Inspection on 02/07/07 for Fairfield House

This inspection was carried out on 2nd July 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fairfield House 08/07/09

Fairfield House 25/09/06

Fairfield House 30/01/06

Fairfield House 07/12/05

Fairfield House 08/02/05

Fairfield House 05/10/04

Fairfield House 08/03/04

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 Fairfield House Ashcombe Road Dawlish Devon EX7 0QQ Lead Inspector Judy Hill Unannounced Inspection 2nd July 2007 10:30 Fairfield House DS0000003699.V338508.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 Fairfield House DS0000003699.V338508.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. Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairfield House Address Ashcombe Road Dawlish Devon EX7 0QQ 01626 862173 01626 868127 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) Education & Care (Devon) Limited Vacant Care Home 17 Category(ies) of Learning disability (17) registration, with number of places Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th September 2006 Brief Description of the Service: Fairfield House provides accommodation and care during term time for students attending Oakwood Court College. Oakwood Court College is a privately run educational service for students with a learning disability aged 16 up to 25 years old. The college offers courses lasting up to three years and is inspected by the Office for Standards in Education (OFSTED) and the Adult Learning Inspectorate (ALI). The College received a re-inspected in April 2007 and the report can be obtained at: www.ofsted.gov.uk. Fairfield House and Fairfield Cottage, which is included in the registration are situated in a rural setting, but are within walking distance of Dawlish town centre. Students who use wheelchairs can be accommodated. Transport is provided for students to enable them to travel to and from college and to participate in activities outside their home. Information about the College and care and accommodation services is available from Oakwood Court College in the form of a Welcome Pack, which will be given to prospective students and their representatives. Copies of inspection reports are available at the home and/or can be obtained on request from the service provider or accessed on the CSCI website. The fees, which are LSC funded, cover the costs of college fees as well as student care and accommodation and currently range from £36,772 to £67,775 (term time). Extended placements current range: £511.25 to £1683.00 per week. The fees do not cover personal items, such as clothing or a weekly personal allowance. Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and was carried out over two days by one inspector. The day of the inspection focussed on records and a physical inspection of the premises and the second visit, which took place in the evening, was arranged to meet the students and staff. The information contained in this report was gained in conversation with the students and staff of Fairfield House and from questionnaires completed by students, staff and management. An inspection of the communal areas of the home was carried out and some of the student’s bedrooms were inspected. Additional information was gained from records, including students assessments, care plans and reviews and staff recruitment, training records and rotas. Documented evidence, including the services Welcome Pack and previous reports were reviewed. What the service does well: What has improved since the last inspection? Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 6 The staff recruitment practices have been improved to ensure that satisfactory references are obtained and background checks are carried out before new staff are allowed to work unsupervised with the students. Fire doors are no longer wedged open. The homes policies and procedures have been audited and reviewed. An application has been received by the Commission to register a manager. 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. Fairfield House DS0000003699.V338508.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 Fairfield House DS0000003699.V338508.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. Prospective students and their representatives have the information they need to make an informed decision about whether the service will meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Oakwood College has student information pack that includes information about the college and the care and accommodation provided for the students at Fairfield House and the other halls of residence. A copy of the Welcome Pack has been given to the Commission for inspection purposes and the preinspection assessment carried out by the service provider states that copies are provided to all prospective students. Some sections of the Welcome Pack are presented in an easy read format by using pictures and text to make them more accessible to the students. The records of pre-admission and continual assessment for two of the students were inspected and found to be comprehensive and well detailed. The records showed that a three to four day assessment stay is arranged before admission and that the assessment and ongoing review process involves significant input Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 9 from the students, their families, their key workers, management and professional representatives. Fairfield House DS0000003699.V338508.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. Individuals are involved in making decisions about their lives and play an active role in planning the care and support they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two students care plans were inspected and provided very detailed records of their care needs, including their emotional needs, their progression and development. Student participation in care planning and reviews was clearly evidenced and very good use had been made of the establishment of achievable personal goals. Decision-making is a key part of the curriculum at Oakwood College, and it was evident through talking to students and from questionnaires completed by five Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 11 of the students that they do make their decisions about their day-to-day lives. Students spoken with gave examples of decisions that they make including choosing what they want to eat and choosing the activities they want to take part in. Decision-making goes hand in hand with risk taking, and student’s work towards taking risks within a safe framework. Students are supported to manage their own finances and two of the students gave examples about how they are able to choose how to spend their own money on the things that they want to buy. Before admission the student’s entitlement to benefits, and the College staff’s involvement in supporting the management of finances is agreed with parents. Students attend regular house meetings and the Commission was told that some of the students are very good at expressing their views, but that the quieter students were given staff support and encouragement to ensure that everyone is able to contribute. Fairfield House DS0000003699.V338508.