Inspection on 27/06/07 for Lawwood

This inspection was carried out on 27th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Lawwood 15/02/06

Lawwood 13/10/05

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

CARE HOME ADULTS 18-65 Lawwood 87 Todmorden Road Burnley Lancashire BB11 3ES Lead Inspector Mr Wesley Cornwell Unannounced Inspection 27th June 2007 10:00 Lawwood DS0000061819.V337130.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 Lawwood DS0000061819.V337130.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. Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lawwood Address 87 Todmorden Road Burnley Lancashire BB11 3ES 01282 435832 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) Lawwood Ltd Mrs Amanda Balmer Care Home 11 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (11) of places Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate up to 11 (eleven) adults up to the age of 65 who have mental health problems. Date of last inspection Brief Description of the Service: Lawwood is registered to provide personal care and accommodation for 10 adults over the age of 18 with a mental illness. Lawwood is a double fronted mid terraced property situated upon a busy road, in a residential area. The home is close to a number of local resources and community facilities. The accommodation available is of a very good standard, homely and domestic in style, all bedrooms are single (one has an en-suite toilet) There are two lounges, a room for smoking and a separate dining room. Satellite television is provided. There are two enclosed courtyard areas with seating, to the rear of the home. Staff are on duty to provided support 24 hours per day. ‘People carrier’ type transport is available to enable service users to visit relatives, take short trips and outings within the community. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home. The range of fees at the home are £476.00 to £850.00 covering all aspects of care, food and accommodation. The manager provided this information on the 27th June 2007. Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was undertaken as part of the homes Key Inspection. The site visit commenced at 10:00am and took place over 4 hours. Prior to the site visit the manager of the home completed an Annual Quality Assurance Assessment form (AQAA) providing detailed information about the service they are providing. A number of residents, their relatives and health and social care professionals were contacted for their views about the home and these have been included in this report. During the site visit the Inspector spoke to seven residents, two staff members, two health and social care professionals and the manager of the home. Staff, care, maintenance and financial records were also examined. A full tour of the premises was undertaken with the manager. What the service does well: The homes assessment procedures were very thorough and care plans had been structured to ensure staff recognise the diverse needs of residents. Observation of practice and discussion with staff members confirmed the staff team had been provided with appropriate training to assist them in understanding and meeting the needs of residents with specific mental healthcare problems. Residents spoken to said the staff team provided sensitive and flexible personal care support and confirmed they liked living at the home and felt well cared for. The residents were very positive in their comments about the staff who were described as being caring and conscientious. One resident said, “ I really can’t fault the care I receive. The staff are all very kind and helpful”. The relative of one resident said, “ My son has lived at the home for a number of years and during that time the staff have changed his quality of life completely. He has been helped more than I a can say to the point where he is almost ready to move out of the home and live independently”. Another relative said, “The support my relative receives is of the highest standard”. A healthcare worker said the standards being achieved at the home were of the highest standard and always found the manager and her staff to be very professional, conscientious and supportive in their dealings with the residents. Staff at the home are well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed residents are treated with respect and dignity. Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 6 The home has been decorated and furnished to a high standard to ensure the comfort of residents. Residents spoken to were very happy with the standard of accommodation provided. What has improved since the last inspection? What they could do better: There have been no requirements or recommendations made of the home during this inspection process. The care provided by the management and staff is achieved by hard work and the commitment of the staff to ensure residents needs are being met. Comments received by residents, their relatives and healthcare and social care professionals described a service that is achieving very high standards and a very pleasant environment for people to live. Staff at the home have been well trained and formal arrangements are in place to monitor the care being provided. However, the management at the home understands there is always room for improvement and they must continue to work hard to ensure the high standards presently being provided continue to be met. During completion of the Annual Quality Assurance Assessment form the manager has identified some areas where she thinks the service being provided can improve so that the present high standards being achieved can continue to be maintained. Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 7 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. Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The care plan records of two residents had full assessment information including the religious/cultural and relationship needs of the residents. Staff members confirmed they had access to this information and could describe in detail the care needs of the residents. Staff responsible for the preparation of meals said they were informed about residents who had special dietary needs and these are always accommodated. All residents spoken to confirmed they were happy their needs were being met by the home. Lawwood DS0000061819.V337130.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of residents health, personal and social care is taken seriously and closely monitored to ensure they are met. EVIDENCE: Individual records are kept for each resident with a plan of care setting out the action that needed to be taken by support staff to ensure all aspects of health, personal and social care needs of the residents were met. The care plans had identified areas of need, possible intervention, resident choices and personal goals. Residents spoken to confirmed they had been involved in the development of their care plan and agreed with the support to be provided. The care plans were structured and were being reviewed with the resident or their relative/advocate and updated to reflect any changing needs and these were being actioned as required. Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 11 The daily records of two residents clearly described the level of support and assistance being provided by the staff team with their daily living routines and any activities being undertaken. Residents spoken to confirmed they are treated and respected as individuals and encouraged and supported by the staff team to pursue their chosen lifestyle within acceptable boundaries. One resident said, “ I really enjoy living at the home. I am treated like an adult and encouraged and supported to undertake activities of my choice. The staff are brilliant”. Residents spoken to said they were consulted by the manager and staff members about the day to day running of the home. Regular meetings are held to consult residents about upcoming events to enable them to have their say about the service provided. One resident said “ I find the meetings useful. The manager and staff listen to what we have to say and will make changes if we request them”. Discussion with the manager and observation of care plan records confirmed the home has clear risk assessment management strategies in place for dealing with potential risks to residents. The home has a good record of dealing promptly with any unexplained absences of residents. Lawwood DS0000061819.V337130.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 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Education and employment opportunities are promoted to ensure the residents have opportunities for personal development. EVIDENCE: Residents living at the home each have a personal activity plan indicating the activities to be undertaken for the week. The plan had been devised with the agreement of the resident and included information about the day and time the activities were to be undertaken, venue, meal provision, transport arrangements and support to be provided. The activities included attending fitness training at the local Gymnasium, pursuing education opportunities at college, voluntary work and visiting relatives. One resident said, “ I really enjoy my activities programme. I go to the Gym a couple of times a week, have attended several courses at college and undertake voluntary work. I couldn’t be happier”. Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 13 One healthcare worker contacted prior to the site visit said, “ The home are always looking to improve their service delivery. They provide a comprehensive range of therapeutic activities including holidays and regular outings. The health of the resident I visit has improved considerably since their admission to the home” Several residents had just returned from a week’s holiday in Majorca. One resident said, “We had a great time. The weather was lovely and it was so relaxing. We often go on holiday and I am really looking forward to the next one being organised” Residents said they were happy with arrangements in place for receiving their visitors and were encouraged by the manager to maintain contact with their family and friends. The relative of one resident said, “I see my brother on a regular basis. A carer from Lawwwod brings him on average once a month for a visit to my home. I also have regular contact by letter and telephone”. All residents spoken to confirmed they were happy with the routines within the home and these were being arranged around their individual and collective needs. The residents said they were provided with the choice of spending time on their own or in the lounge areas and the manager and staff respected their privacy. One resident said, I have lived in a number of homes but this is by far the best. It really feels like home. I am so comfortable. All the residents and staff get on really well”. Residents spoken to confirmed they had access to the kitchen to prepare snacks and drinks and are also involved in the preparation of meals. Breakfast and lunch is left to individual choice with the main meal being prepared by a staff member. Residents with special dietary needs said these were being met. All residents spoken to confirmed they are offered a healthy diet and enjoyed the meals provided by the home. Lawwood DS0000061819.V337130.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 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously and personal support is provided in a flexible and sensitive manner. EVIDENCE: Discussion with residents confirmed their personal care needs were being met as identified within their care plan and this was being delivered in a sensitive and dignified way. One resident said they were able to attend to their own care and personal hygiene needs and was happy with the level of supervision and guidance available to them. Entries on care plans confirmed staff communicate clearly and work in partnership with health and social care professionals. Healthcare and social care professionals said the manager and staff at the home demonstrated a clear understanding of the needs of residents and they were satisfied with the overall care being provided. One healthcare worker said, “ I have been visiting the home for a number of years and feel they provide an excellent service. The manager and her staff are good communicators, very professional and have a Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 15 good record of adhering to care plans and providing support for residents as identified. I am always impressed with the standards being achieved”. The manager of the home has produced an Annual Quality Assurance form, which documents all contact residents have with healthcare workers. The manager said completion of the form enabled her to monitor the access residents have to healthcare professionals and identify any residents who have not seen appropriate services. Medication practices observed were safe and good records had been maintained. The staff members responsible for the administration of medicines had received training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. Lawwood DS0000061819.V337130.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission to the home. Residents spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. The relatives of residents contacted prior to the site visit also said they were aware of the complaints procedure but hadn’t had any cause to make a complaint about the home. At the time of this site visit no complaints had been received by the home or referred to the Commission for Social Care Inspection. The home has a procedure in place for dealing with allegations of abuse. The manager and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff members on duty said abusive practices and how to recognise these had been covered during training provided by the home. Lawwood DS0000061819.V337130.