Inspection on 27/09/07 for Clayton Road, 62

This inspection was carried out on 27th September 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clayton Road, 62 11/09/06

Clayton Road, 62 20/02/06

Clayton Road, 62 26/07/05

Clayton Road, 62 23/02/05

Clayton Road, 62 25/08/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Clayton Road, 62 62 Clayton Road Jesmond Newcastle upon Tyne Tyne & Wear NE2 1TL Lead Inspector Carole McKay Key Unannounced Inspection 27 September, 4th October 2007 09:30 th Clayton Road, 62 DS0000033054.V346572.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 Clayton Road, 62 DS0000033054.V346572.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. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clayton Road, 62 Address 62 Clayton Road Jesmond Newcastle upon Tyne Tyne & Wear NE2 1TL 0191 281 1956 0191 281 1956 eleyne.dugdale@newcastle.gov.uk 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) Newcastle City Council Social Services Department Alayne Dugdale Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The ground floor only must be used to accommodate service users who have a physical disability 11th September 2006 Date of last inspection Brief Description of the Service: 62 Clayton Road is a care home registered to provide personal care for ten adults with learning disabilities. It is a local authority resource offering respite, short term, care to 89 people. The home is located in a residential area of Jesmond, Newcastle Upon Tyne. The property was converted into a care home and has been extended since it was built. Accommodation is over three floors. A passenger lift is not provided and service users with physical disabilities are accommodated in ground floor rooms. There is easy access to local facilities, shops and public transport networks. The registered manager is Mrs Alayne Dugdale. The fees are £9.24p per night. Information about the home and inspection reports is readily available. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The manager of the service provided information prior to the inspection. This was used to help plan the inspection. Surveys were sent out to staff and service users. Only two of these were returned. The home was visited on three occasions. One of the visits was used to give feedback to the manager. A meal was taken with service users and staff. Time was spent with a service user away from the staff. What the service does well: What has improved since the last inspection? The service has a developed the service users guide, so that people who are considering coming to live at the service have the information they need to make the right decision. The monies belonging to service users are stored and accounted for individually, so that the interests of service users are safeguarded. The way the service assist people with medications has been made safer for service users. Meetings have been arranged between the manager and the staff who do nights, so that all staff are supported equally in caring for the people who use the service. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 6 Shift procedures have developed so that service users receive a consistent level of service. 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. Clayton Road, 62 DS0000033054.V346572.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 Clayton Road, 62 DS0000033054.V346572.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): 1,2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can make an informed choice about staying at the service. Staff will understand their needs. EVIDENCE: An information pack “ All About Clayton Road “ has been produced. The manager said that a copy of this is given to each service user before they come to stay for the first time. A copy of the most recent inspection report is available in the entrance hall. In surveys both service users answered yes to the question about whether they had received enough information about the service. One person commented that they were invited to several tea visits before they went to stay overnight. The service has clear admission criteria. These are written down. The admission process is also very clearly described as is the process for introducing new people to the service. The process has clear stages and useful information is gathered about the person using the service, before they come to stay at Clayton Road for the first time. The assessments carried out by the care manager for the service user, and any other professional assessments are Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 9 taken into account. There is evidence in the files that this information, once gathered together, is shared with the service users and/ or their representatives. The information is used to form the service user plan. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service will be involved in the planning of their care. They are supported to continue their current lifestyle and will be offered new opportunities. EVIDENCE: Each service users has a service user plan. These contain the essential information about each person’s important contacts and their daily routines, such as how and where they spend their time during the day, and other services they attend. For example times of attendance at day centres are included, as appropriate. Information about identified risks and how these will be managed, so that people can maintain independence, is also included. The service user plans include detailed individual care plans for staff to follow. For example in assisting a service user with personal care or in managing Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 11 behaviour to avoid self harm or harm to others. One service user’s plan included a care plan for assisting the person with diet, in a way that suited the person’s culture. Regular evaluations are recorded of the plans. This makes sure that they continue to meet the needs of service users. The manager has also identified future improvements to the way the service communicates with staff from other services to develop the person centred approach. Since the last inspection, the service has altered the way that each person’s stay at the service is evaluated. The staff on duty at the end of the stay carries this out, so that the information is immediately updated. The manager and assistant manager have audited the files to make sure that they are up to date. Occasionally people who have booked to stay at the service do not arrive, but fail to cancel. The manager has identified a system for follow up and that this needs to be used consistently. People are encouraged to make decisions. On the day of the visit to the service choices about going out for the evening were being discussed with the people staying at the service. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The service is flexible. People will be supported during their short stay at the service to maintain their lifestyle. Beyond these commitments they will also be encouraged to get out and about in the community. EVIDENCE: People who come to stay at Clayton Road will be supported to continue to attend their usual educational, work and social commitments, for the period of their stay. At the beginning of each stay service users make choices about how they wish to spend their spare time. This information is recorded in the daily reports. Rotas for staff are adapted to take account of this. External activities include visiting local shops, cafes, pubs, theatre and other local places of interest. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 13 The person on duty evaluates following each stay the experience. This involves considering the things that have worked well or not so well for the person. Useful suggestions are included in the evaluation. The home does not employ a cook, so care staff do the catering. The assistant manager has put a lot of work into planning menus and providing staff with easy to follow recipes. The menus are varied and balanced and we saw staff offer service users alternative choices to the menu. Staff respect the service users’ rights to refuse food or to change their minds. The home is promoting the use of door keys to protect the privacy and security of the people staying at Clayton Road. . Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are safely assisted with their health care needs. Their preferences and capacity to make choices are respected. EVIDENCE: Most of the people who use the service require some degree of help with personal care. Just under half of the service users have a physical disability. The information provided states that where possible service users are supported with personal care by staff of the same gender. The gender balance among service users is not reflected in that of the staff team however. But the rota planning takes this into account as far as possible. The manager said that to employ more male staff would make it more difficult to match staff with female service users. The care plans cover the preferences and care needs of service users. The home has had adaptations and aids fitted to assist staff in caring for the people who use Clayton Road. Some service users have assistance aids that they bring with them to the home. Detailed plans describe the arrangements for Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 15 assisting service users to move around, or to transfer from one position to another. Daily routines are written down, so that people can meet their daytime commitments away from the home. Where necessary these plans are updated. Each service user has an allocated key worker on the staff team who takes responsibility for updates. Because the service provides very short-term care, the people who use the service would not rely on Clayton Road for their routine health care screening. But on going medical needs are assessed prior to arrival. All service users have their on going health monitored during each stay. And records are kept of observations made by the staff. Where necessary non-urgent problems can be addressed by a local GP through temporary registration, but the service also supports service users to visits their own GP where possible. Health and personal care to service users is supported by staff having procedures and guidance that they can refer to. For example, recently guidance to do with pressure area care and continence care has been made available. We saw that the service was holding a small amount of medication for service users. This was safely stored in an appropriate cabinet. The records were examined and these were up to date with no unexplained omissions. The correct records are used for different kinds of medication. Low levels of medication are disposed of, but medications are routinely returned home with service users. Medications are checked in and out of the service. Sometimes they return home with the service user via the day service they are attending. The staff at the home make sure that these medications are securely bagged and sealed. The details of returned medications are properly recorded. There have been medication errors recently. These have been identified through the checking process. The manager said that the practice of administration has been altered so that medications are given from the original containers. This is a safer method. Since the last inspection the community pharmacy advisor has visited the service. Staff have received training in administering medication and other health related tasks. The home has a written process for confirming the competency of staff to administer medication. Up to date records for staff assisting with health care tasks are not available. The manager said that there are some people who use the service who are unable to consent to treatment. The representatives of these people record their agreement on forms used by the home. Matters to do with consent may need to be revised in light of the Mental Capacity Act 2005, which recently came fully into force. The manager said that she and her team are receiving training in this in the near future. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to voice their concerns. They have their interests protected and are safeguarded from abuse. EVIDENCE: A suitable complaints procedure is in place. A complaints log is maintained to record any complaints received and the outcome of the investigation. The Commission for Social Care Inspection (CSCI) has received no complaints about the service since the last inspection. Service user meetings are held. At these, the people who use the service are encouraged to give both positive and negative feedback There is evidence that the local procedures for safeguarding adults are known, used and followed through where necessary. The staff training schedule shows that some of the staff have had training in the local procedures and other people are booked to take this in the near future. The service makes use of the procedures for safeguarding service users as necessary and will take appropriate action. There is a written procedure for staff to follow to do with safe handling of service users’ monies. The written entries confirm that staff have read these. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 17 We saw staff auditing service users’ monies. These were securely stored and clearly accounted for. Some training to do with managing behaviour and physical intervention by staff is outstanding Clayton Road, 62 DS0000033054.V346572.