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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. The students are able to make choices about their life style and are supported to develop their life skills. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the students attend Oakwood College for up to three years where they attend a variety of classes including animal care, horticulture, basic skills, drama, music and arts and crafts. On the first day of the inspection a class of students were observed taking part in a brick laying lesson at Fairfield House. Oakwood College is inspected by the Office of Standards in Education and their latest report stated that a key strength of the Collage was ‘very good standards achieved in independence skills and personal development’. Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 13 Fairfield House complements the work of the College by teaching the students basic living skills within their home environment. Each of the students has a single bedroom and a key to their room. Three of the students said that they were responsible for keeping their own rooms as they like them. One student also described how he helped to keep other areas of the house clean and said that he was eager to learn household skills because he wanted to move into a home of his own after he left college. Social activities are arranged for the students outside of their home and college environment. These include a choice of evening classes most nights of the week and additional activities at weekends. The students spoken with said that these activities include driving lessons at Westpoint, Yoga, Kick Boxing and disco’s. Some of the students have part-time jobs in the community. Outside work includes shop work and working in a local pub/restaurant. The students have opportunities to make new friends and retain existing friendships both at college and in their home and leisure time. Families are encouraged to maintain contact and to participate, with the students consent, in care planning and reviews. The daily routines observed at the house actively encourage the students to recognise their rights and responsibilities. During the week the students have their main meal of the day at Oakwood College. In the evenings each of the students prepares his or her own evening meal with as much or as little staff support as they need. Two of the students spoken with said that they plan their own evening meals and buy their own groceries from the supermarket. One of the students said that Sunday lunch was a communal meal and that some of the students helped to prepare a roast dinner for all of the students to share. Fairfield House DS0000003699.V338508.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. The health and personal care that the students receive is based on their individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The level of support for personal care needed by the students at Fairfield House varies considerably. The three students with the highest support needs live at The Cottage, which is in the grounds of Fairfield House, and are provided with one to one support from 8am to 10pm. At the other end of the scale some of the students need little more that supervision. The students care plans and assessments provide the staff with guidance on the level of support needed and regular reviews ensure that support is provided in a way that actively encourages the students to develop their own skills for self care. Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 15 All of the students spoken with knew who their key workers were and had a good understanding of their roles. The students healthcare is monitored and two of the students spoken with showed a good understanding about their own responsibilities for ensuring that they lead healthy lifestyles by eating healthy food and taking regular exercise. The students are registered with a local GP during term time but are generally expected to retain and visit their existing dentists, chiropodist and optician during the College holidays when most of them will return to their parents or carers homes. At the time of the inspection eight of the students were taking prescribed medication and two of these were on controlled drugs. None of the students were administering their own medication and no evidence was seen to show that risk assessments had been carried out to provide justification for them not doing so. The student’s medication is kept in a locked cupboard and a locked cupboard within this is used to store controlled drugs. All of the staff who administer medication to the students have received training to do so. The Medication Administration Record sheets were seen and it was noted that some of the hand written entries for medication used on an irregular basis could be improved upon as they lacked clarity. The medication administered to students had been initialled by the member of staff administering it and countersigned by the students. Fairfield House DS0000003699.V338508.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. The students may express their concerns and are protect from abuse, but improvements in this area could be made through the provision of additional staff training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is included in the Welcome Pack and is available in an easy read format for the students. Four of the six students who completed questionnaires for the Commission said that they would know who to talk to if they were not happy about the service they receive. Two of the students spoken with said that if they were not happy about something they would talk to the staff or the Head of Residential Support Services, however one student said that they had made a complaint to a member of staff but that their complaint was not taken seriously. No complaints or concerns have been made to the Commission since the last inspection. The Home keeps the Commission informed of any incidents or events that could affect the wellbeing of the students living at the home. Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 17 One allegation of abuse has been reported since the last inspection. This was investigated and dealt with in accordance with the Protection of Vulnerable Adults Procedure. The chief executive of Education and Care (Devon) Ltd has stated that all but two of the care staff had attended training courses on the Protection of Vulnerable Adult training and the Protection of Vulnerable Children at the time of the inspection. The six students who completed a questionnaire for the Commission all said that they felt safe at the home. Fairfield House DS0000003699.V338508.