Inspection on 05/08/08 for Oxley Woodhouse

This is the latest available inspection report for this service, carried out on 5th August 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/11/2008.

CARE HOME ADULTS 18-65 Oxley Woodhouse Woodhouse Hill Fartown Huddersfield West Yorkshire HD2 1DH Lead Inspector Cheryl Stovin Key Unannounced Inspection 5th August 2008 09:30 Oxley Woodhouse DS0000070772.V369552.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 Oxley Woodhouse DS0000070772.V369552.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. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oxley Woodhouse Address Woodhouse Hill Fartown Huddersfield West Yorkshire HD2 1DH 01943 865654 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) oxley@woodleigh-care.co.uk Isand Ltd -------------------(not yet registered) Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC; to service users of the following gender: Either; whose primary care needs on admission to the home are within the following categoies: Learning Disability - Code LD. The maximum number of service users who can be accommodated is: 13 New Service 2. Date of last inspection Brief Description of the Service: Oxley Woodhouse is registered to provide accommodation and care for up to thirteen adults with a learning disability and associated challenging behaviours. The home is situated in a residential area in the Fartown district of Huddersfield. There is easy access by public transport to the town centre. The home is well maintained throughout. All bedrooms are for single occupancy and all are equipped with en-suite facilities. There are spacious and comfortable communal areas which are furnished and fitted to a high standard. People’s weekly charge is subject to the level of care required. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is Two Stars. This means the people who use this service experience good quality outcomes. This report brings together evidence gathered during the Key Inspection of Oxley Woodhouse. This included a visit made by two inspectors to the home on 5th August 2008. A total of six hours were spent on the visit. During this visit we looked round the building looked at records and talked to people living and the home and to management and staff. This was the first inspection of the home since it was registered and no additional visits have been made. The purpose of the inspection is to make sure that people receive the care and support they need and that they and their families are satisfied with the service. An Annual Quality Assurance Assessment (AQAA) completed by the home was returned promptly and gave useful information. I would like to thank everybody for their warm welcome and assistance given during this inspection. What the service does well: This was a very positive first inspection of Oxley Woodhouse. There is a warm, homely and lively atmosphere in the home with staff and people living at the home working together as a team. People said that they enjoy living at the home and are very satisfied with the services and facilities provided. The staff are well trained and provide assistance to people in a manner which promotes independence and dignity. People living at the home said that the staff always treat them well and relationships between everybody are relaxed and friendly. The home is well managed and the manager is committed to ensuring that people living at the home and the staff contribute to the decision making processes. People are protected by the recruitment procedures which makes sure that all the necessary checks are carried out before staff are employed. This makes sure that only suitable staff are employed in the home. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 6 The home is well maintained throughout and furnished and fitted to a good standard. All of the bedrooms are spacious and equipped with en-suite bath or shower facilities. People are encouraged to personalise their own rooms and they are obviously very proud of their personal possessions People live active and varied lives and are very much part of the local community and make use of a wide range of social and recreational facilities. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oxley Woodhouse DS0000070772.V369552.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 Oxley Woodhouse DS0000070772.V369552.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2&4 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are assessed before moving into the home to make sure that the home can meet their needs. EVIDENCE: Everybody is fully assessed before moving in to make sure that the home can meet their needs. People are encouraged to visit the home several times before moving in to give them an opportunity to meet the staff and other people living at the home, and to sample the daily routine. The care plan for a person in the process of moving into the home was seen and it was very detailed and the visits had been taken at the persons own pace. The assessment process is on-going with detailed involvement from the person using the service and their relatives and fellow professionals. Oxley Woodhouse DS0000070772.V369552.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s current needs are recorded in their care plan to make sure that support is given in accordance with their needs and preferences. People are fully involved in all aspects of daily life within the home and are encouraged and supported to be as independent as possible. EVIDENCE: Six people’s care records were looked at. The care plans are detailed and clearly show how people prefer to be supported in their daily routine. The care plans are completed with the people living at the home. This helps staff to understand the person as a whole, and contains details of people’s abilities, likes and dislikes, interests and family history. The care plans are detailed and give very clear instructions as to how the individual prefers the care to be given and the routines to follow from the beginning to the end of the Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 10 day. The care plans contain what time people like to get up and what routines they like to follow during the day. Everybody’s care plans are reviewed every month by a ‘catch up’ meeting which is held on a one to one basis with their key worker. This meeting identifies areas for development and goals and aspirations that people have, and details who will do what to help meet the goals set. Detailed risk assessments are in place which are reviewed on a regular basis, this makes sure that risks are minimised and people are kept safe. The risk assessments include any potential risks both in and out of the home including the use of public transport. People are encouraged to participate in the day to day running of the home and join in all activities of daily living. Staff and everybody living at the home appeared to be working together as a team. Oxley Woodhouse DS0000070772.V369552.