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Inspection on 18/07/07 for Seaview

Also see our care home review for Seaview for more information

This inspection was carried out on 18th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Seaview provides a comfortable and homely place to live. It is spacious, well equipped and decorated to a good standard. People` bedrooms reflect individual preferences and show that people have been encouraged to personalise their rooms and to treat the home as their own. The home continues to welcome visitors and encourages people to maintain contact with families and friends. Care plans and records are of a good standard and contain sufficient guidance to enable staff to offer support in a way that meets the wishes of each person. The home places a high value on communication and is continuing to develop ways through the use of pictures and symbols to provide service users with information in a way that may be more easily understood.

What has improved since the last inspection?

The home`s programme of activities continues to be tailored and developed to meet the individual needs of people living at the home. Additional garden equipment and furniture has been provided. Six staff had commenced a National Vocational Qualification training course at level 2, which means the recommended target of at least 50% of staff achieving the qualification, will have been exceeded.

What the care home could do better:

Continue to explore the use of photographs, symbols and other methods that can be used to aid communication and enable people to make choices.

CARE HOME ADULTS 18-65 Seaview 44 Seaview Avenue West Mersea Colchester Essex CO5 8BY Lead Inspector Brian Bailey Unannounced Inspection 18th July 2007 10:20 Seaview DS0000066394.V346259.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 Seaview DS0000066394.V346259.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. Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Seaview Address 44 Seaview Avenue West Mersea Colchester Essex CO5 8BY 01206 382800 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) oakshealthltd@btconnect.com Oaks Health Limited Mr Keith Walters Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 5 persons) 24th August 2006 Date of last inspection Brief Description of the Service: Seaview is a large detached property situated in a residential area of West Mersea, near Colchester. The property has been adapted to accommodate 5 adults with learning disabilities. There are four bedrooms downstairs and one upstairs; all rooms have en suite facilities with bath or shower. Communal areas include a lounge, dining room and a fitted kitchen. There is a small conservatory to the rear that may be used as a private lounge. Some shops and a church are located close to the home. To the rear of the property is a patio area and a large garden, mostly laid to lawn, with some trees. To the front of the home is a garden, mainly paved for vehicular parking. The service supports younger adults with complex needs to live in an ordinary home environment. Information about the service may be obtained by contacting the manager. The home charges between £2,250.00 and £2,260.00 a week for the service they provide. Items that are extra to fees include hairdressing, toiletries, chiropodist, and personal items such magazines. Inspection reports are available from the home and from the CSCI website www.csci.org.uk Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection looking at the core standards for the care of adults. This report is based on a range of information that has been accumulated from our inspection records, which includes a detailed assessment of the home completed in June 2007 by the manager, a site visit to the home that took place on 18th July 2007 at 10:20am, a tour of the property, discussions with the team leader, staff and all the people that live at the home, observations, questionnaires issued by CSCI and a sample of many of the records kept at the home. This was the second inspection of Seaview since it was registered. On the day of the visit there were five staff on duty and five people in residence. During the morning all five people went out with staff to various activities in the area and returned at lunchtime. The atmosphere in the home was again observed as relaxed and welcoming and the inspector was given every assistance from the staff and people living at the home. From observation, discussion and the information available, it was evident that the manager and staff had continued to develop the home and introduce new ideas and experiences to benefit people at the home. What the service does well: Seaview provides a comfortable and homely place to live. It is spacious, well equipped and decorated to a good standard. People’ bedrooms reflect individual preferences and show that people have been encouraged to personalise their rooms and to treat the home as their own. The home continues to welcome visitors and encourages people to maintain contact with families and friends. Care plans and records are of a good standard and contain sufficient guidance to enable staff to offer support in a way that meets the wishes of each person. The home places a high value on communication and is continuing to develop ways through the use of pictures and symbols to provide service users with information in a way that may be more easily understood. Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 6 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. Seaview DS0000066394.V346259.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 Seaview DS0000066394.V346259.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): 1, 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures prospective people have the information they need to make an informed choice about where to live. The home ensures people are admitted on the basis of a full assessment. People are given the opportunity to visit and “test drive” the home as part of the transitional process. EVIDENCE: Up to date statements of purpose were available. These contain a good range of information about the home, including its aims and objectives, the facilities offered and the staffing structure. Information about the home was available to people in an alternative format, which had been developed since the last inspection. From observation throughout the visit, numerous examples of information/guidance were seen that were in a format that some people may have been able to understand more easily. Previous inspection reports were available at the home. Two care records were checked. These showed that the home had obtained a detailed assessment of needs for each person from the placing authority and senior staff had completed their own assessment. Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 9 It was explained by the team leader that the home expects all people that are thinking about moving to home to visit as often as possible. This is to enable people to meet and get to know the staff, other people at the home and to look at the facilities available. The home offers people a settling in period, during which the placement is reviewed. Records examined show evidence of this review process. Seaview DS0000066394.V346259.