Inspection on 13/09/06 for Orchard Court Residential Home

This inspection was carried out on 13th September 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Orchard Court Residential Home 18/10/05

Orchard Court Residential Home 14/06/05

Orchard Court Residential Home 17/02/05

Orchard Court Residential Home 18/08/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Orchard Court Residential Home 3a Orchard Gardens Thurmaston Leicestershire LE4 8NS Lead Inspector Kim Cowley Unannounced Inspection 13th September 2006 11:00 Orchard Court Residential Home DS0000048204.V311236.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 Orchard Court Residential Home DS0000048204.V311236.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. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Court Residential Home Address 3a Orchard Gardens Thurmaston Leicestershire LE4 8NS 0116 2640086 0116 2697926 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) Active Care Partnerships Ltd Vacant Care Home 20 Category(ies) of Learning disability (20), Physical disability (20) registration, with number of places Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The home can receive residents within the registration categories LD (Learning Disabilities) and PD (Physical Disabilities) The number of persons who can receive residential accommodation at any one time shall not exceed 20. The home can admit persons of either gender. No person may be admitted to the home who falls within category PD unless that person also falls within category LD I.e. duel disability. To be able to admit the person, falling in the category SI, named in variation application number 56695 received on 6 October 2003. 18.10.05 Date of last inspection Brief Description of the Service: Orchard Court is a residential care home that provides care for up to 20 residents with learning disabilities and associated needs, including physical disabilities and challenging behaviour. The home is situated in a purpose-built bungalow. This is divided into three individual units (Cedar, Willow and Rowan), each providing different levels of support depending on residents needs. The home is in a residential cul-de-sac in the village of Thurmaston. It has extensive grounds that are secure and secluded. Fees range from £1,269 to £1,328 per month. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home and inspection planning. Prior to the home visit, the inspector spent half a day reviewing the last inspection report, and information relating to the home received since that inspection. During the course of the inspection, which lasted five hours, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that the inspector looked at the care provided to three residents living at the home by talking with the residents themselves; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were inspected. The inspector also spent time with three other residents, and interviewed the Deputy Manager, two support workers, and one of the Activities Organisers. The activities programme and the staff team were commended. Three Recommendations were made. What the service does well: Orchard Court provides good quality care in a homely and stimulating environment. On the day of inspection the home had a busy, lively atmosphere. Residents were taking part in various daytime activities both in and out of the home. One resident said he had ‘plenty to do’ at the home, and another commented, ‘I like the different day care activities we have.’ The staff team were friendly, helpful, and enthusiastic about the work they do. Those interviewed said they were committed to enabling residents to live more independent lives. One member of staff said, ‘I’m here for the people who live at Orchard Court. As I see it, I come into their home and support them. I also speak up for those residents who can’t speak up for themselves. One resident said, ‘I like the staff. They always talk to me.’ Staff were observed interacting with residents in warm and positive manner. The premises were comfortable and homely. All areas inspected were well decorated. The home was purpose-built and is accessible throughout to residents with limited mobility. A range of aids and adaptations were available to assist residents in their day-to-day lives. Bedrooms were personalised and individual to each resident. Staff have put a lot of thought into making each one suitable and pleasant for the occupant. Orchard Court Residential Home DS0000048204.V311236.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. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 7 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 Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. 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 the service. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. EVIDENCE: Prospective residents are fully assessed by social services and staff at the home prior to admission. Following this, they have a three-month trial period. In this time their needs are re-assessed and their risk assessments re-visited and amended to reflect any changes in their lifestyles. Towards the end of the three-month period a staff meeting is held to consider how well the resident’s needs are being met. Further meetings are held to discuss progress until the resident is settled in the home. Involving residents in the assessment process was discussed. The Deputy Manager said, ‘The best way to dot his is to invite them to the home for tea or to take part in an activity. We can talk to them about the home and show them pictures of it, but they need to actually see it before we can get any proper indication of whether they would like to live here or not.’ Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents care needs are met. EVIDENCE: Care plans are based on residents’ social work or care management assessments. They are compiled in consultation with residents, where appropriate, and with any professionals/family/friends involved in their care. The majority of care plans inspected contained up to date information and had been regularly reviewed, which staff see as the key to their effectiveness. The Deputy Manager said, ‘I have been here for 13 years and the residents never cease to surprise me. They often have hidden abilities that suddenly come out. Care plans reflect that because nobody stays the same and the continual re-writing of care plans ensures that staff kept up with the residents.’ A new format for care plans based on Person Centred Planning has been introduced. All staff are receiving training in this area. Staff said they hoped the new care plans will enable them to further involve residents in their care. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 10 One member of staff said, ‘We’ve just started doing PCP here. This will be really good for the residents. There’ll be more focus on them as individuals.’ However, although most care plans were up date, two residents’ plans contained no evidence of any evaluation or review (either internally, or by social services). This should be addressed as staff said these residents’ needs had changed, and they were progressing towards independent living. However there was no reference to this in their records. Reviews should be carried out promptly in consultation with staff members, care professionals, and family members/friends (where relevant). It is important that everyone involved in the care of these residents is aware of their progress and future goals. (See Recommendations) Each resident has a key worker. Their responsibilities include getting to know the resident, finding out their likes and dislikes, and encouraging them to develop interests and take part in activities. Key workers also organise holidays, birthdays and other celebrations, shopping, and hairdressing for the resident they key work. The key worker is also the point of contact for relatives wishing to discuss the care of individual residents. Appropriate risk assessments were in place, and there was evidence that relevant professionals had been involved when serious risks were being considered. Records showed that residents are encouraged to take risks in stages so the chance of success is more likely. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are encouraged to lead full and active lives. EVIDENCE: The home’s two full-time activities organisers are responsible for planning on and off-site activities for residents. Care records showed that all residents participate in a wide range of activities including college, day centres, sport, and trips out. Two residents had just returned from a seaside holiday and showed the inspector their photos. One resident said he had ‘plenty to do’ at the home and another commented, ‘I like the different day care activities we have.’ One of the activities organisers said, ‘We want to get people away from the TV. All our residents like going out so there’s a big emphasis on that. Residents are assessed for activities once a month because they change. We try everything. We’re starting swimming again and everybody’s being reassessed. Those who didn’t want to do it last time might want to this time.’ The activities programme was commended. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 12 Since the last inspection one of the home’s three small lounges has been turned into a fully equipped ‘beauty salon’ where residents can have makeovers, manicures and pedicures. One member of staff is training as a beauty therapist so she can work in the salon. One resident told the inspector, I’m going to the beauty room this afternoon to have my nails done.’ Residents are encouraged to maintain family links and to communicate with their families and friends through visits and phone calls. Staff offer extra support to residents who do not have contact with their families. Relatives get a newsletter from the home every few months. This lets them known what activities residents have been involved in, and other news about the home. Improvements should be made to the meals served in the home. Although the food served appeared wholesome, of good quality, and well prepared, there was limited choice for residents. The home employs two part-time cooks, and staff felt they didn’t have enough time to prepare the variety of food the residents would like. Residents’ comments included: ‘The food’s boring.’ ‘It would be nice to try some different food sometimes, like mushroom stroganoff.’ ‘I’d like to have a choice (at mealtimes)’ ‘The tea is worse than lunch. We get dried up sandwiches.’ The staff on duty agreed that residents should have more variety and choice, and the opportunity to sample food from different countries. Menu records were inspected. There was usually only one choice of dish at each meal, with an occasional vegetarian option (staff said none of the residents are vegetarian, but one resident preferred vegetarian dishes if given the choice). It is recommended that menus are reviewed and consultation carried out with residents and staff to see what can be done to improve residents’ enjoyment of their meals. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health and personal care needs of residents are met. EVIDENCE: Residents’ personal care needs are initially assessed prior to their admission. Once in the home they are subject to continual review. Residents’ preferences about their personal care are actively sought. Records showed that where possible residents use local community health care services. If specialist care is needed this is catered for at a centres where staff are experienced in working with residents with learning disabilities. Residents have regular ‘MOTs’ at a local ‘Well-Person’ clinic. District Nurses give advice and training staff in basic nursing techniques, for example administering insulin. Other services provided include physiotherapy, speech and language therapy, aromatherapy, and hydrotherapy. No residents presently self-medicate. Staff are trained medication administration by a senior member of staff who is a qualified nurse. The home’s contract pharmacist provides further training where necessary. Staff work with consultants towards helping residents to reduce their medication. If Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 14 medication has been used previously to control behaviour, staff try and use alternative methods so that medication can be stopped. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents feel able to talk to staff about any concerns they might have. EVIDENCE: The home has a written complaints procedure, which meets minimum standards. This was displayed in the entrance to the home. Relatives have been reminded of the home’s complaints procedure through newsletters and other correspondence sent out by staff. A copy of the last inspection report has been sent out to them. Key workers build up relationships of trust with residents and encourage them to express any anxieties they might have. The Deputy Manager said, ‘Some of the residents are quite outspoken, there will let you know verbally or in other ways if something’s wrong. Others are quieter and more vulnerable so we rely on their key workers to advocate for them.’ One resident commented, ‘If someone was mean to me I’d tell the staff. If the staff were mean to me I’d tell Mandy (the Acting Manager).’ Policies and procedures are in place to protect residents from abuse, and the staff on duty were familiar with these. All staff have adult protection training during their induction, and further training as necessary. Since the last inspection all staff have been given written guidance on safeguarding vulnerable adults. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in an environment that is comfortable and well maintained. EVIDENCE: The premises were comfortable and homely. All areas inspected were well decorated. The home was purpose-built and is accessible throughout to residents with limited mobility. A range of aids and adaptations were available to assist residents in their day-to-day lives. Bedrooms are personalised and individual to each resident. Staff have put a lot of thought into making each one suitable and pleasant for the occupant. Records showed that the premises are properly maintained with all servicing and checks up to date. This was an unannounced inspection and the home was clean and tidy throughout. The home employs one part-time (30 hours per week) housekeeper who works to a schedule designed by the Acting Manager. All care staff carry out light housework in conjunction with residents, where possible. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 17 Since the last inspection one of the small lounges has been turned into a beauty salon and some bedrooms have been redecorated. One resident said, ‘I chose the colours for my bedroom.’ The home is non-smoking. Residents who smoke do so in the gardens. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Friendly and professional staff meets residents’ needs. EVIDENCE: The care staff team consists of the Acting Manager, Deputy Manager, senior support workers, support workers, and two activities organisers. The Deputy Manager and two of the senior support workers are registered learning disability nurses. Records showed that staff turnover is low. The home has its own bank staff and does not use agency staff. Staffing hours exceed the recommended minimum which means staff have time to facilitate residents’ activities as well as carrying out care tasks. The staff team were friendly, helpful, and enthusiastic about the work they do. Those interviewed said they were committed to enabling residents to live more independent lives. One member of staff said, ‘I’m here for the people who live at Orchard Court. As I see it, I come into their home and support them. I also speak up for those residents who can’t speak up for themselves. One resident said, ‘I like the staff. They always talk to me.’ Staff were observed interacting with residents in warm and positive manner. Residents who were unable to give their views verbally appeared to have excellent relationships with the staff on duty. The staff team were commended. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 19 All staff have two written references and up to date CRB/POVA checks. This helps to ensure that residents are safeguarded. Residents have the opportunity to meet potential staff members as part of the interview process. Staff receive a weeklong induction followed by a three-month probationary period to ensure they are suitable for the home. All unqualified staff are encouraged to study for NVQs. Ongoing training (at the moment focussing on Person Centred Planning) is provided externally, and by the Owning Body. Every member of staff has an annual appraisal and a supervision session every two months. Overall staff receive appropriate training and support and this helps them to provide good quality care to residents. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a home that is safe and well managed. EVIDENCE: The home still does not have a Registered Manager. A suitable person should be put forward for registration. The Deputy Manager was in charge on the day of inspection. She has worked at the home for 13 years and is a qualified learning disability nurse. She was knowledgeable about the running of the home and appeared to have good relationships with residents and staff. Regulation 26 reports indicate that the home is well supported by the Owning Body. Regular audits are carried out to ensure staff are following the correct policies and procedures, and all records are accurate and complete. Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 21 Discussions with the Deputy Manager and staff, maintenance records, risk assessments, and Regulation 26 reports, showed that health and safety is a priority in the home. A full-time handyman is employed to maintain the premises. Orchard Court Residential Home DS0000048204.V311236.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 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 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Orchard Court Residential Home DS0000048204.V311236.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations The two care pans identified at the inspection as in need of improvement should be reviewed so as to reflect residents’ assessed and changing needs. 2 YA17 Menus should be reviewed and consultation carried out with residents and staff to see what can be done to improve residents’ enjoyment of their meals. A suitable person should be forward for registration as manager. 3 YA37 Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 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 Orchard Court Residential Home DS0000048204.V311236.R01.S.doc Version 5.2 Page 25 - 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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