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): 24,26 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure residents live in a comfortable, homely, clean and safe environment. EVIDENCE: The home has been well maintained and decorated for the comfort of residents. All furnishings were of a very good standard and helped to provide a homely environment. Satellite television is available in the lounge areas for the entertainment of residents. The home also has a computer with internet access. Residents were observed enjoying this facility. The home has a selection of communal areas providing residents with a choice of where they wish to sit and receive their visitors. All residents spoken to were very happy with the standard of accommodation being provided and said they felt completely at home. Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 18 Since the last inspection one new bedroom with en-suite facilities has been created and four bedrooms redecorated. The manager said the refurbishment of the home was ongoing and there were further plans for refurbishment throughout the home to ensure the present high standards are maintained. Residents and their visitors were very pleased with the improvements being made. A tour of the building confirmed resident bedrooms had been personalised with their own belongs and decorated and furnished for their comfort. Each bedroom had been fitted with a lock and the resident issued with their own key ensuring their privacy was being promoted. All residents spoken to were happy with their rooms and said they had the choice of spending time on their own or in the lounge area’s. One resident said they liked to spend time in their room listening to music and the manager and her staff always respected their privacy. Hot water temperatures throughout the home were checked and found to deliver water at a safe temperature in line with health and safety guidelines. It was observed during the visit the home was clean and hygienic ensuring a pleasant environment in which to live. Lawwood DS0000061819.V337130.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): 32,34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The homes recruitment procedures are robust and these provide safeguards for the protection of residents. EVIDENCE: Staffing levels were sufficient for the number of residents living at the home. Residents said they were happy with the care and support they receive and were well treated by the staff team. Staff members were observed coming on duty to support residents to undertake activities identified in their personal activity plan. Residents spoken to all said they were very happy with the level of support they were receiving and enjoyed being able to pursue individual activities of their choice. The relative of one resident said, “ My relative receives fantastic support, over and above expectations. The staff are all consistent, caring, capable and always willing to help and smile doing it”. Staff spoken to said they were clear about their role and work well as a team to ensure the individual and collective needs of residents are met. Records show all staff members have access to a structured training and development programme ensuring the residents are being cared for by a well trained and Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 20 competent staff team. Over 90 of support staff have achieved National Vocational Qualifications (NVQ) with the remaining staff members in the process of working towards these. This will ensure the residents are in the safe hands of a qualified and competent staff team. Examination of staff records showed good systems were in place for obtaining relevant documentation for staff members employed by the home ensuring the protection of residents. Lawwood DS0000061819.V337130.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 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well run and has policies and procedures in place to ensure the health and safety of residents and staff are promoted and protected. EVIDENCE: The manager of the home has several years experience in residential and nursing care. She is a Registered General Nurse, Registered Mental Nurse at Diploma level, has an Honours Degree in Health Studies and the D32/33 Tutor Assessor Qualification for the delivery and assessment of National Vocational Qualifications. In addition she has achieved a relevant management qualification and has access to training to ensure her knowledge and skills are updated and the home continues to be well run and for the benefit of residents. Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 22 Residents and their visitors were very positive in their comments about the manager and her staff who were described as being friendly, approachable, very helpful and professional. The home has effective quality assurance systems in place to monitor the level of service being provided for its residents. An annual quality assessment of standards is undertaken by a professionally recognised organisation who completes an audit of the care being provided and seek the views of residents and their relatives. In addition the home has in place its own quality assurance systems in place to gather the views of residents and keep them informed about events being organised by the home. Residents and their relatives confirmed they are consulted about any changes taking place within the home and kept fully informed about forthcoming events being organised. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation to provide a safe environment for residents and staff. Risk assessment strategies were in place to ensure safe working practices and these were being regularly reviewed and updated. Staff members had been well trained on Health and safety issues and all staff employed by the home hold a first aid certificate ensuring a qualified first aider is on duty at all times to deal with any potential emergencies. Lawwood DS0000061819.V337130.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 X 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 4 25 X 26 4 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 4 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 4 X 4 X X 3 X Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 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. 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. Refer to Standard Good Practice Recommendations Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Lawwood DS0000061819.V337130.R01.S.doc Version 5.2 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!