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Inspection on 12/06/07 for Ocean Hill Lodge

Also see our care home review for Ocean Hill Lodge for more information

This inspection was carried out on 12th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

During the course of the inspection considerable care and kindness was noted from the staff to the service users in the delivery of care. On the day of the inspection the weather was very hot and a number of service users chose to sit outside. Staff always ensured that shade from the sun was provided, sun cream applied and regular drinks were given. Staff spoke at all times with respect and consideration to each service user. The registered provider employs the staff on a contract basis with hours that suits them, consequently there are a number of different shift hours being worked. The staff appreciate this and the registered provider stated that it helped retain the staff. This in turn is appreciated by the service users who all spoke enthusiastically about the "wonderful staff at Ocean Hill Lodge".

What has improved since the last inspection?

A review of progress with requirements and recommendations in the last inspection report shows that slow progress is being made. The registered provider is very "hands on" in the delivery of care at her home and consequently she struggles with time to ensure paper work is fully in place. This report does though acknowledge that improvements are being made in particular to care planning and staff training.

What the care home could do better:

Requirements are brought forward from the inspection report of the 13th September 2006 to this report. The registered provider manages the home on a day to day basis. She is involved in the maintenance of care procedures and also an administrative role. There is evidence that records are not maintained as required by legislation and a review of the management role, time, management skills and resources available is necessary to ensure compliance with requirements.

