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Inspection on 23/01/06 for Clovelly House Residential Home Ltd

Also see our care home review for Clovelly House Residential Home Ltd for more information

This inspection was carried out on 23rd January 2006.

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

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

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

What the care home does well

Service users can feel reassured that the initial assessments prior to placement are detailed in their individual plans of care to ensure that staff are able to meet their needs. Service users benefit from good health care and are protected by the homes medication policies and procedures. Service users benefit from experiencing the lifestyle that they expect and have a wide variety of choice with regard to social and recreational activities offered to them. Service users feel that they are listened to and they are protected from potential abuse by robust adult protection procedures and knowledgeable staff. Service users benefit from living in a comfortable, well maintained safe environment. Service users are protected by the homes robust recruitment procedures.

What has improved since the last inspection?

One recommendation was made at the last inspection. The recommendation made for 50% of the staff to achieve NVQ level 2 in care had been achieved. Some staff are starting NVQ level 3.

What the care home could do better:

Four requirements and four recommendations were made at this inspection. Requirements were made under the heading health and personal care for photographs to be on each individual plan. Recommendations were made for the potted history`s to be completed to give holistic view of the individual and for the emotional needs of the individual to be expanded upon in the individual plans to develop a more holistic view of the individual as a person and to have an understanding of what it is like for them living in a residential home and how and why certain emotions may be expressed. A requirement was made under the heading staffing for new staff to undertake fire training including the use of fire extinguishers to safeguard both service users and staff. Recommendations were made for the rota to be revised to include as a permanent record the job role and responsibility of the staff and the designated person on duty on shift. One requirement was made under the heading Management and administration for the Commission to be notified if a service user is admitted to hospital under a Regulation 37 Notices. A recommendation was made for the time of fire drills to be recorded.

