Inspection on 21/06/06 for Seabank House

This inspection was carried out on 21st June 2006.

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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Seabank House 31/08/09

Seabank House 24/07/08

Seabank House 22/11/07

Seabank House 17/03/06

Seabank House 13/12/05

Seabank House 10/01/05

Seabank House 21/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Seabank House 111 Seabank Road Wallasey Wirral CH45 7PD Lead Inspector Helen Carton Key Unannounced Inspection 21 & 29th June 2006 09:30 st Seabank House DS0000018938.V294316.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 Seabank House DS0000018938.V294316.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. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Seabank House Address 111 Seabank Road Wallasey Wirral CH45 7PD 0151 630 2791 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) Ms Helen Gifford Ms Helen Gifford Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th March 2006 Brief Description of the Service: Seabank House is a large detached house in the Wallasey area within easy reach of New Brighton and Liscard town centre. There is a wide range of facilities such as shops, churches, community centres, a library and public transport within walking distance. The house has a large rear garden, with a driveway to the front. Accommodation is provided for nine adults with a learning disability with bedroom accommodation being offered in one shared room and six single rooms. There is a lounge, separate dining room, bathroom and a separate toilet on the ground floor. The registered person has begun to replace the most damaged and worn windows. However the overall condition of the building is poor with work required to improve the living environment for residents. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two site visits were made to the home as part of the key inspection the inspector spent approximately 10 hours in the home. Time was spent sitting and talking with residents and observing the day-to-day routines of the home and the support staff as they provided support. The inspector looked around the building to assess its suitability to provide a comfortable, safe and homely environment for the enjoyment of all residents. A selection of records kept where looked at and the inspector also checked that the requirements made at the last inspection had been completed. The main focus of the inspection process was to understand how the home was meeting the needs of the service users and how well staff were themselves supported by the manager of the home. To make sure they had the skills, training and support to meet the needs of the residents. What the service does well: What has improved since the last inspection? The manager is continuing to make improvements to the home to improve the environment for resident so that the home is a more comfortable, safe and pleasant place to live. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 6 Since the last site visit the manager has looked at all the information the home has about residents’ needs and produced new care plans and risk assessments which give a fuller picture of individuals needs and aspirations. These plans enable the staff team to offer appropriate support and when necessary supervision to residents’. The staff team are taking part in regular training courses to enable them to support residents safely and to enable them to make positive choices and decisions in the daily lives. 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. Seabank House DS0000018938.V294316.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 Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. The home’s Statement of Purpose and Service User Guide provide good information about the care and support they can offer. The home’s pre admission assessment processes are good and safeguard prospective residents as well as those already living in the home. Contractual arrangements and responsibilities between the home and residents are clear and transparent. EVIDENCE: The home’s Statement of Purpose provides detailed information about the type and level of support the home can provide. It also provides information about the staff team and the facilities available for use by prospective residents. The inspector advised the manager to amend this document to reflect the home now has two ground floor bedrooms. Since the last site visit there has been an admission to the home. Examination of the pre-admission assessment indicates prior to the resident being admitted the home made every attempt to gain as much information as possible. This included information from the resident, their relatives, day services and the Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 9 individual’s social worker. Having detailed information prior to the admission taking place allows the staff team to make the home as comfortable and risk free as possible. The manager told the inspector she felt the resident had settled in well and they had used the assessment to develop their initial care plan. Residents’ contracts provide good clear information about what services the home provides and details those that they do not. Contracts also detail the provision of a month trial period which offers both parties time to decide if Seabank House is the right place for them. Seabank House DS0000018938.V294316.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. Care planning systems and risk management strategies are good with residents supported to be central to any decision making about how they live their daily lives. EVIDENCE: Since the last site visit the manager has reviewed all information held about residents including care plans and risk assessments. As a result of this review more detailed easily readable care and risk management plans are being produced. At the time of the inspection visit the inspector viewed three residents’ files that had the new plans in place. The care plans provide the staff team with detailed information and clear guidance as to the type and level of support residents need regarding their personal care needs. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 11 The plans also provide detailed and individualised information about what makes the residents happy, sad, frightened and angry. The plans build a picture of the important things to residents including those things that are non negotiable in their daily lives. Risk assessment information is very detailed and provides the staff team with clear guidance and where appropriate instructions as to the support and supervision residents require in a range of environments and situations. The inspector discussed the new care and risk assessment plans with members of the staff team who made the following comments: “The new care plans are good they give a lot of information that we all knew but had not been written down. When new staff start it will help them get to know the residents better”. “The care plans and risk assessments help us to know how to support residents with the good things in their lives but also to help them when things are difficult.” Seabank House DS0000018938.V294316.