Please wait

Inspection on 13/03/08 for Rachel Mazzier House

Also see our care home review for Rachel Mazzier House for more information

This is the latest available inspection report for this service, carried out on 13th March 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The atmosphere in the home was comfortable, homely and relaxed and staff were seen to be kind, encouraging and caring towards people living in the home. Staff have the skills and commitment to encourage people living in Rachael Mazzier to live active lives and therefore individuals are able to access the wider community by attending day centres, local colleges and doing voluntary work in local centres. Each individual has a plan of care that clearly outlines their chosen daily living routines and preferred ways of receiving care. People moving into the home are encouraged to bring in their personal possessions to personalise their bedrooms. There is an open-house policy, which welcomes visitors at all reasonable times and satisfactory arrangements are in place for dealing with complaints are ensuring that people living in the home and their relatives feel their concerns are listened to and acted upon.

What has improved since the last inspection?

Individual risk assessments are now in place in respect of hot water delivery temperatures, temperature controlled valves have been fitted to all hot water outlets as required and hot water delivery temperatures are checked weekly. All staff have now received training in risk assessments to ensure they are aware of risks and how to minimise them.

What the care home could do better:

That a temperature controlled valve is fitted to the staff toilet washbasin as although people living in the home are not supposed to use it they do have access to it so there is a risk. A fire risk assessment needs to be carried out for the entire premises and made available for inspection. That a written reason is given for any gaps in employment history and that relief staff, who work alone, be trained to at least National Vocational Qualification level 2 in care.