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People enjoy active and varied lifestyles and participate in a wide range of community activities. EVIDENCE: The atmosphere in the home is lively and welcoming, with everybody working together in the day to day running of the home. People are very much part of the local community and make use of a wide range of social and recreational facilities. Some people go to college and day centres, horse riding, sports centre’s, swimming, church and pubs. During the visit people were going out and about, some accompanied by staff others independently. People are encouraged to maintain and develop their own interests and to learn new skills. One person living at the home is a keen gardener and proudly Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 12 showed us the hard work he has out in transforming the garden since he moved in. In addition to shrubs and flower garden he has also developed a vegetable plot and a herb garden which will be used in the meals cooked at the home. People said that they enjoy living at Oxley Woodhouse and relationships between everyone during the visit were seen to be relaxed and friendly with appropriate use of light hearted humour and ‘banter’. People are encouraged to keep in touch with family and friends. One person is shortly moving out of Oxley Woodhouse to return to his home town. Arrangements for keeping in touch with another resident with who he has struck up a firm friendship whilst living at the home are very much part of his future plan of care. There is an emphasis on healthy eating in the home. There are no set mealtimes and people living at the home choose the menu’s to make sure that everybody has the chance to eat their favourite meals. Everybody works together preparing and cooking the meals and doing the food shopping. Oxley Woodhouse DS0000070772.V369552.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s health care needs are met and personal care is given in accordance with their preferences. EVIDENCE: People’s personal support needs are assessed and form part of their plan of care. People’s physical and psychological health care needs are assessed and detailed in their individual support plans. Some people have significant and complex support needs, clear strategies are in place to ensure support is given consistently by all staff. All personal care is given in private, and people were seen to be treated with dignity at all times. People living at the home said that they are treated well and staff spoken to were able to demonstrate a thorough understanding of people’s needs. The home has a regular quality assurance monitoring procedure in place where health and social care professionals and relatives are regularly consulted as to Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 14 their opinions on the standard of care provided. The results are collated and published. The latest findings from the report of July 2008 were very positive. Some of the comments received from professionals included: “The service has been exceptional at working towards meeting the clients needs and working in conjunction with our service”. “Able to meet the needs of a person who presents with difficult to manage behaviours whilst ensuring a person centred approach . Focus on improving the quality of life of the individual”. “X has presented some challenging behaviour and anti-social behaviour, which have been managed well by the care team”. “They have the ability to meet the complex needs of the individual whilst maintaining health, safety and well-being”. “A very supportive service with a clear emphasis upon a person centred approach, with clear goals to improve on skills of the service user and reduce distress”. “A quick supportive response in meeting the needs of the individual at a highly stressful time for him”. Relatives made the following comments: “Oxley Woodhouse give good overall care”. “X had a bad experience before coming to Oxley, we can see a big change in him already, he seems happier and relaxed. Thanks to Jackie and staff for the excellent job they are doing”. One relative couldn’t comment as they said that they “had had no information about how their family member was doing”, a senior member of the management team within the organisation said they would follow this up. The person in charge on the day confirmed that all staff that gives medication to people have had training and the staff confirmed this. There was also evidence that the manager audits the medication weekly to ensure that it is being given correctly and safely. A sample of medication and records were checked, and with the exception of dental gel and bath oil for one person, the administration and recording of the medication were done correctly. The staff were not always signing the medication chart to show that the dental gel and bath oil had been used. The manager said that she would ensure that all staff sign the medication chart when those medication have been given. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 15 In one of the handwritten entries the member of staff had not copied the instructions from a box of medication as it had been written onto the medication chart. Staff should ensure that the instructions on the medication chart match that what is recorded on the prescribed medication container to ensure that administration errors are not made. These areas were discussed with the manager and she said that she would continue to monitor and audit the medication weekly to prevent further errors occurring. With reference to the storage of controlled drugs, in 2007 the law changed. All care homes, whether providing nursing or personal care, must now keep controlled drugs (CD) in a controlled drugs cupboard. As the home does not presently comply with these requirements, a timescale of three months is given for the ordering and installation of the cupboard. The provider of the service is recommended to contact their local pharmacist should they need further advice. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are protected by the adult protection procedures which the staff understand and put into practice. This makes sure that people living at the home are safe. EVIDENCE: The home has a complaints procedure which is displayed and includes details of who to contact if anybody is unhappy about anything in the home. A record is kept of any complaints received and what the outcome of the investigation was. Staff training records showed that all staff undertake Protection of Vulnerable Adults (POVA) training. Staff I spoke to demonstrated an awareness of the protection of vulnerable adults, and of the procedure to follow if they witnessed or suspected that people were not being treated properly. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a safe and clean environment which suits their needs. EVIDENCE: Oxley Woodhouse is situated in a residential area in the Fartown district of Huddersfield with easy access to the town centre. The property a large detached residence has recently been totally renovated and adapted to meet the needs of the people living there. Everybody has their own spacious bedroom which is fully equipped with either bath or shower en-suite facilities. The communal areas are spacious and comfortable and provide sufficient areas for activities to take place. All bedroom doors are fitted with locks and a lockable facility is provided for people to keep their belongings safe. People said that they liked their own rooms and the majority of people have personal possessions displayed to truly make it feel like home. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 18 A full tour of the home was undertaken which showed that all areas of the building were seen to be fresh and clean. There are some areas of the building, where following renovation work, the finish to the paintwork etc., has not been completed to a high standard. It was suggested that the building contractors be contacted to rectify this. There are well maintained and easily accessible gardens for people to enjoy in the warmer weather. There is a smoking area on the patio for people wishing to smoke. There are well equipped laundry facilities where people are assisted to wash and dry their clothes. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s needs are met by a well trained and competent staff, and are protected by the rigorous recruitment practices. EVIDENCE: There are sufficient staff on duty to meet the needs of the people living at the home. There are eight support workers on duty, plus the manager, during the day time and at night there are three waking night staff. The staff team work flexibly to meet the social and recreational needs of people. The staff appeared to work together as a team and relationships with people living at the home were observed to be relaxed and friendly, with appropriate use of informality and humour. There is a commitment to staff training in the home with all staff required to undertake training to LDAF (Learning Disability Award Framework) specification. There is an induction training programme in place which meets the common induction standards to Skills for Care specification. Mandatory training for staff includes, restraint and control, fire awareness, first aid, health Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 20 and safety, food hygiene, moving and handling and safe handling of medication (for senior staff). In addition to the mandatory training staff have also received training around peoples specific needs, for example epilepsy and autism training. Staff said that they enjoy and appreciate the amount of training provided. To make sure that people receive consistent support from a competent and qualified staff team all are required to undertake NVQ training. As staff complete a satisfactory probationary period they will be registered to complete the NVQ level 2 or level 3 award. The staff recruitment files of three recently appointed support workers were seen. All of the files contained CRB (Criminal Records Bureau) and POVA (Protection of Vulnerable Adults) disclosures. Two written references, an application form and proof of identity were also in place. This makes sure that only suitable people are employed at the home. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41 & 42 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a well run and managed service. People’s health and welfare is protected by the home’s health and safety practices. EVIDENCE: The acting manager of the home is experienced and competent to run the home. She is qualified and has completed the NVQ level 4 Registered Managers Award. She is in the process of applying to us to be registered as manager of the home. The management team are committed to ensuring that an open and positive atmosphere is prevalent in the home. The manager was seen to be very Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 22 approachable during the visit and welcoming the opinions of people living at the home and the staff team. All people have their own bank accounts and financial procedures are in place to make sure that people’s money is handled safely. There is a commitment to health and safety and safe working practices in the home. All staff receive mandatory health and safety training with regular updates. Fire drills are carried out on a regular basis and all staff receive fire safety training. Detailed risk assessments are in place which are reviewed and updated on a regular basis. Certificates were seen which showed compliance with gas and electrical regulations. There is a formal quality assurance system in place to make sure that people are satisfied with the service provided. The last survey showed that people living at the home, their relatives and fellow professionals were highly satisfied with the service provided by Oxley Woodhouse. Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 x 28 3 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 3 2 3 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 2 3 3 3 3 x 3 3 x Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 YA20 Regulation 13.- (2) Requirement The Law for the storage of controlled drugs (CD) changed in 2007, therefore the provider is required to provide a cupboard for the storage of the CD’s to comply with this Law. Timescale for action 05/11/08 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. Refer to Standard YA20 Good Practice Recommendations Staff should ensure that they sign the medication chart to show when cream, gels and oils are given to ensure that people are receiving the correct treatment as prescribed by their doctor. Staff should ensure that when they are hand writing instructions from a box of medication onto the medication chart, that they correctly copy the instructions to ensure that administration errors are not made. To make sure that people receive consistent care from qualified staff 50 of the staff team must be qualified to National Vocational Qualification (NVQ) level 2. 2 YA20 3 YA32 Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oxley Woodhouse DS0000070772.V369552.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!