Inspection on 27/06/07 for Linelands

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

Linelands 30/01/06

Linelands 16/05/05

Linelands 20/12/04

Linelands 18/10/04

Linelands 12/02/04

Linelands 09/12/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Linelands All Saints Lane Nettleham Lincoln Lincs. LN2 2NT Lead Inspector Mr David Bacon Unannounced Inspection 27th June 2007 09:00 X10015.doc Version 1.40 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 Linelands DS0000041866.V323988.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 Older People. 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. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Linelands Address All Saints Lane Nettleham Lincoln Lincs. LN2 2NT 01522 750889 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) sheila.sibbons@lincolnshire.gov.uk www.lincolnshire.gov.uk Lincolnshire County Council Mrs Sheila Joan Sibbons Care Home 27 Category(ies) of Dementia (1), Old age, not falling within any registration, with number other category (24), Physical disability over 65 of places years of age (2) Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Linelands is a care home owned by Lincolnshire County Council. It is situated on the outskirts of the City of Lincoln in the village of Nettleham. The home is a two-storey property, which is a purposely built unit and is surrounded by gardens with ample parking to the front and the side of the home. There are local shops, churches, café and public houses within walking distance of the home. The home is split into six wings, five of which are used to provide care and accommodation for older people. Each wing has its own lounge, quiet room, bathroom and two toilets. The first floor has three kitchen areas where drinks can be made. There are three dining areas in the home. Accommodation is provided in single rooms on the ground and first floors. There is a passenger lift, which enables service users to access the second floor. The home provides intermediate/rehabilitation care and short-term care. There are some long-term service users staying the care home who were admitted to this home prior to the policy of the home being identified as to provide service users with short-term care with a view to them returning to their home within agreed target dates. A separate day centre, which is situated in the care home, did not form part of this inspection. The home is registered to provide care for 27 service users. Copies of inspection reports are maintained in the entrance to the home for service users and members of the public. The care fees range up to £348 per week. Hairdressing and private chiropody are not included in the fees. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during June 2007 and the visit to the home was undertaken over approximately 4.5 hours. The methodology for the inspection visit used is called ‘case tracking’. This means that the care received by three service users was looked at in detail, including service users care, staff and general home records, which pertain to their care and support. We also spoke with four service users and two of their representatives, the acting manager and a three staff members about the support offered to people living at the home. Observations were also made of day-to-day care practice. A partial tour of the premises was conducted including areas relating to the service users who were case tracked. Notifications received along with a pre-inspection questionnaire, completed by the manager were also viewed as part of the overall information gathering regarding the service. Fourteen completed quality satisfaction surveys were also received prior to the visit, which have been used to further inform the judgements made within this report. What the service does well: There are good systems in place for promoting service users rights and choices during their stay. Quality assurance procedures have recently been developed, to further seek the views of service users and their representatives in the aim of improving the services provided. The home is well managed and service users spoken with said they feel safe here, they enjoy the meals and they choose how they spend their time. Comments included: “Staff listen in my best interest”. “Very good, they will do things for you but they know to encourage you to get on your feet”. “Very high level of service, no problems at all”. “Very tasty meals”. “Overall, a very nice place with competent staff”. “I have been very happy and comfortable during my stay”. “The staff work hard and are excellent, they get you moving again”. “Wonderful place, the treatment is not what you would expect, a five star hotel”. Service users receive high quality standards of care and they are supported to maintain their life skills in the aim of them returning to their own homes. Comprehensive recruitment procedures are in place to protect service users and staff are well trained to meet individuals care needs. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 6 The physical environment is of a good standard and provides a safe, clean and comfortable place for service users. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Systems are in place for the introduction of service users to the home although service users are not always fully involved in this or provided with comprehensive information about the service provided. EVIDENCE: A statement of purpose and service user guide have been produced although the acting manager acknowledged that these had not recently been updated to reflect the current services provided and they were not fully available in the home. A new leaflet has recently been produced giving a brief insight as to the services provided, which is displayed in the entrance hall. Linelands provides care for individuals needing a short stay and for those being part of the intermediate care service. Due to the nature of the services provided the staff only undertake home visits to assess service users care needs for short stay admissions. The assessment of service users being part Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 9 of the intermediate care service is undertaken by separate care co-ordinators of which the assessment information often arrives with the service user at the beginning of their stay. Staff said that admissions often took place in the evening when there were fewer staff on duty, thus limiting the time available to complete the admission process, which was further confirmed by the acting manager. It is acknowledged some admission information is located in service users bedrooms although this was not consistent. Admission checklists are in place for each admission although those seen were not fully completed. The service users spoken with were not fully aware if they had been involved in the assessment process and records did not document that they had all received information about the services provided or their rights. For example, a terms and conditions of residence, which was further confirmed in the completed satisfaction surveys seen. The care records viewed evidenced that a comprehensive assessment of service users care needs had been undertaken, which clearly identified potential risks and individuals likes and general preferences. Discussions held with service users confirmed that they were satisfied with the homes admission arrangements. Comments included: “Well, I didn’t know what to expect but really, they are marvellous at helping you, they couldn’t have done better”. “I was in a bit of a state but they train them very well, I have been very well looked after from the start”. “The staff did go through some things with me but I was in a bit of a state so I don’t remember”. “No, I didn’t receive information as such but they were all on hand to help or to answer anything, I’ve no complaints”. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a supportive and well-informed staff team who treat them with respect and they can be assured that their care needs are met. Procedures for the administration of medication are appropriate. EVIDENCE: A care plan is completed for each service user following the initial assessment and the care records seen documented each service users care needs and how these were met. Care records included a brief history of the service user and identified needs such as pressure area care, mobility, personal care, falls, nutrition, night care, and medication. Individual preferences were also recorded. Records identified the support required to assist service users to return home, which was further confirmed by the service users spoken with and through the input provided by supporting health professionals. For example, physio and occupational therapy. Any assessed health care needs are identified, acted Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 11 upon and reviewed as necessary. The service users spoken with said: “You are a bit lost when you get here because you don’t know what to expect but they know what they are doing, to get your confidence back and get you moving”. “I cannot thank them enough, I felt very weak when I came and they have reassured me and been just the tonic I need, the staff are exceptional”. “You get the care you need but more so you are helped to help yourself”. “Faultless care, wonderful, you are fully involved so you go at a pace that is right”. “They respect you and treat you perfectly”. Systems are in place to support service users to administer their own medicines where this is risk assessed as appropriate. Medicines were properly stored and records clearly documented medicines as receipted into the building, as administered and where disposed. Staff whom administer medication receive accredited awareness training regarding this. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to choose how they spend their time and to maintain and develop community links as they prefer. Service users enjoy the meals provided and their dietary needs are met. EVIDENCE: Service users said they were able to make informed choices during each day, that there were no restrictions as to how they could spend their time and that their visitors were made welcome, which was confirmed by the representatives spoken with. Comments included: “Well, I would say that they’ve got it just right, you do what you like apart from meals but you could be late for those and they wouldn’t mind”. “It’s very nice”. “You get up when you like and do as you like but you know they are here to get you well again”. “It is not pressured or rushed, they go at a pace that suits you”. Service users said that they enjoyed the meals provided of which a choice of food is available at each mealtime. Comments included: “I don’t know how they do it, I am a funny eater but to be fair they try their best to accommodate what you like”. “No complaints, it can’t be easy with so many people but they Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 13 do wonders”. “Food tastes fresh, there’s plenty and you get a choice, what more could you want”. Service users are initially consulted with about their dietary needs and preferences as part of the admission process and this information is forwarded to kitchen staff. Meal safety checks are undertaken and records of these are maintained. Service users said that they were aware of some activities available to them during their stay but confirmed that these were limited and there is little information regarding activities in the home. Recent activities have included: walking in the village, darts, music, coffee and chat. Service users comments regarding activities included: “I’m happy watching telly or chatting, I haven’t seen much activities but there are some”. “I’m very happy and wouldn’t want any more than there is”. “They ask you occasionally if you want to do something but I’ve not seen much really”. “It suits me as it is but some would probably like more to do”. “I suppose they could do a bit more but I don’t know what really”. Information in the homes completed satisfaction questionnaires stated that most service users found that activities were available “sometimes” or “usually”. The acting manager agreed to address this. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel able to complain about the care they receive but they should be better notified overall of these procedures. Staff are made aware of the systems in place to protect service users from abuse. EVIDENCE: The pre inspection information received identified that policies and procedures are in place to protect service users, which was further confirmed during the visit. Records show that there has been one complaint and no safeguarding adult’s referral since the last inspection visit. The acting manager said that there is a culture of openness within the home and the service users and staff members spoken with further confirmed this. Comments included: “They are very well trained and they are very approachable, you only have to ask”. “I have no complaints about the service they really have looked after me very well”. “You could talk with any of them if needed and I would think they would sort any problems out”. “They may have showed me something about this but I have no complaints”. The comments made in the quality satisfaction surveys seen further confirmed these. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 15 There was no complaints procedure displayed in the home during the visit although some of this information was contained within statement of purpose documents. This matter was swiftly addressed by the acting manager who said that some service users occasionally took this information home with them at the end of their stay. The staff members spoken with were aware of the need to safeguard service users from abuse and the correct action to be taken in the event of a concern being identified. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the physical environment is good, with the organisation ensuring the maintenance and safety of each area of the home. EVIDENCE: The environment was clean, tidy and well maintained throughout all the areas seen. The acting manager said that a rolling programme of decoration was in place, which was evidenced throughout all the areas seen. The service users spoken with were satisfied with the cleanliness of the home and comments seen in the homes completed satisfaction questionnaires further confirmed this. Comments included: “It’s as clean as it is now, which is not bad is it”. “The standard of it all is the very best”. “They clean your room, I don’t think I’ve seen any mess anywhere”. “Oh you could not expect better than you would find here”. “The accommodation is very good, I don’t think you could expect any more”. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 17 Substances identified as being potentially hazardous to health are stored appropriately, and there are information sheets, policies, procedures and risk assessments providing guidance for staff. The staff spoken with were satisfied with the systems in place to maintain a safe environment and with the awareness training they received regarding this subject matter. Systems are in place to minimise risks of infection through water outlets and water temperature valves are fitted to water outlets of which testing records are maintained. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are safeguarded through comprehensive recruitment procedures being in place and the staff receive induction when commencing work at the home and a awareness training to meet service users care needs. Staff are not always sufficiently deployed to fully meet service users individual needs during their admission to the home. EVIDENCE: The service users and representatives spoken with said that they were fully satisfied with the standards of care provided, which was further evidenced in the completed satisfaction questionnaires seen. Comments included: “They really do know what they are doing, they give you everything you need to get you back on your feet”. “The care is very special, I’m very pleased with everything here”. “They help you when you need it but more than that they help you help yourself”. “They are kindness itself and will do whatever they can to help, I’m very impressed” “No complaints here”. “There are staff, immediately, whenever you need them”. The staff members spoken with were satisfied with the recruitment process and confirmed that they received induction and regular training appropriate for their roles, which was further evidenced in the training records seen. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 19 Staff confirmed that they enjoyed working at the home and that any routines were flexible where possible to meet service users individual choices and lifestyles. Staff members said that there were occasional difficulties when service users were admitted in the evening when were fewer staff on duty, which put extra pressure on staff and had some negative impact on the admission process for service users. For example, service users were not all fully included in the planning of the care they would receive or informed of their rights or the services provided. This was further confirmed by the acting manager and through the records of admissions seen. The staff records seen evidenced that appropriate recruitment checks and procedures had been undertaken of which clear guidelines are in place. Recruitment records contain application forms, references, criminal record bureau checks, and identification. Equal opportunity monitoring and awareness is included within these. Staff attend induction training upon commencing work at the home of which records are maintained. A training plan is in place and any outstanding training needs are identified and addressed. Pre inspection information received stated that more than 50 of care staff have achieved a national vocation qualification relevant to their work, which was further confirmed during the visit. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and systems are in place to ensure that care is provided in a safe and appropriate manner and improvements are currently being made with quality satisfaction systems. Improvements should be made regarding the testing of the homes fire safety systems. EVIDENCE: Some formal quality satisfaction procedures are in place, which include questionnaires being located in the main entrance. Satisfaction surveys are also forwarded to service users following their stays. The acting manager said that improvements were being made with this to more accurately review and Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 21 act upon any comments received and that this would include holding regular meetings with service users. The service users and staff members spoken with were satisfied with the acting manager’s approach to the role and that they felt fully able to discuss any views with staff about the care provided. Comments included: “It’s all very well run, you can speak with any of them and they would do their best for you”. “They are well trained to help but to help you to help yourself”. “I was not sure about coming here but any fears have gone, they have helped me no end”. “I would come again and next time would not have to worry about it”. All areas of the home seen were well maintained of which records are kept and a risk assessment of the premises has been undertaken, which is updated and acted upon as necessary. Pre inspection information received stated that the necessary health and safety checks are undertaken as necessary although fire safety tests were not fully undertaken as per fire safety regulations. The acting manager took action to address this during the visit. Policies and procedures are in place to protect service users where the home has any involvement in their finances. Monies are kept separate and receipts and records of transactions and totals are maintained. Service users sign for any transactions where possible. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 4 Requirement A statement of purpose must be in place to provide service users with detasiled information about the services provided. Each service user must be provided with a written contract or terms and conditions of residence. Fire safety tests must be undertaken ads per the fire safety officer’s instructions to safeguard service users. Timescale for action 31/08/07 2 OP2 5 31/08/07 3 OP38 23 (4) 31/08/07 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 3 Linelands Refer to Standard OP12 OP16 OP27 Good Practice Recommendations Sufficient activities should be provided to meet the needs of service users during their stay. Service users should be provided with sufficient information regarding how to complain. Staffing levels should be reviewed to ensure sufficient DS0000041866.V323988.R01.S.doc Version 5.2 Page 24 levels of staff are present during the admission of service users to the home. Linelands DS0000041866.V323988.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Linelands DS0000041866.V323988.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!