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 & 17. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. The home’s practices are service user led with them proactively supporting residents’ to make positive choices and be centrally involved in all decision making. EVIDENCE: The home works hard to support residents’ to make positive decisions and choices in their lives including being involved in voluntary work, college courses, leisure activities, holiday destinations and relationships. The home has few set routines. However there is an expectation that residents’ will assist with some household chores such as tidying their rooms and helping with meal preparation. Residents’ are encouraged to view Monday to Friday as time to carryout work related tasks and the weekend as leisure time. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 13 Discussions with members of the staff team and entries in residents’ daily diary sheets indicate one to one support is provided to a number of residents’ regularly. The inspector spent time, over two visits with six of the residents. Residents told the inspector they had enjoyed watching England play in the world cup and had a few drinks. They talked to the inspector about their holiday this summer and their favourite TV programmes. The inspector observed the residents and members of the staff team interacting in a relaxed, supportive and warm manner. At the time of the site visit one resident was away on holiday. The support workers at the home are responsible for all catering duties and encourage residents to eat a balanced diet. Examination of care plans and risk assessments indicate special dietary needs are catered for. Residents told the inspector they liked the meals offered. Seabank House DS0000018938.V294316.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome group is adequate. This judgement has been made using available evidence including a visit to the service. Residents’ personal care needs are met by the home in an individualised sensitive and supportive manner. The home meets the physical and emotional health needs of residents well. The home’s medication policies and procedures currently do not sufficiently safeguard residents’ health and wellbeing. EVIDENCE: The care plans and risk assessments provide the staff team with detailed information about the most appropriate and safe way to support residents with their personal care needs. This guidance involves practical help for the staff team regarding how clients like their hair washed and how to use lifting and moving equipment to cause the least distress and anxiety to residents. All contact and input by health care professionals are recorded in daily diary sheets and when necessary documented in individual care plans. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 15 A selection of residents’ medications and the accompanying Medication Administration Record (MAR) sheets were examined. The following issues were raised with the manager during a telephone conversation after the site visits on the 11/07/06. The manager faxed the inspector information that indicated medication procedures where being reinforced with the staff team. A MAR sheet had significant numbers of gaps where staff had not indicated whether the medication had or had not been administered A number of MAR sheets had the dates medication had been commenced however they did not indicate the number or amount of medication delivered to the home. During the inspection the staff team where unable to find the medication logbook, which documents medication that has been delivered and that which is to be returned. Issues regarding whether the home can administer medication rectally was discussed with the manager who was advised specialist training would need to be provided with regular updates. Also care plans and risk assessments must provide clear guidance to the staff team as to when it would safe and appropriate to use this method of administering medication. The manager told the inspector she intended to seek specialist advice prior to making a decision regarding this issue. Seabank House DS0000018938.V294316.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome group is adequate. This judgement has been made using available evidence including a visit to the service. Seabank House deals with complaints or concerns in a professional and sensitive manner. The home’s practices promote residents wellbeing and offers protection to them from abuse, neglect and incidents of self-harm. EVIDENCE: Residents receive information about how to complain and raise concerns about the service they are receiving in the Statement of Purpose and the Service User Guide. There are also detailed policies and procedures for the staff team to refer if they witness or are told about incidents of abuse. This also includes a whistle blowing policy. Nine of the eleven members of the staff team are completed or are in the process of completing NVQ training. This training includes units regarding the protection of vulnerable adults. Staff members spoken to demonstrated an awareness of what would be considered abuse, oppressive or neglectful practice. The manager told the inspector she intended to arrange appropriate training for those staff not involved in NVQ. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 17 The level of detail held in residents care plans and risk assessments enable the staff team to support residents’ appropriately and limit the potential for the development of poor or neglectful practice. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 & 30 Quality in this outcome group is poor. This judgement has been made using available evidence including a visit to the service. The manager has significantly improved the environment in which residents live however further improvement is required to ensure it meets the individual and collective needs and aspirations of residents. EVIDENCE: As detailed in previous reports issues regarding the furnishings decoration and general maintenance of the home have been raised. Since the last site visit, the manager, who is also the owner, has replaced further windows with plans to replace the remaining ground floor windows by the end of September 06. At the time of the visit the inspector observed the following with regard to the environment of the home: Hall, stairs and landing – This area of the home is currently being decorated and a new carpet has been ordered. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 19 Dining room – this area has been decorated, the windows and door have been replaced and tiles are to be fitted on the floor. New furniture and curtains have been purchased. Ground floor Bathroom – the window has been replaced. Lounge – a new carpet has been ordered and new curtains have been fitted. The manager told the inspector she intends to redecorate all bedrooms and where necessary refurbish when money from the business becomes available. Also the following work is to be carried out over the next few months; a new emersion heater is to be fitted, new radiators are to be fitted as rooms are redecorated and all rubbish currently stored in the back garden is to be removed. Residents told the inspector they liked their home and did not mind the decorating happening. The inspector acknowledges work is being carried out to provide residents with a more comfortable and attractive environment to live. However work must continue to ensure all areas of the home meet a minimum standard as detailed in the National Minimum Standards for Care Homes for Adults (18-65) and the accompanying Care Homes Regulations. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34 & 35 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. The staff team are well motivated with staff moral high. This has a positive impact on the quality of care offered to residents as they provide a more proactive, supportive and enabling environment for residents to live. EVIDENCE: The manager employs eleven support workers to care and support residents with all aspects of their daily lives. At the time of the site visits three members of the staff team had successfully completed NVQ 2 with a further five undertaking this training. Since March 06 members of the staff team have taken part in the following training sessions: fire awareness training, basic food hygiene, adult protection awareness training, communication methods for adults with a learning disability, manual handling, COSHH awareness training and first aid. The manager told the inspector Alzheimer’s awareness training has been planned to take place in the next six months. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 21 The inspector discussed with the manager the need to provide further specialist training in the area of learning disabilities. To ensure the staff team are aware of best practice within this field. Examination of a sample of staffing records indicate the home carries out all relevant checks prior to the offer of employment being made. Members of the staff team spoken to told the inspector the manager provides supervision both formally and informally and that they found her supportive and flexible regarding their work patterns. Residents told the inspector they liked being with the staff and liked going out with them. Discussion with members of the staff team examination of residents’ daily diary sheets and the staffing roster indicates one to one time is allocated to support residents with particular activities. Or when individuals need support through crisis situations. During the two site visits the inspector observed the staff team supporting residents in a caring supportive and at appropriate times humorous manner. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41 & 42 Quality in this outcome group is adequate. This judgement has been made using available evidence including a visit to the service. The management of the home continues to improve with the ethos of the home being resident focused and looking to positive outcomes for individuals. The home’s policies, procedures and practices on the whole protect and promote residents and the staff teams health and safety. EVIDENCE: The manager and a senior support worker are commencing NVQ level 4 in a few weeks. The management style within the home supports and guides the staff team to be more focused on outcomes for the residents receiving their care and support. Also to be aware of the impact of there actions and behaviour on residents’ in there own home. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 23 The accident/ incident records were examined and indicated appropriate information and actions had been taken. The fire safety logbook was examined and records indicate appropriate checks and training are taking place at the required intervals. All electrical appliances were tested and assessed as safe in August 05. A safety check of the electrical wiring within the home is to be commenced in October of this year. The manager has sought advice from the Fire Authority and is currently reviewing and amending the home’s fire risk assessments. Issues regarding the medication procedures are raised earlier in this report. The inspector examined a sample of financial records, which were well maintained. Since the last inspection the manger has produced new care plans and risk assessment these document provide detailed information about the holistic needs of the residents living at the home. Discussion with residents and examination of a selection of care plan, risk assessments and daily diary entries indicate residents opinions are sought and valued in all areas of the homes life. The manager continues to improve the overall organisation, structure and storage of documentation required by the Care Homes Regulations 2003. This work must continue to ensure the safety of residents and the continuing competency of the staff team. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 24 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 3 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 2 25 2 26 X 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 3 3 X 2 2 X Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA 20 Regulation 13 Requirement The registered person must ensure the medication practices within the home safeguard residents. This with particular regard to accurately recording when medication has been administered and when it has not. The registered person must ensure all staff employed at the home receive protection of vulnerable adults training to ensure residents are supported by a staff team with the skills and expertise to safeguard them from abuse and neglect. The registered person must continue to improve the home environment for residents and provide the Commission with a monthly update as to the work to be carried out and work completed. Timescale for action 29/06/06 2. YA23 13 30/09/06 3. YA25 16 30/09/06 4. YA35 10 The registered person must 30/09/06 ensure that a variety of specialist training is provided to the staff team. Enabling them to support adults with learning disabilities in a proactive and enabling DS0000018938.V294316.R01.S.doc Version 5.2 Page 26 Seabank House manner. 5. YA41 17 The registered person must ensure the home reviews and maintains all records required to be held as detailed in the Care Homes Regulations 2003 to ensure a safe living environment for residents and a safe working environment for employees. The registered person must ensure fire safety assessments are carried out and documented. This is with regard to environmental and individually identified risk factors. 30/09/06 6. YA42 23 30/09/06 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 YA37 Good Practice Recommendations The registered person should continue to organise the documentation within the home to support and assist the staff team in their work. Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Seabank House DS0000018938.V294316.R01.S.doc Version 5.2 Page 28 - 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!