Inspection on 15/06/06 for 2 Seafarer`s Walk

This inspection was carried out on 15th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 Seafarer`s Walk 17/06/08

2 Seafarer`s Walk 10/07/07

2 Seafarer`s Walk 22/11/05

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 2 Seafarer`s Walk Sandy Point Hayling Island Hampshire PO11 9TA Lead Inspector Kathryn Kirk Unannounced Inspection 15th June 2006 10:30 2 Seafarer`s Walk DS0000064967.V295971.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 2 Seafarer`s Walk DS0000064967.V295971.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. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 Seafarer`s Walk Address Sandy Point Hayling Island Hampshire PO11 9TA 0151 420 3637 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) www.c-i-c.co.uk. Community Integrated Care Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2005 Brief Description of the Service: The home is situated in a quiet residential area to the southeast of Hayling Island and within easy reach of the beach. Local shops and amenities can be accessed, but to use a wider range of facilities travel is necessary to locations off the island such as Portsmouth, Southsea and Havant. The home is situated next to a similar registered home. The homes share the front car park. The home was purpose built with suitable adaptations and all of the facilities are provided on one level with the exception of the garden. This slopes away to the front and rear of the home making independent use difficult and restricting the amount of usable space. The home is suitable for people who have physical as well as learning disabilities. All of the service users have single rooms. They have use of the kitchen/diner, a lounge and a sensory room. The current fees, as given in April 2006 is £1312 per week. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Visits to this service took place on 15 and 20 June 2006.At the time of the visits, five service users were living at 2 Seafarers Walk. Their needs are such that they were unable to contribute verbally to the inspection process. Evidence gathered for this report was obtained through talking to the staff, spending time with residents, touring the building and by looking at some paperwork in the home. Other evidence was gathered from a pre inspection questionnaire, which had been sent to CSCI, from reports of monitoring visits by senior mangers of Community Integrated care and from written information about significant events in the home provided by staff. The findings of the previous inspection report of November 2005 were also reviewed. What the service does well: What has improved since the last inspection? A statement of purpose and service user guide is now available. Plans of care for service users have been updated and some consultation has taken place with health care professionals where particular areas of risk have been identified. There are more opportunities for residents to take part in appropriate activities. Some redecoration has taken place within the home. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 2 Seafarer`s Walk DS0000064967.V295971.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 2 Seafarer`s Walk DS0000064967.V295971.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1and 2 Quality in this area is adequate. The judgement has been made using available evidence including a visit to the home. A system is in place to ensure that prospective residents needs are assessed. Information available to residents and their supporters needs to be reviewed to ensure that it is as clear as possible and that it accurately reflects the service provided. EVIDENCE: The current residents have lived at the home for a number of years, the most recent arriving two years ago. At the last inspection an admissions policy was seen in which it was made clear that no prospective service user would come to live at the home without having had their needs and wishes assessed. A Statement of purpose and service user guide has been developed since the last visit to the home. The Statement of purpose contains information personal to current residents.It was discussed with staff that this could breach confidentiality. The Service user guide contains a statement of purpose and information about contracts. Those seen had been signed by a representative of the service user. It was discussed with staff that as only two wheelchair users can be accommodated at any one time, this information should be included in the service user guide. Documents are in written form and as such are not accessible to service users. Staff said that they could not envisage how this information could be made available to current service users in a meaningful way. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 9 Staff agreed that these documents would be reviewed . 2 Seafarer`s Walk DS0000064967.V295971.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10. Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. Systems for care planning and risk assessment need to be further improved to help to meet residents needs and wishes. Confidentiality is not always respected. EVIDENCE: The last inspection report identified that there was insufficient evidence of clear up to date care plans being followed through, and that service users would benefit from person centred planning. Since the last visit, care plans have been reviewed but two seen still did not identify goals. CIC responded to the last inspection stating that person centred plans would start to be implemented for each service user by the end of february 2006.There is no evidence that this work has started. Issues identified in the care planning process for example, the need to provide day services for one service user and the need to provide a particular hoist to enable one service user to use the bath have not been actioned in any reasonable time. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 11 There continues to be little evidence about how service users are helped to make choices although staff spoken with had a good knowledge of service users likes and dislikes. A number of the service users have limited vision. Staff were asked if they have knowledge of how to support service users with a visual impairment. They said it would be useful to have further training and guidance in this area. Risk assessments have been reviewed, but actions identified as necessary within them have not always been implemented, for example, one seen regarding the use of bedsides. Systems for storing information about service users have improved and information is held securely. Some consideration needs to be given to ensure that confidentiality is maintained for example, minutes from staff meetings indicated that service users are sometimes present where issues about other service users are being discussed . 