Inspection on 06/06/08 for Oakleigh

This inspection was carried out on 6th June 2008.

CSCI found this care home to be providing an Good service.

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

Oakleigh 21/05/09

Oakleigh 15/07/07

Oakleigh 11/08/06

Oakleigh 25/10/05

Oakleigh 11/01/05

Oakleigh 26/11/04

Oakleigh 20/07/04

Oakleigh 27/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Oakleigh 22 Great North Road Alconbury Weston, Huntingdon Cambridgeshire PE28 4JR Lead Inspector Dragan cvejic Unannounced Inspection 6th June 2008 08:30 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 Oakleigh DS0000015107.V366555.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. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakleigh Address 22 Great North Road Alconbury Weston, Huntingdon Cambridgeshire PE28 4JR 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) 01480 890248 01480 896308 harriscelia@btconnect.com Mr Styllianakis Styllis Celia Ann Harris Care Home 27 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (27) of places Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th July 2007 Brief Description of the Service: Oakleigh provides accommodation, care, and support for up to 27 older people, including some who might have a degree of dementia. The home is in the small village of Alconbury Weston, which has a shop, public house and church, and is within easy reach of Huntingdon and Peterborough. The building was originally a private bungalow but it has been extended a number of times and now offers accommodation in 24 rooms on the ground floor, and one room on the first floor which is accessed by a stairs or a stair lift. All 25 rooms have en-suite facilities; the two double rooms are currently used as superior singles. The building surrounds an attractive central courtyard; residents have a choice of communal accommodation, including 3 lounges and a dining room. The gardens surrounding the house are attractive, well maintained and frequently used by the residents and their families. The home is staffed 24 hours a day, with 2 staff on duty overnight. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection of the service. The site visit to the service was carried out on 06/06/08 and lasted for 4.5 hours. During that time, six people who used the service, two staff and the management team were spoken to and provided their comments on the service. Four randomly chosen users’ files were checked and, using the case tracking methodology, these users were spoken to. Observation of the care process and comments from the users illustrated the experience of people that use the service. Nine users sent their questionnaires back, three staff members and three relatives of people that use the service also provided their comments in questionnaires, commenting on the service provisions to users of the service. The home conducted a self assessment and reported on the AQAA form their findings about the experience of people who use this service. . A tour of the house and comments from users of the service provided a picture of the environment where the users of the service live. The management team, the manager and her deputy, were present in the home during the site visit and commented on issues concerning quality of care for users of the service. What the service does well: The home provided very good information about the service in their updated statement of purpose, user’s guide and the home’s brochure, enabling users of the service and their families to make an informed choice when they choose the home. The home organised and conducted a pre-admission assessment, ensuring that the assessed needs would be met if a potential user decides to move into this home. This was confirmed in two relatives’ questionnaires and in four checked users’ files. The home had good documentation for each individual user of the service. Care plans, risk assessments and other documentation helped staff to focus on the assessed and recorded needs and offer care that was discussed and agreed with users of the service. Staff were able to make users safer by this recording system, as was seen in one example in a file that contained this comment: “now needs hoist for all movements”. Medication process was safe and properly conducted, thus ensuring users of the service received health care that was agreed with their professional health workers, GP (General Practitioners), nurses and other medical professionals. Although the home organised varied and interesting activities, not all service users could fully enjoy these due to their health conditions and limited abilities. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 6 The home saw the potential for improvement and the manager was working on identifying and planning additional activities that would expand the potential for users with dementia to join in and have the opportunity to engage in and enjoy day time more. “Food is excellent”, commented a user of the service and several others reconfirmed this statement. We have seen lunch, well presented, nicely served and several users ate with visible satisfaction. Menus checked showed that food was varied, nutritional and individual choices were respected. There were no complaints from users of the service, but the home kept records of all complaints and the one from a relative was dealt according to the set procedure, offering reassurance to the users of the service that any complaint would be taken seriously and used to improve service and provisions. In the home’s self assessment they stated: “Involvement of residents in decorating and furnishing their own space”, showing how the users could choose colours for their bedrooms and make them homely by bringing in their own furniture. Staff worked with consideration for users’ dignity and showed respect to the users of the service. Good training and staff motivation reassured users of the service that staff had the knowledge on how to help and to protect them. The home was managed by an experienced and committed manager and her deputy in such a way that both users of the service and staff felt supported, looked after and protected. What has improved since the last inspection? What they could do better: The auditing medication process was carried out regularly, but the amount of medication carried over from month to month, to a new sheet, was not recorded to help in checking the amount of medication present, rather than checking previous monthly sheets when auditing was carried out. Introducing this additional record would reduce the possibility of medication errors and protect the users of the service. Although all comments on staff quality of work were very positive, there was evidence from the comments of users of the service, their relatives, staff Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 7 themselves and even the manager that staff complement was not sufficient to meet generally increased needs of users of the service. Peak times and weekends were particularly affected. The manager was aware and was negotiating an increase of staff per shift with the provider, but users of the service and staff wanted to see a faster solution to the shortage identified. 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. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 8 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 Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Users of the service and their relatives could choose the home based on information provided prior to admission and on properly conducted initial assessments as an indicator that the assessed needs would be met. EVIDENCE: The manager stated that the statement of purpose and user’s guide were reviewed and updated where necessary. In their self assessment, AQAA, the home reported that contracts were issued to either users of the service or their relatives. Questionnaires returned indicated that relatives and some users were aware of the contracts and that all necessary information was included in contracts. Two returned questionnaires confirmed a detailed initial assessment was carried out prior to admission. Four randomly chosen users’ files contained a Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 10 comprehensive assessment of the assessed needs and contained a risk assessment drawn up at the same time. A service user commented in her questionnaire: “This home is excellent. The food is first class. The carers are first class.” During the site visit 6 users of the service were spoken to and confirmed the earlier information that their needs were met. However, 3 users stated that the home did need more staff, as the needs of some users had increased due to their general deterioration and staff needed to spend more time helping them. This resulted in less time to talk to users with low or medium needs. The same comment was provided form a relative in the questionnaire. Care plans, daily records, observation and comments showed that users’ needs were generally met, although the staffing level could be increased to maintain the quality of service that the home used to offer. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 11 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 good. This judgement has been made using available evidence including a visit to this service. Users of the service were protected by appropriate and well organised health care and prompt involvement of external medical professionals when the need arose. EVIDENCE: Four users’ files were checked. All had updated and regularly reviewed care plans. Risk assessments were also up to date and, throughout the documentation, a deterioration of health of two of these users was obvious. Care plans indicated increased needs through comments such as: “from Feb 08 two carers needed for moving a user” or “now needs hoist for all movements”. This practical arrangement meant that users’ needs were met. Six users were spoken to during the site visit and five of them confirmed that they knew their care plan goals. Care plans were detailed and addressed all aspect of needs, including mobility, choice, respect for self care when possible (as underlined in one file) social, Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 12 psychological, cultural and health care needs. The care plan format contained a section to indicate change in risk assessments. The risk assessment included all areas of risk, including risk of falls, sensitive skin conditions and the ability to make decisions regarding any relevant areas of their lives. Thus, health protection for users of the service was ensured. Medication was stored and recorded securely and appropriately. Five records were checked. Only one comment to transfer the amount of medication carried over from one sheet to another still needed to be dealt with, while the other records were accurate and easily checked. Controlled drugs were kept and recorded accurately. Good medication process enhanced safety for the users of the service. All six users of the service proudly stated how their privacy and dignity were respected. Observation of care staff for 15 minutes during the site visit also demonstrated that dignity was highly respected. The home analysed their provisions to users whose general health deteriorated and concluded that the extra training on palliative care would further improve the standard of service. The manager stated that she was currently exploring options for this training that would improve outcomes for people using the service. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. The home offered a range of activities, but needed to expand on variety that would suit all users, regardless of their conditions. EVIDENCE: Users of the service had an opportunity to choose organised activities. The programme was displayed on a board, allowing individuals to decide if they wanted to take part, or informing them of the events that take place in the home. However, the list of activities did not contain alternative activities, more appropriate for the differing health conditions of the users, for example those with dementia. The majority of the answers in the questionnaires and three comments from users during the site visit, found the activities to be an area that needed improvement, both in terms of quality and quantity. All six users spoken to stated that they could choose a different meal if the meal from the menu was not of their liking. A cook showed a list of users’ preferences held in the kitchen, that helped prepare food according to individual choices, likes and dislikes. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 14 All four care plans checked indicated users’ religious beliefs and two files indicated regular attendance of church service. All three surveys retuned by relatives showed that they felt welcome and comfortable when they were visiting. Autonomy and choice of users were respected and promoted. A user insisted on keeping some of her medication with her. A risk assessment for that was drawn up and the wish was respected. Several users brought in their personal possessions to make their rooms more homely. The list of the items brought in was made. “Food is excellent”, commented a user in her questionnaire. Four other users stated that food was really good, nice and well presented. During the site visit, the kitchen and cleaning records in the kitchen were checked. All records and a short observation of a lunch time demonstrated that food was well prepared, nicely presented and that majority of users that ate there, were more than happy with food. A staff member was observed helping a user to eat, patiently and with full respect for dignity. Food recorded on a menu showed appropriate nutritional values. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 15 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. Users of the service were protected by a clear complaints procedure and by an open atmosphere that ensured both practical and procedural protection of people who used the service. EVIDENCE: Although one response in questionnaires stated that the person did not know how to complain, 8 others stated that they knew and trusted the home would deal with potential complaints. The manager stated that there was a complaint from a relative of a user, related to the fee level. This complaint was responded to the complainant. There were no referrals to Protection of Vulnerable Adults (POVA) scheme. Six users of the service spoken to stated that they did not have any reason to complain. Oakleigh DS0000015107.V366555.