CARE HOMES FOR OLDER PEOPLE Ocean Hill Lodge 4/6 Trelawney Road Newquay Cornwall TR7 2DW Lead Inspector Elaine Bruce Key Unannounced Inspection 09:15 12th June 2007 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 Ocean Hill Lodge DS0000063399.V340339.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. Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ocean Hill Lodge Address 4/6 Trelawney Road Newquay Cornwall TR7 2DW 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) 01637 874595 01637 874595 oceanhilllodge@hotmail.co.uk Mrs Sandra Dunn John Howard Dunn Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (18), Old age, not falling within any other category (18) Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit one named service user under the age of 65yrs with dementia 13th September 2006 Date of last inspection Brief Description of the Service: Ocean Hill Lodge is a care home registered to offer personal care and accommodation to a maximum of eighteen service users over the age of sixtyfive, who may also have a mental disorder. The home is situated in the seaside town of Newquay, within walking distance of the shopping centre and Trenance gardens. The boating lake is near and service users are assisted to enjoy the walks and coffee shop. For service users who are unable to get to town, services such as hairdressing and chiropody are arranged at the home. On the ground floor there is a smoking lounge, lounge/dining room and patio garden area. There is a chair lift to the first floor. All rooms are singles, with the exception of two rooms, which have been combined for a couple. There is limited parking to the rear of the home and on street parking to the front of the premises. The Service Users are encouraged to take their meals in the dining room, although this is flexible depending on their wishes. Family and friends are welcomed to the home. Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key unannounced inspection at Ocean Hill Lodge took place over the hours of 0915 to 1640. During the course of the inspection the registered provider was on duty, and although very busy was able and happy to assist in the inspection process. During the course of the inspection service users were met and spoken to, case tracking took place for six service users and one visitor was spoken to. During the course of the day staff on duty were also spoken to. The premises were inspected and records were also inspected relating to the welfare of the service users. The home is able to offer short term stays (when there is a bed available) as well as longer term care. On the day of the inspection a potential service user was spending the day at the home with a view to an admission. The weekly cost of the care is from £300.58 to £349.01 depending on care needs. What the service does well: During the course of the inspection considerable care and kindness was noted from the staff to the service users in the delivery of care. On the day of the inspection the weather was very hot and a number of service users chose to sit outside. Staff always ensured that shade from the sun was provided, sun cream applied and regular drinks were given. Staff spoke at all times with respect and consideration to each service user. The registered provider employs the staff on a contract basis with hours that suits them, consequently there are a number of different shift hours being worked. The staff appreciate this and the registered provider stated that it helped retain the staff. This in turn is appreciated by the service users who all spoke enthusiastically about the “wonderful staff at Ocean Hill Lodge”. Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 6 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. Ocean Hill Lodge DS0000063399.V340339.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 Ocean Hill Lodge DS0000063399.V340339.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 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service user guide document provides information on the services at Ocean Hill Lodge and the terms and conditions of admission and care delivery. Service users have their needs assessed before moving into the home and receive information needed to chose a home that will meet their needs. EVIDENCE: The registered provider has completed a statement of purpose and service user guide regarding the facilities and services available at the home. This information is fully up to date and has been provided to all service users and their advocates to assist in the admission process. Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 9 The service user guide is full of important information that is presented well to include information on the assessment process prior to admission. On the day of the inspection a potential service user was spending a day at the home which is part of the assessment process. Detailed information on his care needs was collected by the registered provider from his next of kin. This is the procedure for all admissions to the home. During the case tracking process evidence is in place of pre admission assessments that include liaison with social and health care professionals. This assessment detail is required to ensure that the needs of all service users can be met at the home and forms the basis for a plan of care. The range of fees for the weekly cost of care is related to the dependency levels of care given. Ocean Hill Lodge DS0000063399.V340339.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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the health and personal care needs of the service users and improvements to care plans are slowly being made. Medication procedures in regard to the management of controlled drugs must be improved to ensure the safety and well being of the service users at all times. Staff respect the individuality of the service users and provide support in a very caring manner. EVIDENCE: At this time compliance for the statutory requirement to improve the recording system for plans of care is not fully met. The registered provider is in the process of re-doing all the care plans in the home. This is a very large task Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 11 and progress is slowly being made. The time-scale for compliance has been extended in this inspection report and a serious note should be made of this date. In addition once the care plan has been updated regular reviews must then be evidenced as having taken place. In addition to the care plans daily records are completed by the care staff. These records clearly evidence that the staff are fully aware of the care needs of the service users at the home and these needs are being met. Particular credit is given to the staff for the regular amount of bathing that is taking place at the home. The service users are able to make a complete choice as to how many baths they would like in a week and this choice is then met by the care staff. Service users are registered with local surgeries and receive appropriate health care support services as required. This includes for example support from community nurses. Records indicate that the home has good working relationships with health care professionals and that they are working in a preventative way by making referrals very early when there are problems. It is appropriate for the medication policy and procedure to be updated which it has not been since 2004. The local pharmacy provides support and training to the home and the care staff. The pharmacy carried out an inspection of the medication procedures/storage on the 12th January 2007. On the day of the inspection medication administration records for the main medication were found to be completed appropriately. This was not the case for the controlled medication records which must be improved as discussed at the time of the inspection. This is included in this inspection report as a statutory requirement. During the course of the inspection all the service users spoken to expressed very positive comments on the kindness of the staff. A number of them said “nothing is too much trouble for them”. Observations of staff and service user interaction confirmed that the staff at the home are very kind and that they treated each service user as an individual with respect and consideration. Ocean Hill Lodge DS0000063399.V340339.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 and 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 engage in various social activity of their choice and maintain contact with relatives and friends. Service users receive a healthy, varied diet according to their preferred choice. EVIDENCE: Service users were observed to exercise choice to enjoy the privacy of their own rooms or join other service users in communal areas for company or meals. Conversations with service users confirmed that they access community facilities and services with support. Every afternoon the registered providers are involved in an activity and or outing with the service users. On the day of the inspection after lunch a number of service users went out and about around Newquay. The home has it’s own transport to facilitate this. Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 13 During the course of the day relatives/friends visited the home and were observed to be made to feel very welcomed. Visiting is “open” and encouraged. All visitors are asked to sign the visitors’ book for the fire regulations. One visitor was spoken to during the course of the inspection. She expressed very positive comments about the home and was delighted that her mother had settled into Ocean Hill Lodge so well. The home will organise occasional visiting entertainers, group activities and church services at the home. On the day of the inspection a hairdresser was in the home. A chiropodist and mobile library also regularly visit the home. External activities in the specialist vehicle include trips to the coastal areas, garden centres and the local boating lake and café. The home employs an activities co-ordinator but she was on holiday on the day of the inspection. The meals provided in the home are good with special diets and choice catered for. All records of meals provided are in place at the home (as required by legislation) and the cook(s) know the service users well. Each service user expressed very positive comments on the standard of the meals at the home. The inspector joined the service users for the main meal of the day which is eaten at 12.30. The meal was roast lamb, roast potatoes and cabbage and carrots followed by peaches and cream. Anyone not wanting the roast lamb was able to have a salmon salad. In the afternoon a carer spends time with each service user asking them what they would like for tea. On the day of the inspection this was individual sandwiches of choice or poached egg on toast followed by cakes and buns. The home works with the District Council Environmental Health Department on keeping records in place for “Safer food and better business” good practice. Ocean Hill Lodge DS0000063399.V340339.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 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users and their representatives have access to a clear complaints process provided to them in the service user guide. Adult protection training is ongoing to all staff to ensure they have the knowledge and skills to protect the service users in their care from abuse. EVIDENCE: The home has in place a clear and simple complaints policy and procedure that includes the address and telephone number of the CSCI and the timescales for complaint investigation. The home maintains a complaints log that includes the action taken to resolve the complaint. A further record is held on the individual file of the service user. The registered provider and some support staff have attended Adult Protection training run by Cornwall County Council. Further training is booked for all staff to ultimately receive this training. Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 15 It is appropriate for the adult protection policy and procedure to be developed and expanded as at this time it does not include clear procedures for informing agencies with an alert. Ocean Hill Lodge DS0000063399.V340339.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The design, layout and facilities provided at Ocean Lodge, enables service users to live in a safe and comfortable environment. EVIDENCE: Ocean Hill Lodge is positioned in a very accessible position and convenient location to access all the facilities of Newquay. A limited amount of car parking is available in the rear grounds of the home with additional parking on the road. Communal space within the home includes a large combined lounge with dining room and a separate television lounge, which is also the smoking lounge. Bedrooms are available on the ground and first floor of the home. All Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 17 bedrooms are individually furnished and decorated. Access to the first floor of the home is by stair lift if required. The home is generally well maintained, very homely if not slightly cluttered in some of the communal areas. This is due to a lack of storage areas for equipment. The home provides appropriate equipment to support service users (where required) in their day to day living. Safety measures are in place to protect those service uses with a dementia. The home was found to be very clean on the day of the inspection. The laundry is small, with one industrial washing machine and one domestic tumble drier. Ocean Hill Lodge DS0000063399.V340339.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Evidence is in place that staff are recruited correctly, staffing levels are satisfactory and training is on going and planned. The staff were noted to be very capable, kind and caring during the course of the inspection. The staff are appreciated by the service users. EVIDENCE: On arrival at the home there were appropriate staff numbers and skills mix available to provide for service users welfare. The rota showed that four carers are on duty during the morning and this reduces to three for the afternoon and early evening. One waking and sleeping carer are provided for service users that may require attention at night. A cook, domestic and maintenance staff support these arrangements. The staff presented very well during the course of the inspection with appropriate skills and good, positive and kind attitudes during their interactions with service users. Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 19 The home maintains a good communication system at handover meetings where senior carers delegate daily tasks and responsibilities to carers. Evidence is in place that satisfactory recruitment procedures are being followed for the employment of new staff. There is a large amount of training for staff booked and ongoing and planned to take place. The statutory requirement for ensuring that a staff member who has a first aid qualification is on duty at all times has been met. Fire drill training for all staff is up to date as is moving and handling training. There are plans on a rolling programme for more staff to attend adult protection training, dementia and mental capacity act training. It is recommended that staff files evidence fully all training that has been undertaken. Ocean Hill Lodge DS0000063399.V340339.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): 31,33,35,37 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered provider is running a good home. She must though ensure that appropriate records and administration is in place to deliver effective management and meet requirements of legislation. EVIDENCE: The registered provider manages the home on a day to day basis and has recently attended a “skills for care” conference on management training. The registered provider has completed the NVQ level 4 in care and has two units of Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 21 the Registered Managers Award to complete. She anticipates achieving this by the end of August 2007. The records inspected around policies and procedures that are the documentation for all practices in the home are considerably out of date. The majority of policies and procedures have not been reviewed since 2003. This must be addressed as a priority and is included in this inspection report as a statutory requirement. The previous inspection report (13/09/06) commented that the registered provider would benefit from additional support to undertaken and complete the administrative role. This recommendation is included in this inspection report. There has been no quality assurance survey undertaken at the home at this time. All the service users are encouraged to hold their own finances or if this is not possible a family member/representative is asked to have these responsibilities. Consequently, there is no money being held on the premises on behalf of the service users. Health and Safety training is planned for staff and this will take place in two separate training days. There is now as required a staff member on duty at all times with a first aid qualification. It is appropriate for all health and safety policies and procedures to be reviewed. Ocean Hill Lodge DS0000063399.V340339.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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 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 3 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x 1 2 Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 23 YES 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 OP7 Regulation 15 Requirement The registered provider must develop the Service Users plan of care to incorporate health, personal and social care needs to enable it to inform and direct care. A service user plan of care generated from a comprehensive assessment (see Standard 3) must be drawn up with each service user and provides the basis for the care to be delivered. NOT PREVIOUSLY MET AFTER AN EXTENDED TIMESCALE. The registered provider must ensure that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. NOT PREVIOUSLY MET. The registered provider must ensure records required by DS0000063399.V340339.R01.S.doc Timescale for action 31/10/07 2. OP9 13(2) 31/07/07 3. OP37 17 31/10/07 Page 24 Ocean Hill Lodge Version 5.2 regulation for the protection of service users and for the effective and efficient running of the business are maintained, up to date and accurate. NOT PREVIOUSLY MET. 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. Refer to Standard OP18 OP30 OP31 Good Practice Recommendations For all staff to continue to attend external adult protection training. For the adult protection and policy to be developed and expanded. For all training to be evidenced as taking place for the staff. The registered provider should complete the 2 units remaining to achieve The Registered Manager Award or equivalent within a short time scale and inform this Commission of the proposed completion date. 4. OP31 The registered provider should consider the use of additional support, a review in the management role, time management skills and resources needed to ensure compliance with the responsibilities of a registered manager. The registered provider should inform this Commission of how the Provider/Manager role can inform this Commission of be a feasible one. 5. OP33 For a quality assurance survey to be carried out involving the service users, relatives and professionals Ocean Hill Lodge DS0000063399.V340339.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Devon Office Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 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 Ocean Hill Lodge DS0000063399.V340339.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. 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