Inspection on 05/02/07 for 12 Linden Road

This inspection was carried out on 5th February 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

12 Linden Road 18/02/09

12 Linden Road 21/02/06

12 Linden Road 19/10/05

12 Linden Road 08/10/04

12 Linden Road 08/10/04

12 Linden Road 08/10/04

12 Linden Road 08/10/04

12 Linden Road 14/06/04

12 Linden Road 14/06/04

12 Linden Road 14/06/04

12 Linden Road 14/06/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 12 Linden Road Brotton Saltburn-by-Sea TS12 2RU Lead Inspector Mrs Ann Ferguson Key Unannounced Inspection 5th February 2007 11:30 12 Linden Road DS0000000054.V329358.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 12 Linden Road DS0000000054.V329358.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. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 12 Linden Road Address Brotton Saltburn-by-Sea TS12 2RU 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) 01287 678489 F/P 01287 678489 www.reallifeoptions.org Real Life Options Ms Janet Fenson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Linden Road care home is a purpose-built two-storey property located in a housing estate on the outskirts of Brotton. The home provides long-term care for six residents with a learning disability. Accommodation is provided in single bedrooms. The service charges between £850.25 and £1004.05 per week. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection commenced at 11.30am and lasted for five and a half hours. Three staff members were spoken to during the inspection including the manager. Three of the service users were case-tracked, looking at including individual plans of care, medication records, and personal allowance records. Three members of staff were case-tracked too. Records of staff recruitment procedures followed, staff training and supervision records were looked at. House records were examined too along with health and safety records, and policies and procedures. The pre-inspection questionnaire was received before the inspection. A tour of the home was carried out. What the service does well: What has improved since the last inspection? What they could do better: The Registered Manager needs to make sure that the individual care plans are reviewed regularly to ensure they reflect any changing needs. Individual goals, and the progress people are making towards these, need to be included in the plans of care too. Whilst all staff have received training in abuse awareness, they could benefit from receiving the ‘No Secrets’ training. Currently only the manager has this training. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 6 A lot of quality information is collected about the home. The organisation needs to devise a formal system of collecting information from a variety of sources to cover all the areas included in the National Minimum Standard. 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. 12 Linden Road DS0000000054.V329358.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 12 Linden Road DS0000000054.V329358.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 Quality in this outcome area is good An examination of the records indicates that a thorough assessment would be completed prior to admission to make sure that the prospective users’ aspirations and needs can be met. EVIDENCE: There have not been any new admissions into the home for a number of years now, however there is an admissions procedure written in August 2004, with a planned review date of August 2007. This describes a very detailed process in which Real Life Options will work with the relevant Social Services department to identify the needs of the individual. The process is service-user focused, making sure that the service user’s views are taken into account, and they can visit the home and meet staff. There is also a user-friendly policy and procedure for new admissions. 12 Linden Road DS0000000054.V329358.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 Quality in this outcome area is good An examination of records indicates that service users’ needs are reflected in their individual plans although no personal goals were evident. Service users are supported to make decisions in their lives. There is a robust system for managing risk in the service. EVIDENCE: Three service user files were examined and they all contained a detailed individualised plan, showing the support they need and how they like that support. These had all been regularly updated within the home. In one file, some restrictions to an individual’s choice were detailed clearly in the support plan. Sound reasons were given for these restrictions on the grounds of their individual medical condition and for their own health and safety. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 10 It was not clear who had been involved in the drawing up of the individual plans, for example, whether the service users or their families had had any input. Whilst the support plans themselves were comprehensive, none of the files examined had any goals for the service users to be working towards. Whilst none of the service users at Linden Road have verbal communication, the staff have identified alternative methods of communication. The service users each have a communication dictionary, which identifies the different ways they can communicate. The manager told the inspector that these were due to be reviewed soon and that more could be made of them as an aid to communication. Staff make much use of body language, gestures, photos and pictures. The inspector saw an example of the weekly menu, which was in an accessible format. Also, the house does have house meetings regularly, usually at spontaneous times of the evening where a few people are together. They record people’s responses to the questions/ ideas to enable the service users to have an input into different aspects of their life. The service users are encouraged to take part in varied activities. Two of the service users’ files examined had risk assessments recently reviewed. The other file did need updating in this area. A wide range of activities are offered to the service users, both within the home and in the community. A particularly useful piece of work had begun to build up a bank of good and varied places people could go to and make sure that information about facilities, parking, access and costs was available beforehand. The purpose of this was so that staff and service users could make an informed choice of where to go, bearing in mind people’s needs and the facilities available. 12 Linden Road DS0000000054.V329358.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 Quality in this outcome area is good An examination of records and discussion with staff indicates that service users are a part of their community. They have good relationships with family, and their rights and responsibilities are respected within their home. Service users are offered a varied and healthy diet. EVIDENCE: There is a weekly activities programme in the home, which details what opportunities are available for each of the people who live there. Everyone has an individual programme that reflects their wishes and needs. Some of the service users attend training centres and others take part in varied activities from the home. Within a week, the range of activities provided included walks out, going to the training centre, weekly household shopping, and going out for lunch. In the home people are supported to do the laundry, tidy their rooms, and help with the making of a meal. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 12 The house makes full use of community facilities, and is well-situated within a residential area. At the end of each month, staff go over what the individual has done and writes a summary to show their participation and achievements. The involvement of family and friends in the lives of the service users is encouraged by the home. Currently, some family members regularly visit the service users in their home. In other situations staff make contact by telephone to notify parents of anything that has happened. For one service user, their parents often take them to their medical appointments and then inform the staff of the outcome of such meetings. Social get-togethers are arranged by the home, inviting the service users’ family and friends, last year it was a barbecue, and the manager feels that these are very positive experiences for all involved. There has been an advocate involved in one person’s life at the home, however this has now ceased. The routines within the home are based around the needs and wishes of the individuals. Staff routinely knock before going into someone’s room. Necessary variations are in place to support one person’s specific disability. Service users can move around the house freely. Service users are supported to assist in their own domestic tasks, in accordance with their individual support plans. A staff member told the inspector that her role within the home was ‘to not do for them, but to encourage, to be a support for them’. The service users receive a varied and balanced diet each week. There is a menu available, and also a pictorial version for the service users. The example available to the inspector showed there to be a choice of food, which included both hot and cold meals each day. Four meals are offered each day, and drinks and snacks are available too. Service users are encouraged to assist in the preparation of meals. 12 Linden Road DS0000000054.V329358.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 An examination of records and discussion with staff indicates that service users receive personal support in the way they prefer. Their health needs are met. The home has robust medication procedures in place, which safeguard the individuals. EVIDENCE: In the three individual plans examined, there were very detailed support plans detailing how people liked to be supported. These were written in such a way as to promote their independence too. Staff spoken to were aware of treating the service users as individuals, and they were familiar with the different needs of the service users. There are daily records kept in the home and these made reference throughout to the skills of daily living. Necessary aids and adaptations are available in the bedrooms, bathrooms, and the home in general to support the individuals as much as possible. Within the communication dictionaries, the staff had information about peoples’ likes and dislikes. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 14 The overall health and well-being of the service users is managed well within the home. Full use is made of all different health professionals, for example, doctors, chiropodists, dentists, and opticians. Clear records are available of appointments made and decisions agreed. At the end of each month, keyworkers write up a monthly update. This covers areas including medical matters, physical issues, family contact, household matters, and community participation. The home has a robust medication policy in place, which safeguards the service users. It has recently been reviewed. The home has written up its own procedure based on the policy and the individual needs of the service users. The medication is stored appropriately, and the stock of medication for three service users was checked and found to be correct. The procedures for PRN medication (that is, medication administered as and when required) were very thorough too. Additional information regarding the administration of PRN medication had been signed by other relevant health care professionals. 12 Linden Road DS0000000054.V329358.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 Quality in this outcome area is good An examination of records indicates that service users’ views are listened to, and they are protected from abuse, neglect and self-harm. EVIDENCE: The complaints procedure is clearly written, and was last reviewed in June 2006. There is also a user-friendly version too. There have been no complaints received about the home since the last inspection. Instead four compliments have been received from students and family members thanking the home in some way. In the three service users’ files, which were examined, there was not a copy of the complaints procedure. Staff receive abuse awareness training to enable them to notice abuse or neglect amongst the service users. Within the induction of new staff, they receive training in ‘Vulnerable Adults’. This is covered again through Foundation training, and within NVQ. The manager has completed the ‘No Secrets’ training and the information file called ‘No Secrets’ was available within the home for all staff to refer to. Currently all staff do not receive the ‘No Secrets’ training but the manager has highlighted this as a service need. Financial procedures for handling service users’ monies are robust and protect the interests of the individuals. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 16 Three individual’s records including receipts and balances were checked and they were all found to be correct. The senior staff member checks the balances each day to make sure they are correct. 12 Linden Road DS0000000054.V329358.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 and 30 Quality in this outcome area is good A tour of the home and an examination of records indicate that the house is homely, comfortable and safe, and is clean and hygienic. EVIDENCE: The home is well-maintained and provides very comfortable accommodation that meets the needs of the service users. All the bedrooms are personalised to reflect their tastes. One person’s room is very stark, however at the moment the service user is comfortable with it that way. The staff have tried many different ways, and sought advice form a variety of sources, to make that room more appealing but they are confident that the service user is happy with it as it is at the moment. Accommodation is provided on the ground floor for those who need it, and necessary adaptations are well-maintained. On the day of the inspection, the alternative fire alarm needed for one service user was being repaired. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 18 All the communal areas are in good decorative order, and personalised with pictures and photographs. There are no issues with the bathroom or shower room. There has recently been a new floor fitted in the kitchen. Laundry facilities are adequate for the needs of the home and meet the required standards. The manager said that there was a regular cycle of re-decoration within the home that was followed, although there was sometimes concern regarding the length of time it took for the housing association to carry out their repairs. On the day of the inspection, the home was clean and smelt fresh. 12 Linden Road DS0000000054.V329358.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, 34, 35 and 36 Quality in this outcome area is good An examination of records and discussion with staff indicates that the service users are supported by competent, qualified, and trained staff. The recruitment processes support the service users further and staff are regularly supervised to ensure they are carrying out their role effectively. EVIDENCE: The staff employed at Linden Road are suitably qualified to carry out their roles. New staff receive induction training which covers the mandatory training and necessary policies and procedures. They then go on to complete their foundation stage and are then registered for NVQ. Currently 71 of staff hold an NVQ at level 2 or above. Training provided by the organisation includes : • Food Hygiene • Epilepsy awareness • Safe Handling of Medication • Autism • First Aid • Challenging behaviour/ Team Teach • Fire training 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 20 Senior staff are provided with further in-house training covering the new areas of their role, for example, supervision, or Risk Assessments. One staff members told the inspector ‘the training is excellent’. In the three staff files examined, there was an up to date record of all training received for the individual staff. In addition the organisation provides the home with monthly training overviews to highlight the need for any refresher training. The recruitment processes are thorough. In the three files examined, application forms and written references were available for two staff members. In the third file an overview sheet was in place providing confirmation of the necessary information, as the organisation’s policy now is that recruitment documentation is held in a central office. Confirmation of suitable CRB checks and PoVA checks was possible for all three staff sampled. The home involves the service users in the recruitment of staff. None of the service users have indicated a wish to sit on interview panels but instead some service users have written down questions that they would like staff to ask potential new staff. The families have been approached by the manager to be involved in recruitment but they have declined. Potential new staff are invited to the home for their interview. The interaction between the candidate and the service users is observed, and used to influence the decision made. Staff receive a high level of supervision within the home to assist them in carrying out their role. In the three staff files examined, written supervision notes were available. The new member of staff had a very thorough record of meetings held during their probationary period. A staff member said that for them supervision was useful, showing them ‘what I need to improve on’. Another person said that support generally was ‘brilliant’. Staff receive an annual appraisal too. 12 Linden Road DS0000000054.V329358.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, 39 and 42 Quality in this outcome area is good An examination of records and discussion with the manager indicates that the service users benefit from a well-run home. The views of the service users are behind all the self-reviewing of the home, and their health and safety is promoted within the home. EVIDENCE: The registered manager is suitably qualified for the position. She currently holds an NVQ Level 4 in Care and has completed the Registered Managers’ Award too. Staff spoke positively of the management of the service. One person said ‘The staff pull together and work as a team’. Another person said ‘I love my job’. She went on to say that she could talk to the manager about anything. Staff said that the manager had proved to be very supportive to staff during difficult times, and that this was appreciated. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 22 There are a lot of systems in place to obtain information to influence developments needed within the home. Monthly audits are carried out by the organisation, which focuses on a broad range of areas. These were all available to the inspector on the day of the inspection. Team meetings are held each month. The minutes sampled showed these to be clear, open, and wellattended by staff. Service users are encouraged to share their views. Whilst it would not be appropriate to call a meeting for all the service users to attend, the staff do make the most of opportunities when they arise to seek the views of the service users. A staff survey was conducted in 2006 and the report was available to look at. There were not any results of other formal surveys carried out by the organisation or the home, for example service users, families, or other health professionals. The manager has completed a development plan for the home for 2007-8. It covered areas including staff training, improvements needed in the house, and ways to improve communication for service users. It will form part of a much bigger corporate plan. The necessary maintenance checks and services have been carried out within the home to ensure that the home is a safe place in which to live and work. Checks carried out include: • Weekly water temperatures • Gas safety certificate • Fire alarm, lighting and extinguisher servicing • Portable appliance testing In addition, all risk assessments regarding hazards within the service had all been recently reviewed. There had been a Food Hygiene Inspection in April 2006 but there had been no requirements or recommendations. Accident records were available for the inspector, and information relating to RIDDOR was available too. 12 Linden Road DS0000000054.V329358.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 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 3 33 X 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 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 4 X 2 X X 3 x 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA6 YA23 YA39 YA6 Good Practice Recommendations The Registered Manager should ensure the individual care plans are reviewed regularly to ensure they reflect any changing needs. The Registered Manager should identify the necessary resources for all staff to complete ‘No Secrets’ training The Registered Manager should ensure that service user and other stakeholders views on the running of the service are collated and available for others to read. The Registered Manager should ensure that the service users all have goals that they can work towards. 12 Linden Road DS0000000054.V329358.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 12 Linden Road DS0000000054.V329358.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. 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