Inspection on 01/05/07 for Manchester Learning Disability Partnership

This inspection was carried out on 1st May 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Manchester Learning Disability... 26/09/06

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Manchester Learning Disability Partnership Short Breaks Service 37 West View Road Northenden Manchester M22 4LP Lead Inspector Val Bell Unannounced Inspection 1st May 2007 2:30 Manchester Learning Disability Partnership DS0000065266.V337550.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 Manchester Learning Disability Partnership DS0000065266.V337550.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. Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manchester Learning Disability Partnership Address Short Breaks Service 37 West View Road Northenden Manchester M22 4LP 0161 945 7231 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) Manchester Physical Disability Service Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home provides accommodation and care on a respite basis for a maximum of four adults aged between 18 and 65 years old whose primary need for care is by reason of learning disability. The organisation must, at all times, employ a suitably qualified and experienced manager. The matters detailed in the attached schedule of requirements must be completed within the stated timescales. 26th September 2006 Date of last inspection Brief Description of the Service: The care home provides 24-hour accommodation and support for up to four learning disabled adults for short breaks to give their carers/families a respite from their care role. The service forms part of the Manchester Learning Disability Partnership (MLDP). The building is a normal domestic dwelling set on a residential street in the southeast of Manchester with good access to local amenities. The building is accessible on the ground floor for wheelchair users. The ground floor has a kitchen, lounge and dining room, toilet and shower facilities. Bedroom accommodation and bathroom facilities are also on the first floor with a staff sleep-in/storage room. There is an enclosed garden to the rear of the building. Information provided to the CSCI detailed that the charges for the service are £13.50 per day. Information about the service can be obtained from the Short-Break Team based at Forrester House. Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on information gathered by the Commission for Social Care Inspection (CSCI) since the last inspection on 26th September 2006 and supporting information provided by the manager prior to a visit to the home. Additionally, two people staying in the home provided information by completing satisfaction surveys. Site visits to the home form part of the overall inspection process and the lead inspector conducted this visit during daytime hours on Tuesday, 1st May 2007. The opportunity was taken to look at the core standards of the National Minimum Standards (NMS). This inspection will also be used to decide how often the home needs to be visited to make sure that the required standards are being met. During the visit time was spent with people living in the home and discussions were held with two support staff and the senior support worker on duty. Relevant documents, systems and procedures were assessed and a tour of the home was undertaken. What the service does well: People using this service have their needs re-assessed during six-monthly home visits and any changes in needs are recorded in their support plans. This ensures that the right level of support can be provided. The service adopts a person-centred approach by listening to individuals’ hopes and preferences in what they want to achieve and their progress in reaching their goals is monitored and reviewed regularly. People stay at the home for a short break every six to eight weeks and they are encouraged to continue to follow their usual routines and activities of daily living during this time. Evening leisure time is flexible and people can choose where to go and what to do. Two of the men staying in the home on the day of this visit had chosen to go ten-pin bowling with a member of staff. Of the two remaining people, one had chosen to relax and the other person wanted to watch snooker on the TV. The home is managed well and policies, procedures and systems afford protection to the welfare and health and safety of people using the service. Staff had received relevant training to equip them with the knowledge and skills to meet people’s assessed needs. Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 6 One of the men staying in the home said that he always enjoyed his short breaks there and he thought the staff were ‘marvellous’. He joined the inspector on a tour of the building. The environment was safe, clean, hygienic and homely. He said that he likes to bring his favourite personal possessions in when he stays. He also confirmed that staff take time to listen to him and he was confident that if he had a complaint or concern, the staff would put things right. What has improved since the last inspection? What they could do better: One requirement and two good practice recommendations were made during the site visit for this inspection. The home held comprehensive health and safety records. However, a shortfall was found in that a current certificate of public liability insurance and the home’s gas safety certificate were not held in the home. The home must provide this evidence to confirm that insurance against loss and personal injury and that maintenance of the home’s equipment protects the rights and safety of people using the service. It was clear that the service was developing a person-centred approach to the support provided. A recommendation was made to develop this further by the introduction of person-centred lifestyle planning. This will enhance the lives of people using the service by enabling them to take control of their aspirations and preferred future lifestyles. Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 7 As previously mentioned, risks associated with the use of wedges to hold open fire doors for some people using the service had been assessed. A recommendation was made to update the home’s fire risk assessment to include the current guidelines on when it is safe to use door wedges. This will ensure that the staff and people using the service are not placed at risk in the event of fire. 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. Manchester Learning Disability Partnership DS0000065266.V337550.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 Manchester Learning Disability Partnership DS0000065266.V337550.