Inspection on 23/08/07 for 122 Green Lane

This inspection was carried out on 23rd August 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

122 Green Lane 24/10/06

122 Green Lane 25/04/06

Similar services:

Belle Vue Country House

Crossways Community

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

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

CARE HOME ADULTS 18-65 122 Green Lane Addlestone Surrey KT15 2TE Lead Inspector Mary Williamson Unannounced Inspection 23rd August 2007 10:20 122 Green Lane DS0000066920.V337316.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 122 Green Lane DS0000066920.V337316.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. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 122 Green Lane Address Addlestone Surrey KT15 2TE 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) 01932 857485 pm-greenlane@together-uk.org www.together-uk.org Together Working for Wellbeing Robert Ross Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (0), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (0) 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - (MD) Mental disorder, excluding learning disability or dementia, over 65 years of age - (MD(E)). The maximum number of service users to be accommodated is 12. 2. Date of last inspection 24th October 2006 Brief Description of the Service: Green Lane is a substantial converted property providing accommodation and nursing care for twelve residents with a mental health disorder. The home has been in operation for several years and is now part of the Organisation Together since April 2006. The home is located in the village of Addlestone within easy access to the local shops and facilities. The accommodation is provided in single en-suite rooms. There is ample communal space, which includes a dining room, and two lounge areas one of which is used as a smoking area. There is a large garden accessible to the residents, which is situated to the side of the building. There are also ample parking facilities at the front of the home. A standard fee of £1108 is charged per week at this home. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first site visit of a key inspection and was unannounced. The inspection took place over five and a half hours. Mary Williamson Regulation Inspector carried out the inspection. The registered Manager Mr Robert Ross was present for the latter part of the inspection. A tour of the premises was undertaken and a number of records relating to the care of the residents and the management of the home were examined. Discussions were held with residents both individually and in small groups. Positive comments were received about the home and the support provided, from residents who wished to express an opinion. Residents invited the inspector to view their bedrooms. Individual discussions were held with staff. They were able to demonstrate a good understanding of residents needs and were knowledgeable regarding individual care plans. The recruitment procedure was explored and three staff employment files were sampled. Staff training and development arrangements were also discussed. Care plans were seen and include health, emotional, social and diverse needs of residents. There is an equal opportunities policy in place. The manager completed an Annual Quality Assurance Assessment prior to the inspection. Ten resident survey forms, two relative survey forms and one medical professional survey form were returned to the Commission for Social Care inspection prior to the visit, with mainly favourable comments regarding the home. There have been no complaints regarding the home since the last inspection on 24th October 2006. The Commission for Social Care Inspection would like to thank the residents and staff team for their help and hospitality during the inspection process. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since the last inspection the statement of purpose has been rewritten and is available to all residents. This now includes a copy of the most recent inspection report. The manager has now been registered with The Commission for Social Care Inspection. Residents now have more choice in how they spend their time. And daily records are kept of the activities undertaken. The kitchen has been refitted and the residents now have free access to allow them to make drinks at any time of the day or night. The standard of the environment has greatly improved and the external walls and windows were being painted during the inspection. Some of the external patio doors have been replaced and window frames repaired or replaced. Various bedrooms have been redecorated and new carpets fitted. The garden has been landscaped and ample garden furniture provided. The staffing levels have improved and there are more permanent staff in post. The recruitment of staff is ongoing and the manager had been interviewing staff prior to joining the inspection. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 7 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. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 8 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 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 9 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): 1, 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to appropriate information in order to make an informed choice about the home. Needs assessments and contracts of occupancy are in place EVIDENCE: The home has a statement of purpose and service user guide in place and all residents have access to this information, which is also available in the main reception area. It was good to note that the most recent inspection report is included in the service user guide which was a requirement made at the last inspection. Each resident has a needs assessment in place. These have recently been revised and reviewed. Three assessments were randomly sampled which, were detailed and informative. Currently there are eleven residents living at Green Lane who have been there for several years. There is a new resident being admitted next week and the staff nurse was able to demonstrate the pre admission needs assessment process and the format used. Contracts of occupancy are in place, which outline accommodation provided, support available, fees paid and by whom. The resident or a designated representative sign these contracts. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 10 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. This judgement has been made using available evidence including a visit to this service. Changing needs and personal goals are outlined in individual care plans. Risk assessments are in place and residents are supported to be independent. EVIDENCE: Each resident has a care plan in place. These have recently reviewed based on the revised needs assessment. Three care plans were randomly sampled. These outline the physical, emotional and social care needs of individual residents. These plans are well written, with the full input of residents identifying individual strengths and needs. Staff have a good understanding of these care plans and update information on a daily basis. The philosophy of the organisation is to promote independence. It was encouraging to observe that residents now have free access to the kitchen and the opportunity to make drinks when they require. Residents with the support of their key worker decide when to get up and go to bed, what to prepare for lunch, how often they go out, and how they attend to their personal grooming. The level of support is determined by the needs assessment and outlined in individual care plans. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 11 Risk assessments are in place and reviewed on a regular basis. These assessments do not restrict independence, but promote safety. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 12 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. This judgement has been made using available evidence including a visit to this service. Opportunities are available for personal development. Community facilities are accessed. Family links are maintained and nutritional needs are being met. EVIDENCE: The home has an activities programme in place, which is flexible to and takes into account the mood and motivation of residents. One resident attends a day centre and was not present during the inspection. Most activities are organised on a one to one basis. On resident was out with a member of staff shopping and attending to personal banking, another resident was planning a visit to the local Harvester restaurant for her evening meal with support. A daily record of activities is kept and includes day trips to places of interest, visits to the local golf club coffee shop, trips to the coast, and leisure centres. Residents use public transport and Dial a Ride to access the nearby town and shops. During discussion with residents one resident stated that she had a bus pass and likes to use this. “It makes me independent”. Another resident stated that he missed having the home’s transport. Staff explained that they could also use their own cars to take residents out. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 13 Residents told the inspector that they are going on holiday next month to the New Forest. Two other residents are planning a trip to Scotland. One resident said that she did not like holidays as they unsettled her. Family links are maintained and visitors are welcome in the home at any reasonable time. A relative support group meet regularly and are consulted on signifent events within the home. Some residents visit family at home and go on holiday with them. Spiritual needs are supported and the diverse requirements of residents outlined in individual care plans. Since the last inspection the cooks post has become vacant. Residents with the support of staff plan the menus weekly during residents meetings. One resident has typing skills from a computer class she used to attend, and she types the menus for the week. Staff support residents to follow a healthy eating plan and the variety and choice of food offered is wholesome and nutritious. Residents prepare their own breakfast and lunch, and help with the preparation of the evening meal. All staff have a current food hygiene certificate. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 14 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. This judgement has been made using available evidence including a visit to this service. Personal support is offered as outlined in individual care plans. Satisfactory arrangements are in place to meet resident’s physical, emotional and health needs. The medication procedure in place safeguards the residents. EVIDENCE: Sensitive support is offered to residents as outlined in individual care plans. Residents are treated with dignity and respect and positive interaction was observed between residents and staff. All the residents are registered with a local GP, and are well supported by her. Help is available to encourage residents if they wish to stop smoking and to follow a reducing diet. Residents are now able to visit the surgery on appointment as opposed to weekly visits to the home by the GP in the past. Home visits will be accommodated if required. Residents have the support of two psychiatrists and specialist input is available on referral by the GP. Dental care is provided at Goldsworth Park NHS Dental Surgery, or at Ashford Hospital if a general anaesthetic is required. Chiropody treatment is provided every three months and the optician can be accessed in the local town. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 15 The home has a medication policy in place and medication is administered according to this policy and in accordance with the NMC (Nursing and Midwifery Council) Code of Professional Conduct. The midday medication administration procedure was observed and was satisfactory. Medication recording charts were examined and are well maintained. Lloyds pharmacy supplies all the medication to the home and undertakes periodic audits. Records are kept of all medication entering and leaving the home. Currently there are no residents in the home that self medicate. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a complaints procedure and abuse awareness procedure in place, which protect the residents. EVIDENCE: There is a complaints procedure in place and all residents and relatives have access to a copy of which is included in the service user guide. There have been no complaints since the last inspection. Residents are aware of this procedure and stated that if they had a complaint they would either talk to the manager or put the complaint in writing to him. It was reassuring to know that some residents were aware if they were not satisfied with the outcome of a complaint that they would contact the Commission for Social Care Inspection. The home has an abuse awareness policy in place. All staff receive training in this procedure during their induction and a staff member stated that she would have the confidence to refer any suspicion of abuse to her line manager. There is also a copy of Surrey’s Multi Agencies policies and procedures on Safeguarding Vulnerable Adults in place and all senior staff have attended the local authority training provided. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment continues to improve and the home promotes a comfortable and safe place for the residents to live in. The standard of cleanliness is satisfactory. EVIDENCE: The standard of the environment continues to improve and the organisation has invested a considerable amount of time and money to meet the environmental standards. The outside of the home was being painted on the day of the inspection and the external windows and doors have either been repaired and repainted or replaced. The large lounge, which is also the smoking lounge has been redecorated and refurnished. The patio doors have been replaced and new curtains provided. A new extractor system is also in place. The lounge overlooks a large garden, which has been landscaped and well furnished with ample garden furniture and a Bar-B -Que. The dining room is well furnished and decorated to a good standard. The patio doors in this room have also been replaced. Some of the ceiling tiles need to be replaced as these are badly stained. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 18 The standard of individual bedrooms varies. Resident’s rooms have been decorated and furnished to a good standard. Some of these have been personalised to reflect individual personalities, while others choose not to avail of this opportunity. Most of the bedrooms have en-suite facilities. However four of these shower units were in a state of disrepair and need to be replaced. The standard of cleanliness in bedrooms also varies with some residents requiring more support to maintain an acceptable level than others. The manager stated that keys are being ordered for resident’s bedroom doors, and a lockable facility is to be provided for valuables. A requirement has been made regarding this. The upstairs corridor windows had just been painted and the manager stated that curtains were in the process of being replaced. The cleaner was on leave and the care staff were undertaking the domestic chores in his absence. 122 Green Lane DS0000066920.V337316.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 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A competent staff team in sufficient numbers to meet their current assessed needs supports residents. The recruitment procedure protects residents in the home. EVIDENCE: The staff duty rota was examined and discusses with the manager. A minimum number of three staff work in the home throughout the day. This is increased according to individual need and activities taking place in the home. Regular bank and agency staff work in the home and the manager stated that he is currently recruiting staff to fill the full time vacancies. All staff undertake induction training, which is coordinated by the home in accordance with skill for care. This includes manual handling, first aid, fire safety, and food hygiene. There is a learning and development programme in place for 2007/2008 and all staff have access to this. Needs and competencies are discussed with the manager and the appropriate training is then accessed. The organisation is an assessment centre for NVQ training. There are four staff with NVQ level 4, two staff with NVQ level 3, and two staff currently undertaking level 3 training. There are also two staff doing NVQ level 2 training. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 20 The organisation has a recruitment procedure in place, which protects the residents living in the home. Three staff employment files were randomly sampled. These are well maintained, and included all the required documentation including written references, an employment history and a CRB (Criminal Records Bureau) disclosure number. 122 Green Lane DS0000066920.V337316.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. This judgement has been made using available evidence including a visit to this service. The home is well managed in the best interests of residents. The health, safety and welfare of the residents are promoted. EVIDENCE: The home is well managed by a competent manager who has become the registered manager since the last inspection. A deputy manager and a team of staff nurses with the experience necessary to manage the home effectively support him. During discussion with residents either in groups or individually they stated that they were satisfied with the management structure in the home and felt supported by this. They also stated that any concerns or problems were listened to and acted upon by the management team. Quality assurance is monitored by monthly regulation 26 visits undertaken by the service manager. These reports are retained in the home for inspection. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 22 Weekly home meetings take place. One resident takes minutes and another types the minutes, which are retained on file. Annual survey forms are distributed to residents, relatives, visiting health care professionals and advocates. The completed survey forms are analysed and feedback acted upon. The health, safety and welfare of residents and staff are promoted. There is a wide range of health and safety policies and procedures in place some of which were sampled through out the visit. Risk assessments are in place for all identified risks. Fire safety records were seen and are well maintained. There is a contract in place for the maintenance of fire fighting equipment and emergency lighting. Comprehensive fire risk assessments are in place due to the high percentage of residents who smoke. Accidents and incidents are recorded satisfactory. 122 Green Lane DS0000066920.V337316.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 3 2 3 3 X 4 X 5 3 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 2 25 3 26 X 27 2 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 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 24 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 YA24 Regulation 23(2)(b) Requirement The registered person must ensure that all parts of the care home are kept in a good state of repair both externally and internally. This must include replacing the stained ceiling tiles in the dining room. The registered manager must respect the wishes of the residents with regard to privacy and dignity and provide residents with locks for their bedroom doors where necessary. The en suite facilities provide in four identified rooms are not suitable for use and the shower units in these bedrooms must be replaced, to promote personal hygiene. Timescale for action 23/09/07 2 YA25 12(4)(a) 23/09/07 3 YA27 23(2((j) 23/09/07 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 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 25 1 YA29 During a discussion with the manager regarding the changing mobility needs of the residents, it was recommended that consideration should be given to the provision of a shaft or stair lift in the refurbishment plans for the home. 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 122 Green Lane DS0000066920.V337316.R01.S.doc Version 5.2 Page 27 - 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!