CARE HOME ADULTS 18-65 Rachel Mazzier House 25 Chatsworth Road Brighton East Sussex BN1 5DB Lead Inspector Gwyneth Bryant Unannounced Inspection 13 March 2008 12:20 th Rachel Mazzier House DS0000014228.V359415.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 Rachel Mazzier House DS0000014228.V359415.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. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rachel Mazzier House Address 25 Chatsworth Road Brighton East Sussex BN1 5DB 01273 564021 01273 564021 mail@sussextikvah.org.uk 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) Sussex Tikvah Ms. Joanne Osbaldiston Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of services users to be accommodated must not exceed six (6). Service users must be aged between eighteen (18) and sixty-five (65) years on admission Service users with a learning disability only to be accommodated. Date of last inspection Brief Description of the Service: Rachel Mazzier, also known as Sussex Tikvah is a registered care home providing support for six people who have a learning disability. The home caters for people of the Jewish faith who have low to medium needs. The home provides only long term placements Brighton Housing Trust owns the building and the Jewish Charity, Sussex Tikvah, is responsible for the day to day running of the home and internal maintenance. The home is located on the outskirts of Brighton and within a fifteen-minutes walk of Brighton town centre, in addition there are local shops and amenities nearby. The home is a converted semi-detached domestic dwelling located in a residential street. Parking is restricted to pay and display bays. The home is presented across three floors with access to all floors via stairs. The stairs and other access arrangements mean that the home is suitable for residents who are mobile. Residents’ accommodation consists of six single bedrooms. Communal space consists of a lounge, dining room and small courtyard garden. The homes literature states that it aims to maximise independence by involving residents in all aspects of the running of the home and support residents in the practice of their religious beliefs. Extras such as: newspapers, holidays, cinema hairdressing, chiropody and massage are additional costs. Rachel Mazzier House DS0000014228.V359415.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 2 star. This means the people who use this service experience Good quality outcomes. This was an unannounced inspection and took place in approximately 3.5hours. The purpose of the inspection was to check compliance with the requirements made at the last random inspection, which was carried out in September 2007 as a result of a safeguarding adults alert, and to check key standards. Six people were in residence on the day of which three were spoken with. The Manager, her deputy and one carer were also spoken with. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. The CSCI normally requests information from the registered providers prior to the site visit, however this request came too late for the information to be provided to inform this site visit. What the service does well: What has improved since the last inspection? What they could do better: Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 6 That a temperature controlled valve is fitted to the staff toilet washbasin as although people living in the home are not supposed to use it they do have access to it so there is a risk. A fire risk assessment needs to be carried out for the entire premises and made available for inspection. That a written reason is given for any gaps in employment history and that relief staff, who work alone, be trained to at least National Vocational Qualification level 2 in care. 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. Rachel Mazzier House DS0000014228.V359415.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 Rachel Mazzier House DS0000014228.V359415.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 and 3 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People moving into the home benefit from an admission process that ensures their individual needs and aspirations are assessed and identified as being able to be met prior to moving into the home. EVIDENCE: There have not been any new admissions to the home for a number of years but the deputy manager confirmed that people who wished to move into Rachael Mazzier would have a full assessment of their needs. She also confirmed that copies of the homes Statement of Purpose and service users guide would be made available on request. Care plans viewed included copies of contracts and statements of the homes terms and conditions each of which clearly outlines the services offered in the home. Rachel Mazzier House DS0000014228.V359415.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 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The standard of care planning provides staff with a good foundation to support individuals in a way that both enables and protects them. People living in the home are consulted and involved in all decisions about their lives. EVIDENCE: Generally people living in the home are fully mobile and independent for personal care, although most require some level of prompting and staff supervision to ensure safety personal hygiene is maintained. Six care plans were viewed and found to include clear information on preferred daily routines with evidence that the basis of care provision is person centred. In addition the care plans are written in plain English to ensure each individual has an understanding of their own care needs and how they will be met. Additional information based on input from social and healthcare professionals are included in care plans and regular visits to opticians and dentists are organised as required. A key worker system is in place ensuring that individuals receive consistent care from a named individual. Discussion with the deputy Manager and two Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 10 staff and observation of their practices, it was evident that they have developed good relationships with the people they support and a good understanding of their needs as individuals. There was evidence to show that individuals are involved in compiling their care plans and agree to any limitations as a result of reducing risks. Both risk assessments and care plans are regularly reviewed to ensure that changes in care needs are identified and planned for. Care plans included information as to how individuals were consulted, both singly and as a group to ensure they have the opportunity to participate in the day-to-day running of the home. A range of risk assessments were found to be in place that demonstrates a positive approach to risk taking and people are supported to take risks to maximise choice and independence. Risk assessments demonstrate that the underlying principle is to enable people to live their lives as they chose with restrictions in place only if absolutely necessary. Rachel Mazzier House DS0000014228.V359415.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, 15, 16 and 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in Rachael Mazzier benefit from the ability to lead independent lives with appropriate support to develop their educational, vocational and social skills and are involved in planning balanced and nutritious meals. EVIDENCE: People living in the home have a wide range of opportunities to participate in a variety of activities both within the home and in the wider community. Each individual attends college to participate in a chosen course of study linked to their preferences. They are also encouraged and enabled to attend various day centres and carry out voluntary work at local centres. Care plans included information on both short and long term goals in addition to aspirations for the future. Currently, five people living in the home spend weekdays doing voluntary work; attend colleges or day centres, with one who chooses to spend most days in the home. All individuals go out into the community alone to shop, visit with friends and family or to visit local attractions and this is supported by Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 12 detailed risk assessments that ensure each person is aware of road safety and other risks. In addition all individuals have an annual holiday to a destination of their choice. One person spoken with said their room had just been decorated and they had chosen the colours and soft furnishings. This person confirmed that she and the other residents are enabled to make the Friday meal which is in line with the religious needs of those living in the home. The written meal rota further demonstrated that individuals are supported to make meals on a daily basis to ensure life skills are learned and maintained. Another person spoken with said she had been on a creative writing course and now writes each day both in her personal diary and for pleasure. Records show that people living in the home are supported to choose well balanced and nutritious menus, with particular regard to the particular dietary needs related to medical conditions and religious preferences. Rachel Mazzier House DS0000014228.V359415.