Inspection on 20/06/06 for Allied Back-up Project Limited - The Old Bakery

This inspection was carried out on 20th 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Allied Back-up Project Limited -... 27/03/08

Allied Back-up Project Limited -... 07/11/05

Allied Back-up Project Limited -... 13/04/05

Allied Back-up Project Limited -... 17/11/04

Allied Back-up Project Limited -... 30/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Allied Back-up Project Limited - The Old Bakery The Old Bakery 54 Park Street Crediton Devon EX17 3HP Lead Inspector Sue Dewis Key Unannounced Inspection 20 June 2006 10:00 Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.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 Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.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. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allied Back-up Project Limited - The Old Bakery Address The Old Bakery 54 Park Street Crediton Devon EX17 3HP 01363 777565 01647 24447 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) Allied Backup Project Limited Mr Frederick James Saunders Mr Frederick James Saunders Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 Brief Description of the Service: The Old Bakery is owned by the Allied Backup Project Ltd, and is situated in a residential area of Crediton. The home is close to the centre of the town and from the road has nothing to distinguish it as a residential home. The Old Bakery is a smaller home and is registered to provide personal care for up to four service users with learning disabilities. The registered person is also responsible for the day-to-day management of the home. The inspection report for the home is available on request from the office. Fees for residents at the home range from £1000 to £1500 per week. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately six hours on one day in June 2006. The inspector used a variety of methods to collect information for this report, including pre-fieldwork planning and a completed pre-inspection questionnaire that had been filled in by the manager of the home. Survey forms were sent out to 8 staff, 3 residents and their relatives, GPs and Care Managers. At the time of writing the report the inspector had received completed forms from 3 staff, 3 residents, 2 relatives and 2 GPs. The inspector met with the 3 residents, 4 staff and the manager. A tour of the building was also made ad records were inspected. The inspector was unable to communicate verbally with the residents, but spent time observing interactions between staff and residents. What the service does well: What has improved since the last inspection? A daily living plan has been introduced for one resident. The bathroom has had some refurbishment. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 6 The complaints procedure now informs people that they can contact the Commission at any time. 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. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.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 Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents will be assured that their care needs can be met. EVIDENCE: There have been no admissions to the home for some time. All three residents’ records were inspected and though there was no evidence of a pre-admission referral on one, there was a shared assessment document for one and a full needs assessment for the other. Residents were unable to confirm whether they had received any information prior to their admission. Mr Saunders is aware that he must obtain a copy of the shared assessment documents should he receive a new referral, and that he must not admit any resident whose needs cannot be met by the home. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place, but this does not readily provide the information that staff need in order to satisfactorily meet the needs of the residents EVIDENCE: The care staff on duty were initially unsure of where care plans were kept and said that they did not routinely refer to the plans. All three residents’ care plans were inspected. The plans included a general ‘pen picture’ of each resident and provide staff with much of the information they needed to meet the needs of the residents on a day to day basis. However, the plans did not include detailed assessments of the residents’ current abilities. Without these assessments it is difficult to build pictures of the current needs of the residents and therefore to plan for increased independence. One resident had completed the ‘My Life, My Plan’ document that showed their preferences on a variety of topics relating to daily living. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 10 Daily recordings are held in a file separate to the care plans. This means staff do not always refer to the care plans during the day, and while any changes to care needs are related at staff handover and written on daily records, they are not always written on the care plans due to the plans not being readily accessible. This could lead to information not being written on the plan and could be avoided if daily recordings and care plans were kept together. Daily recordings were not always useful in so far as they reported ‘good mood’ and did not specify the behaviour associated with this mood. Residents at the home have limited verbal communication and it was not possible for the inspector to ask them direct questions about their lives at the home. However, staff were heard offering alternatives for meals and drinks and responding appropriately to one resident’s requests to go for a walk. Staff and residents were seen to communicate well and appropriately with each other. Staff told the inspector that residents make choices about many aspects of their daily lives and are encouraged to do so as much as their abilities allow. Risk assessments for residents were seen and discussed, and in particular one issue where a resident was being more closely monitored because of a complaint received from a neighbour. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a good range of opportunities for residents to take part in social and leisure opportunities within the local community, but these are limited within the home. Families and friends are encouraged to keep in contact with relatives EVIDENCE: The inspector spoke with staff about the behaviour of one resident and alternate ways in which their energy could be channelled. The inspector was told that a psychiatrist had been involved in drawing up daily plans for this resident and that these had been very useful in giving the resident a focus for their day. One resident visits a local day centre and another likes to visit the church for coffee mornings. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 12 During the inspection the inspector saw staff and residents interacting well with laughter and smiles. Residents were encouraged to plan their day and helped to go out shopping. Staff displayed a good knowledge of individual residents, but appeared unsure of how to occupy residents other than taking them out of the home. One member of staff wrote on a comment card that they would like ‘more in-house activities for clients’. All residents regularly visit their families in the community. One relative commented in writing that after visiting them at home their relative was ‘always happy to go back’ and that if they were happy the relatives were ‘confident they are being well cared for’. One member of staff wrote on a comment card that ‘all staff and manager treat service users with great respect and treat them as equals’. Residents chose what they wanted for lunch from a range of healthy options, and staff and residents were seen eating lunch in a relaxed and comfortable manner. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good understanding of the residents’ personal support needs, and residents benefit from the positive relationships they have with staff. The health needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basis. Though the systems for the administration of medications are generally good, some recording practices are poor and potentially place residents at risk. EVIDENCE: Residents’ care plans contained information relating to health and personal support. It was possible to track where a health issue had been identified, reported to the GP and medication prescribed. Residents are generally taken to visit the surgery rather than being visited by the GP at the home. One comment card received back from a GP said that they felt ‘communication was good’. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 14 All residents have six monthly reviews by a psychiatrist, who has recently drawn up a plan for one resident in order to try and manage their behaviour more effectively. There was evidence around the home that this plan was being followed, staff also spoke of the positive benefits for the resident who was now more relaxed and able to undertake some small tasks for an increased length of time. Not all residents’ plans contained their wishes relating to dying and death. The inspector was told that home tries to ensure there is one male and one female member of staff on duty in order to ensure residents have a choice as to the sex of the person providing their personal care. However, on the day of inspection there were two male carers on the morning shift and two female carers on the afternoon shift. The inspector was told that residents did not object to receiving care from a person of the opposite sex, but this was not recorded. The home uses the Boots MDS (Monitored Dosage System) system including the associated documentation. Medication was stored securely and staff were signing the MAR (Medication Administration Record) when they had given medication to residents. However, the home was still not recording the quantities of medication being received into the home. Two of the three staff spoken with had received accredited training, the third had received training, but had not been assessed following the training. There was good guidance on when ‘as required’ medication was to be given and staff were aware of the procedure, including that two staff always make the decision. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with evidence that complainant’s views are listened to and acted upon. Staff training generally ensures residents are protected from abuse. EVIDENCE: Residents at the home are unable to express their views verbally, however staff know the residents well and said they were confident they would be able to recognise if residents were unhappy. One complaint had been received by the home, and the home had notified the Commission about the incident and had dealt with the matter to the satisfaction of the complainant. No complaints have been received by the Commission, since the last key inspection. Staff were able to give clear examples of all types of abuse and all said they would have no hesitation in reporting any suspected abuse. Two of the three staff had received formal training in POVA (Protection Of Vulnerable Adults) issues, but the third had not. All residents have individual savings accounts into which their weekly personal allowance is paid. The home then withdraws small amounts of cash as needed to be held at the home. The records for two residents were checked, they had been well maintained and all monies held were correct. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 16 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): 24, 25, 28 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the home is in fairly good decorative order. However, there are some areas of the home where the standard of décor is poor. The home does not, therefore, present an entirely homely and comfortable environment for residents. All areas were clean and odour-free, though there is the potential for some cross-infection. EVIDENCE: The home is generally in a reasonably good decorative order, and provides the residents with a homely environment. The lounge area was comfortable and contained many pictures and ornaments. However, there are areas around the home that need attention. For example, there are several small holes in the kitchen ceiling, one in the lounge and one in the hallway. The bathroom has recently had some refurbishment but the Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 17 work needs to be ‘finished off’ and the decorations completed. Mr Saunders told the inspector that the hall, stairs and landing would be decorated within the next few months. More attention to detail would provide residents with a more comfortable environment and ensure that they feel they are valued as individuals. Residents’ rooms were small, but contained many items of a personal nature, and reflected the particular likes of each individual. There is no lift to the first floor and there are no ground floor bedrooms, therefore the home would be unable to offer a placement to anyone with mobility problems. All areas of the home were clean and fresh smelling, and staff reported they had access to disposable gloves and aprons if needed. However, there was no paper towels or liquid soap in either the bathroom or the laundry room. This has the potential for cross infection due to staff and residents being unable to wash their hands effectively. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 18 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 outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are appropriate to meet the needs of the residents. Training arrangements for staff are adequate but would be further improved with specialist learning disability training The procedures for the recruitment of staff are robust and offer protection to residents. EVIDENCE: Three staff were spoken with during the inspection and two files were inspected. Eight comment cards were sent to staff and at the time of writing the report three had been returned. The three staff spoken with had received a variety of training, including NVQ’s and non abusive physical interventions. However, only one had received training specifically designed for staff working with residents with a learning disability, and none of them had received LDAF (Learning Disability Award Framework) accredited induction or foundation training. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 19 All staff confirmed that the home had followed the appropriate procedures in relation to their appointment. The two files inspected contained the required information, including two references and CRB (Criminal Records Bureau) checks. Staff reported different levels of supervision, from one who receives supervision regularly to one who has not had supervision at all. There were no records to indicate that supervision takes place and Mr Saunders is aware that all staff should receive regular supervision and that it should be recorded. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 20 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 outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and this generally results in practices that promote and safeguard the health, safety and welfare of the residents. There is no quality assurance system in place to ensure that the standard of care is monitored. EVIDENCE: Mr Saunders is currently responsible for the day to day management of the home, although he is hoping to register a manager in the near future. There is still no formal quality assurance system in place, and the home has not been proactive in establishing a system by which the quality of care can be Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 21 measured. Mr Saunders told the inspector that he had sent out questionnaires to a variety of interested parties but had not received any replies. The fire log book showed that all required tests had been completed and that staff had last received training in fire precautions on 20 June 2006. Staff were able to confirm that they received regular training in fire precautions. No accidents had been recorded. Insurance cover for the home expires in November 2006. All radiators around the home are covered and windows on the first floor have restricted openings. The pre inspection questionnaire completed by the provider showed that there are good arrangements in place to check appliances, central heating, temperature checks, the electrics etc. Staff told the inspector that they had all received basic health and safety training, and they displayed a good knowledge of safe working procedures. Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 22 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 3 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 2 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 2 3 X 1 X X 3 X Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 23 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 YA39 Regulation 24 Timescale for action You are required to ensure that a 28/09/06 system is in place to monitor the quality of care provided (previous timescales of 30/11/04, 14/06/05 and 28/02/06 not met) Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA6 YA6 YA6 YA7 YA12 Good Practice Recommendations You are recommended to ensure detailed assessments of residents’ current abilities are available You are recommended to ensure that care plans are more easily accessible to care staff You are recommended to ensure daily records usefully describe the resident’s day You are recommended to ensure the preferences of residents in relation to the sex or the staff providing personal care You are recommended to ensure that a range of in-house activities are offered to residents. DS0000021873.V293162.R01.S.doc Version 5.2 Page 24 Allied Back-up Project Limited - The Old Bakery 6 7 YA20 YA21 You are recommended to ensure that the actual amount of medication coming into the home is recorded You are recommended to ensure you obtain all service users wishes in relation to terminal illness and death, where possible. You are recommended to ensure that all staff are trained in POVA issues You are recommended to ensure that minor repairs are undertaken in order to ensure the home is in good decorative order You are recommended to ensure there is liquid soap and paper towels available in the bathroom and laundry You are recommended to look at using LADAF accredited induction and foundation training. You are recommended to ensure that all supervision sessions with staff are recorded 8 9 10 11 12 YA23 YA24 YA30 YA35 YA36 Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Allied Back-up Project Limited - The Old Bakery DS0000021873.V293162.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!