Inspection on 27/06/06 for Stoneswood

This inspection was carried out on 27th June 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

Stoneswood 16/12/08

Stoneswood 31/01/08

Stoneswood 29/09/05

Stoneswood 25/04/05

Stoneswood 05/10/04

Stoneswood 19/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Stoneswood Oldham Road Delph Oldham OL3 5EB Lead Inspector Steve Chick Unannounced Inspection 11:00 27th and 30th June 2006 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 Stoneswood DS0000005522.V301690.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. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stoneswood Address Oldham Road Delph Oldham OL3 5EB 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) 01457874300 NO FAX Northern Care Homes Limited Mrs Michelle Elizabeth Jacques Care Home 28 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (18), of places Sensory Impairment over 65 years of age (2) Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 18 OP up to 8 DE(E) and up to 2 SI (E) Date of last inspection 29th September 2005 Brief Description of the Service: Stoneswood is a residential care home providing personal care and accommodation for up to 28 older people. It is owned by Northern Care Homes Limited which is a private company. The home, which is a large Victorian building, stands in its own grounds in a semi-rural location on the outskirts of Delph, approximately six miles from Oldham Town Centre. There is a public transport link to Oldham. The home provides 22 single and three double bedrooms. The proprietors have chosen to use the double rooms as singles, and use the remaining three registered places for day care. Accommodation for service users is provided on the ground and first floors of the building, with a passenger lift for ease of access. The basement area is used for storage and utility rooms. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection included an unannounced site visit to the home. For the purpose of this inspection three service users were interviewed in private, as were two visiting professionals. Discussion also took place with other service users. Additionally discussions took place with the manager and one of the owners. Two staff members were interviewed in private. The inspector also undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. The home charges £336.00 per week. What the service does well: What has improved since the last inspection? All areas identified for improvement at the previous inspection had been addressed, although some required further work to ensure full compliance with the regulations and national minimum standards. Staff training and supervision had improved significantly. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 6 The manager, who was relatively new in post at the last inspection, has settled into her position and had a positive impact on the running of the home. 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. Stoneswood DS0000005522.V301690.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 Stoneswood DS0000005522.V301690.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. Service users are appropriately assessed before moving to the home to ensure that their needs can be met. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: A selection of service users’ files was inspected. All had a copy of an appropriate assessment undertaken by a suitably qualified community based professional. The manager reported that the home undertook its own assessment before any prospective service user was offered a place at Stoneswood. Some examples of this were seen on files. Stoneswood does not offer intermediate care. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 9 Stoneswood DS0000005522.V301690.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. Written care plans were not all in sufficient detail to fully inform staff of the manner in which an individual service user’s needs should be met, however this had not detracted from service user’s need being met. Medication procedures are not always followed with sufficient rigour to guarantee the safety of service users. Staff practices ensure that service users are treated with respect and their dignity is maintained. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: In the random selection of files looked at, all had a copy of a written care plan. Care plans included the signature of the service user, or, if they were unable to sign, a relative, to signify their involvement in the care planning process. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 11 There was documentary evidence that these plans were regularly reviewed. One example was seen where a care plan had been amended as a consequence of changing needs. This is clearly good practice, but would be improved if there was written confirmation that the service user had been involved and was in agreement with the change. The written care plans varied in the degree of detail they contained. One example was seen where the plan relating to a service user with substantial needs was not in sufficient detail to fully inform staff as to what actions they needed to take to meet the identified needs. Similarly the ‘daily records’ maintained in respect of each service user were not always as detailed as best practice would require. Discussion with staff members identified other mechanisms within the home which complemented the written plans and daily records. These included a verbal hand over at shift changes and a staff communication book. The communication book was seen and did present as often being more detailed than the daily records. Staff also cited low staff turnover and the ability to get to know service users as individuals as mechanisms for ensuring appropriate care was offered. Some examples were seen where there was a record of the service user’s personal history. This is good practice as it reinforces the individuality of the service user and can be used to inform social activities which they may be interested in pursuing. As with other aspects of the care planning process the depth and detail of these records varied. The manager reported that she had identified this as an area needing more work, and was endeavouring to obtain fuller social histories for ‘new’ service users. Service users spoken to during the site visit were complimentary about the care offered at Stoneswood. Comments made include “other residents are looked after well”, “inside a lovely home and its absolutely brilliant”. There was documentary evidence that service users had access to the full range of medical and para medical services available in the community. Two visiting health professionals were interviewed during the site visit. They both expressed confidence, in the staff’s ability to carry out any instructions appropriately. One sad, “the staff are lovely with patients, always there for them”. Staff and service users spoken to confirmed their confidence that appropriate medical support was sought in a timely manner. Medication was seen to be stored appropriately. Stoneswood used a pre dispensed monitored dosage system to administer service users’ medication. A selection of medication administration records were looked at. These presented as being predominantly appropriately maintained. However, one example was seen where medication was recorded as being given four times a day, when actually it was only given three times a day. This error, while only relating to one record, served to diminish the credibility of the other records. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 12 A written risk assessment was seen in connection with a service user administering their own medication. This did not address all the predictable areas of risk. Discussion with the manager indicated that this was an administrative issue as the predictable areas had been considered, but not recorded. Service users and visitors spoken to during the site visit, as well as observation, indicated that service users were treated with respect and dignity within the home. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. A range of activities are available, and there are no restrictions on visiting, which enables service users to be socially stimulated if they wish. Service users are able to maximise their autonomy and exercise choice, within the context of communal living. The provision of food is good and enhances service users’ satisfaction. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The manager reported that various social activities had been tried at Stoneswood, but that most service users do not express an interest in group activities. Minutes of a service users’ meeting were available where activities had been addressed. An activities coordinator was reported as working four afternoons a week. A record is kept of who participated in which activity. The notice board in the dinning room identified which activities were available. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 14 Some group activities do take place including occasional visits from entertainers. It was reported by the manager that ‘arm chair’ activities had been organised the previous week which was enjoyed by a number of service users and will be re booked. Service users who were asked, indicated satisfaction with the range of activities on offer. Some made the point that they appreciated the fact that staff had the time to ‘simply’ sit and chat with them. The manager reported that Catholic and Church of England Clergy visit the home. The home has a policy of encouraging visitors at any reasonable time. Although no visitors were spoken to at this site visit, service users confirmed that there were no unreasonable restrictions on visiting. Service users spoken to confirmed that they were able to exercise autonomy and choice about how they spent their time. Service users confirmed they were able to get up and go to bed when they chose, and could use their room whenever they wanted. The manager reported that service users could have their meals in their room if they wished. Service users spoken to were positive about the provision of food at Stoneswood and confirmed choice at meal times. One service user reported that fruit and drinks were always available. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Service users are confident that any complaint will be appropriately dealt with. Service users are protected from abuse or exploitation by the home’s policies and practices. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: Stoneswood has an appropriate complaints procedure which is made available to service users and their representatives. The record of complaints presented as only being maintained for more ‘formal’ complaints. Service users who were asked, expressed the view that any complaint they may have would be dealt with appropriately. This view was shared by staff who were interviewed. More training had been provided for staff in connection with issues around adult abuse since the previous inspection. Staff who were interviewed demonstrated an understanding of the need to be vigilant about abuse issues. They were confident that service users were safe at Stoneswood and demonstrated an understanding of their responsibilities to ‘whistle blow’ if necessary. Service users who spoken to expressed the view that they were safe at Stoneswood. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. The home is appropriately maintained to provide a safe and homely environment for service users. The home is clean, tidy and hygienic to promote the comfort and well being of service users. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: During the site visit a tour of the building was undertaken. This included a random selection of service users’ own bedrooms. The home presented as predominantly well maintained and decorated. An area of the ceiling in the front lounge had suffered some water damage. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 17 The manager reported that an estimate for the repair and redecoration to this area had been sought the previous day. No issues in connection with the fabric or décor of the building were identified as needing remedial action, which had not already been identified by the manager. Staff who were asked confirmed that they were encouraged to report any defects they identified, and that these were repaired in a timely manner. Stoneswood is set in large grounds, most of which would be inaccessible to service users with restricted mobility. However, several service users were seen to be enjoying the pleasant weather at the time of the site visit, in a fenced area, with appropriate garden furniture, next to the building. The home presented as clean and tidy throughout, with no unpleasant odours. This was confirmed as the usual state of the building by service users and visitors spoken to. Staff also confirmed that cleanliness in the home was good. They also confirmed that standards of hygiene were maintained by the availability and use of appropriate equipment such as disposable gloves and aprons. Service users spoken to said the home was “clean and tidy”. One commented that the “cleanliness was spot on. The room is cleaned daily, and bed and laundry done daily, washed and ironed”. Stoneswood DS0000005522.V301690.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. Stoneswood provides an appropriate number of appropriately trained staff to ensure service users are cared for appropriately. Recruitment procedures are in place minimise the likelihood of employing staff who are unsuitable to work with vulnerable adults. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: A copy of the staff rota for the week beginning 12th June 2006 was examined. This demonstrated that a minimum of three care staff were on duty. The day is split into three shifts :- 08:00 – 15:00; 15:00 – 22:00; 22:00 – 08:00. The manager reported that the dependency of service users was taken into account in the staff rota, and more staff would be made available if necessary. The manager’s hours are in addition to those identified above. In addition to the carers there are, House keepers, cooks, a part time maintenance worker and an administrator. The manager reported that of the nineteen care staff eleven have NVQ II or higher (58 ), two are undergoing NVQ III, four are undergoing NVQ II. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 19 One member of the care team was also reported as having an HND in health and social care. The manager reported that the staff team has a low turnover, and consequently only one member of staff had been recruited since the last inspection. The recruitment documentation relating to that person was looked at. Most of the required vetting procedures had been appropriately undertaken. However the application form only asked for the previous ten years employment history, when a full employment history must be obtained. The application form had been amended by the time of the second visit. Good records were maintained of staff training. These demonstrated that a range of training had been made available for staff, including moving and handling, dementia, life story work, adult abuse and continence management. Group and individual discussion with staff confirmed that training had improved significantly since the arrival of the current manager. Stoneswood DS0000005522.V301690.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 37 and 38. Quality in this outcome area is adequate. The manager is appropriately experienced and qualified to run a care home for the benefit of service users. Quality Audit and Quality Monitoring systems do not offer clarity to service users and other people with an interest in the home about how their views are taken into account in future planning to improve the service. The systems in place to protect service users’ financial interests are sufficiently robust. Health and safety procedures are implemented for the benefit of the well being of service users. This judgement has been made using available evidence, including a visit to the service. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has several years experience in a management position and holds an appropriate qualification for the role. Good working relationships exist between the manager and the owners, with clear lines of accountability. Staff and service users who were interviewed described the manager as open and approachable, and receptive to new ideas. Stoneswood used a variety of tools to assist with Quality Audit and Quality Monitoring. The manager reported that this included a questionnaire for service users. In the context of several service users having communication difficulties a relative had been used to try to elicit an independent and objective level of feedback from service users. The manager reported that even this approach did not result in a great deal of information. The manager reported that the questionnaire results had been analysed and the issues raised at a residents meeting. Minutes of the residents meeting were seen. This process would be improved by having a written report of the outcomes and a written action plan which identified how Stoneswood was going to address any issues identified. There was evidence – mainly around individual activities – that action had been taken, but as with other areas the documentation to back this up was less good. The home had produced a business plan and a current public liability insurance certificate was seen. A selection of records relating to money held by Stoneswood on behalf of service users were looked at. The records presented as being appropriately maintained to safeguard the interests of the service users. Staff who were interviewed confirmed that they did receive regular supervision and appraisal. A selection of supervision records were seen to confirm this. Apart from specific issues identified elsewhere in this report recording is predominantly adequate. One exception to this is in connection with the requirement for the registered person to produce a monthly report on the running of the home. Staff, the manager and one of the owners all confirmed that the owners were regular visitors to the home and were approachable and supportive. However no written reports were available for inspection. The manager reported that equipment in the home was regularly serviced. Not all maintenance certificates were looked at on this inspection. The record of tests to the fire detection and alarm systems presented as being appropriately maintained. There was no record of a fire drill having been Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 22 organised. The manager reported that drills took place as a part of the training but were not recorded. Records of accidents to service users were maintained. As identified at the previous inspection the recording in the accident book was inconsistent and did not always give clear information. Specifically this related to clarity about whether or not an accident had been witnessed, and whether or not the accident had resulted in an injury. Staff confirmed the availability of disposable gloves and aprons to minimise the risk of cross infection. Stoneswood DS0000005522.V301690.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 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 3 3 X 2 2 Stoneswood DS0000005522.V301690.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. 1 Standard OP7 Regulation 15 Requirement The registered person must ensure that all written care plans are in sufficient detail to inform staff as to what action is needed to ensure each service user’s needs are met in an individualised manner. The registered person must ensure that all aspects of the medication procedure are rigorously followed at all times. The registered person must ensure that risk assessments relating to service users administering their own medication address all predictable areas of risk. The registered person must ensure that there is a written analysis of the Quality Audit and Quality Monitoring outcome. This must include an action plan detailing what steps are to be taken to improve the service for service users identified as a consequence of any information received. Timescale for action 01/09/06 2 OP9 13 01/08/06 3 OP9 13 01/09/06 4 OP33 24 01/10/06 Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 25 5 OP37 26 6 7 OP38 OP38 17 17 The registered person must ensure that a monthly report is available for inspection which addresses all the issues identified in Regulation 26 of the Care Homes Regulations 2001. The registered person must ensure that accident records are accurately maintained. The registered person must ensure that all fire drills are recorded. 01/09/06 01/08/06 01/08/06 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 2 Refer to Standard OP7 OP16 Good Practice Recommendations The registered person should ensure that service users, or their representatives, sign to confirm their agreement with any change in the written plan of care. The registered person should ensure that a record is kept of all complaints, even if they are of a minor nature, or immediately resolved to the satisfaction of the complainant. Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Stoneswood DS0000005522.V301690.R01.S.doc Version 5.2 Page 27 - 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!