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 adequate. The students live in a spacious home in an idyllic setting but the house is in need of a considerable amount of refurbishment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the Fairfield House and the Cottage was carried out. Both buildings are old and were found to be in need of considerable repair especially around some of the wooden windows and skirting boards. The students at Fairfield House share a lounge, hobbies room, dining room, kitchen and laundry. The Commission was told that plans are in place to refurnish the lounge and replace the sofas and chairs, some of which have torn covers. There are also plans to convert the hobbies room into a computer Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 19 room for the students and to convert the cellar into a games room. Some of the students spoken with said that they would like their new hobbies room to include disco lights and a poor table. Plans are also in place to refurnish the dining room, which currently has a very institutional appearance. The kitchen had recently been refitted and is large and spacious. The bathroom and toilet facilities at Fairfield House were satisfactory, although the lock on one of the toilets did not work and needs repairing or replacing and two of the students raised concerns about light bulbs going out. This is believed to relate to an automatic switch in one of the bathrooms that needs adjusting to ensure that the light remains on until the students have finished bathing. The Cottage accommodated three students. It has a shared lounge, which had recently been refurbished, a dining room, kitchen and laundry. Each student had his or her own single bedroom, which is lockable and keys are provided and used by the students. The bedrooms that were seen had been personalised by their occupants and it was evident that both the students and staff recognise that this is their personal space. Fairfield House is in a rural location, but is within a mile or so of Dawlish town centre. There is a good sized garden and ample parking facilities are available for staff and visitors. Accommodation is provided for staff sleeping in but this is in such a poor state of disrepair that the staff prefer not to use it. Fairfield House DS0000003699.V338508.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. The staff are motivated and employed in sufficient numbers to supervise the students. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An inspection of staff recruitment records showed that there were gaps in the recruitment records where appropriate checks and references had not been received. However, it is acknowledged that some of the records preceded the last inspection report and that safe recruitment practices are now in place. It is however recommended that where POVA and POCA checks and references from previous employers have not been received, these checks are carried out retrospectively. Two members of staff who completed and returned surveys for the Commission said that they had not been given identity badges or cards, which Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 21 would be useful as the staff work with the service users at Oakwood College as well as at the home. Records were seen of staff induction, on-going training and supervision. Although few staff currently hold National Vocational Qualifications, arrangements are in place to introduce a fast track NVQ programme in August 2007. Three care workers and two shift co-ordinator were engaged in conversation and all of them were very positive about their work with the service users. The staff turnover is high but in conversation with the staff it was apparent that this was because the staff are offered secure employment during term time only (thirty-eight weeks a year) and not because they do not enjoy their work. Staffing levels for the students who live at The Cottage are one to one from 8am to 10pm with two to one support and supervision from 9am to 10pm for students living at Fairfield House. Because the students attend college daily and attend social classes or activities most weekday evenings, much of this support and supervision is provided away from their home environment. Fairfield House DS0000003699.V338508.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. The Home is well managed and the students are involved in the development of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Chief Executive of the College was registered as manager, but the other responsibilities of his post mean that he could not manage the day-to-day running of the home. The Head of Residential Support Services is generally regarded by the staff and students as the person managing the home and an application has been received by the Commission to register him as the manager. Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 23 Quality assurance systems have been put into place using staff and student surveys and meetings to ensure that they can influence the day-to-ay development of the service. The pre-inspection questionnaire completed by the Head of Residential Support Services indicates that all of the relevant recommended policies, procedures and codes of practice are in place and that they were last updated in April 2007. The pre-inspection questionnaire identifies that regular checks and services are being carried out on gas, electrical and fire safety appliances. A student spoken with said that a recent fire drill had been carried out and that all of the students had known what to do and evacuated the premises. Health and Safety Notices were seen posted within the home. Fairfield House DS0000003699.V338508.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 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 2 X 3 X 3 X X 3 X Fairfield House DS0000003699.V338508.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 YA24 YA30 Regulation 23 23 Requirement The premises must be brought up to and maintained in a good state of repair. Repairs must be carried out to ensure that the home can be kept clean and hygienic. Timescale for action 02/01/08 02/01/08 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 YA20 Good Practice Recommendations A review of the medication administration sheets should be carried out to ensure that all of the information provided is clearly written and easy to follow. The students should be helped and encouraged to administer their own medication unless it can be demonstrated through a detailed risk assessment that it would not be safe for them to do so. A review should be carried out to ensure that all the students understand how to make a complaint and that the staff understand how complaints should be dealt with. At least 50 of care staff should complete a National Vocational Qualification in Care at Level 2 or above. DS0000003699.V338508.R01.S.doc Version 5.2 Page 26 2. 3 YA22 YA32 Fairfield House 4. YA34 Where references from previous employers were not taken up or POVA & POCA checks were not carried at prior to employment, retrospective checks should be made to ensure that the staff are safe to work with children and young people. Fairfield House DS0000003699.V338508.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Fairfield House DS0000003699.V338508.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. 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