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. People using the short break service can be confident that their current needs will be identified and recorded to ensure that the staff team know what support to provide in meeting their needs. EVIDENCE: The files of four people staying in the home were examined. Assessments of need had been carried out every six months by visiting people in their own homes and any changes had been incorporated into support plans. The views of relatives and carers had been taken into consideration. Assessments were very detailed and included people’s aspirations, likes and dislikes. This ensured that the right level of support could be provided to meet the current needs of people in a way that met their individual preferences. Manchester Learning Disability Partnership DS0000065266.V337550.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. Staff provide the right level of support to ensure that people using the service can achieve their personal goals. EVIDENCE: The four support plans examined contained detailed and specific information that described what support a person needed to meet their individual goals. The likes, dislikes and preferences in relation to a person’s daily routine were consistently recorded. This demonstrated that people using the service were respected as individuals and encouraged to maintain their chosen lifestyles during their stay at the home. Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 11 Furthermore, it was pleasing to note that individuals’ personal profiles had been written in the first person. This provided evidence that the service is developing a person-centred approach to the support provided. A recommendation was made to develop this further by the introduction of person-centred lifestyle planning. This will enhance the lives of people using the service by enabling them to take control of their aspirations and preferred future lifestyles. Identified risks had been assessed and detailed instructions were available so that staff knew what they had to do to keep people safe. One of the people spoken to said that he continued to follow his daily routines during his short breaks at the home. Throughout the site visit, staff were observed to encourage people to make decisions and exert their right to make choices according to their individual life preferences. Restrictions on choice and personal freedom made during the assessment process had been agreed and recorded as recommended at the last inspection. In conversation with the staff on duty it was evident that they put the needs of people using the service first. One member of staff commented that it was rewarding to support people in reaching their personal goals. Manchester Learning Disability Partnership DS0000065266.V337550.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, 15, 16 and 17 Quality in this outcome area good. This judgement has been made using available evidence, including a visit to this service. People are respected as individuals and are able to follow their chosen lifestyles during their stay in the home. EVIDENCE: The four support plans examined recorded the likes, dislikes and preferences in relation to planned activities of daily living. Structured daily timetables detailed the activities people had chosen to engage in and this was consistent with what people were actually doing at the time of the site visit. Evening leisure time was flexible and it was pleasing to observe staff asking people what they would like to do. One person chose to watch a snooker championship final on the TV and two of the other people staying in the home chose to go ten-pin bowling with a member of staff. The fourth person wanted to relax after a busy day and this was consistent with her usual routine as Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 13 detailed in the support plan. This demonstrated that people using this service could make choices that were consistent with their preferences. One of the men was asked what he does during the day. He said, “I go into Manchester on my own every day. I enjoy running errands and doing odd jobs for people that have been family friends for a long time. I like coming here.” This provided evidence that people can follow their usual lifestyle during their stay at the home. Mealtimes are flexible and it was noted that people were given individual choices in what they liked to eat. Records detailed individual’s likes and dislikes and the actual food that people had chosen at mealtimes. This was evidence of good practice and it shows that individual preferences are respected. One of the support plans provided evidence that although restrictions had been placed on the frequency of the person’s access to drinks, this had been done in consultation with the relevant health professionals during the assessment process. This protected the person’s health and wellbeing. Health and safety regulations relating to the storage and preparation of food were being followed at the time of the visit. Staff spoken to confirmed that special diets such as Halal and vegetarian food were available and that this would be agreed during the assessment process. Manchester Learning Disability Partnership DS0000065266.V337550.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 good. This judgement has been made using available evidence, including a visit to this service. People using this service can be confident that their personal and healthcare needs will be met safely and in accordance with their personal preferences. EVIDENCE: The four support plans examined, detailed individual needs in relation to communication, diet, health and personal care. Checklists recorded individual’s preferences in how their personal care should be delivered and detailed the specific toiletries that they would like to be used. Where specialist input was needed, referrals had been made to the relevant service, such as speech therapy and psychology. Guidelines provided by health professionals had been followed accurately. For example, a psychologist had provided guidelines on communication, interaction and the management of behaviours that challenge for one of the people staying in the home. Daily records showed that staff were adhering to the guidelines and this was also observed in their interactions with the person during the site visit. Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 15 Medication administration records included an audit trail from receipt to disposal of medication. The balance of stock held for one of the medicines was checked and found to be correct. Medication was securely stored. Records provided evidence that staff take care to check that medication received is correct. Records for 30/04/07 detailed that the frequency of dose for one of the medicines had been changed on the box. This was queried with the person’s general practitioner and it was discovered that a relative had altered the dosage. The support worker rang the relative to inform her that this had not been authorised by the doctor and that staff would be administering the medication according to the doctor’s instructions. A medication error report form had been completed. This evidence of good practice demonstrated that staff take care to ensure that people using the service take the correct medication as prescribed by their doctors. Manchester Learning Disability Partnership DS0000065266.V337550.