Inspection on 13/09/07 for Sandbourne House

This inspection was carried out on 13th September 2007.

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

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

Other inspections for this house

Sandbourne House 23/09/09

Sandbourne House 27/09/06

Sandbourne House 25/01/06

Sandbourne House 26/09/05

Sandbourne House 23/03/05

Sandbourne House 08/02/05

Sandbourne House 18/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Sandbourne House 1 Sandecotes Road Parkstone Poole Dorset BH14 8NT Lead Inspector Tracey Cockburn Key Unannounced Inspection 13th September 2007 8:55 Sandbourne House DS0000004080.V350153.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 Sandbourne House DS0000004080.V350153.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. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandbourne House Address 1 Sandecotes Road Parkstone Poole Dorset BH14 8NT 01202 742284 F/P01202 742284 sandbournehouse@yahoo.co.uk 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) Mrs Helen Vivien Somerville Mrs Janet Lesley Young Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one named service user (as known to the CSCI) prior to their eighteenth birthday. 27th September 2006 Date of last inspection Brief Description of the Service: Sandbourne House accommodates 8 adults, with a purpose of providing care and support to residents who have a learning disability. Mrs Helen Somerville and Mrs Janet Young own it. A new manager has been appointed but is not yet registered with the commission. The home was first registered in 1997. It is a large family style house in a residential area of Lower Parkstone. The shopping areas of Parkstone are walking distance away and there is accessible public transport to the towns of Poole and Bournemouth. The house comprises a lounge, separate dining room and kitchen, bathroom, separate WC and each resident has their own bedroom. 4 of the bedrooms have en-suite facilities. Through the kitchen is an office, staff sleeping in room, shower and toilet. The home has a well-kept garden. The home is staffed 24 hours of the day, with at least two staff on duty when the people who live there are at home. At night only one sleep in member of staff is on duty. Current fees provided on 13/09/07 are between £500 and £600 per week, which is inclusive of day care. Fees do not include personal items such as toiletries, hairdressing, chiropody, transport and magazines. For further information on fee levels and fair terms of contracts you are advised to referred to the Office of Fair Trading website: www.oft.gov.uk Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place during the morning and early afternoon. There were 2 people who live in the service at the home. The manager was present throughout. Part of the planning process included examination of the AQAA submitted by the new manager for the service. Survey forms were received from relatives, staff and people who use the service. Comments received included: “ We are grateful to the management and staff for their commitment to all residents at Sandbourne” (relative) “ The Staff are very caring and kind” (relative) “ If all care homes were like Sandbourne House the world would be a better place” (relative) What the service does well: People moving into the home have their individual needs and wishes assessed. People who live in the home say they are able to make decisions about their lives. There is also evidence that they are supported to take risks in their daily lives. The staff in the home encourage people to participate in activities which interest them in the local community. People living in the home are in contact with family and friends who are important to them. People living in the home say they have their rights respects. The service encourages the people living there to maintain a healthy diet. People say they are supported in the way they like and prefer. Records are clearly kept on how individuals are supported in looking after their physical and emotional wellbeing. The home has a policy and procedure in place to manage medication and staff receive training, this means that people living in the home are protected. People say they are listened to and their concerns acted upon. Staff receive the training they need to ensure that people living in the home are protected from abuse. People say they like the home they live in as it is homely. The home is clean and there are procedures in place to ensure it is hygienic. Staff receive the training they need to do the job. The manager encourages NVQ training. The home’s recruitment process means the people living in the home are protected. Staff receive training to meet the needs of the people living in the home. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 6 There is a quality assurance process in place, which demonstrates that people’s views are listened to and incorporated into an annual development plan. The home promotes and protects the people living there by ensuring that their health, safety and welfare are maintained. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sandbourne House DS0000004080.V350153.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 Sandbourne House DS0000004080.V350153.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): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who are considering moving into this service have their needs and aspirations assessed. This means the service is able to say clearly whether or not they have the staff and skills to meet individual need. EVIDENCE: One file for a person who recently moved into the home was reviewed as part of the inspection. The individual file for this person was case tracked and there was evidence a care management assessment and plan was completed prior to admission. The home also carries out their own initial assessment that details personal care needs, life skills, health and communication and funding/benefits. An admission checklist records details of introductory visits and evidence that the person had been given all relevant information about the home such as the service user guide and CSCI inspection reports. The checklist provided further opportunities to assess how the prospective resident interacted with other residents and staff. Contracts were in place in an accessible format for people living in the service. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Individual plans reflect changing needs and goals, which mean people receive support appropriately. People are enabled to make decisions about their lives and supported to take risks. EVIDENCE: A sample of 2 service users’ plans was reviewed as part of the inspection. Evidence from previous inspections showed that care plans were in place for all people living in the home, setting out their needs and how these are to be met. Care plans cover a whole range of service users’ needs such as health, personal care, work/occupation, mobility, domestic tasks, social life, financial, night care and personal relationships. These address the person’s needs and the staff tasks that are required to meet them. There was evidence that plans were regularly reviewed and updated to reflect any changes in care. Further guidance was available to staff concerning managing specialist needs such as challenging behaviour. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 10 There was evidence that service users were consulted on a regular basis and encouraged to make decisions about their lives. Regular residents’ meeting were held in the home and the minutes of these were seen. Issues such as outings, staffing, health and safety and complaints had been discussed. One person said they were supported to make decisions about their lives on a regular basis, e.g. spending their money, going out on activities and their daily routines. Observation of practice demonstrated staff actively promoted service users decision-making, encouraging them to make choices independently where possible. All people living in the home have their own bank accounts and are supported to manage their own finances. The registered proprietor is currently appointee for 3 residents. A sample of service users’ financial records was checked as part of the inspection and these were found to be accurate with details of all transactions being recorded and receipts of all purchases kept. Risk assessments were seen for each service user. These were appropriate and well documented. Where restrictions were necessary there were clear reasons why. For example where service users needed support with medication, going out on their own, holding their own keys. The assessments were based on promoting skills where possible such as working towards going out unaccompanied. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in the service are able to participate in activities, which interest them in the local community. People are able to have relationships with whom they want. EVIDENCE: Two people who live in the home were out at their usual daytime activities, 3 people were in the home at the start of the inspection. One person went out for the day with their key worker and the other 2 remained in the home. Individual care plans showed that people attended activities including local day services, college courses, adult education classes and work placements. One person does not have any structured day activities and the home is looking into how this can be achieved. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 12 Observation during the inspection showed a member of staff taking a resident out for the day. Another resident was able to access public transport independently to travel to local shopping centres. People have their family details recorded on their individual files. The manager said the home welcomes visits from friends and families. Service users are encouraged to attend social events and develop new relationships with other people and they attend outside clubs and social events. One person who lives in the service said that their privacy was respected and that they could spend time alone in their room or socialise in the communal areas of the home. This person also said that they felt if they talked to someone privately they would have their confidence kept. Responsibilities for household chores were clearly set out in individual plans, e.g. laying the table, making simple snacks, making drinks, washing up and using the washing machine. A sample of menus was viewed as part of the inspection. These were found to be varied and nutritious. The manager said people are involved in the planning of the menu and picture formats were used to assist people in making choices. People said they enjoyed the food in the home and were able to make choices and help with meal preparation. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported the way they prefer, their physical and emotional needs are identified and met. A system is in place to deal with medication and this process protects the people living in the home. EVIDENCE: Personal care needs were clearly documented on individual care plans. These varied with some residents being independent only requiring occasional verbal prompting to those residents that were more dependent on staff assistance. There was an emphasis on supporting service users to do what they could but this needs to be recorded in more detail. One person spoken to said that they received the care they needed and they were treated with dignity and respect. A tick box system is used to highlight tasks, which have been done with individuals. However this information only evidences that tasks have been done not how or whether further support is needed. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 14 Health care needs were clearly set out in individual plans taking into account both physical and mental health needs. Records showed people had good access to healthcare services such as attending clinics for hearing or breast screening and access to healthcare professionals such as dentists, opticians and chiropodists. There was evidence of liaison with other professionals such as community nurses/psychologists to provide further guidance for staff such as suggestions of activities to promote positive behaviour. Good records were kept of service users’ current medication and further information about health conditions such as epilepsy was available in the home. The home has a written policy and procedure for the administration of medication that is specific to Sandbourne House. Risk assessments have been carried out on all service users’ abilities to administer their own medication and the level of support they need. Medicines are kept securely in a locked cupboard. A monitored dosage system is used and records were checked and found to be accurate and up-to-date. The manager has overall responsibility for ordering and checking medication and the quantities received are recorded on the MAR sheets to facilitate monitoring. Details of all medications prescribed, what it is for, drug descriptions and side effects are clearly listed for members of staff. All staff receive training in the safe handling of medication prior to administering it to residents. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in the home say they are listened to and their views and concerns acted upon. Staff receive the training they need to ensure that people living in the service are protected from abuse. EVIDENCE: The home’s complaints procedure is also available in a format suitable for people living in the service. People are offered further opportunities to raise any concerns and there was a regular item for discussing complaints at the residents meeting, which was evident on the minutes seen by the inspector. The home keeps a complaint log, however, no complaints have been received concerning the service. There has been one adult protection concern raised since the last inspection, which was unsubstantiated. All staff working in the home have received safeguarding adults training and the manager states in the AQAA that this is updated yearly. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a place, which is homely and comfortable. Systems are in place to ensure that the environment is clean and hygienic. EVIDENCE: A tour of the premises was carried out as part of the inspection and all communal areas were viewed and one resident’s room was seen. Communal rooms consisted of a lounge, dining room and kitchen. They were seen to be clean and bright and decorated in an attractive, homely way. People who use the service were observed to have unrestricted use of all communal areas. The paintwork on the window frames was flaking and worn; during the inspection the painter turned up to start work on the window frames. This had been arranged for some time but due to the bad weather work had not been able to start earlier in the summer. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 17 Bedrooms had been individually personalised and one person said they were very happy with their room. Four of the 8 rooms have en suite facilities. The manager states in the AQAA that the home is not able to accommodate people who are in a wheelchair. In the last 12 months 4 bedrooms have been decorated. On the day of the inspection the home was found to be clean and tidy. There is an infection control policy kept in the home and staff have undertaken infection control training. Sandbourne House DS0000004080.V350153.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): 32,34,35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff receive the training they need to do the job. Recruitment procedures are good and ensure that people living in the home are protected. EVIDENCE: The home currently employs 8 members of staff. People living in the home spoke positively about the staff. Observations made during the visit indicated that service users shared good relationships with staff, and that staff were knowledgeable and understanding of each person’s needs and preferences. The home currently has two staff with NVQ level 2 qualification. One person will be starting NVQ level 3 and two new members of staff will be starting NVQ 2 on successful completion of their probationary period. The manager is aware of the need to encourage staff to undertake this training. The home’s recruitment procedure consisted of placing an advert, sending out application forms and job descriptions, giving prospective candidates the opportunity for an informal visit to the home to meet the residents who were Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 19 then able to give feedback on the applicant. Interviews were then carried out with reference to equal opportunities. Successful applicants were then appointed subject to satisfactory references and a clear enhanced CRB and POVA check. A sample of one staff file was viewed. All records were complete with relevant references and CRB checks in place. Staff received terms and conditions and were appointed subject to a 3-month probationary period. There was evidence that a review was carried out after 3 months and the employee was then either made permanent or the probationary period extended if necessary. Copies of the General Social Care Council’s codes of conduct and practice were available to all staff. There is an in-house programme that provides staff with certificates in health and safety, first aid, fire training, infection control, management of medication and challenging behaviour. An induction package has been set up for new staff that is very comprehensive and based on the latest guidance from Skills for Care. The manager states in the AQAA that due to management changes in the past 6 months training and supervision have not been kept up to date. Sandbourne House DS0000004080.V350153.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): 37,39,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is well run with procedures in place which staff follow. There is a system in place to ensure that the people living in the home are listened to and used in the development of the service. Systems are in place to protect the health, welfare and safety of the people living and working in the home. EVIDENCE: At the time of the inspection there was no registered manager. However a new manager has been appointed and has been in post a few weeks. The manager does not have an NVQ level 4 or the Registered Managers Award but will be undertaking this training. She previously worked as the manager of a registered service and although that wasn’t in a residential setting she Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 21 demonstrated a good understanding of the systems within the service and the role and responsibilities of being a manager. The home has an effective quality assurance system. Residents’ and relatives’ surveys are carried out on an annual basis. The annual development plan for the home has not yet been completed for this year. The inspector examined records that showed that the home was meeting the requirements of other agencies such as Dorset Fire and Rescue Service and Environmental Health Department. Records of fridge and freezer temperatures were kept. A fire risk assessment was in place and staff carry out visual checks on equipment. A record of fire drills is kept and these showed the times of these had now been varied. The home had clear policies and procedures relating to health and safety practices. The manager confirmed her awareness of relevant legislation and certificates were in place showing staff had attended various training courses in safe working practices. Portable appliance testing had been completed in the last 6 months. Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations The manager should ensure that information on daily tasks is collected in a more detailed way, which demonstrates the abilities of each individual and the action, which is taken by staff to support each person living in the home. The manager should change the current system of storing information such as individual reviews and risk assessments. They should be stored in the individual’s file not in a collective file. The manager should arrange for regular, recorded supervision meetings at least 6 times a year. The manager should complete the Registered Managers Award. 2 YA10 3 4 YA36 YA37 Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Sandbourne House DS0000004080.V350153.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!