Inspection on 21/12/05 for Resthaven Nursing Home Limited

This inspection was carried out on 21st December 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.

Other inspections for this house

Resthaven Nursing Home Limited 08/05/08

Resthaven Nursing Home Limited 14/05/07

Resthaven Nursing Home Limited 12/06/06

Resthaven Nursing Home Limited 14/07/05

Resthaven Nursing Home Limited 31/01/05

Resthaven Nursing Home Limited 12/08/04

Resthaven Nursing Home Limited 16/03/04

Resthaven Nursing Home Limited 09/12/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Resthaven Home Of Healing Pitchcombe Nr Stroud Glos GL6 6LS Lead Inspector Mrs Janice Patrick Unannounced Inspection 21st December 2005 10:10 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 Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 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. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Resthaven Home Of Healing Address Pitchcombe Nr Stroud Glos GL6 6LS 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) 01452 812682 Resthaven Home of Healing Limited Mrs Jayne Elizabeth Claire Roberts Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 2005 Brief Description of the Service: Resthaven is situated in quiet countryside over looking the surrounding valley and the woods behind. Some residents have particularly chosen this Home for the surrounding countryside and its wildlife. The Home completed a major new build and part refurbishment in 2004/2005 and now benefits from new bedrooms and facilities. The older part of the Home is yet to be refurbished, although a lot of decorating and re-carpeting has taken place. Resident accommodation comprises of single bedrooms that all meet the National Minimum Standards of which many enjoy superb views. There is also ample communal space. The Home has its own chapel attached to the Home, which is used regularly for prayer and worship. At the front and side of the building there is ample car parking and access to the Home for wheelchair users is at the front and side of the building. The Home has a qualified nurse on duty at all times and provides access to other health care services. Specialised equipment is available if required. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one Inspector between the hours of 10:00am and 5pm. The Commission for Social Care Inspection (CSCI) made several requirements during the last inspection in July 2005, these were discussed and the progress made to meet these inspected. A tour of the building was carried out. Several care records were inspected with an emphasis on the care planning and assessment system. Staff files were inspected and the Home’s recruitment practices scrutinised. Staff training records were inspected and staff supervision discussed, as this had recently been a subject of Enforcement Action by the CSCI. The general management and auditing of care and other services was inspected. Staffing numbers and skills were inspected. The medication system was inspected. The general security of the Home was reviewed with the management. This report also contains a summary with outcomes, of a complaint that was investigated by the CSCI in August 2005. These are as follows: 1. Bullying by staff members of a named service user that amounts to psychological abuse. Partially Upheld. 2. Inappropriate care of another named service user that amounts to psychological abuse. Upheld 3. Poor manual handling practices with hoists, subsequent injuries from this. Partially Upheld. 4. Footplates not being used on wheelchairs, subsequent injuries from this. Upheld. 5. Residents in the new wing not being facilitated to eat their meals appropriately. Unresolved. 6. Food not delivered to the new wing hot or in adequate amounts. Unresolved. 7. Lack of supervision of care delivery by carers by qualified staff. Upheld. 8. Over sedation of a named service user. Not Upheld. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 6 9. Lack of care to a deceased named service user. Unresolved. 10. Inadequate staffing within the new wing. Not Upheld. 11. Lack of adequate induction for new staff. Not Upheld. 12. Lack of appropriate staff allocation by senior staff. Not Upheld on the evidence seen. A copy of this Additional Inspection Report in Response to a Complaint can be obtained through the CSCI. What the service does well: What has improved since the last inspection? What they could do better: The social and recreational needs of those that are more confused and who have shorter concentration ability should be improved upon. The Home’s recruitment practice must improve and all the criteria within the Care Home Regulations 2001 met before staff commence in post. This has been inconsistently met over a period of time and must be adhered to in order to avoid further action being taken by the CSCI. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 7 The management must ensure that the Home operates within the registration category stated on its Registration Certificate and use the appropriate channels provided by the CSCI when needed. Adequate supervision must be afforded to all staff employed at the Home. This should be at least six times a year and more often if required. This was subject to Enforcement Action being taken by the CSCI prior to this inspection and has been partially met. A further date for completion of 10/2/06 has been given. If this date is not met with the CSCI will seek legal advice to prosecute. The Manager must produce an annual development plan, which can demonstrate, that from an effective quality assurance system, the Home, after taking into account residents, relatives and visitors views will improve its quality of care and services offered. These findings must be formulated in a report to the CSCI and to the residents/representatives. This has been an ongoing requirement and must be met in order to avoid further action being taken by the CSCI. 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. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The new format for the assessment of a resident’s needs prior to admission should ensure that the resident is only admitted if the Home can meet the individual’s needs. EVIDENCE: A new pre admission assessment has been devised. It meets all the criteria laid down within this standard and also prompts the assessor to make a judgement on any confusion or memory loss the resident maybe suffering from. One resident’s assessment prior to her admission was seen completed using the new format. A further assessment based on the Activities of Living has also been introduced for ongoing assessment purposes. At the time of this inspection four residents’ paperwork had been transferred over to the new format. There was some confusion between staff as to the use of the new paper work. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, & 10 The new care-planning documentation will make it a lot easier for staff to get clear guidance on how residents’ needs are to be met. The system for medication storage and administration is organised and ensures that residents receive their medication safely. The care in this Home is carried out in such a manner that preserves the residents’ privacy but not always their dignity. EVIDENCE: The Manager, in response to a requirement made by the CSCI in July 2005 to improve the written content of the care documentation has recently audited all care plans. The outcome has been a change in format. The new paperwork was seen in the care file of a resident who had been admitted nearly two weeks prior to this inspection, but as yet had not been completed. The Inspector is aware that it takes time to change a system over, however, the new resident had several care needs that should have been care planned for earlier in the admission. Another resident’s care needs were discussed and the Home is confident that her needs can be met. The risk assessment accompanying her care plans was Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 11 not robust enough to ensure her safety and was to be reviewed following this inspection. The Home will also be required to apply for a variation to their registration certificate to accommodate this resident. The Inspector looked at another resident’s care notes in detail and was also present during a review of her needs by a visiting external health care professional. These care notes clearly show that this resident had been inappropriately placed at the Home for sometime. The reasons for the continuing situation were discussed and the emotions that come with a situation like this, understood by the Inspector. However, the care documentation clearly demonstrates that there were many times when the care needs of this individual were not being adequately met. The medication system was inspected thoroughly, with the Lead Nurse responsible for the organisation of this present. Storage of medication and paperwork was organised. There were no gaps in the administration records. Appropriate documentation showed good procedures in the checking in of new stock and the return of stock. New requirements relating to medication returns were being adhered to. Accredited update training in the handling of medication is required to be completed by all staff that administer medication in the Home. Certificates within staff files show that staff have received training in Pain Control and the use of a syringe driver. The residents spoken with said that their care is delivered in a manner that preserves their privacy. One resident particularly commented that before any care is started the staff always close her bedroom door. The recent care of one resident which was discussed prior to and at this inspection, although well meaning, did not preserve her dignity and needs reflecting on by the staff to avoid this situation in the future. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 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 the following standard(s): Standards in this section not inspected on this occasion. N/A EVIDENCE: N/A Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 18 Although staff have received some basic awareness in abuse issues a designated training in Adult Protection and the presence of relevant up to date information in the Home would ensure that residents are more sufficiently protected. EVIDENCE: The Manager explained that she had completed training on this subject, but this was a few years ago. The Lead Nurse covered Adult Protection and Abuse briefly in a one-day dementia awareness course. There was no certificated evidence to demonstrate that staff had received training in these subjects, but the Manager confirmed that seven staff received some training on abuse whilst training in challenging behaviour in January 2005. The ‘Alerters Guide’, which gives guidance to staff and visitors on Adult Protection/Elderly Abuse with contact numbers, has not been seen by the Home. The Inspector agreed to arrange for the Home to receive this. A leaflet by the Gloucester Voice Against Elder Abuse was on the notice board. A partially upheld element of the complaint made in the summer of 2005 and a further anonymous comment made during this inspection would indicate that staff although caring and having received some basic awareness in abuse would benefit from designated training on this subject and still need to be aware of what now constitutes elderly abuse. The CSCI in conjunction with the Adult Protection Unit and the Police are formulating a training plan on these subjects which will be available from April 2006. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 19 The Home has been extended and refurbished to offer residents an improved standard to live in. EVIDENCE: All building work has now been completed and the new extensions are a real improvement to the Home. The older wing of the Home has been decorated in areas and has had a new carpet in the main hallways. This has been an expensive journey and the management now need to take stock of their finances before any further work is contemplated. The Inspector did note on this visit that the Home was not particularly warm and several residents were cold to the touch. This was due to heating engineers working on the system trying to rectify a problem that originated from the building works. However, this is not the first time this has been commented on within the old wing. It was hoped that the work being carried out during this inspection would sort the problem out. This will be monitored by the CSCI in future visits. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Although at present the staffing numbers are adequate to meet the needs of the residents this is not always the case as when care needs increase the levels are not reviewed. Induction processes for new staff are not organised well enough to ensure staff receive enough support and adequate training in the practices of the Home to enable them to be fully competent on duty. Recruitment practices in the Home are not robust enough to protect vulnerable elderly residents. EVIDENCE: Prior to this inspection and during, the staffing levels were not adequate to meet the increased needs of one particular resident. This was particularly relevant at night, but there had been no review or increase of the staffing to meet this demand. Since this inspection the care needs within the Home have reduced and numbers are relevant to the care needs again, although the Home still provides minimum staffing at night. A mixture of day and night staff hold the NVQ Award in Care. Further training is to be organised to provide NVQ training for two staff that have shown an interest in this. The Home currently has two new members of staff who are qualified nurses within their own country, who wish to undergo adaptation training in order to Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 16 register as nurses in the United Kingdom. The Home is currently going through the process to become a training centre for overseas nurses. Both these members of staff have received Moving and Handling training and basic ‘in house’ fire awareness. As yet they have not completed a structured induction programme despite their commencement in the Home in October 2005. Evidence of the recruitment criteria now required by the Care Home Regulations 2001 was not evident at the time of this inspection, despite an agency for overseas employment being used as an intermediate link. The Manager said that both members of staff were always supervised, however, during this inspection both were found to be working in one part of the Home on their own. The Inspector is not questioning the competency levels of these staff, but pointing out that staff without appropriate clearances are working alone with vulnerable adults. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 34 The Manager’s support from the Trustees is improving, but support from her staff remains extremely fragile and makes communication and managing some staff difficult. As the Manager does not have a recognised and structured quality assurance system it is difficult for the Manager to evaluate the levels of care and services provided and plan changes and improvements. The Home’s management and Trustees use the funds available to increase the standards for residents and endeavour to run the business in a responsible manner. EVIDENCE: The Registered Manager has been in post for five years. Over the last three years the Home has had to make huge changes and improvements to the Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 18 fabric of the building to meet the Care Home Regulations 2001 and remain competitive. This it has achieved and the Manager has confirmed that the Home’s finances are ‘on track’. Formal evidence of this has not been requested this year. The refurbishment period was an extremely stressful time for the staff, management and Trustees, and the already fragile dynamics between the groups became of concern to the CSCI. The CSCI have had discussions with all groups and required that arrangements were made to try and move forward with these issues. This process has begun, but progress remains slow and will continue to be monitored by the CSCI to ensure these conflicts do not ultimately affect the care of the residents, which up to now, there has been no direct evidence to suggest this has occurred, residents have always indicated that they are very happy and settled. The Manager has completed some auditing on the care plan system, which resulted in a change of documentation to try and improve this. Falls and accidents are monitored within the Home. However, one resident was falling several times at night as a result of wandering excessively, but this did not result in an increase of staffing to ensure her safety or any other change in care. A health and safety audit is completed annually. However, several basic systems mentioned in this report are not operating consistently and result in regulatory action from the CSCI to address them. The Home does not have a quality assurance system that allows for a developmental programme to be devised and used as a guide to reviewing and improving areas of care, management and services within the Home. This has been a requirement by the CSCI before and needs to be addressed. A questionnaire was sent out to residents and relatives many months ago asking their view on several areas i.e. care, food, activities, but the results of these have not been collated or have any actions been identified. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 19 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 2 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 3 X X X X Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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(1) Requirement The Registered Manager must ensure that care plans are written in such a way that staff have clear guidance on how to meet the needs of the resident. (Timescale of 31/10/05 not met) The Registered Manager must ensure that residents’ care and health needs are being met at all times. The Registered Manager must ensure that all staff who administer medication have the appropriate updated skills and knowledge to do so. The Registered Manager must ensure that a resident’s dignity is preserved throughout their care. The Registered Manager must provide and ensure that day and night staff receive training in Adult Protection and Elderly Abuse. The Registered Manager must review the number of staff within the Home when care levels increase and ensure there is sufficient staff on duty at all times. (Timescale of 31/10/05 DS0000016559.V269857.R01.S.doc Timescale for action 31/03/06 2 OP8 12(1)(b) 01/03/06 2 OP9 18 (1)(c)(i) 30/04/06 3 4 OP10 OP18 12(4)(a) 13(6) 01/03/06 30/06/06 5 OP27 18(1)(a) 01/03/06 Resthaven Home Of Healing Version 5.0 Page 21 not met) 6 OP29 19 The Registered Manager must ensure the following criteria are met obtained prior to an individual starting work at the Home: • • Proof of identity, including a recent photograph. Details of any convictions or cautions given by a constable. Two written references, including, where applicable, a reference relating to the person’s last employment, which involved work with children or vulnerable adults, of not less than three month duration. Where a person has previously worked in a position, which involved contact with children or vulnerable adults, written verification of the reason why he/she ceased work in that position unless it is reasonably practicable to obtain such verification. Documentary evidence of any relevant qualifications and training. A full employment history, together with a satisfactory written explanation of any gaps in employment. An enhanced Criminal Record Bureau (CRB) clearance and clearance against the Protection of Vulnerable Adults list (POVA). A statement by the person Version 5.0 Page 22 01/03/06 • • • • • • Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc as to his/her physical and mental health. Details and evidence of registration with, or membership of, any ‘professional body’. The Registered Manager must devise a system that enables the care and services provided by the Home to be evaluated and improved upon, whilst taking into account the views of residents, relatives and other visitors to the Home. A report on the above must be submitted to the CSCI and made available to residents/representatives for consultation. 7 OP33 24(1) (2) & (3) 01/06/06 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 OP33 Good Practice Recommendations The report referred to in standard 33 of the requirements should be annual. Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Resthaven Home Of Healing DS0000016559.V269857.R01.S.doc Version 5.0 Page 24 - 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. 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