Inspection on 02/10/07 for Sunhill Court

This inspection was carried out on 2nd October 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sunhill Court 10/09/08

Sunhill Court 03/03/08

Sunhill Court 29/11/06

Sunhill Court 22/11/05

Sunhill Court 04/08/05

Sunhill Court 21/10/04

Sunhill Court 07/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Sunhill Court Mill Lane High Salvington Worthing West Sussex BN13 3DF Lead Inspector Mrs Annie Taggart Unannounced Inspection 09:45 2 October 2007 nd 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 Sunhill Court DS0000024220.V343310.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. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunhill Court Address Mill Lane High Salvington Worthing West Sussex BN13 3DF 01903 261563 01903 261563 sunhillcourt@btinternet.com 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) Woodean Limited Mrs Linda Kilgarriff Care Home 40 Category(ies) of Dementia - over 65 years of age (13), Old age, registration, with number not falling within any other category (40), of places Physical disability (3), Physical disability over 65 years of age (3) Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of service users accommodated at one time should not exceed 40. To include up to thirteen (13) persons in the category Dementia Elderly (DE)(E) can be accommodated. 29th November 2006 Date of last inspection Brief Description of the Service: Sunhill Court is a care home able to provide nursing care to forty older people. Thirteen people living at the home may have dementia and other related mental disorders and it is also registered to accommodate three service users in the category physical disability between the ages of fifty-five and sixty-five. The home is located in a very quiet residential area in the north of Worthing. The access to the main road is via a partly unmade road, which does not have street lighting. The home has thirty-two single rooms and four doubles. There are three levels all accessible by a vertical lift. The home has a sunroom built on the ground level and commands views over the Findon Valley. The current scale of fees being charged at the home is from £499 to £700 per week. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparation for the visit an Annual Quality Assurance Assessment (AQAA) was sent to the manager, this was returned completed on the 25/9/07 following a reminder letter being sent by the Commission and a telephone call to the manager. The last two inspection reports were read along with any other relevant documentation and correspondence relating to the home and a planning document was completed. The unannounced visit was carried out at 9.45am and lasted for 4.5 hours. We spent time talking with service users both in their private bedrooms and in communal areas and also spoke with two visitors and a local doctor who regularly visits the home. Five care plans with all supporting documentation were tracked with any issues that needed further clarification being discussed with the relevant service user or the staff team on duty. Four staff files were seen, three were in good order but one did not contain all of the required documentation. We also spoke to five of the staff on duty during the day. We saw the main meal of the day being prepared and served and also looked at food records. Records for the running of the business were seen including fire check and staff fire training, the complaints book, an accidents and incidents log and health and safety records. The Registered Provider was in the home for part of the visit dealing with a tap that we had identified as being too hot for safety. The manager was not present during the day but received feedback via a telephone discussion with the inspector following the visit. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: In order to ensure that service users needs and wishes are adequately met and that people are protected from harm, the manager must ensure that: That there is a programme of activities and outings in place within the home and that attendance at sessions are recorded for each service user. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 7 Healthcare records are updated to reflect the care given to people being cared for in bed and how often the care is provided. The medication recording systems must be reviewed to ensure that they detail any changes in administration and topical creams should only be used for the person for whom they were prescribed. All of the staff team must attend training in the protection of vulnerable adults from abuse and also dementia awareness training. Staff records should be current and contain all of the required documentation including evidence of a current Criminal Bureau Check and records of staff training and development should be kept for monitoring purposes. In order to ensure that the staff team are monitored and supported, all of the staff team must receive supervision at least six times a year and regular staff meeting must be held. Records for the running of the business must be current and reports of incidents, accidents and deaths in the home reported to the Commission as required under Regulation 37 of the Care Standards Act 2000. 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. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 8 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 Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 9 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 3 and 6 Outcomes for service users in this area are considered as good, This judgement has been made using available evidence including a visit to this service. Prospective service users and their families can be confident that they will be given current information about the home and that in order to meet individual needs and wishes they will be involved in the pre-admission process. EVIDENCE: The home has a Statement of Purpose and Service User Guide in place and both documents have recently been updated. In order to ensure that individual needs and wishes can be met, the home carried out pre-admission assessments and service users confirmed that they and their families were able to visit the home prior to moving in. Contracts of terms and conditions of residency are agreed and samples seen on file at the home had been signed by the service user or their representative. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 10 Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 11 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 Outcomes for service users in this area are considered as poor This judgement has been made using available evidence including a visit to this service. Although the people living in the home receive good healthcare support, there are potential risks regarding the management of medication and the lack of daily records of the individual support being given to people being cared for in bed. EVIDENCE: In order to inform the staff team of the needs of the people they support, for each person living in the home there is a plan of care in place that has been completed using information from the pre-admission assessments. We tracked five care plans and each plan had information regarding the health and social needs of service users including personal preferences, risk assessments, pressure area and manual handling assessments. Where bed rails are in use for people there are agreements in place. Families or service user representatives had signed two of the agreements but three Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 12 others were still unsigned. Three care plan agreements had been signed by the service user or their representative but two others had not been not signed. There was evidence that the home works with other healthcare professionals and we spoke to a doctor who said that they visit the home every two weeks in order to monitor people regularly. The doctor said that they were happy with healthcare support that the home currently provides. Specialist equipment such as pressure relieving beds are in use and as already stated, pressure area risk assessments are undertaken. As good practice the level the pressure beds should be set at for each person should be recorded in the care plan to ensure they are set at the correct rate. Daily records should also be kept regarding food and fluid intake and how often people who are being cared for in bed receive pressure relieving care. There are polices and procedure in place regarding medication management and only trained nurses administer medication in the home. Medication is suitably stored in a locked cabinet that is clean and well organised. Gaps were found in the Medication Recording Sheets and for some people medication had not been signed for at all or had not been administered as prescribed on the record sheets. The registered nurse on duty said that this was because some medications had now been discontinued or had been represcribed by the doctor to be used as PRN (when needed). To ensure that people are receiving the correct medication at the correct times a Requirment has been made that the home must liaise with the pharmacist and doctor to ensure that the recording sheets reflect the current medication prescribed for each service user. Controlled medication is well managed, two service user’s records where checked and found to be correct. When visiting service users in their bedrooms we found that for several people, topical creams prescribed for another person were in use or the name had been crossed out and another persons written in. The management of medication was also a Requirment at the last visit. Sunhill Court DS0000024220.V343310.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 Outcomes for service users in this area is adequate . This judgement has been made using available evidence including a visit to this service. The people living in the home are encouraged to keep in touch with family and friends and are offered a choice of fresh home cooked meals. Although the home says that a variety of activities are available, this is not recorded in service user’s records. EVIDENCE: The AQAA states that a variety of activities and entertainment opportunities are available for people and that alternative therapies such as aromatherapy and massage are in place but attendance by people at activities is not recorded in the care plan or in daily records. Service users said that they had recently enjoyed visiting musicians but there is no programme of regular activities or outings displayed and no specialist input or activities are recorded for service users in the unit for people with dementia. The people living in the home said that they were able to keep in touch with family and friends whenever they liked and many people have their own telephones. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 14 A visitor commented, “I live abroad and the home uses the Internet to keep me up to date on how Mum is. I like the home, the staff are caring and my Mum has her own things around her and has her own telephone to keep in touch”. A service user said, “ I have been here for eighteen months, generally everything is very good indeed, the staff are brilliant and I choose what I want to do”. From looking at menus and speaking to the people living in the home, it is clear that a variety of fresh, home cooked meals are provided. We saw the main meal of the day being prepared and served and service users said that the meal was tasty and that they had enjoyed it. Where people needed support with eating this was carried out in an unhurried sensitive way by the staff on duty. Records show that the religious and specialist dietary needs of one service user are addressed and catered for. A service user commented, “ There is a choice on the menu and the food is very good. At suppertime they read it out to me to choose for the next day. They know I don’t like tea and coffee so always bring me Bovril, which I love”. Sunhill Court DS0000024220.V343310.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Outcomes for service user in this area are adequate. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are recorded and acted upon but there are potential risks to service users as not all of the staff team have attended abuse awareness training. EVIDENCE: The home has a complaints procedure, a copy of which is displayed in the entrance hall. We saw the complaints book, which showed that the manager records and investigates complaints and concerns. Service users and two visitors said that if they had a complaint they would feel confident about telling the manager or a member of staff. The AQAA states that three complaints have been received in the past twelve months and that these have been responded to by the manager in the given timescales. Records show that all of the staff team have not yet attended training in the protection of vulnerable adults from abuse or received training in dealing with people suffering from dementia. The manager said that training videos had been purchased but training sessions had not yet been held. The staff on duty were aware of their responsibilities should they suspect any abuse had occurred and said that they would report concerns to the manager. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 16 Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 17 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 22 24 and 26 Outcomes for service user in this area are good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, attractive environment for the people who live there and this will be further improved when the current work being undertaken is completed. EVIDENCE: There is a programme of refurbishment and redecoration underway in the home and recently the sun lounge has been extended, the gardens landscaped and some bedrooms redecorated. Two large plasma screen televisions have been purchased for the lounge areas. The home is situated over three floors with a separate unit on the first floor for people with dementia. There is a passenger lift for access to the second floor. The third floor is used as staff accommodation. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 18 Bedrooms are light, airy and comfortable and have been personalised by the people living in the home. During the visit several carpets were being cleaned and the home was generally clean and fresh. Specialist equipment such as pressure relieving beds and hoists have been provided as required but some of the staff said that more wheelchairs to move people about would also be helpful. The hot water tap in one toilet was running at a temperature that could have caused a scalding accident. The nurse on duty reported this to the Provider who ensured that this was attended to and made safe immediately. During the morning coffee break we noted that some of the mugs in use were very chipped, which could have been an infection control risk, this was pointed out to a member of staff who said they would check through the mugs and remove any that were chipped or cracked. Recent visits by the Fire Officer and Environmental Health Officer have identified several requirements for improvement to the home and during the visit work was being undertaken to meet these. At the last visit a Requirment was made regarding the unsafe surface temperatures of radiators. The radiators in the home have still not been covered but were at a safe surface temperature. Environmental risk assessments have been recorded for bedrooms and are kept on file in the home. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 19 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 Outcomes for service users in this area are poor. This judgement has been made using available evidence including a visit to this service. Although people say that the staff team are kind and caring, there are potential risks to service users from the lack of specific staff training and from employment records not being available. EVIDENCE: One registered nurse, four care staff, three supporting ancillary staff and the cook were on duty during the day and the rota showed that at night, one nurse and three care staff are available. The manager’s hours are in addition to the rota. Service users were complimentary about the staff team and comments included, “I don’t want to move anywhere else, the staff are perfect, kind and thoughtful and the choice of food is good” and “ I have been her for three years, the staff are very kind indeed and always come when you ring the bell”. The staff on duty were kind and attentive in their dealings with service users and said that they were aware of the care plans and of people’s individual needs. The home has policies and procedures in place regarding staff employment. Four staff files were seen, three contained all of the necessary documents including a Criminal Bureau Check (CRB) number, but for one person who has recently been employed, there was only one reference on file, no evidence of Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 20 an induction having taken place and no CRB evidence. This was discussed via the telephone with the Provider and manager after the visit and the manager said that the records had been found on another file. They were however not available at the time of the visit. Training certificates are held on individual staff files but there is no overall training plan in place to monitor when training is due and as previously stated all of the staff team have not attended training specific to the needs of the people they support, for example people with dementia. The AQAA states that seven of the care staff now have the level 2 NVQ award. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 21 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 36 37 and 38 Outcomes for service user in this area are poor. This judgement has been made using available evidence including a visit to this service. There are potential risks to service users from lack of staff supervision and support, staffing records not being in place, accidents and incidents not being reported and errors in medication management. EVIDENCE: The Registered Manager has four years management experience and as yet has not completed the Registered Manager’s Award. Service users and most staff were complimentary about the manager and said that she was approachable and friendly. One person commented that they did not feel that their comments or requests were always taken seriously. Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 22 Regulation 26 Registered Provider’s visits are carried out and recorded and outcomes from these visits detail improvement plans for the future of the home. A Requirement was made at the last visit for all staff to receive supervision at least six times a year. Records show that this has not been met and records show that staff meetings are very sporadic. This requirement has now been outstanding from 22/11/06. A further Requirment regarding consultation with the fire officer made at the last visit has been met and work is currently being undertaken to improve fire safety in the home. Fire training for staff was recorded as having been held on 13/8/07. The AQAA states that service users and their families will be informed by letter that automatic closures will be fitted to bedroom doors on request. Accidents and incidents in the home are recorded in an accident book. The records were not available during the visits but we were shown a monitoring log, which showed what service user each page taken from the accident book referred to. Our service history of Sunhill Court shows that accidents, incidents and deaths in the home are not being reported to the Commission as required under Regulation 37 of the Care Standards Act. The last incident report was received in 2006. Sunhill Court DS0000024220.V343310.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 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 1 1 1 Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? yes 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 OP9 Regulation 12.1(a) Requirement Timescale for action 20/10/07 13 (2) (a) 2. OP36 18.2 Medicines must be administered according to the directions of the prescriber. The reason must be recorded for withholding doses of a medicine, prescribed to be taken regularly (Outstanding from 1/12/06) Topical creams must only be used for the person for whom they are prescribed. To ensure that the staff team are 30/10/07 monitored and receive support All care staff must receive formal supervision at least 6 times a year. (Outstanding from Inspection 22/11/06) To safeguard service users and for monitoring purposes, the registered manager must ensure that staff records including a current Criminal Bureau Check and 2 references for each person are available for inspection. To ensure that there is evidence that service users receive opportunities for interest and DS0000024220.V343310.R01.S.doc 3. OP29 19 20/10/07 4. OP12 16 .2 (m) 30/10/07 Sunhill Court Version 5.2 Page 25 5. OP8 12 6. OP30 13 (6) 7. OP37 37 (1) (a to g) stimulation, attendance at activities and outings must be recorded in the care plan or daily records. In order to ensure that the 20/10/07 correct level of support is being offered, care plans should record the level that pressure-relieving beds should be set at and how often care and nutrition is provided to people who are being cared for in bed. To ensure that the staff team 15/11/07 have the skills to carry out their roles and that service users are protected, all staff must attend POVA and dementia awareness training. To ensure that the management 20/10/07 of the home is monitored and that incidents, accidents and deaths in the home are reported the Registered Manager must send details of these occurrences to the Commission in line with Regulation 37 of the Care Standards Act 2000 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sunhill Court DS0000024220.V343310.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Sunhill Court DS0000024220.V343310.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!