review is not evident.

p.7

What they could do better:

Some of the records had the written entry deleted out through being scribbled. All errors should be deleted by a single line through the entry and a signature to identify who carried out the deletion.

p.7

What they could do better:

A number of the Diary Sheets did not indicate when unannounced visits took place to foster homes. A system needs to be agreed and for this to be applied consistently by all the fostering social workers.

p.7

What they could do better:

Consideration should be given to a review of the method of paying agreed expenses to ensure that these are administered more efficiently. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 8 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. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 9

p.7

CONTENTS

Statutory Requirements Identified During the Inspection East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 10

p.9

The intended outcomes these Standards are:

• The fostering service promotes the health and development of children.(NMS 12)

p.10

The Commission considers Standard 12 the key standard to be

inspected at least once during a 12 month period.

p.10

JUDGEMENT – The intended outcomes for these Standards are

The children ‘s health and development is being met by the foster carers.

p.10

EVIDENCE:

The foster carers spoken to demonstrated a good awareness of the importance of ensuring that the children placed with them enjoyed good health. They felt strongly that accurate health information was provided by the social workers so that they could ensure that the children’s health needs were met. Some foster carers made positive reference to the Health Care Assessment record which they found easy to read and understand. Although some foster carers were critical of the delay about the health information provided by some field social workers, they nevertheless, took the initiative of registering the children with their GP practice soon after they placement commenced. If full details of the health needs are not available before the placement, a high priority is given to ensuring that the information is obtained and passed to the foster carer once the placement is made. The procedures of the agency make it clear

p.10

EVIDENCE:

that depending on age and understanding, the child has access to and understands the health record kept by the fostering service. The foster carers are expected to take full responsibility for ensuring that any health appointments for the child are kept including dental and optician appointments. They are also aware of the need to monitor every day health care issues such as diets and personal hygiene matters and to advise and support the child in dealing with these. The health of the child is an important topic that is discussed during reviews and the foster carers are required to provide up to date information. There is evidence to indicate that there is a good link with the CAMHS team.

p.10

EVIDENCE:

One foster carer demonstrated a strong commitment towards obtaining the appropriate health care resources when this had been refused by the local Primary Care Trust. The foster carer succeeded in securing funding for specialist treatment outside of the county. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 11

p.10

The intended outcomes these Standards are:

• Any persons carrying on or managing the service are suitable. (NMS 3) • The fostering service provides suitable foster carers.(NMS 6) • The service matches children to carers appropriately.(NMS 8) • The fostering service protects each child or young person from abuse and neglect.(NMS 9) • The people who work in or for the fostering service are suitable to work with children and young people.(NMS 15) • Fostering panels are organised efficiently and effectively.(NMS 30)

p.11

The Commission considers Standards 3, 6, 8, 9, and 15 the key

standards to be inspected at least once during a 12 month period.

p.11

JUDGEMENT – The intended outcomes for these Standards are

The children in foster homes are protected by carers who have been appropriately checked.

p.11

EVIDENCE:

There is evidence to confirm that all foster carers and staff are appropriately checked in accordance with Regulations and the Standards.

p.11

EVIDENCE:

The foster homes visited during the inspection were clean and comfortably furnished. All homes are inspected by the fostering social worker as part of the annual review of foster carers. The bedrooms of all the foster children were seen during the visits and these were comfortably furnished and decorated. One child said that “ having my own room is great and I can have all my personal gear with me”. The children confirmed that they could personalise their rooms as they wished. Foster carers are provided with training by the agency covering health and safety issues and this is covered in the Foster Carer’s Handbook.

p.11

EVIDENCE:

The children placed by the agency are matched as far as possible with suitable carers and the process takes into account a child’s racial, ethnic, religious and cultural needs. Where practical the policy is for each child to have the opportunity for a period of introduction to a proposed foster family so she/he can express an informed view about the placement and to become familiar East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 12 with the carers and their children. All foster carer records have a written agreement and evidence of these was seen. When emergency placements are made, the matching process is limited and depending on the circumstances an effort is made to attempt a match.

p.11

EVIDENCE:

There is a well established training programme in place for foster carers that includes training in child protection awareness, safe caring skills, managing behaviour and recognising signs of abuse. Safe caring guidelines are provided in the Foster Carer’s Handbook. Each foster carer is provided with full information about the foster child and the child’s family background to enable the carers to protect the foster child, their own children, other children whom they have a responsibility for and themselves. In addition the fostering service has included in the Handbook the procedures to follow if a foster child goes missing. All the foster children spoken to confirmed that they felt safe in their foster homes.

p.12

EVIDENCE:

The fostering service has clear written recruitment and selection procedures for appointing staff that includes good practice in safeguarding children and young people. All applicants for employment are formally interviewed as part of the selection process and the Resources Manager confirmed that all references were now subject to a telephone check. None of the files checked contained evidence of this but these were of staff who had been in service for a long time. The social workers employed by the service are all professionally qualified and evidence of this was seen in personnel records. During interviews the social work staff demonstrated a good understanding of:

p.12

EVIDENCE:

• The importance of communication with children. • The agency’s complaints and child protection procedures. • The need to promote equality, diversity and the rights of individuals and groups. • The roles of other agencies in particular health and education. • Child protection procedures.

p.12

EVIDENCE:

The Fostering Panel is organised efficiently and the members spoken to were clear about their role to ensure that good quality decisions are made about the approval of foster carers in line with the overriding objective to promote and safeguard the welfare of children in foster care.

p.12

EVIDENCE:

The Chair of the Panel is currently working with the members of the Panel to develop an improved quality assurance role. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 13

p.12

The intended outcomes these Standards are:

• The fostering service values diversity.(NMS 7) • The fostering service promotes educational achievement.(NMS 13) • When foster care is provided as a short-term break for a child, the arrangements recognise that the parents remain the main carers for the child.(NMS 31)

p.13

The Commission considers Standards 7, 13, and 31 the key standards

to be inspected at least once during a 12 month period.

p.13

JUDGEMENT – The intended outcomes for these Standards are

The children are encouraged to develop and achieve their potential and to enjoy themselves.

p.13

EVIDENCE:

The foster carer’s handbook has a policy clearly outlining the expectations of the service, that foster carers will provide an environment which respects and preserves a child’s ethnic, religious, cultural and linguistic background. There is a training programme in place for foster carers and this now includes issues covering equality, diversity and ethnicity.

p.13

EVIDENCE:

Those foster carers spoken to during the inspection were positive about their role in ensuring that the educational aspirations of the children was promoted and they clearly took this responsibility seriously. One foster carer said “ I always attend meetings at school for all the children in my home ”. Other foster carers confirmed that they maintained appropriate school contacts by attending parent’s evenings and any other links with the child’s school in line with the care plan. It was evident from those carers who were seen that the fostering service expected them to provide an environment where the education of the foster child is taken as seriously as it is for their own children. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 14

p.13

The intended outcomes these Standards are:

• The fostering service promotes contact arrangements for the child or young person. (NMS 10) • The fostering service promotes consultation.(NMS 11)

p.14

The Commission considers Standards 10 and 11 the key standards to

be inspected at least once during a 12 month period.

p.14

JUDGEMENT – The intended outcomes for these Standards are

The children are supported by their foster carers to make a positive contribution to their placement.

p.14

EVIDENCE:

All foster carers spoken to say that they actively support contact between the children and their families if this is part of the care plan. The children confirmed that they kept contact mainly through planned visits home and by telephone. The assessment and training of foster carers includes the role of the carers in working with child to support contact where this is seen as in the best interests of the child. Where necessary, foster carers are on occasions, expected to be actively involved in contact arrangements and the training programme deals with difficult issues that may arise. The foster carers viewed this as part of the overall fostering role and welcomed being involved. There are procedures in place setting out how appropriate contact arrangements for each child in foster care are to be established, maintained, monitored and reviewed.

p.14

EVIDENCE:

The views of the children about their experience within their individual foster homes are sought at every review. Most foster homes are provided with a computer by the local authority and children can access a site known as Viewpoint. This enables the children to comment on how they feel about the placement and to make any comments on issues that affect them whether positive or negative. The children can also join a group known as Children’s Participation where they take the initiative to consider various topics where they can apply some influence. The majority of the children felt that they were not supported enough by their placing social workers. One child said “ I know East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 15 when my review is due because my social worker suddenly arranges to come and visit me”.

