Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 21/04/05 for Partnership In Care, Sherrington House

Also see our care home review for Partnership In Care, Sherrington House for more information

This inspection was carried out on 21st April 2005.

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

Staff worked well with residents and made visitors feel "welcomed". Relatives said staff kept them up to date with resident`s health and welfare. Relationships between the staff and residents were good. Residents said that they received a good level of care from friendly staff. They "were not told what to do" and could make their own decisions. Staff are committed to providing good care. This was confirmed by residents who said the care was "good" and staff "are perfect". Staff put a lot of effort using pictures, soft furnishings and ornaments, to make the units more "homely".

What has improved since the last inspection?

New bedding, pillows, and towels have been purchased to replace items, which were seen to be worn or unusable during the last inspection. Work has commenced on redecorating bedrooms, with further work planned in the next few months. New kitchen units have been purchased, which were waiting to be fitted. The home has managed to recruit staff to fill their vacancies, which will give more care and domestic cover. The home is ensuring that they have obtained all recruitment paperwork before starting new staff. Training records are being looked at, and staff training updated to ensure staff have the knowledge and skills to care for residents.

What the care home could do better:

The home must continue decorating and replacing worn furniture, to make all areas of the home look bright and welcoming. Staff and management need to speak to each other and work out why some staff felt no one is listening to them. Two residents commented that they did not always know when the manager was in the building. Relatives commented on the noise from the call bell, which was loud at times. The manager explained that the call bell was also set off, when the front door bell was rung. Staff need to look how they can reduce the noise level in the home, without putting residents at risk. Staff must use the information collected before a resident leaves hospital, to make a clear plan on how the home will look after them.