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 home offered a comfortable and nice environment where users of the service were deciding on decoration and furnishing, thus expressing themselves freely. EVIDENCE: Tour of the home demonstrated that the home was clean, free from odours and that infection control measures were in place and respected. Seven returned questionnaires indicated an excellent feeling about the cleanliness of the home. Four out of six users of the service spoken to during the site visit talked very complimentarily about the environment, cleanliness and comfort in the home. “Toilets are always very clean, that is so important”, stated a user who despite her conditions was able to relax and express her opinion and feelings about the home. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 17 A staff member commented in a survey: ”Safe and warm environment. Hygiene of the home is of a good standard.” This high standard and users’ satisfaction were explained in the self assessment, AQAA: “Involvement of residents in decorating and furnishing their own space. Have a good maintenance programme. High standard of hygiene and infection control.” A user of the service concluded after describing her views on the provisions: “I would not move from here, no way.” Oakleigh DS0000015107.V366555.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. Increased needs of users of the service determined the need for an increase of staffing at least during the peak period, in order to fully meet the needs of people that use the service. EVIDENCE: Most comments received from users of the service praised staff for their efforts and kindness. A relative commented: “Staff are generally considerate and caring, but at times the low staff to resident ratio causes distress to those residents with medium needs level, who have to wait while more pressing matters are dealt with.” A user of the service stated: “They are always so busy, no time for small talk. I feel they need more staff.” Four of six users spoken to provided similar comments and felt that, with increased needs of some other people in the home, the staff do not have time to stop and talk to users “as they had used to”. The manager stated that she had started negotiating the staffing level with the provider with the intention of increasing staff number per particular shift, or at peak times. Observation during the site visit demonstrated how the staff responded immediately to the call bell. The number of calls was relatively high during the Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 19 site visit and, although the staff response was immediate, people with low needs were sometimes left when staff responded to these individual calls. The home started using agency staff in the period prior to the site visit that indicated again that the need for staff’s immediate response to the needs of users was higher and that more staff were needed. The home promoted staff training and motivated staff to work on personal development. The manager stated that more than 50 of staff were NVQ qualified. The management team also continued with self development: the manager restarted her NVQ level 4 and her deputy also started this programme. Recruitment of staff was conducted according to set, robust procedures that ensured protection of users of the service. All new staff were properly checked before they started working with users of the service. The staff training programme was improved since the last inspection. Staff’s motivation and enthusiasm helped create a stable training programme. A user of the service answered: “Yes, staff are well trained and they know what and how to do.” The deputy manager had just become a certified trainer for Moving and Handling, thus providing the opportunity for all staff to undertake this training regularly. A new staff member confirmed that she received all induction training in the first month and a half since she had started working in the home. Oakleigh DS0000015107.V366555.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): 31,33,35,36,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were protected by well organised and managed processes of care that were backed up by safe working practices, policies and a good recording system. EVIDENCE: Since the last inspection, the manager continued with self development and training in her role and both she and her deputy started the NVQ 4 training programme. The manager’s style, attitude and goals of providing quality of care in a safe and pleasant environment helped users of the service develop trust and feel respected. Two users talked very complimentarily about the Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 21 manager and emphasised how important her style being followed by staff in the home was. A staff member expressed her wish to further improve communication between the management and the staff team. The manager explained that quality assurance review of the service was conducted continuously, but the questionnaires were distributed to users of the service, their relatives and external professionals that were involved in the care process in the home in the previous month and that analysis would follow upon retuned questionnaires. Families were encouraged to help users of the service with their finances, thus ensuring that users’ interests were represented both for themselves and their relatives. This principle also ensured better protection of users. Staff confirmed that they received regular supervision and felt supported by the management. Having a trained deputy who could provide regular training and updates on moving and handling also meant that safety while handling people that needed physical help for their mobility was respected and better protection of users was promoted. Fire safety records were up to date. Records of food hygiene kept in the kitchen and also cleaning records showed that infection prevention measures were in place. All accidents/incidents were analysed and used to reduce reoccurrence and ensure better protection of users of the service. Oakleigh DS0000015107.V366555.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 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 23 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 OP12 Regulation 16.2 (n) Requirement The activities organised by the home must be expanded to include activities appropriate for users abilities and conditions and include some activities appropriate for people with dementia. The staff number per shift must be increased to ensure that users’ needs are met at all times, including peak times and weekends. Timescale for action 30/08/08 2 OP27 18.1 (a) 30/08/08 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 OP9 Good Practice Recommendations Medication recording system should be improved by recording the amount of medication when it is transferred from one monthly sheet to another. This would reduce potential errors and improve protection of users of the service. Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 24 Oakleigh DS0000015107.V366555.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge CB21 5XE 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 Oakleigh DS0000015107.V366555.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!