Inspection on 19/12/06 for 103 Steyne Road

This inspection was carried out on 19th December 2006.

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

The inspector 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.

Other inspections for this house

103 Steyne Road 13/11/08

103 Steyne Road 06/12/05

103 Steyne Road 20/07/05

103 Steyne Road 05/01/05

103 Steyne Road 21/07/04

103 Steyne Road 19/08/02

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 103 Steyne Road 103 Steyne Road Seaford East Sussex BN25 1AL Lead Inspector June Davies Unannounced Inspection 19th December 2006 10:00 103 Steyne Road DS0000020991.V319299.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 103 Steyne Road DS0000020991.V319299.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. 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 103 Steyne Road Address 103 Steyne Road Seaford East Sussex BN25 1AL 01323 490508 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) Southdown Housing Association Limited Devlin Storm Nye Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is four (4). Service users must be aged between eighteen (18) and sixty five (65) years on admission. Only adults with a learning disability are to be accommodated. Date of last inspection Brief Description of the Service: 103 Steyne Road is a Southdown Housing Association service providing residential care to four adults who have learning disabilities. The home is located close to the seafront and to Seaford town centre. There are public transport links within walking distance. The home is a detached property, with four single bedrooms, two lounges, a dining room, kitchen and conservatory. There is a secure garden and patio area at the back of the property. Service users are able to decorate their bedrooms to suit their individual preferences. There is a downstairs bathroom, with a bath seat available. Service users are supported to access a range of day, educational and leisure facilities from the home and in the local community. Fees are £1,200.00 to £1,500.00 per week. 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection carried out over a period of three hours, the inspector was able to speak with one service user, three members of staff, made a short tour of the premises and also viewed the documentation relevant to the key standards. The registered manager was not available at the time of the inspection. Since the inspection the inspector has also been able to speak with one relative on the telephone. What the service does well: What has improved since the last inspection? One service user who has become too frail to remain in a first floor bedroom has now moved into a room on the ground floor, this entailed some major alterations to meet with the requirements of the fire safety officer. What was previously a first floor bedroom has now been made into a quiet lounge for the other service users. Re-decoration of bedrooms and communal areas has taken place. A new specialist bath has been fitted into one of the bathrooms to meet the assessed needs of the service users. The outside of the building has been redecorated and a garden wall has been replaced as well as the garden furniture. The front door security lock is now integrated into the fire alarm system to ensure the front door automatically opens should there be a fire and further security lighting has been installed externally. 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 103 Steyne Road DS0000020991.V319299.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 103 Steyne Road DS0000020991.V319299.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): Standards 2 and 4 Quality in this outcome area is good. Pre-admission assessment is comprehensive, allowing the home to identify the needs of prospective service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new service users in the home for a number of years. The inspector viewed the pre-admission assessment and found it to be comprehensive and gives good information on which to base a care plan. All staff are aware of the policy and procedure for assessing prospective new service users. The home also obtains pre-admission assessments from Care Manager, Psychiatrist/Community Nurse where possible and relevant. The member of staff spoken to, said that while the staff may be able to meet the needs of the prospective service user, the staff also have to ensure that relationships with a new service user and present service users will be good. All prospective service users will be required to visit the home prior to moving in. 103 Steyne Road DS0000020991.V319299.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): Standards 6, 7 and 9 Quality in this outcome area is good. Care plans give very good information regarding the care and support that service users require, both in with personal and social care, and know that potential risk will be managed. Service users are well supported by staff to take make choices in their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector viewed the care plans of three service users presently living at 103 Steyne Road. The care plans were very informative and individual regarding the level of care and support that these three service users need. All care plans contained detailed evidence of how challenging behaviour can be reduced, key points that may spark challenging behaviour. Each care plan is reviewed six monthly, by manager and the service user’s key worker, followed 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 10 by a bigger review each year where the key worker, manager, members of multi disciplinary team and families present. As far as their disabilities will allow service users are able to make choices in regard to their everyday lives, what food they would like to eat, what activities they would like to be involved in, where to go on trips and holidays, what television programmes to watch. The inspector observed staff helping a service user to make a choice of what they would like for tea. This service user told the inspector that he is able to make choices, and showed the inspector his photograph album of trips that he had made. He also said that he is able to choose when to go for a beer with a member of staff. The inspector noted within the three care plans all had risk assessments relating to risks in the service users everyday lives. The inspector noted that all risk assessments gave clear guidelines to staff as to how the level of risk can be reduced for the service users. A member of staff said that they try to explain to the service users what the risk is and what must be done to reduce the risk. The home has policies and procedures in relations to risk assessment and service users absconding/missing from placement both these documents had been reviewed in the last year. 103 Steyne Road DS0000020991.V319299.