Inspection on 20/06/08 for 64-66 Ragstone Road

This inspection was carried out on 20th June 2008.

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

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

Other inspections for this house

64-66 Ragstone Road 21/06/07

64-66 Ragstone Road 24/10/06

64-66 Ragstone Road 31/10/05

64-66 Ragstone Road 26/04/05

64-66 Ragstone Road 12/10/04

64-66 Ragstone Road 13/04/04

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Ascot Nursing Home

Fountain View

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 64-66 Ragstone Road Slough Berkshire SL1 2PX Lead Inspector Julie Willis Unannounced Inspection 20th June 2008 11:45 64-66 Ragstone Road DS0000011405.V365162.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 64-66 Ragstone Road DS0000011405.V365162.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. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 64-66 Ragstone Road Address Slough Berkshire SL1 2PX 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) 01753 524869 01753 524869 morgan.mkwezalamba@advanceuk.org Advance Housing and Support Ltd Manager post vacant Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2007 Brief Description of the Service: The home is two detached houses linked together by an office/reception area and is situated in a residential area, which is close to local shops at Chalvey and the town centre of Slough. There are eight beds for people, between the ages of eighteen and sixty-five with mental health needs. The home is run by Advance Housing and Support Limited and is staffed 24 hours a day by a team of support workers. The fees are £841.35 per week. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. This unannounced inspection took place on weekday morning and afternoon over the course of four and a half hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the service since the last inspection. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for residents and visiting professionals such as doctors and nurses. Any replies were used to help form judgements about the service. Consideration has also been given to other information that has been provided to the Commission since the last inspection. The inspector toured the building, examined records and met all of the residents. The inspector also spent time talking informally to staff and observing how care was being delivered to the residents. From the evidence seen by the inspector and comments received, the inspector considers that this service has a good awareness and understanding of equality and diversity issues and would be able to provide positive outcomes for residents in the areas of race, ethnicity, age, gender, sexuality, disability and belief. The inspector gave feedback about her findings to the homes Assistant Manager at the end of inspection. There were no legal requirements made as a result of this inspection. The Commission has received no information concerning complaints since the last inspection. What the service does well: The home is comfortable, clean and satisfactorily decorated and furnished throughout. Residents are encouraged to personalise their own rooms and these are decorated and furnished to a good standard. There is enough staff on duty at all times to meet the needs of residents effectively. Recruitment practices are well carried out and the staff files contain all information needed to ensure that residents are kept free from harm. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 6 The written care records are well kept and up-to-date and provide staff with the information they need to provide the right care to the residents. Residents are involved in planning their care and feel their views and opinions are valued and listened to. Food provided by the home offers residents variety and choice and is well presented in pleasant comfortable surroundings. 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. 64-66 Ragstone Road DS0000011405.V365162.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 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 People who use the service experience good quality outcomes in this area. Residents are fully assessed prior to admission to ensure the home will be able to effectively meet their need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although there have been no new admissions to the home for a significant period and much of the paperwork has been archived it was evident from discussions with staff and residents that people were fully assessed prior to their admission to the home. The home has a comprehensive admissions policy, which details the comprehensive and holistic assessment that will take place and the need to fully involve the person to be admitted, their families, advocates and a multidisciplinary team of professionals. All residents have regular contact with mental health services and have regular CPA (Care Programme Approach) meetings. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 9 People who use the service experience good quality outcomes in this area. The care plans were sufficiently detailed to enable staff to effectively meet service user need and activities that could be hazardous were underpinned by effective risk assessment and risk management strategies. Residents are encouraged and supported to make decisions in relation to their everyday lives and their individual goals appeared realistic and achievable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of care documentation and discussion with staff and residents evidenced that the home positively encourages users to develop their independence and life skills. Residents are encouraged to be actively involved in carrying out the tasks of daily living and these form part of their individual support plans. Examination of care records and risk assessments indicated that adequate support and supervision are provided whilst involving residents in activities that could pose a risk to their safety. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 10 Examination of the content of four care plans evidenced that residents are supported to take risks as normal elements in their everyday lives. These risks have been fully assessed and guidelines have been put in place to minimise any risk to the resident and to staff. Individual support plans are in use at the home and it is clear that staff involve the residents in their production. All have agreed objectives, which have been agreed and signed by the resident. The objectives are reviewed fortnightly in a meeting between the resident and their allocated key-worker. The care plans encompassed residents personal and health care needs, social activities, specialist needs and behaviour management guidelines in an effective way. Staff were clear that they needed to adopt a uniform approach to respond to any challenges to the service in a planned and consistent way to avoid any confrontation or escalation in behaviours. The residents confirmed that they knew what was in their individual care plan. One resident said, “I talk to my key-worker regularly”; “ they make sure my plan is up-to-date”. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16, 17 People who use the service experience good quality outcomes in this area. Residents take part in activities that provide opportunity for personal, practical and emotional development. They are encouraged to be part of the local community and citizenship is encouraged and supported. Residents are provided with a menu that is nourishing, varied and meets their individual and cultural need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From examination of documentation and discussion with residents it was evident that residents are provided with the opportunity to engage in activities that are stimulating and worthwhile. There was evidence in the daily records that residents make good use of communal facilities including local restaurants, cinemas, sports facilities and public houses. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 12 Residents are involved with the shopping, cooking, cleaning and laundry activities in the home and this is a well-documented part of each residents care plan. One resident is supported to attend work each day and thoroughly enjoys the experience. Another is currently in a relationship and enjoys meeting with their friend on a regular basis at the local swimming baths and other community venues. Several residents are supported to attend local church groups and local drop in centres including the local ‘Mind’ day centre. Residents are encouraged to maintain their relationships with family and friends. Records indicate that most of the residents keep in regular contact with their family, friends or advocates and have regular visits and correspondence. The home provides a nourishing menu, which meets the needs of residents. They are provided with choice and variety and are regularly consulted about the menus during the monthly residents meetings. Those residents that require a religious or cultural menu are supplied with appropriate foodstuffs including Halal meat and vegetarian options. Residents confirmed that the food was to their liking. One resident said, “We have plenty of choice, the staff are good here, they are good at cooking”. Another said, “We get to choose what’s for dinner, I can’t complain there’s always something I like”. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19, 20 People who use this service experience good outcomes. Peoples physical and personal support needs are well met at this home and well-trained and competent staff deals with medication safely and appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of resident’s documentation and discussion with staff and residents indicated that all residents are registered with a local doctor. Regular health checks and routine screening and treatments are offered by the practice and several residents regularly see the practice nurse for blood tests and other advice and treatments. All residents have regular contact with mental health services and have their medication reviewed at appropriate intervals by mental health specialists. Details of the outcome of these appointments and any changes in treatment or medication are well documented in the care plans and daily records. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 14 There was evidence that residents also have regular dentistry, podiatry and attention to their vision and hearing and their attendance is appropriately recorded in the care records. The home has robust medication policy, procedure and practice guidance in place. Staff are aware of their responsibilities in relation to the safe administration of medication and have been properly trained. One of the current residents will soon move into supported living and has been supported to take their medication unsupervised. This is working well and staff regularly consults with the resident to ensure the resident is managing their medication effectively. This forms part of their on-going review. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 People who use the service experience good quality outcomes in this area. The home has a satisfactory complaints system. Residents feel their views are listened to and acted upon. Residents are protected from abuse and exploitation by staff that can demonstrate knowledge of the homes abuse of vulnerable adults This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a complaints procedure, which is clear and accessible to residents. Residents are provided with information on how to make a complaint to the home, the time scale for response, and the stages and process of the Organisations complaint procedure. Examination of the complaint records indicated that there has only been one complaint made to the home since the last inspection. The detail of the complaint was well documented. The complaint had been fully investigated by management and an outcome had been provided to the complainant. The CSCI has not received any information concerning complaints about the home since the last inspection. There was evidence in staff files and from discussion with staff, that they receive training in safeguarding adults as part of their formal induction to the 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 16 home. This learning is later consolidated when undertaking NVQ training in which it forms a core module. Staff interviewed were aware of the homes whistle-blowing policy and understood the importance of protecting users from abuse and exploitation at all times. 64-66 Ragstone Road DS0000011405.V365162.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): Standard 24 & 30 People who use the service experience good quality outcomes in this area. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From a tour of the building and gardens it was evident that residents live in clean and comfortable environment. All areas of the home were found to be clean and hygienic at the time of inspection. Each resident has their own private bedroom and locks their own door. Staff may only enter if they ask the resident for permission. Each bedroom is personalised by the occupier to meet their individual preference and need. One resident has a flat in the home. The resident is supported to remain as independent as possible with a view to moving into the community in the long64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 18 term. The resident confirmed that they liked having their privacy and enjoyed living in the flat. The lawn to the rear of the property required mowing at the time of inspection. The inspector was informed that residents are encouraged to maintain the gardens as part of their daily living skills, but can be reluctant to get involved. There are plans to spend the forthcoming weekends tidying the garden before the residents participate in summer barbeques. There is a large communal room in the garden, which is used by the staff for training purposes, meetings or for engaging residents in activities. It would be helpful if the belongings of a previous resident could be removed to enable current residents to gain full use of the room. Staff have received training in health & safety and are mindful of the need to prevent cross contamination and to wear protective clothing when carrying out personal care. As part of individual residents activity programmes users are encouraged to participate in the cleaning of the home and to assist with the laundering of their personal clothing. This is well documented in their individual care plans. 64-66 Ragstone Road DS0000011405.V365162.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): Standards 32, 34, 35 People who use this service experience good quality outcomes. Residents are provided with care and support by a team of well-trained and caring staff that have been robustly recruited. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector examined the recruitment records for two of the staff. The content of files evidenced that all necessary checks are undertaken on prospective staff to ensure the safety and protection of residents. The content of the files met the National Minimum Standards and Regulations. The policies and procedures relating to selection and recruitment ensure resident safety and are robust, transparent and meet the requirements of current good practice guidance and legislation. From discussion with two permanent staff and examination of their training records it was clear that they have received structured induction training to Sector Skills Council specification. All staff receive core skills training in fire safety awareness, health & safety, infection control, safeguarding adults, food hygiene, first aid and manual handling. All staff are encouraged to attain National Vocational Qualifications at levels 2 & 3. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 20 Additional training is offered to the staff of the home to enable them to effectively meet the needs of residents with a variety of complex needs. This training includes responding to violence & aggression, models of care, challenging behaviours, person-centred planning, equality & diversity and mental health needs. It would be helpful if future training could incorporate information about the Mental Capacity Act and its effect on residents. All staff receive on-going support and are formally supervised at least six times a year. One of the meetings is a performance review. Staff have additional opportunities to air their views and to have a say in the way the home is run in the regular team meetings. The minutes of these meetings were examined by the inspector and appeared to follow a shared agenda and were resident focused. Staff interviewed informally by the inspector seemed knowledgeable, motivated and caring and clearly knew the needs of individual residents well. Residents appeared relaxed and happy in the staffs care. The staff team were observed throughout the course of inspection to offer residents appropriate choices in relation to their everyday lives. 64-66 Ragstone Road DS0000011405.V365162.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): Standards 37, 39, 42 People that use the service experience good quality outcomes. Residents benefit from living in a well managed home where their health and safety is of prime importance. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes Manager - Morgan Mkwezalamba has applied for registration with the Commission. He has worked at the home for the past four years and has until recently been carrying out the role of Deputy. The Manager has an NVQ 3 and is nearing completion of an NVQ level 4 and Registered Managers Award. Staff confirm that the Homes Manager demonstrates effective leadership skills and is ‘hands-on’ accessible and supportive. Staff confirm that they have the opportunity to express their opinions openly in staff meetings, supervision 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 22 sessions and staff handovers. They say that they are provided with plenty of opportunity to express concerns, share information and to feel included and involved in the way the service is delivered. Proprietor’s Representative visits are carried out monthly and an action plan is put in place, which identifies how the service can be further developed and improved. The residents are complimentary about the management of the home and feel that the office is always open and accessible to them. Residents feel that they are regularly consulted on issues that affect them and feel that their views are taken into account on a day-to-day basis. From examination of the minutes of residents meetings there was evidence that when requests are made or concerns expressed in the meetings the issues raised are followed up promptly by management. A number of health and safety records were examined including fire records, water temperatures and fridge & freezer temperature records. These checks evidenced that essential servicing and maintenance of equipment is undertaken routinely to safeguard the health and welfare of residents. Risks to residents are identified using comprehensive risk assessments that are reviewed at regular intervals. So far as possible risks are reduced or eliminated. 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 3 x 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 24 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. 1 Refer to Standard YA35 Good Practice Recommendations Consideration should be given to providing staff with access to Mental Capacity Act training so they can understand how this new legislation will impact on the rights and best interests of residents. The garden room should be emptied of the previous residents belongings so that residents may make full use of the facilities. 2 YA24 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 64-66 Ragstone Road DS0000011405.V365162.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!