Inspection on 04/10/07 for Herbert Road, 185

This inspection was carried out on 4th October 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Herbert Road, 185 29/07/08

Herbert Road, 185 29/03/07

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Herbert Road, 185 London SE18 3QE Lead Inspector Lorraine Pumford Unannounced Inspection 4th October 2007 13.00p Herbert Road, 185 DS0000065983.V348632.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 Herbert Road, 185 DS0000065983.V348632.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. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Herbert Road, 185 Address London SE18 3QE 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 8854 9393 020 8854 9393 Hillgreen Care Ltd vacant post Care Home 3 Category(ies) of Learning disability (0) registration, with number of places Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 3 29th March 2007 Date of last inspection Brief Description of the Service: The home is registered to provide care for three people who have been assessed as having a learning disability. The home is owned and managed by Hill Green Care. The home is an older style detached house set back from the road in a large pleasant garden. The home is within easy reach of local transport, services and shops. There is off road parking. Accommodation consists of three single bedrooms, one of which is on the ground floor. There are bath/shower rooms and toilets on both floors. Also situated on the ground floor are a lounge dining room, kitchen, utility room and office which are also used as the staff sleeping in room. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken by one inspector who was in the home for five hours. On the day of the inspection only one of the three residents was at home. The acting manager and two care staff were on duty and assisted with the inspection. CSCI surveys were sent to all three residents who chose not to complete then. During the course of the inspection records pertaining to one resident were examined in detail including the homes management of this residents finances. A number of other documents were examined for all residents including activities and additionally parts of the premises were inspected. The fees currently range from £1,500 to £1,800 per week. What the service does well: What has improved since the last inspection? Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 6 Staff now keep a record of activities residents participate in. Since the last inspection the person in charge of the home on a day-to-day basis has submitted an application to the CSCI to be the registered manager. The provider ensures that copies of their monthly audits undertaken by them are forwarded to the CSCI on a regular basis. A recommendation made at the time of the last inspection in relation to medication has been addressed. 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. Herbert Road, 185 DS0000065983.V348632.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 Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with information about the service in a user-friendly format. A comprehensive assessment is undertaken to ensure that the home is able to meet the needs of a resident prior to admission. EVIDENCE: The resident group has remained the same since the last inspection. Pre admission documents were examined in relation to one of the residents admitted to the home approximately two years ago. This indicated a detailed assessment had been undertaken by the provider and included relevant information from health and social care agencies. The manager was asked to ensure that in the event of a new resident being admitted a letter was sent to the prospective resident/ representative stating that following the assessment the home was able to meet the residents needs prior to admission. Since the last inspection the provider has produced a Service User Guide which provides information regarding the care and service provided in a pictorial format. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 9 Herbert Road, 185 DS0000065983.V348632.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): 6,7,8 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans provide guidance for staff on how to meet residents assessed needs. Risk assessments are designed to promote residents independence whist minimising risk. EVIDENCE: Staff have prepared a detailed care plan for each resident. These identify each persons needs, sets goals and provided staff with guidance on action to be taken to meet these. There was evidence that regular reviews were taking place and care plans were being updated. Staff record information regarding residents health, activities and demeanour in individual daily diaries. Records seen were comprehensive and it was Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 11 possible to ascertain a clear picture of residents routines, health and well-being from the documents seen. Risk assessments were seen to be in place which promote independence and safety; for example, these had been completed for residents in relation to use of equipment in the home and transport and activities outside of the home. Some of the residents have been assessed as having challenging behaviour and care plans include guidance for staff on managing the behaviour likely to be exhibited. The manager was advised to undertake a risk assessment on staff working alone in the home with residents. Two of the residents manage there finances independently, one resident is unable to manager his finances and in this instance staff make purchases on his behalf using company petty cash and then reclaim this money from money paid to the resident by the benefits agency and local authority funding. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with activities appropriate to their age and supported to access appropriate training opportunities. Residents enjoy a varied nutritional diet. EVIDENCE: Since the last inspection staff have assisted two of the residents to find work experience placements. Records seen indicated that staff support residents to participate in a range of social and recreational activities in the local community. Records seen indicate two of the residents also spend periods of time independently socialising with friends in the community. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 13 Since the last inspection one of the residents has been supported by two staff to have a holiday. The resident was able to indicate some of the activities he participated in whilst away, such as playing snooker; he clearly enjoyed this very much. Staff took lots of photographs for him to look back on. A recommendation was made at the time of the last inspection regarding the need to keep a more comprehensive record to evidence activities undertaken by residents and it was apparent that action has been taken to address this. However a number of entries refer to one resident being taken out for a walk. Staff were asked to keep a more detailed record in relation to this activity to reflect that the resident has the opportunity to participate in a number of different experiences on a day to day basis. From records seen and discussion with staff and residents it is apparent that residents are supported to maintain links with family and friends. Menus seen indicate residents are provided with a varied nutritious diet which reflects their cultural preferences. Staff ensure that a record is kept if residents are provided with an alternative to the menu displayed. The Manager stated that all residents are provided with keys to there bedrooms. Resident are able to move around the home freely and residents who are able can make refreshments and snacks when they wish. Herbert Road, 185 DS0000065983.V348632.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 adequate. This judgement has been made using available evidence including a visit to this service. Currant medication procedures protect residents living in the home. Staff need to involve health and social care professionals to manage the behaviour exhibited by one resident. EVIDENCE: Residents use local community health care services as and when required. Records for one resident indicate that this persons behaviour can at times be inappropriate. Staff were asked to liaise with relevant health and social care professionals to decide a plan of action on how best the resident could be helped and supported. The storage, recording and administration of medication were examined in detail for all three resident and no errors were found. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 15 A recommendation was made at the time of the last inspection that a record should be kept of staff members names and their corresponding initials used on the medication record for the purpose of auditing the medication system and action has been taken to address this. The manager stated that medication is decanted into a dossette box when residents are away from the home overnight. This dossette includes details of the medication in case the resident needs to go to hospital whilst away from the home. The manager was advised that photographs of residents should be attached to residents MAR sheet. The manager stated this would be addressed. Records seen indicate that one resident has consistently refused to take his medication. The manager was advised to contact the residents GP to arrange a review to ensure that as far as possible staff are able to meet the residents health care needs. Other issue discussed with the manager, The Royal Pharmaceutical Society has issued new guidelines in relation to medicine management. These are the need to have a medicine profile for each resident with evidence of regular medicine reviews. The need to have protocols in place for administration of ‘as required’ medicines such as pain relief for residents with poor or no communication skills and the need to evidence that staff responsible for medicine management are assessed annually as being competent to do so. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the organisations Safeguarding Adults Policy and appropriate training for staff. There is a comprehensive complaints procedure in place. EVIDENCE: Information regarding the organisations complaints procedure is included in the Service User Guide; copies of this are available in pictorial format. There is a logbook to record any complaints brought to the managers attention. To date there have been none and the CSCI have received no complaints in relation to this service. From discussion with staff and records seen it is apparent they have received Safeguarding Adults training. The Manager also has obtained a copy of the London Borough of Greenwichs procedure on reporting and investigating adult protection issues. The manager was advised to contact the Local Authority Safeguarding Adults Coordinator regarding any additional possible training opportunities. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. Action must be taken to ensure that residents are provided with a clean, safe, comfortable and well maintained environment. EVIDENCE: A number of issues arose in relation to the decoration and furnishings in the building. A number of carpets were stained and soiled and in need of thorough cleaning or replacement. The fire door leading to the kitchen/ laundry room cannot be shut. The manager stated she believed this had been caused by some movement to the building as it had been necessary to have a tree which was close to the house cut down. Action is required to repair the door as this is a high risk area in terms of fire. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 18 The manager stated it had been necessary to replace the cooker; this has left a gap between the wall, cooker and worktop, which cannot be effectively cleaned and action. The cooker hood was grimy and the filter was greasy and in need of replacement. Action is required to address these issues. Two of the three residents bedrooms were seen. The walls of the ground floor bedroom are badly marked around the bed and in need of repainting the plaster has also been damaged and action is required to address this. The resident of the ground floor bedroom has pulled the TV wall bracket out of the wall and the television is presently being stored in the laundry. The manager stated that although the resident enjoyed watching television in the lounge he was always destructive towards the one in his room. She was concerned however that the CSCI would expect all residents to be provided with televisions. Discussion took place regarding this issue and the manager was asked to do a risk assessment and advised that it was not necessary given these circumstances to place a television in this residents bedroom. Discussion took place in relation to the bedding and bed linen. In both rooms seen quilts and pillows were very flat and in need of replacement. The bed linen was grubby, stained and in need of laundering. The manager stated one resident did not like staff going into his room and discussion took place regarding the need for this issues to be incorporated into his care plan to enable staff to work with him to improve his standard of hygiene. The office is also used as the staff sleeping in room and with the desk, other office equipment and