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): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is good. Links with the community are good and support and enrich the service users social opportunities. Staff ensure that service users are able to maintain their links with families and friends. Personal care is offered in a way to protect service users’ privacy and dignity. The meals in this home are good offering both choice and variety and catering for special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users are supported by the staff in the home to take part in a range of activities within their capabilities. Two service users due to their frailty are more limited in what activities they can participate in but staff do 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 12 take them out on a daily basis, to local cafes and shops. Another service user likes gardening, and attends a gardening placement. All the service users like to go shopping with staff and visiting local cafes. Communication is limited and is mainly through picture cards and visual aids. One service user who spends a lot of time in the home enjoys playing with cards and toys and occasionally watches the television. All the service users have life books with photographs of activities and outings they have taken part in. Service users go into the community on most days. The service users also enjoy using all forms of public transport to go further a field. The inspector evidenced via the duty rotas that during the evening and at weekends sufficient staff are on duty so that the service users may go out if they wish to. One service user likes to go to the pub some evenings with a member of staff. Service users in the home are encouraged by the manager and staff team to maintain links with their family and friends. Two service users do have family and receive regular visits from them, another service user who does not have family does have a long term friend who visits. During the inspection the inspector witnessed staff respecting the service users privacy and maintaining their dignity when carrying out personal care. Service users are able to lock their bedrooms, but the locks can be opened by staff in the case of emergency. All the service users in the home would need help and support with their mail, staff will sit down with service users who have received mail, to help them open it, and to explain the contents. The inspector evidenced that staff have continuous interaction with the service users in the home. Service users are set goals in regard to daily tasks, and are assisted to complete these by the staff team on duty. The home has a five-week rotating menu, which is produced in picture form so that the service users may choose which meals they would like on which day. The inspector was able to view copies of these menus and evidenced that the service users are offered a nutritious and balanced diet. All the service users are offered three meals per day, and are able to have drinks and snacks inbetween their meals if they wish to. One service user is diabetic and therefore staff need to be aware of this when assisting with choosing a meal, another service users needs their food cut up and this is done in an appealing and appetizing way. Service users have their weight checked each month and this is recorded into their care plan and any concerns are reported to the G.P. The service users are able to choose where they wish to eat, but mainly use the dining room, mealtimes are relaxed and unrushed, and are flexible to fit in with the service users activities. 103 Steyne Road DS0000020991.V319299.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 and 20 Quality in this outcome area is good. The health needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. The medication in the home is well managed promoting good health. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal care is provided in a sensitive and flexible way and in the privacy of the service users own bedroom or bathroom. One service user told the inspector that they are able to get up and go to bed when they wish to. All the service users’ need some level of assistance with personal hygiene from members of staff. The staff take the service users out shopping so they may choose their clothes. All the service users have limited communication and are supported by staff in the form of picture cards and where necessary the assistance of the speech and language therapist is sought. 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 14 From viewing the care plans of the service users the inspector was able to ascertain that service users receive a variety of health care resources from diabetic nurse, speech and language therapist, psychologist, learning disability nurses, continence nurse, physiotherapist and regular visits from general practitioners, chiropodists, dentists and opticians Service users are able to visit the G.P. of their choice in the G.P.’s own surgery if they wish to. The service users always have a member of staff to accompany them to the G.P., dentist, chiropodist, optician and to hospital appointments due to their difficulty in communication. The home has a medication policy and procedure that was reviewed in July 2006. All the staff are trained to administer medication to the service users and the inspector witnessed that there is a list, with the names of the staff, their signatures and initials. None of the service users are self-medicating. Two members of staff always initial the MAR sheet for all medication given in the home. At the time of the inspection none of the service users were prescribed controlled drugs. One service user needs insulin injections for their diabetes and all staff have been trained in the administration of insulin. The inspector carried out an audit of medication and found that MAR sheets had all been signed off correctly and the medication tallied with the MAR sheet. All medication had been appropriately recorded when coming into and going out of the home, with dates, quantity and initials of the staff responsible. 103 Steyne Road DS0000020991.V319299.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): Standards 22 and 23 Quality in this outcome area is good. The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted on. Staff have a good knowledge and understanding of adult protection issues which protects service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy and procedure together with the whistle blowing policy and procedure have been reviewed this year. The home has received no complaints since the last inspection. Staff said they were able to tell if the service users were unhappy, by body language and their general mood. Staff then try to ascertain what the problem might be and try to resolve any problems within their team meetings. The home has recently reviewed adult protection, harassment, absconding/missing, bullying, management of service users money and valuables policies and procedures, the inspector viewed the policies and procedures file, which is kept in the staff office. Staff were able to confirm that they were aware of and had read these policies and procedures. There have been no adult protection concerns since the last inspection. All staff have received training in the protection of vulnerable adults and it is also part of new staff induction training. 