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. Policies and procedures for dealing with complaints and for safeguarding people from abuse afford protection to the safety and welfare of people using the service. EVIDENCE: The home had a compliments and complaints policy and staff knew how to reference this. One of the men staying in the home knew who to talk to if he had any concerns. He stated that staff always took time to listen to him and, although he had never needed to complain, he was confident that they would take action to put things right. The home followed Manchester local authority multi-disciplinary policy and procedures in safeguarding vulnerable adults from abuse. Staff spoken to had received training in the awareness of abuse and were familiar with the guidelines that they should follow if abuse was alleged or suspected. Manchester Learning Disability Partnership DS0000065266.V337550.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People using this service are provided with a comfortable, pleasant and safe living environment that meets their assessed physical needs. EVIDENCE: One of the people living in the home took the inspector on a tour of the environment’s communal and private space. This person had brought his favourite personal possessions in with him and he said that he had all the home comforts he needed. A ground-floor bedroom had been adapted to meet the needs of people with physical impairments. Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 18 The environment was found to be well maintained and no health and safety issues were present. An upstairs shower had leaked and this had left a stain on the dining-room ceiling. This had been reported and repair work was awaited. The environment was clean, safe and hygienic and no offensive odours were detected. The senior support worker said that new beds had been provided and that the environment was due for refurbishment. One of the people who completed a satisfaction survey suggested that the provision of Sky television and DVD players in bedrooms would be a welcome improvement. Manchester Learning Disability Partnership DS0000065266.V337550.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 good. This judgement has been made using available evidence, including a visit to this service. Appropriately trained and experienced staff are employed to meet the assessed needs of people using this service. EVIDENCE: Personnel records are held at the homes head office in Manchester and these were not examined during this inspection. These records will be examined at a future inspection of one of the Short Break Service’s homes. Staff on duty at the time of this site visit confirmed that the required pre-employment checks had been obtained prior to their appointment. One member of staff had achieved level 2 NVQ in care and was currently studying for a level 3 in this qualification. Staff also confirmed that they received regular refresher training in mandatory health and safety, such as moving and handling and food hygiene. Additionally, staff had undertaken specific training (Learning Disability Award Framework) that equips them with the knowledge and skills to understand and meet the needs of people using the service. Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 20 Staff spoken to confirmed that they met with their line manager every six to eight weeks for job consultations (supervision) This gave them the opportunity to discuss their performance, any work problems and future training and development needs. Staff also confirmed that their work performance was assessed every year. Manchester Learning Disability Partnership DS0000065266.V337550.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 good. This judgement has been made using available evidence, including a visit to this service. The home is managed well and staff have the support that they need to meet the assessed needs of people using the service. EVIDENCE: Staff on duty at the time of the site visit said that they received regular linemanagement support and that an on call system was available if they needed guidance at any time. Two people had been appointed to each have the dayto-day management of two homes that provide a short break service. Both these members of staff had achieved the Registered Managers Award. Additionally, a registered manager had been appointed, as required at the last inspection, to oversee the management of the four homes that comprised the Short Break Service in Manchester. Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 22 Staff said that satisfaction surveys were issued annually to people using the service and their representatives, although evidence of this was not seen on this occasion. It was also confirmed that the outcome of the most recent survey had been analysed as recommended at the last inspection and that this report was available on request. A sample of health and safety records was examined and generally the required records were currently available. Copies of the current landlord gas safety certificate and certificate of public liability insurance could not be located, although the person in charge was confident that these would be available at the head office. The home must provide this evidence to confirm that insurance against loss and personal injury and that maintenance of the homes equipment protects the rights and safety of people using the service. At the last inspection a requirement was made in relation to the risks associated with the use of door wedges. The use of door wedges in certain situations had been risk assessed and a decision taken to install self-closing doors that are linked to the homes fire alarm. Work was expected to start on this in the near future. While this work was awaited a recommendation was made to update the homes fire risk assessment to include the current guidelines on the safe use of door wedges. Manchester Learning Disability Partnership DS0000065266.V337550.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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 13 (4) Requirement The registered person must provide evidence to confirm that insurance against loss and personal injury and that maintenance of the homes equipment protects the rights and safety of people using the service. Timescale for action 01/06/07 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 Refer to Standard YA6 Good Practice Recommendations The registered person should consider the introduction of person-centred lifestyle planning. This will enhance the lives of people using the service by enabling them to take control of their aspirations and preferred future lifestyles. The registered person should update the home’s fire risk assessment to include the current protocols on the safe use of door wedges. 2 YA42 Manchester Learning Disability Partnership DS0000065266.V337550.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Manchester Learning Disability Partnership DS0000065266.V337550.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!