CARE HOMES FOR OLDER PEOPLE Clovelly House Residential Home Ltd 83-89 Torrington Park London N12 9PN Lead Inspector Rebecca Bauers Unannounced Inspection 10:05 23 January 2006 rd X10015.doc Version 1.40 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 Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 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 Older People. 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. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Clovelly House Residential Home Ltd Address 83-89 Torrington Park London N12 9PN 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) 020 8445 6775/1175 020 8445 7651 clovellyhouse@tiscali.co.uk Clovelly House Residential Home Limited Mrs Catherine Frances Thorn Care Home 39 Category(ies) of Dementia - over 65 years of age (0), Mental registration, with number disorder, excluding learning disability or of places dementia (0), Old age, not falling within any other category (0) Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Six service users. A maximum of six service users aged 40 years and over, can be within the category of mental disorder, excluding learning disability or dementia. 20th April 2005 Date of last inspection Brief Description of the Service: Clovelly House is a care home registered to provide personal care for a maximum of 39 residents who are over 65 years of age and who may have dementia. The homes conditions of registrations has also been varied to allow it to provide care for six adults with a mental disorder who are over forty years of age. The stated aims of the home are to provide a secure, relaxed and homely environment in which care, personal well-being and comfort are of prime importance. The home consists of four adjoining houses, which have been converted to their present use. Bedrooms are situated on all three floors of the home. The lounges and dining room are on the ground floor. All floors are served by a shaft lift. There are thirty six single bedrooms and three shared bedrooms. The home has five lounges and a dining room. Clovelly House is located in a residential area within walking distance of shops, cafes, and other community facilities located along the high road in North Finchley. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on the 23rd January 2006 and took six hours to complete. The inspection took place as part of the annual inspection programme and the quality of care provided in the home was measured against the core minimum standards. The overall quality of care provided in the home continues to be good. The inspection involved looking at care records, health and safety records and staff records. Four staff were spoken to as a group and two were spoken to independently. Six service users were spoken to either in small groups or on an individual basis. The registered manager was present throughout the entire inspection. Further information was gathered through observation of interactions between staff and service users. What the service does well: Service users can feel reassured that the initial assessments prior to placement are detailed in their individual plans of care to ensure that staff are able to meet their needs. Service users benefit from good health care and are protected by the homes medication policies and procedures. Service users benefit from experiencing the lifestyle that they expect and have a wide variety of choice with regard to social and recreational activities offered to them. Service users feel that they are listened to and they are protected from potential abuse by robust adult protection procedures and knowledgeable staff. Service users benefit from living in a comfortable, well maintained safe environment. Service users are protected by the homes robust recruitment procedures. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 6 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. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5,6 Service users can feel assured that the home will meet their needs based on the initial comprehensive assessment, which, informs the comprehensive individual plans. Prospective service users and relatives are able to visit the home prior to placement. The home does not provide intermediate care. EVIDENCE: There have been six admissions to the home since the last inspection. Full comprehensive assessments are carried out prior to admission by the experienced registered manager and head of care to ensure that the home is able to meet the individual needs and that they can be assured of that. On the day of the inspection relatives were visiting the home to assess the quality, facilities and suitability of the home. There are however no vacancies in the home. The home does not provide intermediate care. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Service users have comprehensive individual plans that set out their health, personal, social care and night-time needs and can feel assured that staff understand and can meet their needs whilst promoting dignity and respect. Service users are protected by the homes medication policies and procedures. Service users can feel assured that their wishes at their time of death will be respected by staff and treated with care and sensitivity. EVIDENCE: Ten individual plans were examined. There are good comprehensive individual plans of care in place for each service user, which cover the individual’s health, personal and social care needs. In addition each individual plan has a section covering the individuals ‘potted history’ this is an excellent addition to the plan of care as it gives an indication of the persons past life history. Of the ten individual plans examined, three of the potted history’s had not been completed. It is recommended that all potted histories be completed to provide a holistic view of the individual’s life, interests and needs prior to moving into the home. The information detailed in the individual plan with regard to emotional care needs could be developed to include more detailed information with regard to typical emotions expressed by the individual, why Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 10 they are expressed and how, and also if there are any triggers to avoid, and how to promote more positive emotions to enhance the individuals life. There was no photograph of each service user on their individual care plan this must be included to enable easy identification of individual plans for staff and service users. There was ample evidence that individual plans and risk assessments are reviewed monthly and that they are agreed with the service user and signed by either the service user or their representative. Service users spoken to confirmed that they had been involved and consulted with regard to the development and review of their individual plans of care. The service users can feel confident that their health needs are met through regular intervention by health care professionals such as district nurse, GP, chiropodist, dentists and opticians. All appointments had been recorded appropriately with outcomes and any follow up action to ensure that the service user receive all necessary care to meet their health needs. Service users are protected by the homes medication policies and procedures. All records of medication were up-to-date and accurate. Service users had recently had medication reviews, some six monthly others annually or as and when required. Service users spoken to state that staff do respect their wishes particularly with regard to the support provided during personal care and daily choices with regard to clothes food and activities. Staff spoken to were very clear with regard to how to promote service users rights and privacy. Whilst being shown around the home, all bedroom doors were knocked and staff would wait for a response prior to entering a bedroom. Service users wishes in the event of illness or death had been recorded in detail and with sensitivity in the individual plans to ensure that their wishes are respected by the home. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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 Service users say that the lifestyle in the home matches and satisfies their cultural expectations. Family and friend contact is promoted. Service users exercise daily control and choice with regard to their lives. Service users appreciate and enjoy the good food provided in the home. EVIDENCE: Service users were observed taking part in a variety of activities on the day of the inspection. The reminiscence group being held after lunch covered circa1937 and was very popular, service users were observed discussing and shouting out the answers to the questions. Looking at the activities record it was evident from the attendance list that other popular activities included the music evenings with live piano playing, live entertainment where service users are encouraged to dance and sing, music and movement sessions. Other activities included art therapy, prayer and communion. These sessions happen several times a week. During the Christmas period service users went out for dinner, had carol singers visit and engaged in other festive activities. Service users spoken to were keen for the summer to come so that they could go out into the large well maintained gardens belonging to the home. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 12 Some service users were observed reading there chosen papers or a receiving hand massage by staff. Staff do well to promote service users mobility. Service users spoke positively with regard to the activities available in the home and felt that staff always had time to ‘sit and chat’ with them. Service users confirmed that they have regular family and friend contact and that they are able to see them at anytime. Service users spoken to stated that they were able to spend time watching TV in the smoking room and other lounges in the home till late at night, they also confirmed that wake up times were decided upon by them. These preferences had been documented in the nighttime care plans including information with regard to preferred drink morning drinks. One service user said ‘ the staff are good here they always bring me a nice cup of tea to my room in the morning before I get up’. Service users were complimentary with regard to the food provided in the home. There is a four weekly rota and a seasonal menu. The food offered was well balanced and nutritious and all service users are always offered a choice or alternative to the menu. The registered manager assured the inspector that all food preferences were known by staff in the home and that these are always taken into account at every mealtime to ensure the service users wishes are taken into account. Preferences are documented in the initial assessments and in the kitchen. Food in the fridge and freezer was stored appropriately and records of temperatures were kept. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Complaints are dealt with promptly. Service users and staff feel that their worries and complaints are taken seriously and acted upon. Service users are protected by the homes adult protection procedures and competent staff. EVIDENCE: The complaint record was seen. Ten complaints had been recorded since the last inspection, all were minor for example, one concerned the watering of plants in one service users bedroom, others concerned missing clothes that were later found. All complaints had been investigated and satisfactory outcomes had been achieved with 28 days, in fact most had been resolved on the day the complaint was made. Service users explained ‘ staff are good hear, if I am worried about something they will look into it and sort it out’. Service users are protected by the homes adult protection procedures and the staff’s knowledge of this. Staff spoken to had very clear ideas with regard to the adult protection reporting procedures. All were familiar with Barnet’s adult protection procedures and many had undertaken adult protection training. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,23,24,25,26 Service users benefit from living in a comfortable, spacious, safe environment. Service users bedrooms are adapted to suit their needs and their preferences with regard to furniture and possessions. The home has appropriate specialist equipment in place to meet the needs of service users. The home is clean and hygienic. EVIDENCE: A partial tour of the home took place. Service users benefit from a very homely, warm and comfortable environment. Bedrooms had been personalised with service users own furniture and pictures. The furniture provided by the home is of a good quality and is in line with the style and preferences of the service user group. Service users have a range of lounges to use including a smoking lounge. The garden is very well maintained and service users were keen for the summer to arrive so that they could spend time out in the garden. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 15 Service users have specialist equipment that they require to maximise their mobility. Staff do well with the promotion of service users mobility. Baths and showers have been adapted accordingly to meet the service users needs. The home is safe, clean and hygienic. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 There are sufficient staff on duty to meet he needs of service users although the skill mix could be demonstrated on the rota. The home has robust recruitment procedures to protect service users. Staff are trained to undertake their jobs with confidence and in a competent manner to safeguard service users. However, fire training is a priority for new staff. EVIDENCE: A recommendation made at the last inspection for 50 of the staff team to have achieved NVQ level 2 had been progressed. More than half the staff team have either achieved NVQ level 2 in care and are now undertaking NVQ level 3 in care or they have an equivalent qualification. All senior staff including the registered manager have achieved the registered managers award. The service users are protected by the homes recruitment policies and procedures. Five staff files were examined. The files were very well organised and contained all information for the protection of service users. The rota was seen and demonstrated that sufficient staff are working in the home to meet the needs of service users. Staff spoken to agreed that the staffing levels were adequate and that staff morale was generally good. It is recommended that the staff rota is amended to include the job role and responsibility of each member of staff and the designated responsible person on duty each shift so that there is a permanent record in the home for future Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 17 reference if required. There is a white board with this information but this gets amended each shift and so is not a permanent record. Staff files demonstrated that staff have undertaken a variety of training this included most statutory training and training suited to meet the specific needs of the individuals such as dementia care. Staff demonstrated a good knowledge of the needs of individuals with dementia. The home is currently developing a training matrix, which will enable quick identification of staff training needs including refresher training. This will have the benefit of ensuring staff are always appropriately trained to meet the needs of service users. Unfortunately there was no record of the newly recruited staff receiving fire training including the use of fire extinguishers. It was also noted in the records of fire drills that some new staff had had some difficulty in remembering the correct zones within the house. This must be addressed promptly to safeguard both service users and staff. It is also recommended that the time that fire drills take place is recorded to clearly indicate the nighttime fire drills involving night staff. Fire awareness is covered during induction and the registered manager stated that she is planning to have an external provider provide fire training for all staff, which will include the use of fire extinguishers. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,38 Service users benefit from an open approachable management style. The home engages with service users to ensure that the home is run to suit their needs. The health safety and welfare of service users and staff are promoted and protected. An omission with regard to notifications of hospital admissions was noted and will be rectified. EVIDENCE: The registered manager has run the home for twenty years and had achieved her registered managers award. The home is very well organised and the staff describe the management style of the manager as open and approachable. Staff feel supported and have regular team meetings where there is always an open agenda so that practice issues can be discussed freely and openly to benefit service users. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 19 Service users have regular meetings to discuss issues concerning them, the running of the home and any changes they may wish for in the running of the home. The health safety and welfare of service users and staff are promoted and protected. The accident and incident book was seen and demonstrated appropriate recording of accidents and incidents. However it was identified that the Commission had not been informed of all admissions of service users to hospital. This is a notifiable event under regulation 37 and so the Commission must be informed in future. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X 2 X 2 Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO 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 OP7 Regulation 17(1)(a) Requirement The registered person must ensure that all individual plans contain a recent photograph of each service user. The registered person must ensure that all new staff receive fire training, that they know how to use fire extinguishers and are aware of the zones in the home. The registered person must ensure that all hospital admissions are reported to the Commission under a regulation 37 Notice. Timescale for action 31/03/06 2 OP30 23(4)(d)( e) 23/02/06 3 OP38 37 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations It is recommended that the ‘potted history’ section of service users individual plans are completed for all service users as this is an invaluable piece of information about DS0000010400.V271049.R01.S.doc Version 5.0 Page 22 Clovelly House Residential Home Ltd 2. OP7 3 OP27 4 OP38 the individuals past. It is recommended that the section concerning the individuals emotional needs are developed to include how the individual usually feels, for example typical emotions expressed and why, what makes the individual happy, sad, how do they express emotion, any background information that may be a contributing factor to an emotion expressed. It is recommended that the staff rota is revised to include clearly the job role of the individual staff member on duty and the responsible person on duty on each shift. This will provide a permanent record in the home, which can be referred to at any time in the future if required. It is recommended that the record of fire drills clearly indicates the time of day the drill takes place to demonstrate that fire drills occur at night; three monthly and include the waking night staff. Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Clovelly House Residential Home Ltd DS0000010400.V271049.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!