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): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home are enabled and encouraged to contribute to the daily life and routines of the home. People could be certain that their care plans were sufficiently detailed to enable staff to meet their needs. EVIDENCE: The care records of two people were examined on the day of the visit and both contained a wide range of detailed information. The care plans were well laid out, consistent in style and easy to understand the identified care need and how this was to be achieved. There were clear guidelines for staff on how to implement the care needs identified. Both care plans looked at had evidence that they are reviewed at regular intervals, the most recent having taken place in May and June 07. It was evident from the records, discussions with staff and from observation, that the staff had the necessary skills, motivation and experience to communicate effectively with people and to support them appropriately. Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 11 There continues to be evidence throughout the home of aids to communication. Picture boards and symbols designed to help people communicate their needs and wishes and to encourage people to make choices were observed. People living at the home receive either one-to-one or two-toone support, therefore staffing levels are good and this maximises the time staff have got to listen and support them in making choices. From discussion with staff and from observation, people are encouraged to be as independent as possible and to make choices. Seaview DS0000066394.V346259.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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are encouraged and enabled to maintain contact with friends and family. People can undertake a range of activities that are interesting, stimulating and appropriate. People benefit from being provided with a healthy and balanced diet. EVIDENCE: None of the people at the home are in any form of paid or voluntary employment owing to their complex needs. However, the home continues to support people to take part in a wide range of activities. On arrival at the home, all were leaving with staff to go on trips to undertake a variety of activities in the local community. Records showed that all people have one-to-one or two-to-one staffing levels identified in their care plans. It was evident from discussion with the team leader and staff that the home supports the young people who live in the home to have every opportunity to take part and experience a wide range of activities. Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 13 The home continues to use a communication board on the wall that makes good use of pictures to indicate planned activities and for showing which staff are on duty. This type of communication aid is in evidence throughout the home with pictures on notice boards and in peoples’ files to assist with choice. The home should consider the use of photographs of activities as this format may enable some people to be more selective. From discussion with staff, it is evident that activities are arranged to meet the needs and likes of individuals. Activities that people take part in include swimming, trampolining, music, golf, shopping, walks, bike rides, ten pin bowling and visits to the cinema. Staff were observed as patient and to speak to people as adult to adult. They were supportive and gave every opportunity to people enable them to make choices. The home ensures family links are maintained and this is well documented in the two files that were examined. Four surveys were sent to people at the home and with support of key staff, comments received indicate satisfaction with the home. Observations on the day of the inspection visit again showed that staff do not enter peoples’ rooms without knocking on the door. Doors to bedrooms rooms have locks and two people had chosen to lock the doors whilst they had gone out. Although the keys are kept in the office people have access to them at any time they wish. This practice is followed as some people in the home do not have the capacity to keep the keys securely or do not wish to hold onto their keys. Menus were examined, which showed that a variety of food is offered, although the menus are there for ‘suggestions’ and in practice people choose what they want to eat daily. The notice board in the kitchen has lists of individual service users specific likes and dislikes. There is also a comprehensive shopping list showing that a wide variety of food is purchased. Evidence was seen of fresh fruit, salad and vegetables in the fridge. An excellent range of photographs was available for staff to be able to illustrate the types of meals available and to encourage choices to be made. Seaview DS0000066394.V346259.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): 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’s care needs are well documented and individual risk assessments are in place so that staff are clear about what is required and how the persons needs are to be met. Procedures are in place to ensure that medication is administered appropriately. EVIDENCE: Information was recorded on care records to indicate the way each person preferred to have their personal care needs met. Each person has either an en suite shower or bath so that they may be assured of privacy. The home employs a mix of male and female staff, but personal care is carried out by staff of the same gender as the person. Care records for each person contained details of their health care needs. There are Health Action Plans on file and charts to record their weight and appointments for health care professionals. These were up to date. Care plans examined contain relevant information about prescribed medication. The home operates a monitored dosage system. There were no controlled drugs in use at the present time. There are currently no people at the home with the capacity to self medicate. Only three people have prescribed medication, which is all stored on separate shelves, clearly labelled, Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 15 in a purpose bought lockable metal cabinet. Neither of the two people case tracked were on medication. No homely remedies are kept at the home. The Medicine Administration Record (MAR) sheets were examined on the day of the inspection visit, these were accurate and up to date. Staff responsible for the administration of medication have been provided with appropriate training. Seaview DS0000066394.V346259.