Inspection on 13/11/06 for Rivercourt Project Short Breaks

This inspection was carried out on 13th November 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 found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rivercourt Project Short Breaks 29/10/07

Rivercourt Project Short Breaks 30/01/06

Rivercourt Project Short Breaks 15/03/05

Rivercourt Project Short Breaks 11/10/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Rivercourt Project Short Breaks 17 Rivercourt Road Hammersmith London W6 9LD Lead Inspector Jacqueline Derbyshire Unannounced Inspection 13th November 2006 09:30 Rivercourt Project Short Breaks DS0000035441.V317347.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 Rivercourt Project Short Breaks DS0000035441.V317347.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. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rivercourt Project Short Breaks Address 17 Rivercourt Road Hammersmith London W6 9LD 020 8563 8683 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) London Borough of Hammersmith and Fulham Ms Angela Joan Mooney Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Rivercourt Road is a registered care home providing short breaks for adults with a learning/physical disability and/or challenging behaviours. The home provides short breaks for people living with their families and each person can stay at the home for up to 12 weeks each year. The London Borough of Hammersmith and Fulham Social Services Department manages the service. The service now also has placements from outside of the locality. The home is located in a residential area, close to the shops and transport links of Hammersmith Broadway and Chiswick. The property is fully accessible to people with limited mobility. All five single rooms have an ensuite shower and toilet and a passenger lift provides access to rooms on the mezzanine and first floors. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Monday 13th November 2006; the Inspector spent 3.30 hours visiting the home. The Inspector spoke with 3 of the service users, the Care Services Manager and 2 staff. The Inspector checked the care records of two service users; all medication records were looked at and were seen to be well recorded. All of the service users bedrooms were looked at and all communal parts of the home. The home provides an excellent standard of accommodation as the whole home has had a refurbishment. The home was seen to be clean and tidy. The requirement that was set 13/09/05 has been met; 8 new requirements have been made from this visit. The staff was very knowledgeable about all of the service users and in discussion with the 3 service users who were at the home for respite they were very positive about staying there, comments can be seen throughout this report. There is an issue that staff requires training refresher courses in first aid. The weekly placement cost is from £704.00 to £1000.00. What the service does well: What has improved since the last inspection? What they could do better: All staff must have an up to date first aid certificate. All care plans must be up to date with all relevant information in place despite the change of documentation that is being introduced that are called Goal Plans. A risk assessment to be completed when a waking night staff member is not required that links in to the fire safety procedure of the home. The Manager to make sure professionals who request medication be given in food has given written information for staff to follow and it is recorded in the appropriate records. The Organisation must look at recruiting permanent staff to make sure that continuity is given to all people who visit the home for respite, as there are 4 vacancies at present. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 6 The Organisation must complete the covering of wires in bathrooms that was requested in January 2006 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. The summary of this inspection report can be made available in other formats on request. Rivercourt Project Short Breaks DS0000035441.V317347.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 Rivercourt Project Short Breaks DS0000035441.V317347.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service user guide contain all relevant information about the respite provision. Records for all service users show a thorough placement plan with information from all relevant professionals. EVIDENCE: The Inspector was given a copy of the Statement of Purpose and Service user Guide that are very informative with all relevant information in place. This information is available in different languages and in a suitable format for all people who will stay at Rivercourt Road. The project is now called Rivercourt Road Short Breaks as requested by people with a learning disability, which is positive and refers to a broader range of opportunities. The Inspector looked at two peoples files that have comprehensive information showing a full assessment and how the needs of the individual will be met by the staff including their aspirations. Service users only stay at the service for a maximum of 12 weeks each year, part of the assessment is identifying goals this is an area of work that is being developed. Two of the service users went to college on the day of the Inspection transport had been arranged for one person and one person was going by public transport as written in their care plans. One of the service users is being assisted to develop independent living skills to enable her to move back into the community. In discussion with the three service users who were in the home at the time of the Inspection they were happy that the home was meting all of their needs. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 9 Both of the files included an individual contract that details the services provided in the home and the service users’ rights and responsibilities. The contract has been produced using pictures and symbols from the Makaton Vocabulary, a language system developed for use by people with a learning disability. The contracts were signed by the service user and a member of the home’s staff team. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are in place for all service users, there is a need to make sure all relevant areas of the plan are completed. Records are in place that shows how service users make decisions in their day-to-day living at the short break home. Risk assessments were seen to be well recorded and linked into the care plan. EVIDENCE: The Inspector looked at two service user files that had care plans in place that did not have all of the areas completed. In discussion with the Manager this was because new records are being introduced called Goal Plans also as there are vacancies in the home and it is difficult at present to allocate a key worker to all of the people using the home for respite. All of the other records that link into the care plan were up to date and informative including a full background record and health report. In discussion with the service users they were happy that all of their needs were being met and that they were able to be independent in lots of areas. One of the service users was preparing their own packed lunch as they were going to college and stated they were happy doing it for themselves as they could choose what to put on their sandwich. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 11 The two files checked had risk assessment records in place that linked into the care plan for any risk areas and how the staff were eliminating or minimising the risk. There is a need for the Manager to complete a risk assessment to show what the procedures are when a waking night member of staff is not required, this risk assessment must also link into the homes fire procedure. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11,12,13,15,and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Records show that service users are encouraged to continue their education and training activities whilst staying at Rivercourt short break service. Service users records show that they are regularly taken out into the community to use the local facilities and amenities. Service users are fully encouraged and supported to continue with their relationships with family and friends. Service users rights are respected as written in the homes placement and care plans. The food provided at the home is always provided in consultation with the service users and any dietary requirements are adhered to. EVIDENCE: The two care plan files and care needs assessments looked at by the Inspector contained information about the service user’s likes, dislikes, hobbies and leisure interests. The services own assessment ensures that service users bring any favourite games or music with them when they stay. Each file also included a weekly timetable of activities and day services or adult colleges used by the service user. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 13 Staff told the inspector that arrangements are always made to ensure that day services continue while a service user stays at the short break service. Service users are also supported to continue their college placements and two went to college on the day of the inspection. One of the service users was being taken out shopping at their request as stating they required new nightwear. Daily care notes completed by staff show that service users are supported to take part in activities in the home and the wider community. Regular use is made of local pub, cafes and the cinema, as well as local parks, records in place stated that the three service users had been to see the Christmas lights in Regent Street and Oxford street at the weekend. In discussion with the service users they stated that they really enjoyed going out and one person stated, “ The Christmas lights were lovely”. Details of service users’ family, friends and other important people are recorded as part of the home’s referral and assessment procedures. Contact details of all significant people are clearly recorded and daily care notes show that friends and relatives visit service users while they are using the short break service. One of the people staying at the home has regular visits by her partner, in discussion with the service user they stated “My partner is always made welcome and likes coming to visit me here”. In discussion with the Manager, staff and service users it was stated that they do not do big weekly shopping for food but shop regularly for the food requested by the service users. The Manager stated that people change their mind on what they would like to eat and that service users also enjoy going shopping for their food. In discussion with the service users it was stated that they all liked the food provided. One service user stated they enjoy helping to shop and cook. Records of what service users had eaten were looked at and discussed with the staff, records show that one of the service users are on a diet which is monitored very closely because of health reasons. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Services users are supported with personal support at the level required to maintain independence. Records are in place for all service users that show that all healthcare needs are being met. Medication records are up to date and accurate and are safely stored. EVIDENCE: The two care plan files looked at by the Inspector contained clear information about the person’s health and social care needs. Referrals to the service are made as part of a multi-agency referral process and each file contained background information and reports from health and social care professionals. The Inspector saw reports from social workers, occupational therapists, physiotherapists, psychologists and speech and language therapists. The reports each contained useful information and guidance for staff. In discussion with the Manager and staff it was clear that different levels of support are required from monitoring to full care support. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 15 The Inspector looked at the medication records kept at the home that were well recorded and accurate. There is an issue with one service user who has a difficulty in swallowing and their medication is put on a yogurt. In discussion with the Manager and staff it was stated that this was recommended by the speech and language therapist. The Inspector looked at the records for the individual but the medication procedure was unfortunately not mentioned. The Manager is liaising with the speech and language therapist to make sure that the information is in place and recorded in the relevant plans as this can be deemed as disguising medication. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a complaints and protection procedure that is available in different formats. EVIDENCE: The Inspector looked at the homes complaint procedure that is also written in the Statement of Purpose and Service user Guide. The complaint procedure is available in different formats including makaton. There have been no complaints at the home in the last 12 months. There is an issue that the Organisation who undertook an investigation at the home has not notified the CSCI of the outcome, this is a requirement. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24,25,28,29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Rivercourt Road provides an excellent comfortable and safe environment for service users and staff. The home is clean and hygienic in all areas. EVIDENCE: The Inspector had a full tour of the home and all areas were seen. Two service users showed the Inspector their bedrooms and stated they were very happy with them. Each bedroom has an en-suite bathroom; there is a requirement that wiring under sinks has to be covered. All areas of the home are tastefully decorated and have good furniture and fittings in all areas. There is specialist equipment that is new, the Manager was very proud of the equipment in place as it enables the home to provide a diverse service that can meet the needs of a lot of individuals that would not have been able to stay at the home. The home was seen to be very clean and tidy in all areas in discussion with the Manager and staff it was stated that staff do take pride in the home and service users are also involved in keeping their rooms tidy. Rivercourt Project Short Breaks DS0000035441.V317347.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,33,34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team at Rivercourt Road are all qualified and has either got an NVQ or they undertaking an NVQ. There is a need for the organisation to recruit to the 4 vacancies at Rivercourt. Service users needs are fully met by the staff team and any agency staff are recruited with all relevant qualifications and mandatory training in place by the Local Authorities Procurement Team. EVIDENCE: On the day of the Inspection there were 3 staff on duty including the Manager to support 3 service users currently staying at the home. The Inspector looked at rotas and sufficient staff was scheduled to be on duty on all shifts. There is a need for the organisation to recruit to the 4 vacancies as in discussion with the Manager it was stated that they are finding it difficult to allocate a key worker system to all service users. The Manager also stated that agency staff at times are not suitable for the home and this puts pressure on the other staff to ensure staffing levels are adequate. All recruitment is completed by the Human Resources team and the procurement team. There is a welcome pack in place for new staff and agency staff that was very informative. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 19 The Manager will have completed NVQ level 4 in December 2006, one member of staff has recently registered to do level 3 and the Deputy Manager has NVQ level 3. The remaining permanent member of staff has just completed her nursing qualification. Staff does attend regular training and the Manager keeps a training and development schedule for staff. There is a need that all staff is up to date with first aid training. Rivercourt Project Short Breaks DS0000035441.V317347.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Manager is qualified and competent and understands her role and responsibilities. There is a quality assurance programme in place that the Manager has to collate all of the information to produce a summary of the findings January 2007. Health and safety records were all up to date. EVIDENCE: The Inspector in discussion with the Manager commented that she was happy that she would have completed her NVQ level 4 in Management December 2006. The Manager stated that she also attends other training to make sure she is up to date. Looking at records and telephone questionnaires linked into the quality assurance procedure it was discussed that questionnaires should also be sent to families and professionals and in a format for service users for a more effective outcome. The Manager and staff spoke of many positive comments made by service users their families and professionals. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 21 Comments from the 3 service users on the day of the inspection were very positive about their stay one service user commented, “I like it here so much and staff really look after me”. The Manager discussed collating all of the information and will send a summary to the CSCI in January 2007. Health and safety records were looked at including the fire test records and evacuation procedure, all records were up to date and well recorded. There is an issue that staff need to complete or renew there first aid training as there has to be a member of staff on duty at all times with this qualification. The bathrooms in some areas still have loose wiring behind the sinks this was discussed after a visit in January 2006 and has not been met. The photocopier needs to be moved off the top landing and put in a more appropriate place. Rivercourt Project Short Breaks DS0000035441.V317347.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 3 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 x 27 x 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 x 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 2 x Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 23 No 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. 2 Standard YA6 YA9 Regulation 15 13 Requirement The Manager to make sure that all care plans are fully completed. The Manager to implement a risk assessment record when no waking night staff member required. The Manager to ensure the correct information is in place that is informing staff to disguise a service users medication in yogurt. The Organisation to send a copy of the POVA investigation. The Organisation to implement a recruitment plan for Rivercourt Road. The Manager to make sure that the home has a member of staff on duty for all shifts that has completed first aid training. The Organisation to complete works in bathrooms covering wires as required by the CSCI 30/01/06. The Manager to make sure the photocopier is moved off the landing in to a more suitable area. Timescale for action 31/12/06 31/12/06 3 YA20 13 30/11/06 4 5 6 YA23 YA34 YA42 13 18 13 31/12/06 31/12/06 30/11/06 7 YA42 13 31/12/06 8 YA42 13 20/11/06 Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 24 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 YA39 Good Practice Recommendations The Manager to collate all quality assurance information for Rivercourt Road and produce an annual summary of the findings, a copy to be sent to the CSCI. Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rivercourt Project Short Breaks DS0000035441.V317347.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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