2 Seafarer`s Walk DS0000064967.V295971.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the service Opportunities to take part in appropriate activities have improved, although this could be improved still further. Family links and friendships are effectively maintained. Food provided is varied and nutritious. EVIDENCE: The last inspection report made a requirement that residents activities must reflect their needs and wishes. Through discussion with staff and examination of records this was found to have improved, some reasons for this are that there are more drivers available, and one staff member is allocated as an activity coordinator. There are still some constraints within the system however, for example, although there are three staff members on duty during the day, some service users have been identified as needing 2-1 support when out, so that this limits the number of activities that service users can do. It was also identified last year that some service users would benefit from some specialist day service or college involvement. This has not happened as yet. Through discussion it was clear that friends and families are welcomed and that their involvement in daily routines and activities is encouraged. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 13 Some daily routines were seen to promote individual choice for example, service users were supported to get up when they chose, and to eat when and where they wanted, although as discussed earlier, some choices, for example bathing, are restricted because appropriate actions have not always been taken to minimise risk. Staff were observed to interact positively with service users. There are two guinea pigs as pets and these are well liked by service users. Adequate supplies of food were seen in the kitchen. Staff felt that the residents ate well and were able to make choices at mealtimes. A menu is provided but is not necessarily kept to. However records did show that a variety of foods are provided. Staff showed that they were aware of what residents liked and disliked. 2 Seafarer`s Walk DS0000064967.V295971.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 and 20 Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the service. Residents benefit from good support in health matters, although they would receive a better service if advice given by health care professionals were acted upon. Medication procedures are largely appropriate, although one procedure needs to be reviewed to ensure that it is in the best interests of service users. EVIDENCE: Records show that service users have input from relevant health professionals where requested, although as discussed previously advice given has not always been followed.Staff demonstrated that they were effective in advocating for service users in terms of their health care needs and were succesful in, for example, ensuring that a service user had appropriate wheelchair provision.Staff said that they feel that they have adequate time to undertake personal care. Medication was observed to be securely and appropriately stored This is an improvement since the last inspection. Records checked of medicines administered tallied with stocks held. Staff said that they had been trained in the safe handling of mecicines. Guidance is provided for staff in how to 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 15 proceed if a service user refuses to take medication. This has not been discussed with health professionals and needs to be, as it involves disguising medicatons in food and advises a course of action that may not be in the best interest of the service user. 2 Seafarer`s Walk DS0000064967.V295971.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the service. More evidence is needed to demonstrate that any complaint would be responded to appropriately. Some policies and procedures regarding the management of service users money need to be reviewed to ensure that they safeguard service users financial interests. EVIDENCE: A Complaints procedure is on display which does not include timescales for responding but informs people who to complain to. No complaints have been recorded at the home but staff said that one representative of a service user had expressed a concern which had been responded to by senior managers. Residents are consulted on a day-to-day basis and rely on staff observation and understanding of behaviours for their needs and wishes to be known. Records show that all but new staff have training in adult protection and that Crisis prevention and Intervention training which provides strategies for managing challenging behaviours is also available. Money held on behalf of one service user was checked and this tallied with records. Money was seen to be kept securely and records showed that balances are checked at the end of every shift. There is a lack of clarity about how meals for service users are paid for when out. ie service users appear to pay for their meals and when on holiday it appeared that service user paid for staff food as well.There is also a lack of clarity about how transport costs are organised. The arrangements appear to be that each service user pays a set amount as part of a vehicle car agreement which is signed on their behalf by a representative of CIC. All pay the same 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 17 although it would appear that the use of this vehicle differs between service users. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the service. The environment is largely suitable but bathing facilities still need to be improved. Some infection control issues still need to be satisfactorily addressed. EVIDENCE: The home was clean and tidy at the time of this visit .Two requirements relating to the environment were made in the last report of November 2005 These were that adequate bathroom facilities must be provided to meet personal care needs and that areas of the home need attention to improve infection control. CIC have responded to the first issue saying that they are liaising with the housing provider. No further progress however appears to have been made. The state of the existing bathroom continues to be poor. The floor is not sealed and water can get underneath it. This is a slip hazard and has already caused one accident.This is also not a satisfactory situation in terms of infection control. There is still no panel on one side of the bath. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 19 Bedrooms seen had been personalised to suit the intersests of service users. . Some redecoration has taken place, for example some rooms have been painted. Paper towels and liquid soap are provided in the bathroom Aprons and gloves were observed to be available to staff.Information regarding the control of hazardous substances was being updated. Laundry facilities are appropriately sited andf are adequate to meet needs. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the service. Staffing levels are generally adequate although this would need fairly continuous review because of the complex needs of service users. Service users are protected by the homes recruitment procedures and by the training provided to the staff team. EVIDENCE: There is an established and experienced staff team. Staff were observed to be comfortable in their role and showed service users respect. Staffing hours have reduced from 493 to 448 hours per week. The rota shows that there are three members of staff on duty during the day. Staff say that there are generally enough staff available to support residents, although as discussed in a previous section, staffing levels can have a detrimental effect upon the range of activities available to service users. Regular bank staff on duty demonstrated a good understanding of residents support needs. Two staff records were examined to evaluate recruitment procedures. Both contained completed application forms, two written references and evidence that a Criminal Records Bureau check had been completed. One file which belonged to a regular staff member contained evidence that an induction and training courses had been completed. Through discussion it was evident that 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 21 bank staff are now included in the CIC training programme. This is an improvement in the service. Training opportunities were found to be appropriate at the time of the last report.A programme of training programme was seen which covers basic health and safety topics.Through discussion it was evident that training is also offered to help staff support service users with specific health conditions.One staff member has undertaken a facilitators course in moving and handling.As discussed in a previous section staff said that they felt that they would benefit from having some training or guidance in supporting service users with visual impairment. Through discussion it was apparent that no supervision sessions have taken place since the manager went on maternity leave in February .Staff meetings continue to be held. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the service Disruption in management has had a detrimental effect upon the development of the service. More quality assurance systems are needed to ensure that the service is meeting the wishes and needs of service users. Systems to protect service users are largely in place although some need to be developed further. EVIDENCE: There is a gap in management structure because the manager is on matrernity leave.The post is being covered by senior carer and overall management responsibility has been delegated to the manager of another CIC home. Staff describe the senior carer as supportive. Although there is evidence that some progress has been made, some requirements from the previous inspection have yet to be met and there is evidence in this report that actions that have been identified as necessary to improve the quality of service users lives have not been progressed. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 23 Feedback from service users is mostly non-verbal and obtained through staff and relatives. Although a monitoring visit takes place every month by a senior manager staff were not aware of any other quality monitoring systems in place. The pre inspection questionnaire indicates that visits to the service have recently made by the fire service and by environmental health and that any requirements made have been implemented. Other maintenance records for the home were seen to be up to date. During the site visit the fire risk assessment was seen to be in place. A risk assessment for the home has been completed.This was a requirment from the last inspection. Procedures for staff to follow in event of fire day or night were seen but found to lack detail.Smoke detectors are in place and fire alarms and emergency lighting is regularly tested. Staff said that assessments regarding the control of substances hazardous to health are in the process of being completed. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 24 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 2 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 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 2 LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 X 2 X X 2 X 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 25 Yes 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 YA6 Regulation 15 Requirement The service user’s plans must detail how service users needs in respect of their health and welfare are to be met. This is a repeat requirement from 12/9/05 Previous requirement partially met. The registered person must ensure that all individual risks to residents are as far as possible eliminated. This is a repeat requirement from 12/9/05 The registered person must ensure that adequate bathroom facilities are in place to meet personal care needs. This is a repeat requirement from 12/9/05 The bathroom needs to be improved to prevent the spread of infection and to minimise the risk of falls. This is a repeat requirement from 12/9/05 Previous requirement partially met The registered person must ensure a system is in place to monitor the outcomes of service provision for residents. DS0000064967.V295971.R01.S.doc Timescale for action 31/08/06 2. YA9 13(4) 31/08/06 3. YA18 16(2)(f) 30/11/06 4. YA30 13(3) 31/08/06 5. YA39 24 (3) 30/09/06 2 Seafarer`s Walk Version 5.2 Page 26 This is a repeat requirement 6of 12/9/05. 6 7 8 9 YA20 YA42 YA36 YA23 13 13 18 17(2) Advice must be sought regarding disguising medication in food. Fire procedures must be more detailed Staff must receive supervision Policies and procedures regarding the handling of residents moneys need to be reviewed to ensure that they are fair to all 31/08/06 31/08/06 31/08/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA7 Good Practice Recommendations That staff should be offered training and guidance in working with people with a visual impairment. 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 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 2 Seafarer`s Walk DS0000064967.V295971.R01.S.doc Version 5.2 Page 28 - 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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