p.14

EVIDENCE:

The children spoken to were aware of how to make a complaint using the local authority complaints procedure. The welcome pack given to all the children when they move into a foster home contains information in a child friendly way about how they can make a complaint or raise concerns. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 16

p.15

The intended outcomes these Standards are:

• The fostering service prepares young people for adulthood.(NMS 14) • The fostering service pays carers an allowance and agreed expenses as specified.(NMS 29)

p.16

The Commission considers Standards 29 the key standard to be

inspected at least once during a 12 month period.

p.16

JUDGEMENT – The intended outcomes for these Standards are

The system for the payment of foster allowances is satisfactory, however, the system for agreed expenses needs review.

p.16

EVIDENCE:

The administration of the system for the payment of allowances works well and this is administered from the foster team office. Where agreed expenses had been approved by the care management social workers, a number of foster carers were very critical at the delay in receiving payments. In some cases this had taken several weeks. Foster carers felt frustration at these delays because they had personally incurred the expenditure on the instructions of the care management social workers. In discussion with the Resources Manager and the Acting Fostering Team Manager, it was agreed that consideration should be given to exploring if all payments could be made from the fostering office. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 17

p.16

The intended outcomes these Standards are:

• There is a clear statement of the aims and objectives of the fostering service and the fostering service ensures that they meet those aims and objectives.(NMS 1) • The fostering service is managed by those with the appropriate skills and experience. (NMS 2) • The fostering service is monitored and controlled as specified. (NMS 4) • The fostering service is managed effectively and efficiently.(NMS 5) • Staff are organised and managed effectively.(NMS 16) • The fostering service has an adequate number of sufficiently experienced and qualified staff.(NMS 17) • The fostering service is a fair and competent employer.(NMS 18) • There is a good quality training programme. (NMS 19) • All staff are properly accountable and supported.(NMS 20) • The fostering service has a clear strategy for working with and supporting carers.(NMS 21) • Foster carers are provided with supervision and support.(NMS 22) • Foster carers are appropriately trained.(NMS 23)

p.17

The intended outcomes these Standards are:

• Case records for children are comprehensive.(NMS 24) • The administrative records are maintained as required.(NMS 25) • The premises used as offices by the fostering service are suitable for the purpose.(NMS 26) • The fostering service is financially viable. (NMS 27) • The fostering service has robust financial processes. (NMS 28) • Local Authority fostering services recognise the contribution made by family and friends as carers.(NMS 32)

p.17

The Commission considers Standards 17, 21, and 24 the key standards

to be inspected at least once during a 12 month period.

p.17

JUDGEMENT – The intended outcomes for these Standards are

Overall the children benefit from a service that is appropriately managed.

p.17

EVIDENCE:

The service is currently being managed on a temporary basis by one of the seniors acting up as manager. The post has been nationally advertised. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 18 However, all the evidence indicates that the fostering service is appropriately managed.

p.17

EVIDENCE:

The foster care social workers are professionally qualified and there is currently sufficient staff employed to ensure that the work of the unit is carried out. The local authority has invested extra financial resources into the fostering service and this has enabled the team to provide appropriate support for foster carers and also to meet their target of providing an extra thirty new placements during 2005. The Acting Manager, assisted by a Senior Social Worker carry out formal one to one supervision and appraisal of the social workers. Evidence of this was seen. Given the current numbers of foster carers the staffing is regarded as sufficient to ensure that all the foster carers are appropriately supported.

p.18

EVIDENCE:

The Foster carers were generally satisfied with the arrangements for their training and development although some admitted that they did not attend enough courses due to family and work commitments. Consideration should be given to organising training events that cater for these groups of carers and to involve them in the planning process. The foster carers spoken to were positive about the high level of support they received from their social worker. “ My link worker is great and if I need advice I only have to pick up the phone” said one carer. The agency has a clear strategy for working with foster carers that is documented in the Handbook. There is concern among the fostering social workers that some staff are on temporary contracts due to financial pressures faced by the local authority. They questioned if the efficiency of the team would be compromised if those staff left for permanent positions

p.18

EVIDENCE:

A system for one to one formal supervision of staff is in place and the policy of the local authority is that this should take place once a month. An examination of the schedules indicated that this frequency was not always maintained. The Resources Manager said that this was mainly due to the management changes affecting the team.

p.18

EVIDENCE:

All records maintained are kept secure in the office and the children’s case files that were seen contained the appropriate information on each child. The structure of the files however, needs to be reviewed so that the Diary Sheets can be read separately. The current practice is for these records to be located in the Key Information section. Other records are interspersed with these making it difficult to identify trends. A number of records did not have the signature of the author at the end of each entry. Some Diary Sheets had the information scribbled out. Any errors should be identified by having a single line ruled across the information to be deleted and initialled by the person responsible. The foster carers spoken to were generally satisfied with the information given to them about a child before the planned placement commenced. One foster carer said that “ you often have to dig out the

p.18

EVIDENCE:

information from the placing social worker, its like pulling teeth and after a East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 19 while you get to know what questions to ask”. Where an emergency placement takes place the child’s social worker is expected to pass on relevant information as soon as possible. The records kept in foster carers homes were seen and these were all stored appropriately.

p.18

EVIDENCE:

The office accommodation is adequate but space is limited and there is no disabled access. However, the manager confirmed that alternative more suitable meeting rooms can be used at the nearby council offices.

p.19

EVIDENCE:

The value and importance of Kinship carers is recognised by the organisation and the service has a dedicated part time social worker allocated to oversee this work. This is a good use of scarce resources. Kinship carers spoke positively about the support they received from their link social worker. Another relative wrote in the questionnaire:

p.19

EVIDENCE:

“ We have not been supported by anyone………we now have at long last a support worker to confide in and share troubles with”.

p.19

EVIDENCE:

A support group comprising of kinship carers has been developed and this is very much appreciated them. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 20

p.19

SCORING OF OUTCOMES

This page summarises the assessment of the extent to which the National Minimum Standards for Fostering Services have been met and uses the following scale.

p.20

SCORING OF OUTCOMES

4 Standard Exceeded (Commendable) 3 Standard Met (No Shortfalls) 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (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

p.20

SCORING OF OUTCOMES

BEING HEALTHY ACHIEVING ECONOMIC Standard No Score WELLBEING 12 3 Standard No Score 14 x STAYING SAFE 29 2 Standard No Score 3 3 MANAGEMENT 6 3 Standard No Score 8 3 1 X 9 3 2 X 15 3 4 3 30 x 5 3 16 3 ENJOYING AND ACHIEVING 17 3 Standard No Score 18 X 7 3 19 3 13 3 20 3 31 x 21 3 22 3 MAKING A POSITIVE 23 3 CONTRIBUTION 24 3 Standard No Score 25 2 10 3 26 3 11 3 27 X 28 X 32 4 East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No

p.20

STATUTORY REQUIREMENTS

This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Fostering Services Regulations 2002 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales.

p.21

STATUTORY REQUIREMENTS

No. Standard Regulation Requirement Timescale for action

p.21

RECOMMENDATIONS

These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out.

p.21

RECOMMENDATIONS

No. Refer to Standard Good Practice Recommendations

p.21

RECOMMENDATIONS

1 FS20 Staff should receive formal supervision in line with the Local Authority’s policy. 2 FS24 The Key Information Section of the Case File needs to be restructured.

p.21

RECOMMENDATIONS

Any written entries that are to be deleted should have a single line drawn through the entry.

p.21

RECOMMENDATIONS

Diary Sheets should indicate when unannounced visits are made to a foster home.

p.21

RECOMMENDATIONS

3 FS29 A review of how agreed expenses are paid needs to be carried out. East Riding of Yorkshire Council Fostering Service DS0000055966.V266679.R01.S.doc Version 5.0 Page 22

p.21

Commission for Social Care Inspection

York Area Office Unit 4 Triune Court Monk's Cross York YO32 9GZ

p.22

Commission for Social Care Inspection

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

p.22