CARE HOME ADULTS 18-65
Jubilee House Jonquil Close 29 Jonquil Close Panshanger Welwyn Garden City AL7 3HX Lead Inspector
Louise Bushell Unannounced 30.06.05 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. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Jubilee House Address 29 Jonquil Close Panshanger Welwyb Garden City Hertfordshire AL7 3HX 01707 391113 01707 394022 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) Jubilee House Care Trust Limtied Michael John Oconnell Care Home 6 Category(ies) of LD LD Learning Disability - 6 registration, with number of places PD PD Physical Disability - 6 Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: There are none. Date of last inspection 14.02.05 Brief Description of the Service: Jubilee House, Jonquil Close, is a 6-bedded purpose-built bungalow for high dependency service users. Services are offered to younger adults with a learning disability, and those with an additional physical disability. The home is situated in a residential area of Welwyn Garden City and the town centre, with its wide range of facilities, is about a mile away. The property is leased through a housing association. There is ample parking for the home and a mini bus is provided for the service users to access appropriate transport. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first inspection of the year, taking place mid morning to mid afternoon. This was a positive inspection, reflecting the positive interpretations made by both service users and staff at the home. Time was spent with the manager and the deputy manager of the home, a number of service users who were present throughout the inspection and several staff members who were on duty. What the service does well:
The home is purpose built to accommodate and support the needs of service users with high complex needs and physical disabilities. Equipment and aids are available within the home to maximise movement for all service users. The home has an extremely well established relationship with all external occupational therapist and community-based services. To further support the service users complex needs the home has a sensory room, which enables the service users to engage in sensory stimulation and activity. All service users have their own bedroom, which provides ample private living space with a washbasin available. Each service user has been supported in the decorating of their rooms, which reflects their individuality and personalities. Daily management of the home appears to be offered in a realistic, flexible manner, with the systems in operation encouraging a homely environment to reside within. There is a clear positive relationship between both service users and staff that is based on mutual respect. Staff appeared to have a clear understanding of the complex needs of the service users. Staff reported that they are provided with regular supervision with in the home where training needs are identified. The home has a comprehensive complaints procedure in place, which details that all complaints are responded to within 28 days. A record is maintained within the home of complaints made detailing actions and outcomes as necessary. All service users have been informed about the complaints procedure. The home has a detailed training plan in place for the forthcoming year, this includes training in basic food hygiene, infection control, emergency first aid, health & safety, fire awareness, effective meetings, absence management and manual handling. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 6 The home has a wonderful purpose built garden, which is accessible to all wheelchair users. There is a large summerhouse and an array of flowers and shrubs encouraging the homely feel to the garden. What has improved since the last inspection? What they could do better:
There is a need for the home to further develop the provision of activities within the home. Whilst it is recognised the specialist complex needs of the service users, the home must explore and actively attempt to encourage effective service user choices and decision making through a method suitable to the service user group. Suggestions were discussed throughout the inspection. Each service user has a number of files that contain all relevant information concerning their needs, assessments and care plans. There is a need for the main file to be organised to ensure that care plans are active, up to date and present as working documents. Inventories for all service users are currently being completed to ensure an accurate audit of personal items is maintained at all times. Jubilee House Care Trust is currently working towards an effective quality assurance system and policy guidelines. There is a need for the home to ensure continual self-assessment through effective quality assurance systems seeking the views of the service users, professionals and friends and relatives.
Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 7 To ensure continued service user safety a fire risk assessment is required to be completed and held within the home. All risk assessments must be actively reviewed and held as working documents. The home has a large kitchen that is adapted to meet the specialist needs of service users. Currently the kitchen is in need of modernisation in order to maintain a minimum standard for infection control and cross contamination standards. Staff within the home are thoroughly inducted ensuring specialist training occurs, however the home should explore the Learning Disability Awards Framework (Ldaf) to ensure all areas are completed. The home has a comprehensive complaints procedure in place, which details that all complaints are responded to within 28 days. However, the complaints procedure must be reviewed to ensure that complainants are aware that they can contact the CSCI at any stage of the complaint. The home should explore issues such as ageing and illness with service users and or their representatives to ensure that individual needs and wishes are respected and meet. 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. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 8 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 Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 9 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) None Standards not assessed on this occasion. EVIDENCE: Standards not assessed on this occasion. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 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 & 10 Individual needs and choices are reflected in the service user care plan ensuring changing need and goals are reviewed, met and developed. Care Planning systems within the home are in need of developing to further ensure that service users have the tools and information to take decisions about their lives. EVIDENCE: All service users have an individual care plan and an allocated key worker to support them in the home. Individual daily notes and guidelines for the service users were observed within the home. All service users are supported within the Care Management Framework and frequent reviews occur to ensure changing needs are continuously assessed and reviewed. There is a need for care plans to be reviewed, restructured and a detailed continual assessment completed with each service user to ensure all needs, aspirations and goals are being achieved. This will ensure that the methods of the planning are person centred, involve the service user at each stage and ensure that care plans are active working documents. The home holds service user meetings, however due to high complex needs of the service user group at times seeking views is mainly achieved through observing body language and facial expression. The home is linked to an external advocacy group and referrals have been made.
Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 11 Further developments within this vital link would be advantageous to the service uses. Ranges of risk assessments are completed within the home for necessary actions. Activities and outings enjoyed by the service users determined that service users are supported to take risks as part of an independent life style. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 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) 11, 13, 14, 15 & 17 An opportunity for engagement in activities and meal choices within the home occurs. The methods used needs reviewing to ensure service users can be encouraged and empowered, as far as practically possible, to make individual choices. The home encourages inclusion into the local community thus enabling integration into community life. EVIDENCE: Service users are supported appropriately to partake in activities within the home. Individual needs, choices and preferences are always considered. A record of activities is maintained. Service users access the local community services frequently and visit the local area, enjoying going out for lunch and shopping. Activity options are not displayed within the home in a method or format appropriate to the service user group, to encourage and empower individual choice. Following discussion with the manager it is recommended that the system regarding the display of activities within the home be further developed to ensure that a person centred approach is achieved, encouraging and empowering service user self determination with the access to an appropriate level of opportunity for understanding. Once implemented this will further develop and support all service users to participate in leisure activities.
Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 13 The home provides a four-week rolling seasonal menu, which is determined through service user choice and preference with specialist dietary advice. A record is maintained of foods eaten. Service users choice and preferences are considered through the completion of the weekly menu and meal choices are discussed with each individual service user able to express a preference. The home has access to a mini bus and allocated drivers. Staff support and encourage all service users to maintain and develop social, emotional, communication and independent living skills. The home is centrally located, and is within a short distance form shops and the local community amenities. The home values and seeks to reflect racial and cultural diversity of service users through celebration of, and awareness of different cultures, religions and festivities. During the inspection staff and service users were observed to interact equally with one another. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 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 & 21 Service users physical and health needs are met, ensuring that their safety, wellbeing and health is promoted at all times. The home should explore issues such as ageing and illness with service users and/or their representatives to ensure that individual needs and wishes are respected and met. EVIDENCE: All care provided is individual and tailored to each person, with service users needs, choices and preferences being promoted. Staff were observed supporting service users in a manner preferable to the service user. Service users have and are supported with all aspects of their physical and emotional health and receive adequate and appropriate input from specialists such as community nurses, consultants, GP, dentists, opticians and dieticians. Information and advice is provided to all services users regarding general health issues. The home should explore issues such as ageing and illness with service users and/or their representatives to ensure that individual needs and wishes are respected and met. Records should be maintained of these decisions so all staff can access this information if required. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 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 & 23 The complaints procedure within the home is sufficient and adequate in order for the service users to feel that their individual views are listened too. Robust policies, procedures and training are in place to ensure service users are protected and safe. EVIDENCE: The home has a comprehensive complaints procedure in place, which details that all complaints are responded to within 28 days, the complaints procedure must be reviewed to ensure that complainants are aware that they can contact the CSCI at any stage of the complaint. A record is maintained within the home of complaints made detailing actions and outcomes as necessary. All service users have been informed about the complaints procedure. To ensure service users are protected from abuse and harm, staff receive suitable and adequate Protection of Vulnerable Adults (POVA) training. Staff employed within the home are all subject to enhanced Criminal Records Bureau (CRB). Staff personnel files were unable to be inspected due to not being held on site. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 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, 28, 29 & 30 Each service users individual space within the home is extremely well decorated and maintained, reflecting individual choices and preferences. EVIDENCE: All resources and equipment is provided within the home in abundance ensuring specialist and individual needs are promoted and changing needs met at all times. Shared space both compliments and supplements service users individual space ensuring that individual space is tailored to personal style and taste. All bedrooms within the home are extremely well maintained and decorated. All service users are supported and empowered to decorate their individual rooms to their own taste and personalities. Staff should be commended for their efforts. Toilet and bathing facilities ensuring that choices and preferences can be met, and specialist equipment is available as per individual service user need. A new specialist bath has been ordered and the home is awaiting delivery and fitting. A new specialist hoist has been purchased.
Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 17 The home was clean and hygienic throughout. An annual redecoration plan is in place to ensure that the home stays looking attractive. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 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, 35 & 36 The home is suitably staffed with well-trained individuals ensuring that at all times service users complex and changing needs can be met. EVIDENCE: Each member of staff has a clear and well-defined role; this is supported by clear and concise job descriptions and person specifications. Training is in place within the home and is offered on a cyclical basis. The home has a detailed training plan in place for the forthcoming year, this includes training in basic food hygiene, infection control, emergency first aid, health & safety, fire awareness, effective meetings, absence management and manual handling. Records are maintained within the home. All mandatory training is attended by staff. A number of staff have gained their NVQ qualifications, a number of others are currently completing the course. Staff within the home are thoroughly inducted ensuring specialist training occurs, however the home should explore the Learning Disability Awards Framework (Ldaf) to ensure all areas are completed and support the needs of the service users. The home has sufficient staff working in the home and the use of agency is minimal with a focus on using regular bank staff for a consistent approach. Staff meetings occur within the home and supervision occur bi monthly and records are maintained. Evidence was seen of the frequency of supervisions occurring. Annual appraisals are also occurring currently within the home.
Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 19 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 The management within the home is secure and effective ensuring that changing needs of service users are met and that the home is meeting its aims and objectives. Systems for effective health and safety management are in place, although there is a need for risk assessments to be reviewed and implemented to ensure the welfare of service users is continuously monitored. Systems based on seeking the views of the service users are required to be developed and implemented within the home to measure it’s success in achieving the aims and objectives. EVIDENCE: The relationship between the service users and the staff is well balanced with interactions observed being appropriate and supportive. The ethos and management approach of the home creates an open, positive and inclusive atmosphere, staff and service users spoken to commented that they feel extremely supported and they feel the home is well managed. A clear commitment is made to equal opportunities within the home, with staff and service users expressing positive views with regards to this.
Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 20 The service users appeared to benefit from this well structured and well run home. Service users spoken to during the inspection appeared to be extremely happy with the home and appeared to be relaxed in their environment. All staff and managers within the home are adequately and suitably trained in order to meet the complex changing needs of the service users. Periodic training occurs within the home to ensure staff development is maintained. The home has a vast range of policies and procedural guidelines in place. Staff are requested to read and sign risk assessments and polices. The home has a multitude of risk assessments in place. All risk assessments must be actively reviewed and held as working documents. There is a need for the home to develop a detailed fire risk assessment to ensure that all area’s of the home are assessed and periodically reviewed. Information was provided for the manager. The home also has an internal intercom monitoring system for the safety of the service users and staff whilst on duty. Currently the home provides one waking night member of staff and one sleeping in member of staff. There is a need for the home to complete a risk assessment to determine and measure the safety of this situation. The internal intercom system must be repaired and/or replaced to working order in order to ensure service user and staff safety. Jubilee House Care Trust is currently working towards an effective quality assurance system and policy guidelines. There is a need for the home to ensure continual self-assessment through effective quality assurance systems seeking the views of the service users, professionals and friends and relatives. All records are secure within the home and were up to date and held in accordance with the Data Protection act 1998 ensuring that service users rights and best interests are safe guarded by the homes polices and procedures. The home has a large kitchen that is adapted to meet the specialist needs of service users. Currently the kitchen is in need of modernisation in order to maintain a minimum standard for infection control and cross contamination standards. Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 21 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 x x x x x Standard No 22 23
ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 3 3 3 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 x 3 3 3 Standard No 11 12 13 14 15 16 17 3 x 3 2 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Jubilee House Jonquil Close Score 3 3 x 2 Standard No 37 38 39 40 41 42 43 Score 3 3 2 2 3 2 x I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 22 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 6 Regulation 15 (2) & 17 (3) Requirement All care plans must be active working documents available to the service user and kept under review. The care plans must be completed in consultation with the service user or a representative. The complaints procedure must be reviewed and updated, ensuring that complainants are aware that at any stage they can raise their complaints direct with the CSCI. The home must ensure that there is an effective quality assurance monitoring system based on seeking the views of the service users / representatives, to measure the success in the aims and objectives of the home. A detailed fire risk assessment must be held on site and periodiaclly reviewed. The internal monitoring intercom system must be repaired and or replaced. Timescale for action 1st September 2005 2. 22 22 (7) 15th August 2005 3. 39 24 1st October 2005 4. 5. 42 42 23(4) 13(4)(a) 23(2)(c) 15th October 2005 15th October 2005 Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 23 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 14 Good Practice Recommendations It is recommended that the home implements a system to inform service users of activities and options available to empower and enable them to have user selfdetermination. It is recommended that the home explores issues such as ageing and illness with service users and or their representatives to ensure that individual needs and wishes are respected and meet. It is recommended that the home completes a full inventory of all service user belongings and maintains this record to ensure security and protction for the service users. It is recommended that the kitchen is refitted and modernised to ensure standards of basic infection control are maintained. The home should explore the Learning Disability Awards Framework (Ldaf) to ensure all areas are covered within the homes induction programme. 2. 21 3. 40 4. 5. 42 35 Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Hertforshire AL7 3BQ 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 Jubilee House Jonquil Close I52_s62294 Jubilee House Jonquil Close v233601 300605 stage 4.doc Version 1.30 Page 25 - 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!