103 Steyne Road DS0000020991.V319299.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): Standards 24 and 30 Quality in this outcome area is good. The standard of the environment within the home is good providing service users with an attractive, clean and homely place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the inspector found the home in good decorative order, it was clean and tidy and there were no offensive odours. The inspector toured the building and since the last inspection one of the service users bedroom has been moved to the ground floor, and the vacant bedroom on the first floor has been made into a quiet communal lounge and all redecorating work has been completed. One of the bathrooms has been renovated and a specialist bath has been provided to meet the needs of the service users. Several of the rooms have been redecorated, two bedrooms, dining room, kitchen, conservatory, lounge and hall and stairs. The exterior of the home 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 17 has also been redecorated, and roof and gutters serviced. Extra lighting has been installed outside, garden furniture has replaced, and garden wall has been rebuilt. Door closures have been fitted and the lock on the front door has been replaced and connected to the fire alarm system, to ensure the door opens when the fire alarm goes off. The premises were found to be clean and hygienic, and systems for the prevention of cross infection were in place. The home has a contract for the disposal of its clinical waste. All clinical waste is disposed of in the appropriate yellow bags. The laundry is situated away from the kitchen, and is clean and well ordered. All staff have received training in the prevention of cross infection. 103 Steyne Road DS0000020991.V319299.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): Standards 32, 34 and 35 Quality in this outcome area is good. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. The recruitment policies are good and ensure that service users are not placed at risk. Staff are multi skilled ensuring a good quality of care and support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector viewed the staff rotas and found that sufficient staff were rostered on duty for the morning, afternoon and night shift. Extra staff were on duty at busy periods during the morning and sufficient staff were on duty at other periods to ensure that service user could pursue their chosen activities. Staff also confirmed that each service user has their own key worker. On the day of the inspection the manager was not available and staff personnel files were locked away. The inspector spoke with three members of staff, all stated that they had completed application forms prior to employment, had given the names of two referees, and had been CRB checked 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 19 prior to employment. All three members of staff had also received induction training and receive regular supervision. Three staff confirmed that they had received TOPPS related induction training as well as further job related training and training updates throughout their employment in the home. Eight of the nine staff employed have achieved NVQ level two or three. The inspector was also able to view the training folders of staff and this showed that all staff have completed mandatory training in relation to health and safety (moving and handling, fire safety, first aid, food hygiene and infection control) together with work related training – adult protection, person centred planning, crisis intervention, administration of medication, administration of insulin and ageing learning disability and dementia. 103 Steyne Road DS0000020991.V319299.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): Standards 37, 39 and 42 Quality in this outcome area is good. The manager provides clear leadership throughout the home and all staff demonstrate an awareness of their roles and responsibilities. Quality assurance systems need to be developed to maintain a high quality of care for the service users in the home. The health and safety of the service users and staff is well protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has achieved NVQ level four and the registered managers award, and has managed this service for a period of two and half years. On the day of the visit staff said that the manager was approachable and provides them with a clear sense of direction. There was evidence to 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 21 show that the registered manager is also innovative in his support to the service users in the home. One service user said he was able to talk to and is supported by the manager about any issues or problems he may have. Due to the disability of the service users, they are unable to complete quality assurance questionnaires, but the registered manager does send out questionnaires to the relatives and friends of the service users. At the present time there are no quality assurance questionnaires to seek the views of stakeholders in the community. There was recorded evidence to show that the registered manager carries out monitoring of systems within the home. The registered manager now needs to develop this further to ensure that an annual development plan is published to include surveys and monitoring processes and to show how the home intends to carry forward and improve upon the quality of care it provides to its service users. All staff had received up to date training for moving and handling, fire safety, first aid, food hygiene and infection control. The health and safety policies and procedures had been reviewed in the last year. The inspector viewed documentation available in the office in regard to safety checks, and found that up to date certificates were available for gas appliances, fire system, hoist, PATS, electrical installation and legionella. Also available were recent risk assessments for fire safety within the home, health and safety risk assessment, water temperature checks and a weekly vehicle check. Accidents were properly entered into a HSE book. Evidence was available on staff training files to show that they had all received health and safety induction in line with TOPPS specification. 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 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 X 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 2 X X 3 X 103 Steyne Road DS0000020991.V319299.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. Standard YA39 Regulation 24(1)(a) (b)(2)(3) Requirement Quality questionnaires are sent to external stakeholders. A report should then be produced to include questionnaires and monitoring of systems to show how the home will maintain and improve on the quality of care given to its service users. Timescale for action 30/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 103 Steyne Road DS0000020991.V319299.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 103 Steyne Road DS0000020991.V319299.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. 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