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): People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from the provision of flexible and respectful personal and healthcare support and are protected by the systems in place to manage medication. EVIDENCE: Staff spoken with individually were knowledgeable about the needs of individuals in the home and how best to meet those needs and care plans including information on healthcare needs such as visits to the dentist and optician as required. Clear records are maintained for those people who need regular hospital appointments to monitor their medical conditions. The care planning systems include the type of specialist support and advice required from psychologists, dietician and occupational therapist to ensure all aspects of healthcare needs are identified and met in full. Care plans include detailed lists of how personal care is to be delivered to individuals and ensure that all staff are able to deliver care in a manner preferred by the individual. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 14 The storage and administration of medication were found to be satisfactory. Medication administration records were clear, accurate and up to date. Some individuals manage their own medication within a risk assessed framework and are provided with lockable storage facilities in their bedrooms. Others living in the home self medicate certain medication such as mild painkillers and asthma inhalers. The deputy manager confirmed that all staff who administer medication have received appropriate training. All aspects of medication administration is regularly checked by the homes’ pharmacist. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that service users feel that their views are listened to and acted upon and they are further protected by satisfactory safeguarding adult procedures. EVIDENCE: A review of the complaints book revealed that the home has not received any complaints since the last inspection nor has the CSCI has not received any complaints in relation to this service. There is a pictorial version of the homes complaints procedure and the deputy manager confirmed that all people living in the home are given a copy. The home has a copy of the new local policies and procedures for the safeguarding of vulnerable adults available in the home and this is in addition to internal policies and procedures on Protection of Vulnerable Adults. Examination of staff training records found that all staff have been trained in Protection of Vulnerable Adults procedures. A safeguarding adults alert was received by the CSCI in 2007 which involved a resident being scalded by getting into a hot bath. As a result of this alert, temperature control valves have been fitted to all hot water outlets used by people living in the home. In addition, detailed risk assessments have been carried out to ensure that individuals have full understanding of the need to ensure bathing water is not too hot. The individual concerned has fully recovered and has returned to live in the home. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. All parts of the home are homely, safe, well maintained and comfortable ensuring that it is a pleasant place in which to live. EVIDENCE: A tour of the premises was carried out and all bedrooms are light, airy and there are sufficient bathing and toilet facilities to meet the needs of people living in the home. The home is run as a family home and it was evident that people living there view it as their own home and take an active part in ensuring it is clean and tidy, although a cleaner is employed for the heavier type of cleaning. The deputy manager confirmed that all staff have been trained in infection control and food hygiene ensuring they have the skills to support individuals in maintaining good levels of cleanliness both personally and in their day to day lives. Laundry facilities are such that although as there is currently no need for industrial washing machines due to the independence of people living in the Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 17 home, however a commercial washing machine has been installed to ensure infection control washing programmes are available if required. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. . People living in the home benefit from a dedicated and competent team of staff but improvements need to be made to the recruitment procedures. Most staff have the skills to enable them to perform their roles effectively. EVIDENCE: The deputy manager confirmed that there are three permanent staff of which two has at least National Vocational Qualification level 2 in care and one has level 3. Four relief staff are also employed and none of these have a National Vocational Qualification. Given that these staff may be working alone at weekends a plan needs to be devised to ensure they achieve this qualification to ensure they have the skills to provide good quality care. Staff have access to a range of mandatory and specialist training including; fire safety, first aid, food hygiene and adult protection and manual handling. Additional training in dealing with Autism is also provided. The staff who met with the Inspector demonstrated a good understanding of the needs of the people they support and it was evident they felt competent to provide the necessary care and support to those living in the home. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 19 Regular staff meetings are conducted with minutes recorded and these are held collectively in the main office. All staff sign a form to confirm they have completed the induction and understand the terms and conditions of their employment and all staff have a job description that outlines their roles and responsibilities. Recruitment records for the last two people employed were viewed and the required documentation including Criminal Record Bureau checks and proof of identity, were in place, however one application form showed an employment gap between 2005 and 2006. A written explanation gaps in employment history needs to be provided to ensure people living in the home are not at risk. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service is well managed and most aspects of the welfare, safety and health of people living in the home are protected and promoted. EVIDENCE: The Registered Manager and her deputy have both worked in the care industry for a number of years and both have the skills, qualification and experience to manage the home and provide clear leadership and direction to staff. The atmosphere of the home is open and throughout the site visit staff were obviously comfortable coming to the office to access information as necessary. Sussex Tikvah has quality monitoring system that includes monthly audits and regular surveys for families and service users. Regular staff and service users meetings are carried out and service users are encouraged to take the minutes of meetings to ensure they develop literacy skills while being enable to comment on the running of the home. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 21 All accidents are recorded and monitored as part of the quality monitoring process to ensure that any risk areas can be addressed promptly. There was evidence to show that regular safety checks are carried out on all equipment, including electrical and gas appliances and systems. In addition there is an on-going programme of maintenance, upgrading and renovation of all parts of the home, including individual rooms. Due to the safeguarding adult alert temperature control valves have been fitted to all hot water outlets, with the exception of the washbasin in the staff toilet. Although people living in the home do not use this toilet it remains accessible to them therefore a control valve needs to be fitted to this outlet to reduce the risk of scalding. All staff receive regular fire safety training but a fire safety risk assessment was not available, however following the site visit the Registered Manager confirmed this document is in place and that the home fully meets fire safety requirements. Regular fire drills are carried and fire alarm systems regularly tested ensuring neither staff nor people living in the home are at risk in the event of fire. Self-closing devices, triggered by the fire alarm are fitted to all internal doors that require them. All staff have been trained in risk assessments, manual handling and infection control. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 X 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 3 X LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 2 x Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2. Standard YA34 YA42 Regulation 18(1) 13(4)(a) Requirement That all employees provide a written explanation for any gaps in their employment history. That all hot water outlets that service users have access to, including the staff toilet are checked regularly to ensure that service users are not at risk of water being delivered above the safe temperature range. Timescale for action 13/04/08 13/05/08 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 YA35 Good Practice Recommendations That a plan be developed to ensure relief staff are trained to at least National Vocational Qualification level 2 in care. Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Rachel Mazzier House DS0000014228.V359415.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!