the increasing problem of storing files etc there is very limited space for staff to use whilst sleeping in. In addition staff have no space to store personal items over night when on duty. Other than residents bedrooms the home does not have a room available for private conversation. It is apparent that some action is needed to resolve these issues and at the time of the last inspection discussion took place regarding the possible addition of a conservatory. The upstairs bathroom did not have soap, the manager stated it would be inappropriately used by one of the residents, discussion took place regarding the need to have a soap dispenser fitted to the wall to enable people living and working in the home to maintain safe standards of hygiene. Staff stated that the laundry equipment provided meets the current needs of the residents accommodated. The brush used to clean the toilet was pushed down behind pipe work running behind the toilet. Discussion took place regarding the need to purchase a brush with appropriate holder to minimise the risk of the spread of infection. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 19 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): 32,32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for by an appropriately trained and qualified staff. Sound recruitment practises safeguard people living in the home. EVIDENCE: At the time of the last inspection a requirement was made that the person in charge of the home on a day to day basis needed to submit an application to be registered with the CSCI. This has been done and the application is currently being processed. The manager has an NVQ three qualification in care and has also completed the Registered Managers Award. 50 of staff working in the home hold an NVQ 2 qualification in care. The manager stated that staff would be invited to enrol on the NVQ 3 course over the next few months. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 20 Records were examined in relation to staff training; Staff receive appropriate training to help them meet the care needs of the residents accommodated. staff have received training to enable them to meet the needs of residents who have additional health and psychological care issues such as epilepsy and challenging behaviour. The manager stated that no additional staff have been recruited since the last inspection. Records seen in relation to staff recruitment indicate sound practises are in place to protect people living in the home. Records seen indicates that staff receive regular supervision to discuss care issues and their individual training and development needs. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to this service. Staff must receive fire prevention training to safeguard residents and staff working in the home. Quality assurance mechanisms must be developed by the manager to monitor the care and service provided. EVIDENCE: At the time of the last inspection it was apparent that the provider was undertaking regular audits of the service however a requirement was made as they were not forwarding copies of these audits to the CSCI. Action has now been taken by the provider to address this issue and the CSCI now receive them on a regular basis. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 22 Discussion took place with the manager regarding the need for her to develop quality assurance mechanisms to monitor and improve the care and service the staff team provide. A requirement was made at the time of the last inspection that staff required appropriate fire safety training. To date this has not taken place therefore a requirement has been set again in relation to this issue. Following the inspection the Responsible Individual for the organisation contacted the CSCI to say that he had in fact arranged fire training for staff however due to a misunderstanding staff had failed to attend. He stated he would be addressing this issue with the manager. Records seen indicate that staff have received food hygiene, health and safety and first aid training. It was apparent from documentation seen that the provider ensures that regular maintenance and safety checks are undertaken to the fire detection system, electrical and gas appliances. Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 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 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 2 X X 2 X Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 24 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 23(4)(d) Requirement The registered person must after consultation with fire authority made arrangements for persons working in the home to receive suitable training in fire safety. Previous 29/06/07 Not met The registered person must ensure residents receive appropriate input from relevant health and social care professional on how to support residents who have additional health care needs. The registered person must ensure that all parts of the home are kept clean well maintained, appropriately decorated and carpeted. The registered person must ensure that residents are provided with appropriate bedding. The registered person must have a system in place for reviewing the care and service provided with a view to developing and improving the service provided. This must be undertaken a least once a year and be available for DS0000065983.V348632.R01.S.doc Timescale for action 30/11/07 2 YA19 13 02/01/08 3 YA24 23(2) 31/01/08 4 YA24 16(2)(c) 30/11/07 5 YA39 24 03/03/08 Herbert Road, 185 Version 5.2 Page 25 inspection. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard YA9 YA12 Good Practice Recommendations A risk assessment should be completed in relation to staff working alone in the home with residents. Records for one resident in relation to activities states out for a walk. This needs to be in more details to reflect the resident has the opportunity to participate in a number of different experiences on a day-to-day basis. The manager was advised to update the homes medication procedures to comply with the Royal Pharmaceutical Societys new guidelines in relation to medicine management. The GP of the resident who has consistently refused to take some of the medication prescribed should be contacted, so a medication review can take place and as far as possible staff are able to meet the residents health care needs. 3 YA20 4. YA20 Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection SE London River House 1 Maidstone Road Sidcup Kent DA14 5RH 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 Herbert Road, 185 DS0000065983.V348632.R01.S.doc Version 5.2 Page 27 - 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!