CARE HOMES FOR OLDER PEOPLE Sherrington House 71 Sherrington Road Ipswich Suffolk IP1 4HT Lead Inspector Jill Clarke Unannounced 21/04/05 at 10:15hrs 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 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. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sherrington House Address 71 Sherrington Road, Ipswich, Suffolk, IP1 4HT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01473 464106 01473 464107 None The Partnership in Care Limited Application in process CRH 40 Category(ies) of 30 places for Older People aged over 65 [OP] registration, with number 10 places for Older People with Dementia [DE,E] of places Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection Brief Description of the Service: Sherrington House, set in a residential area close to Ipswich town centre and local amenities cares for 40 older people. The home is divided into 4 areas called units. There is a lift to the first floor. Sunset and Park view units provide care for 22 frail older people. Horizon unit offers short term care for 8 residents. Dalesview unit provides care for 10 older people with dementia. Each unit has their own lounge, dining room, communal bathroom and toilets. All bedrooms are single, and have a wash hand basin, 2 also have ensuite toilets. The large garden has seating areas, and there is car parking to the front and rear of the home. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out on a weekday from 10.15am to 6pm. Time was spent with 6 of the residents, and 2 visitors, to listen to their views on the quality of service provided. The Manager, Deputy Manager, and 2 Carers also gave information on what was happening in the home. A tour of the building took in all the lounges and dining areas, 2 toilets, 1 bathroom, 4 bedrooms and staff room. Staff recruitment, training records and residents care records (care plans) were looked at during the inspection. The manager said that people living in the home do not like being referred to as service users, but preferred to be known as residents. This reports reflects their wishes. What the service does well: What has improved since the last inspection? New bedding, pillows, and towels have been purchased to replace items, which were seen to be worn or unusable during the last inspection. Work has commenced on redecorating bedrooms, with further work planned in the next few months. New kitchen units have been purchased, which were waiting to be fitted. The home has managed to recruit staff to fill their vacancies, which will give more care and domestic cover. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 6 The home is ensuring that they have obtained all recruitment paperwork before starting new staff. Training records are being looked at, and staff training updated to ensure staff have the knowledge and skills to care for residents. 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. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4 and 5 . The level of information supplied by the home is more informative to permanent residents, than people using the ‘transitional’ care service. The Home’s admission procedure ensures that resident’s needs are properly assessed, to ensure staff can give the level of care required. EVIDENCE: One resident said that they knew the home and “had asked to come here”. A relative said they had “sent off for the CSCI report” to give them further information. The home referred to the short stay unit as offering ‘transitional’ care. Discussions with the Manager confirmed that they also at times, provided care for residents waiting to go home. The ‘Resident’s handbook’ gave a good level of information on the home for permanent residents. For residents waiting to go home or on to sheltered housing, there was no information on the extra support given, to keep them mobile and independent. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 9 There was no record of Physiotherapist or Occupational Therapists linked, with the home as part of an on-going support for residents discharged from hospital. Completed pre-admission assessments signed by the manager were held on file. One resident said the care was “very good”, although they thought that someone was going to “teach them” to use the stairs. Five residents spoken to, felt that they were well cared for, one resident described staff as being “perfect”. Another resident said they would like to see more “going on in the home”. All residents and relatives spoken to commented on the “caring” “happy” staff. One resident said that they “trusted them completely, anything I want, they do”. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 8. Staff are not always provided with clear information on how residents using the short-term care unit, health and social care needs will be met. These shortfalls have a potential to place residents at risk. EVIDENCE: Two residents, staying on the short term care unit, records were looked at. The first gave a good level of information; to ensure all aspects of health, personal and social care needs were identified and planned for. Staff had written daily comments on the resident’s welfare. Time spent with the resident looking at their plan of care, confirmed that the information given, reflected their wishes. Although they did not remember being shown the care plan before. The second care plan did not contain the same level of information. There was no clear guidance on how staff would support the resident. Staff said that they had read the pre-assessment and hospital letter. Information given from the hospital had caused some confusion to staff over the resident’s physical health. Staff had asked the Community Nurse to advice them, and were waiting to hear from them. Comments written in the daily report said that the resident had “refused personal care”. A member of staff was asked how they were dealing with the Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 11 situation? They explained, that the resident had refused help from staff, as they did not want/require help. The member of staff realised that the wording used in the records, could have been written clearer. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14 and 15 Staff treat residents with respect, and support them to maintain as much, or as little control over their life as they wish. The activities programme suits some, but not all the residents’ leisure needs. Residents are provided with a balanced and varied diet. EVIDENCE: When asked about the different activities going on in the home, one resident said they were a “bit short at the moment”. Bingo is undertaken regularly, and residents were watching videos, in the smoking room. One resident enjoyed playing cards, but could not always find other residents who wished to play. Another resident, whose family visited regularly, felt they had enough to occupy their time. Staff felt they did not always have time to undertake activities with the residents. A member of staff had just been employed, to organise group and one to one activities. They would be starting work in the next two weeks, once their recruitment checks had been completed. The ‘leisure preferences’ for two residents, whose care records were looked at, had not been completed. Residents walked freely around the home. Some took advantage of the hot weather and were sitting out in the main garden. The smoking room Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 13 overlooked a small unkempt courtyard, which residents said, “looked terrible”, and could not be used. One resident said they liked going out visiting the local shops. The flexible routine of the home was confirmed during discussions with residents, who felt they were able to do what “they wanted”. This included going to bed, getting up and going out. A resident was asked for the key to their room so it could be cleaned. Relatives felt “comfortable” when visiting; their only concern was that the sound of the call bell, which seemed loud at times. They felt that the manager was very “helpful” and staff made them feel welcome and kept them up to date on the welfare of their relative. Two residents were sitting in one dining room having a drink. The breakfast menu was displayed on each table, which gave the daily choices of cereal, Toast, cooked breakfast (by order), poached, scrambled or boiled eggs, porridge, fruit or yogurt. The day’s menu was displayed on a board which included, Pork Slices, ‘Daily Special’ or Cauliflower Cheese served with fresh vegetables. Lighter options of Jacket Potatoes with a choice of fillings, Salads and Omelettes were also available. Staff confirmed that although residents are asked their choice the day before, they could always change their mind on the day. One resident said the meals had “gone down since the new owners”, they felt that sometimes “cheaper food” was used for tea. Example given included Fish Fingers and Fish Cakes, rather then Kippers. The other five residents spoken to said the food was “quite nice”, “good” and that they “liked the food”. All residents spoken to agree that there was always a “choice”. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has procedures in place to deal with complaints. EVIDENCE: The home’s complaint procedure is displayed on notice boards within the home, and in the home’s ‘Statement of Purpose’. Residents and relatives felt comfortable to raise any concerns with the Manager or staff. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22 and 23. Many areas of the home show signs of wear and tear, which does not promote a comfortable, bright, airy environment for people to live in. Bedrooms were personalised and met the needs of the people living in them. EVIDENCE: Since the last inspection the home has put together a redecoration and refurbishment programme, which is due to start in May 2005. A person is being brought in to support the handyperson, to address areas of the home that require attention. Planned work to be undertaken includes redecorating nine bedrooms, communal areas repainted. New carpets, kitchen units, and bedside cabinets have been ordered. Wall hangings and ornaments had been used to add colour and interest to make the décor look less worn. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 16 Relatives said they had just informed the Handyperson of a problem keeping a window open, to allow “a little fresh air”. Temporary action had been taken, until advice could be sought. A resident wanted to show their bedroom, which they had personalised with photographs of their family. Three other bedrooms seen were also personalised, which included small items of furniture. One resident said although they felt their room was small; they had “everything” that they needed. Hot water temperatures were being checked by care staff and written down, before a resident got into the bath. Water temperatures were recorded at times to be on the cooler side at 32°C. The hot water was run and found to be warmer at 38°C. A resident confirmed that staff ran a bath for them, but made no mention of the water being too cool. The Manager said that individual temperate controls would be fitted in June 2005 to all hot water outlets, to control the temperature. Staff confirmed that the home had enough manual handling equipment to safely assist residents with transfers. Cupboards, contained handling belts and slide sheets (to assist residents moving up and down the bed), were found on each unit. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 The home has safe recruitment procedures in place to ensure the safety of people living there. Some staff felt better trained and supported than others to undertake their work. This could potentially place residents at risk. EVIDENCE: Following the last inspection (22/2/05) staff were left comment cards, which they could return to the CSCI. Three staff had sent back their views on the management and support given. Two of the three staff said they had not received enough training. One member of staff had written that most carers ‘did not have up to date manual handling training’. Staff felt they were asked to take on more responsibility, without having the training and support from management. Training records seen at the last inspection (22/2/05), showed new staff had received training in moving residents safely. The Manager said when they started work at the home a year ago, they had found no up to date information on staff training. All staff was being asked what training they had been on. During this inspection, posters displayed, gave information on manual handling training arranged for May 2005. A member of staff confirmed that they were going on the training to update their knowledge. Other training, which had been arranged, was on spotting abuse, and providing care around each resident’s choices and wishes (Person Centred Care). Staff felt they had Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 18 received enough training and information on looking after people with infections (MRSA) and use of bags to collect bodily fluids (Stoma). The Manager said that they had contacted a Nurse to arrange the training. Residents and staff spoken to, felt that staff had the training to look after them. A file for a new member of staff was looked at. It held information to confirm that the checks had been made on their character, and to confirm their identity, before they started work. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 33 The management and staff are not always communicating well. Communication links between staff and management must be improved, before it affects the people living in the home. EVIDENCE: Staff had written to the CSCI, saying they ‘were not happy’ and ‘morale was at a all time low’. The manager has ‘no idea at all, and ‘no respect or regard for residents and staff’ and ‘did not know some of them’. One resident was seen to go up to the Manager to ask for support, which was given. Relatives said that the manager had been very helpful, and “seen them many times”. A resident confirmed the manager had come to see them before moving into the home. Three residents spoken to knew who the manager was, saying they “liked the manager”. One resident understood they were busy, but would like to “see more of them”. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 20 A resident due to their dementia was unable to say who the manager was, but smiled when the manager approached. Staff felt at busy times they did not get the support. Staff said the last manager was seen more on the units, and worked alongside staff. If staff had a problem now they were expected to “deal with it”. Staff confirmed that they had received ‘hands on’ support from the Deputy Manager. They were aware of some of the work, which had been undertaken by the new manager. This included training and recruiting staff, visiting new residents, and improving the amount of information held on staff and care records. In the staff room, a ‘flip’ chart was used to write messages for staff. There were information sheets on training, infection control and staff issues. When staff were asked how they thought the situation could be made better, they felt the Manager should hold “more meetings”. Notes from a staff meeting held on 1/3/05, showed half of the domestic staff and only seven of the twenty-six care staff, had turned up. Staff confirmed that they had supervision from a senior member of staff, but felt this was not the same as having supervision from the manager. Another member of staff was asked what they meant by “lack of support”. They thought this was linked, to what they felt was low staffing levels. Staff confirmed that the manager had not changed the staffing levels. Discussions with staff identified that they were not aware of the role of the manager and how it had changed. The Manager said part of the role of Deputy Manager was to give hands on care when needed, and to monitor how staff worked. Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 x 3 3 x x x STAFFING Standard No Score 27 x 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 2 3 x x x x x Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 22 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 1 Regulation 4, Schedule 1 (3) (6) Requirement The statement of purpose and residents handbook requires more information for people waiting to go home or sheltered housing. The information should include: 1. How other services and equipment will be accessed to support residents to maintain their independence. 2. Information on training staff has undertaken to support selfcare. Residents care plans must be in sufficient detail to provide clear guidance for staff on the actions to be taken to meet their health and welfare needs. The courtyard must be tidied up, and made safe for residents to use. Staff must receive sufficient training to ensure they have the knowledge and skills to perform their work. Staff and management need to work together to address the communication problems. Timescale for action 01/08/05 2. 7 15 01/08/05 3. 4. 20 30 13, 23 18 01/07/05 31/08/05 5. 32 12 31/08/08 Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 23 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 8 12 19 Good Practice Recommendations Ensure staff write clear information, which reflects the situation, and is more informative to the person reading the care plan. The new activities co-ordinator should ask all residents what activities and outings they would like to take part in, and used to produce the home’s social programme. To keep residents, relatives and staff informed on the planned an ongoing refurbishment programme. Staff should display a weekly update, stating what work is being done and items replaced. The call bell system should be looked at, to see if the sound level can be reduced, without causing a risk to people living in the home. The home should use an outside trainer to conduct a team day. Members from each staff group should attend and work with the management group to identify and resolve problems. 4. 5. 22 32 Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection CSCI 5th Floor St Vincent House Ipswich Suffolk, IP1 1UQ 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 Sherrington House I54-I04 S29250 Sherrington House V223299 050421 Stage 4.doc Version 1.30 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. 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!