Inspection on 18/08/05 for Field House, Minehead

This inspection was carried out on 18th August 2005.

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

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

Other inspections for this house

Field House, Minehead 17/06/08

Field House, Minehead 30/06/06

Field House, Minehead 20/02/06

Field House, Minehead 08/03/05

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 Field House The Parks Minehead Somerset TA24 8BU Lead Inspector Kathy McCluskey Unannounced 18th August 2005 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 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 Stationary 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. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Field House Address The Parks, Minehead, Somerset, TA24 8BU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01643 708751 Miss Dawn Paxton Personal Care Home only 5 Category(ies) of Learning Disability (5) registration, with number of places Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2005 Brief Description of the Service: Field House is a large detached house situated in the Seaside town of Minehead in Somerset. The home is situated in a quiet residential area, which is only a few minutes walk from the town centre and benefits from beautiful views over the surrounding countryside. Field House is registered with the Commission for Social Care Inspection to provide personal care for up to 5 service users between the ages of 18 and 65years, who have a learning disability. The home is not registered to provide nursing care. All service users are accommodated in single bedrooms which are situated on the first and second floor. The home has large landscaped sloping gardens and access to the home is via a number of steps. Field House would therefore not be suitable for service users with mobility difficulties. The registered provider/manager is Dawn Paxton. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home’s last inspection was announced and was carried out on the 8th March 2005. No requirements or recommendations were raised. This unannounced inspection was conducted over one day (3.25hrs) by CSCI Regulation Inspector Kathy McCluskey. The inspector was able to meet with all three service users living at the home. The registered provider/manager was available throughout the inspection. The inspector carried out a brief tour of the premises and examined records pertaining to staff, service users and health and safety. This was a very positive inspection. No requirements or recommendations were raised. The inspector would like to thank the service users, staff and the registered manager for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report and the last announced inspection report. What the service does well: Field House provides a comfortable and homely environment for service users with a learning disability. All service users have their own bedroom, which they are able to personalise. The home has a good range of comfortable and well equipped communal areas and a beautiful garden. All areas of the home are decorated and furnished to a very high standard. Service users benefit from an ethos which is both open and inclusive. Service users are encouraged and supported to be fully involved in all aspects of life at the home. This was very evident at the time of the inspection. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 6 During the inspection, interactions with service users were observed to be very relaxed, kind and respectful. Service users are supported and encouraged to pursue their own hobbies/interests and to be involved in many activities in the local community. Service users informed the inspector that they were looking forward to their holiday with the provider and her partner, in Brixham next week. 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. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5 Service users are provided with the information they need to enable them to make an informed choice about living at the home. The home takes appropriate steps to ensure that the assessed needs of service users can be met. EVIDENCE: The home has produced a Statement of Purpose and Service user guide. Both were made available to the CSCI as part of the homes registration process. The Statement of Purpose and Service User Guide provide clear information on the facilities and services offered by the home. The home provides transport for organised trips and activities at no extra charge to the service user. Service users retain any DLA money awarded to them. The home’s current scale of charges is between £1167 & £1267 per week. This is a guide and fees are determined upon the assessed needs of an individual. Extra charges are met by the service user for personal items/toiletries and chiropody treatment. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 9 Each service user is issued with an agreed contract. The home’s contract clearly sets out the terms and conditions of residence and fees to be charged. Social Services financial agreements are in place where appropriate. All prospective service users are fully assessed by the registered provider/manager prior to a decision being made about admission. Assessments are also obtained from relevant professionals where appropriate. Evidence of this was seen in the care plans examined. This ensures that the home can fully meet the assessed needs of a prospective service user. Where appropriate, service users are invited to visit the home prior to making a decision to move there. The inspector was informed that service users would be invited for the day and that an over night stay could be arranged. The views and needs of existing service users would be taken into consideration. The first 12 weeks of admission are considered a trial period to ensure that all parties are happy that the individual’s assessed needs can be met by the home. Emergency admissions are avoided. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 and 10 The home’s care planning process is clear and consistent. The home ensures that service users are encouraged to take informed risks as part of their agreed plan of care. EVIDENCE: Two service user care plans were examined at this inspection, which included records pertaining to the most recent service user. Records were well maintained and demonstrated service user input. Very detailed records were seen relating to daily events. Good information was seen relating to appropriate contacts, social history and preferences. Details regarding health professional visits/appointments were also seen. Detailed and appropriate risk assessments were in place where required and those seen gave clear instructions for staff and the rationale for use. The inspector was able to see evidence that service users are supported to take informed risks in line with their agreed plan of care. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 11 On the day of the inspection it was very apparent that service users are encouraged to be fully involved in all aspects of life at the home. This was ascertained through observation and discussion with service users. All service users appeared very relaxed comfortable in the presence of the provider/manager and informed the inspector that they could discuss any issues with her. All service users have their own personal bank accounts. The provider/manager offers support to service users in managing small amounts of ‘pocket monies’ where appropriate or requested. The inspector was able to view records maintained by the home. These were found to be detailed and well maintained. Details of any transactions are signed by the service user. Regular audits are carried out by the provider/manager. The home also has policies and procedures in place relating to the management of service users monies. The home has developed policies regarding confidentiality. All records seen were well maintained and appropriately stored. Service users have access to their individual files in accordance with the Data Protection Act 1998. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 and 17 The opportunities for personal and social development are good. Service users benefit from a well-balanced and varied diet, which they are involved in planning and cooking. EVIDENCE: Field House encourage and support service users to maintain and develop independent living skills as part of their agreed plan of care. This was observed during the inspection. Staff provide appropriate levels of support to service users to enable them to meet their individual needs and goals. Staff input is increased where appropriate to meet individual’s needs. Evidence was seen to support this in one care plan examined. Since the last inspection, the provider/manager has accessed suitable activities for service users within the community. Local community resource centres are also being utilised. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 13 On the day of the inspection one service user went swimming with a staff member. This is a regular event. As a new programme of activities is due to commence in September, this will be examined in more detail at the next inspection. Service users are supported and encouraged to pursue their own interests and hobbies. One service user enjoys gardening and has done a wonderful job of maintaining the garden and growing vegetables. Fishing trips are also a great favourite! Service users choose what time they get up and go to bed and the preferences of the service users are clearly recorded in the individual’s plan of care. Service users have a key to their bedroom and are made aware that the home maintains a spare key, which would only be used in the case of an emergency. Menus are agreed with the service users. The main meal is enjoyed at teatime. On the day of the inspection, service users were observed choosing what they would like for lunch. As part of the agreed plan of care, service users are supported to prepare their meals where appropriate and service users are involved in shopping for food. Service users have access to drinks and snacks as they require. Fresh fruit is also available. Service users were positive regarding the provision of meals at the home. The home has a spacious and well equipped kitchen which is accessible to service users. Examples were given where the home supports service users to maintain family links as appropriate. Service users were positive about the support they received. The inspector was informed that visitors are welcome at the home in line with the wishes of the service users. Service users can choose where to see their visitors. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Service users are appropriately supported to meet their personal and healthcare needs. The home’s procedures for the management and administration of medication are good. EVIDENCE: Care plans examined detailed clear information regarding how personal care needs should be met. This also took into account the preferences of the individual. Health care contacts and information relating to health care needs and visits were seen to be detailed and informative. Given the assessed needs of service users living at the home, prescribed medication is currently managed and administered by staff. The home uses the monitored dosage system (MDS) with pre-printed Medication Administration Records (MAR). Medicines were seen to be securely stored with MAR charts appropriately completed. The provider/manager stated that the home has excellent support from the dispensing pharmacy. The provider/manager confirmed that she would contact the CSCI Pharmacist Inspector for advice where required. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home takes appropriate steps to reduce the risk of harm or abuse to service users. EVIDENCE: The home has produced a complaints procedure which is also available in the Statement of Purpose and Service User Guide. No complaints have been received by the home and no concerns have been raised directly with the CSCI. At the time of this inspection, no concerns were raised by service users. Service users informed the inspector that they could talk to the provider any time. The home takes appropriate steps to reduce the risk of harm or abuse to service users. The home has produced policies relating to adult protection and the prevention of abuse, Whistle Blowing, bullying and aggression. The home also has a copy of Somerset’s Policy on Safeguarding Vulnerable Adults. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, and 30 Service users benefit from a safe, clean, homely environment which meets their needs and provides private accommodation with a good range of communal areas. The home takes appropriate steps to reduce the risk of the spread of infection. EVIDENCE: Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 17 Field House is a large three storey detached house situated in a quiet residential area, which is not far from the centre of Minehead. The home is in an elevated position and enjoys far reaching views to the surrounding countryside. All areas of the home have been decorated and furnished to a very high standard and the home promotes a ‘homely’ feel. Communal areas are located on the ground floor, with bedrooms and bathrooms located on the first and second floor, which are accessed by stairs. There is a toilet on the ground floor. The home has large landscaped gardens to the front and rear. As the gardens are sloping, they would not be accessible to those with mobility difficulties. The home is fitted with appropriate fire detection systems and fire fighting equipment. A call bell system has been installed throughout the home. All up stairs windows have been restricted to ensure the safety of service users. All service users are accommodated in single bedrooms, which are fitted with the provision of a wash hand basin. One bedroom is fitted with en-suite shower facilities. Service users are encouraged to personalise their rooms. Privacy is respected and service users have a key to their rooms. Three bedrooms are situated on the first floor and two on the second floor. Stairs give access to first and second floor accommodation. Service users have access to spacious and comfortable communal areas, which are situated on the ground floor. The home has two very large lounge areas, which are decorated and furnished to a very high standard. A dining area is available in one of the lounges. One lounge has a television and the other can be utilised for those wishing to enjoy some quiet time. This lounge also has the provision of a payphone. On the day of this inspection, the cleanliness of the home was of a very high standard. Cleaning is carried out by the provider/manager. Service users are supported to clean their own bedrooms as appropriate. Liquid soap and paper hand towels were seen to be appropriately sited throughout the home. The inspector was previously informed that, with the approval of the local fire officer, laundry facilities are located in a locked area under the stairs. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 Service users benefit from a small staff team who have the skills to meet the assessed needs of service users. The home follows appropriate staff recruitment procedures. EVIDENCE: Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 19 Since the last inspection, the home has recruited a member of staff. The provider and her partner continue to provide 24 hour cover as they live at the home. The recruitment file for the newly appointed member of staff was examined and this was found to contain all information as required in Schedule 2 of the Care Homes Regulations 2001. This also included evidence of an enhanced CRB check and POVAFirst check. The inspector was able to see evidence that the employee had completed a period of induction and had been issued with a job description, contract of employment and had been made aware of appropriate policies and procedures. The provider/manager is keen to promote NVQ training and is currently in the process of trying to access appropriate training courses. Progress will be followed up at the next inspection. The provider manager has introduced a system for staff supervision and will be implementing this for the new staff member. Progress will be followed up at the next inspection. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, 42 and 43 Service users benefit from an open and inclusive style of management where their views are encouraged. The home takes appropriate steps to ensure the health and safety of service users, staff and visitors. EVIDENCE: The registered provider/manager is Dawn Paxton. Dawn has worked with service users with a learning disability since 1994. Dawn has previously been registered with the NCSC in Surrey as a manager of a care home for younger adults with a learning disability. Dawn has a City & Guilds certificate in ‘Advanced management for care’ and certificates in ‘epilepsy and the administration of rectal diazepam’ and ‘Nonphysical & physical intervention’. Dawn is also in the process of updating certificates in First aid and food hygiene. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 21 At the time of this inspection, 3 service users were living at the home and 1 staff member is employed. It was very apparent to the inspector that the provider/manager promotes an ethos which is open an inclusive. Service users benefit from a ‘family’ type atmosphere where they are included in all aspects of life at the home. The views of service users are encouraged at all times. This was observed during the inspection and was confirmed by service users spoken with. Given the size of the home, formal meetings are not felt to be appropriate. The provider/manager stated that any concerns or issues raised by service users would be appropriately documented and actioned. Interactions observed during the inspection were relaxed and respectful. The provider/manager takes appropriate steps to ensure that the rights and wishes of service users are respected. The home has a comprehensive range of policies and procedures, which are discussed with staff. All records seen at this inspection were up to date, very well maintained and stored in accordance with the Data Protection Act 1998. Records relating to the health and safety of service users and staff were examined at this inspection and the findings were as follows: First Aid – The provider/manager is in the process of arranging first aid training. This will be followed up at the next inspection. Portable Appliance Testing (PAT) – Records indicated that portable appliance testing was up to date. The last test was carried out on 20/05/05. Detailed records are maintained Hot Water Outlets/surfaces – Records are maintained for hot water outlets to ensure that they do not exceed HSE recommend limits. These are checked weekly. The last recorded check was 15/08/05. FIRE – The home records weekly checks for fire detection systems, emergency lighting and extinguishers. The last recorded check was 15/08/05. The home’s fire detection systems and fire fighting equipment was serviced by an external contractor on 15/04/05. Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 22 Electrical Hard Wiring – The inspector was able to see an appropriate certificate dated 10/05/04 which is valid for 5 years. Gas Servicing – An up to date Landlords Gas Safety Certificate was seen dated 16/04/05. Environmental Risks – The home has detailed policies and procedures relating to health and safety and environmental risk assessments have been completed as appropriate. Upstairs windows have been fitted with restrictors to ensure the safety of service users. Wardrobes have been secured to the wall. Accidents – The inspector was informed that there have been no accidents since the last inspection. The home displays appropriate and up to date employers liability insurance which expires on 01/08/06 Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Field House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Riverside Chambers Castle Street Taunton TA1 4AL 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 Field House D53-D02 S60745 Field House V233392 020805 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!