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service have spacious and comfortable accommodation suited to most of their needs. The shortfalls in the accommodation will be addressed in the future so that service users benefit from a more adapted service. EVIDENCE: The service is accommodated in premises that are entirely in keeping with the residential area in which it is located. Nothing obvious draws attention to the service or detracts form the appearance of the premises. The service is well located for local amenities and transport. The accommodation is spacious and there is good provision of communal space. But as there is no passenger lift, so some service users are unable to access the games room on the first floor. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 19 Service users who have a physical disability are accommodated on the ground floor. The ground floor bathroom has been specially adapted. Some of the bedrooms on the ground floor do not provide wide access doorways. We saw that this can make accessing rooms difficult for some people who need to use a wheelchair, and especially for those people who are able to propel the chair themselves. The available space in the house provides for people who use the service to have time away from other people, if this is their preference. But some of the bedrooms are large enough to allow for sharing if this is what people choose. People who do not have physical disability can use non-adapted facilities. The laundry room is well equipped. The kitchen needs attention. An environmental health officer report highlighted necessary improvements in this area. One of these matters is outstanding. The home provides attractive safe clean and comfortable accommodation but there is water damage to the walls on the corridor. The plaster and paint is peeling away. This detracts from the work done to upgrade the décor in other areas of the building. Clayton Road, 62 DS0000033054.V346572.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff who are experienced, supported and trained to understand their needs will support people who use the service. EVIDENCE: We met two staff who were new to the service. These staff confirmed that they were receiving induction training. The manager said that when the service uses agency staff they attempt to use the same person(s) so that they get to know the service and the people who use it. These staff also follow the induction process as for permanent staff. A training assessment for the staff team as a whole has been carried out. The manager has involved the NVQ trainer/assessor. The assessment has resulted in training for staff in autism and bereavement. As yet an impact assessment of staff training has not been carried out. There are arrangements made to make sure that the training staff must receive is offered and kept up to date. 4.5 of care staff hold a national vocational qualification (NVQ) at level 2 or above. But most of the staff are Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 21 experienced and have attended many courses related to the work they do. Additional specialised training is also planned in. For example safeguarding service users and training in The Mental Capacity Act 2005. Staff are recruited following the procedures of Newcastle City Council and the records are held centrally at the council headquarters. The staff recruitment files were not examined at this inspection. The manager confirmed that safeguards to do with how staff are recruited are built in to the process she has to follow when recruiting new staff. Staff also receive yearly appraisals and regular one to one meetings with their manager. All of these meetings are recorded. Clayton Road, 62 DS0000033054.V346572.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 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 run with a focus on the service users. Service users’ views regarding the running of the home are respected. The health, safety and welfare of service users are protected. EVIDENCE: The registered manager, Alayne Dugdale, has experience in working with adults with learning disabilities. Alayne has identified her own training needs. The staff team and service users, who commented, confirmed that she is supportive and approachable. The service is supported by the corporate policies and procedures of Newcastle City Council, Adult Services Department. The manager said that she plans to introduce these into service user meetings in the near future. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 23 Regular meetings are held with the day staff and service users to discuss any issues that arise and to ensure the home is run in the best interests of the service users. Minutes of the meetings were available for inspection. A representative of the provider visits the service monthly. Alayne sends out surveys to people who use the service. She has introduced written procedures for staff on shift to follow so that the level of service is maintained consistently. The records show that the necessary safety checks and training are up to date. The fire office and the environmental health officer have both visited the home since the last inspection. Their reports are now available. Both reports made recommendations for improvements. Some action has been taken to address these matters. Some action is outstanding. Infection control guidance and procedures are in place. Clayton Road, 62 DS0000033054.V346572.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 3 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 2 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 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 2 x Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 25 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. 1. 2. Standard YA20 YA23 Regulation 17 Schedule 4 18(1)(c)(i) Requirement Confirm in writing with the staff their competence in carrying out health related tasks Staff must receive specialist training in behaviour management and the use of physical intervention. Repairs must be made to the wall in back corridor Confirm in writing that all of the recommendations of the fire and environmental health officer have been complied with. Timescale for action 31/12/07 30/01/08 3. 4. YA24 YA42 23 (2)(b) 16(2)(j) 23(4) 30/01/08 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA6 YA20 YA24 Good Practice Recommendations Consider how each service users’ plan could be briefly updated prior to each visit. This would avoid missed visits and alert staff to recent changes. Review records to do with the capacity of each service user to consent to treatment Kitchen unit doors should be renewed. DS0000033054.V346572.R01.S.doc Version 5.2 Page 26 Clayton Road, 62 4. YA35 Carry out an assessment of the impact staff training has on the outcomes for service users. Clayton Road, 62 DS0000033054.V346572.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Clayton Road, 62 DS0000033054.V346572.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. 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!