Inspection on 12/12/06 for Springdale

This inspection was carried out on 12th December 2006.

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

The inspector 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

Springdale 26/01/09

Springdale 01/02/06

Springdale 05/07/05

Springdale 26/01/05

Springdale 19/08/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Springdale Cucumber Lane Brundall Norwich Norfolk NR13 5QY Lead Inspector Ann Catterick Unannounced Inspection 12th December 2006 09:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Springdale DS0000036310.V324295.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springdale Address Cucumber Lane Brundall Norwich Norfolk NR13 5QY 01603 712194 01603 787363 springdale.socs@norfolk.gov.uk www.norfolk.gov.uk Norfolk County Council-Community Care 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) Mr Paul Mann Care Home 35 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (35) of places Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Springdale can accommodate service users who require wheelchairs to assist with independent mobility at the point of admission into those rooms which are over 12 sq metres. This means that only rooms numbered 1, 2, 12, 13, 14, 18, 19, 20, 21, 22, 23 and 33 are suitable for wheelchair users. One (1) Service User, who is named in the Commission’s records and who has dementia, maybe accommodated within the overall number of 35 Service Users Springdale is registered to offer personal care for up to 35 service users who are aged 65 and over. 1st February 2006 2. 3. Date of last inspection Brief Description of the Service: Springdale is a Local Authority home catering for up to 35 elderly people. It is situated in the village of Brundall, a few miles east of the city of Norwich. The home is set in sizeable grounds with garden areas to the side and rear and parking space to the front. The home is operated by Norfolk County Council Social Services Department. The weekly fee at the time of the inspection was £368.72. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was a key unannounced inspection and the visit to the home took place over a period of 8 hours. Thirty services users were accommodated on the day of the visit, 28 permanent residents and two residents admitted for short-term care. The home offers up to four day care placements a day to service users from the local community. Information about the home was received prior to the inspection including a pre inspection questionnaire from the home and comment cards from service users, their relatives and local health professionals. All written comments received were positive. The inspector was able to speak with service users, visitors, staff and management as well as have a tour of the home. The inspector was also able to inspect care plans, staff files and look at some of the homes policies. This was the first time the inspector had visited the home and found it well managed with competent and caring staff offering a good quality service to the service users. What the service does well: All service users and visitors spoken with spoke well of the staff in the home. “Carers are really kind.” “Staff excellent.” “Manager is very good.” “It’s wonderful here, really good.” Service users spoke very positively about the food provided and the kitchen staff. “Cook very good.” “You can have what you want and if they have not got it they will get it for you.” “Lots of choice.” Staff presented as competent and caring enjoying their work. Some staff comments. “A really good atmosphere here.” “Residents come first” Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 6 “Would be happy for my nearest and dearest to live here.” Service users were satisfied with their rooms and the communal areas. Service users had the opportunity to become involved in many different activities within the home. 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. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prior to admission the manager ensures that the home can meet the identified needs of the prospective service user. Information is available to give to service users and their families to ensure that they know what services and care are offered at the home. EVIDENCE: The home has a Statement of Purpose and a Service User Guide. These include all of the information required and the Service User Guide is well presented and easy to understand. Signed contracts were seen on file. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 9 Prior to admission the manager receives an assessment from the placing social services worker and if appropriate a health assessment from the GP or hospital health worker. The manager or another member of the senior team always visits a prospective service user and completes their own assessment. The information from this pre placement assessment is collated into the care plan and it is difficult to identify what information was gathered prior to admission. It is good practice to include the information in the care plan, however it would also be useful to keep a separate copy of the assessment information as well. A recommendation has been made in this area. All of those service users spoken with said they were having their needs met. Intermediate care is not offered in this home. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of service users are met. Medicines are cared for and administered in a safe way with service users having the opportunity to self administer if this is what they choose to do. Privacy and dignity are promoted and supported within the home EVIDENCE: The home has just started to use a new care plan format. The manager had completed a care plan about himself to enable staff to be clear on how a care plan should look and what information should be included. This was seen as a good way to transfer learning and knowledge. Care plans seen were comprehensive and full of useful information. The new format is relatively new and an improvement on previous care plan formats. When fully completed they should provide a good plan of care for service users. It was noted that at present there is no nutritional page within the care plan, however the Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 11 inspector has been informed that training in this area is planned in the near future. This training is to be provided by the local nutritionists. Service users health needs were being met. Positive comments were received from the local health services about the home and the health care received by service users. On the day of inspection two service users were being cared for in bed. Both had fluid and food intake charts but neither of these had been filled in at all on the day of inspection. A recommendation has been made in this area. Medication policy, procedure and processes were inspected and all appeared in good order. The home is to move to the Boot MDS system in March 2007. All staff who administer medication have had the appropriate training. This includes a half-day training session as well as ‘in house’ training. Medication was observed being administered in a safe and competent way on the day of inspection. Privacy and dignity is promoted and this was observed on the day of inspection. All of those service users spoken to said staff were respectful and sensitive in the way they cared for them. Staff spoke very positively about the general care provided within the home and when asked staff said they would be happy for their nearest and dearest to live in the home. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home aims to ensure that the daily life and social activities provided to service users meets their needs. Service users are encouraged to have choice in their lives. The food provided is of good quality and well presented. Service users expressed satisfaction in this outcome area EVIDENCE: On entering the home a notice board is on the wall displaying all of weekly and special activities. For example, weekly bingo, weekly gardening club, weekly aromatherapy. There was also Communion, extend exercise, a Christmas party and Christmas choir. Another more general notice board had information on for staff, service users and relatives. The manager has created a good quality newsletter for service users and this gives all up to date information about what is going on in the home with regard activities, staffing or any other they may need to know. The graphics used made the Newsletter eye catching and easy to read. This was seen as good practice. Staff felt it would be nice to have more time for one to one time with service users but Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 13 generally felt that they had time, especially in the afternoon to offer one to one time. A service user informed the inspector that they were never bored or idle and there was always things to do. Visitors spoken to said they were always made welcome in the home. A visitor spoken to said he was always kept informed about his relative and any changes to their health were shared with him. He said that staff were excellent and his mother had always been provided with excellent care. Service users spoken to informed the inspector that they were given choice within their daily lives in a number of areas and this was seen to be the case on the day of inspection. All comments about the food provided were positive. Several service users made particular comment about the cook saying that she catered for all individual needs. On the day of inspection the food was presented well and looked nutritious and appetising. The manager said that the kitchen staff had won and been runner up in an award presented by the company that employs them. There was a choice and individual preferences were met. For example the desert was apple crumble and the cook was aware that one resident had a very sweet tooth and ensured that she had additional sugar on her desert. Another service user said that you could have whatever you wanted and if the cook did not have it she would get it for you. The cook was seen interacting with the service users on the day of inspection. This is clear evidence of person centred care. The dining in area is an attractive and spacious place to eat and the midday meal was not rushed and when staff assisted service users with their lunch this was done in a sensitive and dignified way. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standards in this outcome area continue to be met. EVIDENCE: The home has a complaints procedure and this is made available to service users and their families. Two complaints had been received since the last inspection and these had been recorded and dealt with appropriately. The home has a policy and procedure for the protection of vulnerable adults and staff spoken to were aware of the whistleblowing policy and all said that they would report poor practice. Staff receive training with regard safeguarding vulnerable adults. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the environment meets the needs of service users but there are areas of improvement needed, especially with regard the size of the lift. EVIDENCE: The home has a development and maintenance plan. Note is taken of the recommendations made at the time of the regulation 26 reports. Other general day-to-day maintenance is referred to the architect department or completed by the handyperson. This was the first time the inspector had visited the home and a full tour of the home was made. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 16 The home has significant grounds and a central garden area is a good facility for service users. This is where the garden club spends time in the summer. An attractive hairdressing room is situated on the first floor and service users said they appreciated this facility. Since the last inspection two lounges have been redecorated and some plastering had taken place in ten bedrooms. The lounge areas are bright and homely offering ample communal areas with four lounges on the ground floor and one on the first floor. There is an intimate seating area on the first floor with views over the grounds and road. This is mirrored on the ground floor next to the entrance and service users were seen sitting in both areas. The home no longer has any service users who smoke and is now a non -smoking home. It would be good practice for this information to be put in the Service User Guide. A recommendation has been made in this are. The bedrooms are not en suite, however, there are ample well -sized toilet facilities throughout the home. At present there are only two bathrooms being used within the home. These bathrooms were of a good size and homely however the third bathroom needs to be developed to offer a bathing or showering service for service users. A recommendation has been made in this area. Several service users gave the inspector permission to look in their bedrooms and all bedrooms seen had been personalised and reflected the personality of the occupier. Some of the bedrooms are small but those service users spoken to who were in small rooms were happy with them. Not all bedrooms have a double socket but when a service user moves into a home if they request a double socket one will be installed. It would be better that these were fitted as part of the general facilities in the home. A recommendation has been made in this area. Only the ambulant and more independent service users are occupying the small rooms. The home is registered for 35 service users but some of the small bedrooms are not used. Thirty service users were accommodated on the day of inspection. The lift is small and inadequate. Many of the service users have their bedrooms upstairs. A person in a wheelchair cannot use the lift without the removal of the footplates and it is difficult, but not impossible, to have a member of staff in the lift with a service user in a wheelchair. A requirement has been made in this area. The home has old fashioned metal windows. The windows are well fitting and there appeared to be no draught from them. Service users were asked about the windows and there appeared to be no concern with regard there function. Some windows had been painted and others need to be painted. The local Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 17 authority will at some time need to replace the windows. The heating in the home is centrally controlled and service users are unable to adjust the temperature in their own rooms. All of those service users spoken to with regard the heating felt that the home was heated adequately throughout and there had been no issues with regard the temperature of their individual rooms. Although service users spoken to were satisfied with the heating the ideal would be that they could control the temperature in their own bedrooms. A recommendation has been made in this area. The home was clean and tidy on the day of inspection and free from any offensive odour. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff working in the home are competent and caring showing that they had received the appropriate training and supervision to fulfil their roles. Service users were in safe hands and were satisfied with the care being provided by the management and staff team. EVIDENCE: Four carers and a care coordinator are on duty for the morning shift and three carers and a care coordinator are on duty for the afternoon shift. The home has a breakfast assistant who enables service users to spend more time with service users at this busy time. On some days an additional member of staff works 5pm to 9pm. Although the home is registered for 35 service users it has not been at full capacity for some time. On the day of inspection 30 service users were living in the home. Staff were seen to work in a relaxed and calm way and all of those service users spoken to said that their care and emotional needs were met by staff. The home does not have a laundry assistant but this is something that is planned for the future. Additional catering and domestic staff are employed. The home has some staff vacancies and has had to use some agency staff. The agency staff Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 19 on duty, on the day of inspection, seemed to have a good understanding of the residents needs. On the day of inspection there appeared to be sufficient staff on duty to meet the needs of service users. Fifty per cent of staff have NVQ level 2 in care and care coordinators are funded to complete NVQ level 3. All staff receive induction and foundation training and evidence of training was seen on staff files. Staff are trained within all areas relating to safe practice, including manual handling and medication. The manager is aware of the new common induction standards and uses these for the induction process. Files of staff were inspected and all contained the relevant information needed. Staff did not start work until all of the relevant information was received. The recruitment and selection process is safe and thorough. Those staff spoken to were happy in their role and very positive about their work. They felt well supported by the manager and said they were offered appropriate training. A member of staff said that although busy care was offered at a steady pace and service users were never rushed. Another member of staff said that it was a happy home and staff worked well together. Staff felt the care offered to service users was of good quality and all said they would be happy for their nearest and dearest to be living in the home if they needed to live in residential care. Staff said there was a good atmosphere in the home and residents always came first. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. 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 managed with effective quality assurance taking place. Service users money looked after by the home is looked after appropriately. Staff receive supervision. The home is managed in a way that promotes the safety of service users and staff EVIDENCE: The manager had now returned to work. In his absence the home was well run by a care coordinator fulfilling this role. The manager is competent and Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 21 experienced having his Registered Manager’s award. He plans to also complete his NVQ level four in care. Staff spoke positively about the management team saying they were approachable and supportive. The home has a quality assurance system and recent findings have now been published. Regulation 26 reports are completed on a regular basis. The home looks after small amounts of money for service users. This was inspected and money is stored safely and accurate records are kept with two signatures for all transactions. Staff receive supervision. Whilst the manager was not a work formal supervision did not take place. However, since his return all staff have received supervision and this will now take place on a regular basis. All staff receive training related to health and safety issues. Domestic staff need to be reminded not to leave chemicals unattended. A recommendation has been made in this area. Fire and first aid notices were seen in different parts of the building giving information about fire procedures and where first aid boxes are located within the home. Risk assessments are completed on the environment and for individuals. The inspector does not feel confident to inspect against Standard 38.4 but believes that the home meets this standard. All accidents and incidents are reported and recorded. Safety posters were seen within the home. Staff receive induction and foundation training and the manager is aware of the new common induction standards. Springdale DS0000036310.V324295.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 2 x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 23.2(a) Requirement The Registered Person must ensure that there is a lift in the home than can be comfortably accessed by all service users. The size of the lift does not enable this to happen at the present time. Timescale for action 01/07/07 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 2 3 4 5 Refer to Standard OP1 OP3 OP8 OP21 OP24 Good Practice Recommendations It is recommended that the Service User Guide inform the reader that the home is now a non- smoking home. It is recommended that the initial assessment, if incorporated in the care plan, is also recorded separately to ensure clarity of need at the time of admission. It is recommended that staff are reminded that they must always complete fluid and food intake charts for those service users being cared for in bed. It is recommended that the third bathroom be refurbished and fit for use for service users to use. It is recommended that each bedroom have two double DS0000036310.V324295.R01.S.doc Version 5.2 Page 24 Springdale electric sockets for use by service users. 6 7 OP25 OP38 It is recommended that radiators in bedrooms have individual thermostatic controls. It is recommended that domestic staff are reminded not to leave their cleaning chemicals unattended. Springdale DS0000036310.V324295.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Springdale DS0000036310.V324295.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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