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Inspection on 31/05/07 for 16 Hill Park Road

Also see our care home review for 16 Hill Park Road for more information

This inspection was carried out on 31st May 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.

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

What the care home does well

The manager is skilled at providing care that enables the people who live at Hill Park to improve their life skills. Care planning is excellent and gives a clear picture of the care needs of the individual and how their needs should be met. The person centred approach the manager uses promotes the rights, independence, choice and inclusion of the people living at the home. The self-contained domestic style accommodation is well maintained and suited to promote self-care within the person`s abilities. The manager/registered provider continues to provide a proactive approach to improving an already above average service.

What has improved since the last inspection?

The manager continues to ensure that she keeps up to date with best practice. The training and development completed since the last inspection continues to link to the care needs of the individuals. The year on year improvements for people living at Hill Park are clearly demonstrated.

What the care home could do better:

Any improvements made to the way the service is managed and delivered will build on already good practice.

CARE HOME ADULTS 18-65 16 Hill Park Road Highweek Newton Abbot Devon TQ12 1NU Lead Inspector Rachel Proctor Unannounced Inspection 31st May 2007 09:00 16 Hill Park Road DS0000003625.V327492.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 16 Hill Park Road DS0000003625.V327492.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. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 16 Hill Park Road Address Highweek Newton Abbot Devon TQ12 1NU 01626 337710 01626 337710 saraton5@hotmail.com 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) Mrs Sarah Louise Vooght Mrs Sarah Louise Vooght Care Home 1 Category(ies) of Learning disability (1), Sensory impairment (1) registration, with number of places 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st March 2006 Brief Description of the Service: 16, Hill Park is a care home for younger adults and provides personal care for a maximum of one person of either gender who has learning disabilities and/or sensory impairments. The home is owned and run by Sarah Vooght, a registered nurse who has completed the registered managers award and NVQ level 4 in care. T he provider offers 1:1 care. Dedicated time is spent with the person between 10:00 a.m. and 18:00 pm five days a week. The provider is on call at all other times. People are encouraged to perform their own house keeping duties and choose weekly menus, the manager assists with shopping and food preparation. People are encouraged to go on outings with the manager, sometimes with her family. For long-term stays a weekly plan is devised, which could include a work placement. Routines and plans are flexible and designed to meet individual needs. The home is situated in a quiet residential area of Highweek, a short car distance from Newton Abbot. There are bus routes into the town centre. The accommodation is provided as a self-contained one-bedroom flat, which adjoins the providers private dwelling. The flat has a kitchen, lounge/dining room and a bedroom with en suite toilet and shower. The flat is accessed by steep driveway, which means that the clients have to be independently mobile. The Statement of Purpose and service users guide is available in the office of the home. The fees stated on 31.May 2007 were from £464.95. 16 Hill Park Road DS0000003625.V327492.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, the manager was told of the inspection the day before. The inspection took place on 31.05.07. A tour of the home was completed and some records were inspected. One person’s care was followed as part of this inspection. During the inspection the people who live at the home and the manager were spoken to. Some of the comments made during the inspection and in the comment cards received prior to the inspection have been incorporated in to this inspection report. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 6 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 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 7 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): Quality in this outcome area is good, 2 This judgement has been made using available evidence including a visit to this service. The people living at Hill Park can have confidence that their care needs will be comprehensively assessed by staff who understand them. EVIDENCE: No new people have been admitted to the home since the last inspection. The manager has a clear assessment template, which enables her to establish the needs of individual people. The person whose care was followed had a clear assessment of their care needs, which had been reviewed and up dated regularly with the person and the people important to them. This person commented that the manager speaks to them about their care needs and helps them to remember things that are important. The care plan for the person whose care was followed contained a comprehensive assessment of the person’s health, personal and social care needs. A care plan had been developed from their assessed needs. Where risk had been identified as part of the assessment the plan of care provided guidance how the risk could be managed to reduce the risk. These included the storage of food, using the pathways around the home and activities outside the home. The person said that they had talked about their care needs with the manager. The person receiving the care had signed their plan of care. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 8 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): Quality in this outcome area is excellent, 6,7,9, This judgement has been made using available evidence including a visit to this service. People living at Hill Park are able to make decisions about their lives and are consulted about all aspects of life within the home. This encourages them to maximise their independence. EVIDENCE: The person living at Hill Park whose care was followed was aware of their goals, which were documented in their individual plan. The care plan showed that the individual was involved in the development of their plan of care. And their opinions, choices and expectations had been taken into account when care was planned. How the person was able to make decisions about aspects of life within the home were clearly recorded. This evidenced that people who live at Hill Park are encouraged to maximise their independence. The annual reviews, which involved the person, their care manager, a family member and the manager of the home, were clearly documented. These reviews showed the achievements the person had made and their future goals and aspirations. The person had signed their review. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 9 The person advised that they managed their own money. They also said they were saving up for a new addition to their computer games. The manager advised that she supports and encourages people to manage their own money and will offer support when it is needed. The person advised that the manager was helping them with the process of finding a job. The person’s plan of care indicated what sort of job the person hoped to get and what they had done so far. The Care plan for the person whose care was followed set out their goals clearly with plans on how to meet them. These goals had been reviewed and agreed with the person. Risks are identified in the care plans and agreed strategies are in place to minimise identified risks. Since the last inspection a risk of the person falling when not using the path to the back garden had been identified. The risk assessment showed that this had been discussed with the person and the agreement to reduce the risk had been signed. All identified risks had actions recorded to reduce the risks that had been signed by the person receiving care. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is excellent, 12,13,15,16,17 This judgement has been made using available evidence including a visit to this service. The people who live at Hill Park have their individual preferences and choices encouraged and valued. This ensures that they are supported to participate in activities that meet their expectations and needs. EVIDENCE: The person whose care was followed advised that they regularly visited family who lived in a different area in the country. They also said they were looking forward to spending their birthday with family. This person said they continued to enjoy being able to go into the town and visit local shops and library. The sort of job they would like was discussed. They commented that they would like to work in a shop possibly one that sold computers. The manager confirmed that she had assisted with the completion of application forms in conjunction with a local agency. This showed that the person was being encouraged to develop their skills and abilities. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 11 The type of activity the person enjoy had been recorded in the plan of care. This demonstrated how they had been encouraged to take responsibility for accessing things they like to do. The person advised that they had chosen the last holiday they had gone on with the manager help. The manager advised that she had accompanied the person on holiday to provide the help and support they needed. The person whose care was followed confirmed that they are able to maintain links with the family. Information provided by the manager showed that family are welcome and their involvement encouraged with the persons agreement. The person living at Hill Park had agreed their own routines with the manager. They choose what time they get up and go to bed and what meals they will eat that day. They had chosen the activities they took part in with the support of the manager. The person commented that they were getting help to complete a CV in preparation for looking for a job. They also said they were continuing to go into the town shopping and go to the library and cinema to see the films of their choice. The information provided and the observations made support that the routine of the home are arranged to allow individual people to achieve personal autonomy and choice over their daily lives. Since the last inspection the person whose care was followed has taken on more responsibility for the meals they eat. They said that they some times choose to buy food and other times they tell the manager what they would like. Risk assessments had been completed for the safe storage and preparation of food, which the person had signed. The manager advised that she encourages the person to be as independent with their meals as they are able; while monitoring the nutritional content of their chosen meals. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is excellent, This judgement has been made using available evidence including a visit to this service. The manager is skilled at monitoring and assisting the people she cares for to maintain their physical and emotional health care needs. People who live at Hill Park are supported and encouraged to take responsibly for their personal wellbeing in a risk managed way. EVIDENCE: The person whose care was followed had a plan of care in place, which had been up dated and reviewed regularly with the person. The views and aspirations of the individual were clearly recorded. The way formal reviews are recorded provides comments from the care manager, family, the person and the manager for the home. The reviews also state what the person has achieved and what their goals were for the coming months. The person whose care was followed said they were mostly self-caring but sometimes the manager reminded them what they needed to do. The manager advised that she had encouraged the person to take responsibility for their life style. There plan of care clearly recorded the type and amount of 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 13 support the person needed. The person had signed this. The care plan viewed contained clear information about what was important to the person, their likes and dislikes. The people who live at Hill Park have continuity of care from the manager of the home. They also have a named social services care manager who keeps in regular contact through the review process to monitor the placement. Visits to the GP for health checks had been recorded and any changes in treatment or management of their condition had been incorporated into their plan of care. The person whose care was followed had copies of letters from health care professional with their care planning information. The person said that they were able to manage their own health care with the support of the manager. The manager advised that the person is able to attend the GP surgery for appointments and she offers support if this is required. The person’s care plan had a risk assessment for self medication completed. The type and amount of medication required had been recorded. The person advised that they only need to take their medication occasionally when they have a problem. They also said that they keep their own medication in their room. The manager had reviewed the risk assessment for self-medication regularly with the person. This was recorded in their plan of care. It was clear from the person’s care planning records that they received regular reviews from their GP regarding the medication they were taking. Controlled drugs were not in use in the home at the time of this inspection. The manger is a registered nurse and was aware of the responsibilities regarding controlled drug records should these be required in the future. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The people who live at Hill Park can have confidence that any concerns they raise will be listened to and acted on by the manager sensitively. The way the manager runs the home ensures that the people who live there are protected. EVIDENCE: The person living at Hill Park said they knew how to raise concerns if they had any with the manager. They also said they felt supported living at the home and were able to make choices about what they did each day. The complaints policy was easily available. Comment cards received prior to this inspection indicated that the people who live there are supported and encouraged. All indicated that they knew how to raise concerns if they had any and felt the manager would listen them. Policies and procedures were seen in place regarding protection of vulnerable adults. The manager confirmed that she had completed adult protection training relevant to the people she cared for. No new staff had been appointed since the last inspection. The recruitment policies and procedures are robust and should protect people from unsuitable staff. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good, 24,30 This judgement has been made using available evidence including a visit to this service. The people living in Hill Park have a safe comfortable environment to live in, which meets their needs. The way the accommodation is arranged enables the person to live as independently as their abilities allow. EVIDENCE: The accommodation is provided as a self-contained one-bedroom flat, which is adjoining the providers private dwelling. The person is able to choose the decorations for the flat, which had been personalised with items of their choice. The person said that they liked the flat and had everything they needed. The furnishings and fittings in the flats are of good quality and domestic in character. The manager provided information about the planned maintenance and renewal programme for the decoration of the premises. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 16 The flat has a kitchen, lounge/dining room, bedroom with en suite toilet and shower. The flat is accessed by a steep driveway, which the current person is able to use independently. The manager has completed a risk assessment for the use of the driveway and access to the rear garden. The person using the flat has access to the rear garden, which is shared with the providers private accommodation. The manager confirmed that the person has been encouraged to do their own laundry and uses the washing line in the rear garden to dry their washing. A risk assessment had been completed for access to the rear garden. The manager advised that the person had sometimes climbed over the wall instead of using the pathway to the garden, which could put them at risk of falling. The risk assessment had been completed and signed by the person. Since the last inspection the manager has painted the ceiling in the flat. The person living there had several posters relating to the football team they support and films theyve enjoyed watching. The manager confirmed that the person is encouraged to be independent with household tasks. She commented that sometimes the person needs encouragement and prompting to clean their own accommodation. Since the last inspection the person has been preparing more of their own food. A risk assessment had been completed for food storage and food safety. At the time of this inspection the person was preparing to go out and was cleaning the kitchen. They said they like to make sure that it was clean and tidy before they went away. The person confirmed that they do their own housework and sometimes needed encouragement and reminding to do things. The persons individual plan of care included how independents with domestic task was encouraged and promoted. A visit to the person is flat confirmed it is kept clean and tidy and hygienic and free from offensive odours throughout. The manager has a system for working with the person to ensure that they are able to maintain the cleanliness in their flat. The flat has a domestic style washing machine in the kitchen, which the person is able to use with support from the manager. The manager has infection control policies and procedures in place for the home. The preinspection information indicated the training the manager had completed since the last inspection included safer food better business. The manager also completes health and safety checks on a regular basis, which are recorded. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good, 32,34,35 This judgement has been made using available evidence including a visit to this service. A competent caring manager who has people’s best interests at heart supports the person living at Hill Park. EVIDENCE: The home is staffed entirely by the registered provider/manager. Certificates for the training courses the manager had completed were available. The manager advised of other training courses she was planning to complete. The personal development plan identified training to be completed as part of her personal goals. The manager has the skills and abilities necessary to ensure the needs of the individual are met in a way that promotes self-care in a risk managed way. The manager has developed a clear recruitment policy that ensures all preemployment checks are carried out prior to new staff starting work. The policies and procedures were available for inspection. However the care home is a small family run business managed by the registered provider/manager to provide care and support the person who lives there. The manager confirmed 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 18 that she continues to work with the person living at home in an enabling way to assist them to improve their life skills. From the information provided prior to the inspection and the records of training completed since the last inspection. It was clear that there was a commitment to ongoing training and development to ensure that the manager keeps her skills and knowledge up to date to care for the people who live at a Hill Park. The manager advised that she gets peer support from other managers working in the same caring field. Minutes of managers meetings were provided to demonstrate the topics covered. Policies and procedures for staff supervision and appraisals were available. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is excellent, 37,39,42 This judgement has been made using available evidence including a visit to this service. The management of this home continues to be effective, clear and transparent. The people living at Hill Park can have confidence that their views will be taken into account and their best interests promoted. EVIDENCE: The manager has continued to seek the views of health and social care professional, relatives and the person living at the home to ensure the service she provides is meeting need. Completed Service satisfaction questionnaires were provided for inspection and the results of a quality audit were forwarded to the Commission prior to the inspection. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 20 The comment cards received from a visiting care manager included the following comments – “I have always found the care provider to be very proactive when meeting my clients needs”. I feel the care provider is very sensitive in enabling my client to live the life they choose”. The persons next of kin commented “I feel that the care helps (my relative) to live independently”. The person advised that they liked the manager and want to continue living at the home because they feel safe and comfortable. All records viewed were found to be well maintained and up to date. 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 21 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 X 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 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X X X X X X 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 22 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. 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. Refer to Standard Good Practice Recommendations 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 16 Hill Park Road DS0000003625.V327492.R01.S.doc Version 5.2 Page 24 - 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!