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): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home are able to live in a safe and secure setting. Staff training and procedures are in place, which are designed to protect people living at the home. EVIDENCE: A copy of the home’s complaints procedure written using symbols has been laminated and is on the wall next to the notice board. The procedure is also included in the statement of purpose. No complaints have been received since the service opened. Records examined show that the home has policies in place for the protection of vulnerable adults (POVA). There is a whistle blowing policy in place so that staff may be assured that they will be protected if they feel the need to raise concerns about practices. As part of the induction process staff are provided with a copy of the General Social Care Council good practice guidelines and have to sign to say they have read and understand it. Records examined show that the home carries out POVA checks and Criminal Records Bureau (CRB) enhanced disclosure checks. Staff receive training on Adult Protection issues as part of the induction programme. Seaview DS0000066394.V346259.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): 24, 25, 28 & 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Excellent standards of accommodation and facilities are provided to enable people living at the home to enjoy attractive surroundings, comfort and privacy. EVIDENCE: Seaview is a two storey detached property that is situated in a quiet residential area of Mersea. A tour of the premises was carried with a senior staff member and this showed that the home continues to be maintained to a good standard. The home presents as a light, modern and cheerful place to live. The quality and standard of furnishings and décor remains, as it was when the home was registered. All bedrooms are for single use and have en-suite facilities. Bedrooms seen were clean, well equipped and individual in appearance with many personal such as televisions, photographs and ornaments. People have their own keys, and two people were observed making use of the facility. One person spoken with indicated they were happy with their bedroom and from Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 18 observation, clearly made themselves at home and appeared very relaxed in the room. There were no offensive odours in the home and there is a good standard of cleanliness throughout the building. The home has a lounge, which is large enough for five people, has comfortable chairs and a television, a separate dining area and a room at the back of the house that overlooks the garden. The laundry facilities were clean and appropriate for the size of the home. The kitchen is a modern domestic fitted kitchen and was clean, well maintained and used by many of the people. There is a small table and chairs in the kitchen so that service users can choose whether to sit with others in the dining room or in the kitchen. There is a large private rear garden that is well equipped with garden furniture and games. Staff records examined show that staff receive training on Health & Safety matters including Manual Handling, Food Hygiene and Infection Control. Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 19 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): 31, 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home benefit from being supported by a team of experienced, trained and motivated staff that can meet their needs. People are protected by the home’s recruitment procedures. EVIDENCE: From information available at the home, all staff have or are in the process of taking a National Vocational Qualification at level 2 or above. A team leader was taking the Registered Managers Award (RMA). This number of qualified staff means the home will have exceeded the recommended target for qualified staff during the first two years of operation. The home has an appropriate recruitment procedure in place. Three staff files were checked. The files were well organised and contained all the relevant documents including application forms, job descriptions, two references, a photograph and proof of identity, Criminal Record Bureau (CRB) disclosure checks at enhanced level, notes taken at interviews, supervision records, and training certificates. Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 20 Staff spoken with confirmed that they are well supported and receive supervision on a regular basis. The supervision records showed that a format is used to ensure a range of relevant topics are discussed at each session. Staff training records were well maintained and easily retrieved for checking. Training records showed that staff receive an initial induction into the home and a more in-depth induction using the Learning Disability Award Framework (LDAF). Other training has also been provided on a range of topics that staff require to support the people at the home. Staff said that they considered Seaview to be a happy home and that they enjoyed their work. Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 21 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 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that live at the home can be confident that the management and staff team run the home effectively and have procedures in place to protect them. People at the home, relatives and others are involved in providing feedback, which helps to influence the way the home is run. EVIDENCE: The registered manager has a number of years experience both as a carer and as a registered manager. He has completed both the Registered Manager’s Award and NVQ level 4 in care. The home has a Quality Assurance system in place, which the manager has continued to implement by obtaining the views of interested parties. Evidence was available to show that surveys had been circulated and a summary report Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 22 was available. Records showed that staff hold meetings with people at the home on a regular basis and that a wide range of the topics are discussed and recorded. Staff meetings are also held approximately every two months. Staff spoken with said they felt able to contribute at the meetings. The minutes of meetings confirmed that the primary focus of all discussions is centred on the support and wellbeing of people at the home. Records showed that the home has good compliance with Health & Safety (H & S) matters. Staff had been provided with the relevant H & S training and certificates were available for all systems and equipment, with the exception of the gas service, to show they had been serviced at the correct intervals. Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 23 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 3 5 X 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 4 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 3 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 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 24 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 YA32 Good Practice Recommendations The manager should continue to support staff who have enrolled for NVQ to complete the awards to increase the percentage of staff with a minimum qualification of NVQ level 2. The manager should continue to explore ways including the use of photographs to help with illustrating what is available for people. 2 YA3 Seaview DS0000066394.V346259.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Seaview DS0000066394.V346259.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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