Inspection on 11/09/06 for The White House Care Home

This inspection was carried out on 11th September 2006.

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

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

Other inspections for this house

The White House Care Home 05/01/09

The White House Care Home 04/03/08

The White House Care Home 13/09/07

The White House Care Home 12/12/05

The White House Care Home 28/06/05

The White House Care Home 14/12/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The White House Care Home Rivelin Dams Manchester Road Sheffield South Yorkshire S6 6GH Lead Inspector Michael O`Neil Key Unannounced Inspection 11th September 2006 09:00 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 The White House Care Home DS0000061514.V308708.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. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The White House Care Home Address Rivelin Dams Manchester Road Sheffield South Yorkshire S6 6GH 0114 230 1780 0114 230 6638 none None Mrs Julia Pauline Cobb Mr Simon Cobb Ms Julie Dawn Frith Care Home 32 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) Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (16) of places The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service users in the category DE(E) will be housed in one building and those in the category of OP in the other. Staffing levels must comply with, at least, those in the publication `Residential Form Care Staffing in Care Homes for Older People` published April 2002. 12th December 2005 Date of last inspection Brief Description of the Service: The White House is a converted property providing personal care and accommodation for thirty two service users over the age of sixty-five. Sixteen of these places are in a separate extension for service users with dementia. The homes registered providers are Mrs Julia Pauline Cobb and Mr Simon Cobb. The home has beautiful views overlooking Rivelin Dams. There are large landscaped gardens and views of the Dams can be seen from the majority of the rooms. The home is located some distance away from shops and other amenities. The accommodation is on two floors with lift access, and the majority of rooms are single. All areas of the home are accessible to wheelchairs. There is a parking area to the rear of the home The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection carried out by Mike O’Neil, regulation inspector. This inspection took place between the hours of 09:00 am and 4:45 pm. Julie Frith, registered manager, was present during the inspection. The manager submitted a pre inspection questionnaire to the CSCI prior to the actual visit to the home. Some information from the questionnaire is included in the main body of the report. Opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home, check the homes policies and procedures and talk to 7 staff, 3 relatives and 8 residents. The inspector wishes to thank the staff, relatives and residents for their time, friendliness and co-operation throughout the inspection process. A copy of the previous inspection report was displayed and available in the foyers of the home. Information about how to raise any issues of concern or make a complaint was on display in the entrance halls. The manager confirmed that the range of monthly fees from 11th September 2006 were £350 - £405 per week. Additional charges included hairdressing and private chiropody. What the service does well: Residents said that the care they were receiving was good. Residents added comments such as “staff are lovely”, “staff are nice and friendly” and “it is a really nice place to live”. Relatives made comments such as “the staff are caring and the standard of care is very good at The Whitehouse”. The inspector observed that residents were well dressed in clean clothes and had received a good standard of personal care. A friendly and welcoming feel was very evident in The Whitehouse. No unpleasant odours were noticeable in the home. Relatives and residents said that the home was always kept clean. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 6 Residents and relatives said that they met regularly with the manager of The Whitehouse and spoke positively about her approachability and helpfulness. Staff said that staff moral was high and that they enjoyed working at 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 White House Care Home DS0000061514.V308708.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 The White House Care Home DS0000061514.V308708.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): Standard 3. Standard 6 is not applicable to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ assessments prior to admission took place. These enabled staff to be aware of residents needs to ensure that they could be met. EVIDENCE: Staff spoken to said that assessments were undertaken prior to admission to ensure the service could meet prospective residents needs. The home’s manager and social workers of the residents carried these out. Copies of care management assessments were available and held within resident files. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 9 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): Standards 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents’ health, social and personal care needs were not documented in sufficient detail and evaluated at the frequency required to ensure that the resident’s needs could be fully met. A range of health care professionals visited the home to assist in maintaining the health care needs of residents. Residents themselves said that the care they were receiving was good. Some medication practices and storage procedures provided a risk to the residents’ health and welfare. Residents said that the staff promoted their privacy and dignity. Staff spoke to residents in a respectful way and showed empathy and patience when providing personal care to the residents. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 10 EVIDENCE: Three resident care plans were checked. The standard of the care plans were not satisfactory, and the information in them, was inadequate to ensure that the resident’s changing health, social and personal care needs could be met. • • • Two care plans had not been reviewed by the staff for 3 months. Some recognised social and health needs had not been recorded as a problem needing staff interventions in two care plans. A resident who had nutritional problems had no care plan identifying interventions required by the staff and the resident had not been weighed in the last 3 months. Two care plans had not been reviewed following a G.P’s visit, when instructions were given by a G.P to change the treatment of the resident. There was no evidence to suggest that the resident or their relatives were involved in the drawing up or the reviewing of the care plans. • • However the manager was arranging reviews with the residents and their relatives. The day to day conversations relating to the residents health needs were not, however, being recorded in the care plans even though the relatives interviewed said they were kept informed about the residents health and well being. Residents said that the care they were receiving was good. Residents added comments such as” staff are lovely ”, “staff are nice and friendly” and “it is a really nice place to live”. Relatives made comments such as “the staff are caring and the standard of care is very good at The Whitehouse”. The inspector observed that residents were well dressed in clean clothes and had received a good standard of personal care. Residents’ health and safety was not maintained because not all Medicine Administration Records (MAR) were adequate. • One resident’s allergy to a specific medication was not recorded on the MAR sheet. • Two of the MAR sheets contained hand written instructions with no signature as to the prescriber. Whilst waiting for a label to arrive from pharmacy two staff members, who check that the correct information is The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 11 documented, or ideally the General Practitioner must sign any handwritten instructions on the MAR sheets. Medicines were not securely stored around the home. In one room, although the medication was locked in a cupboard, there was no lock on the door of the room and the window in the room was wide open. The manager confirmed that the medication had been stored in the room for many years but agreed that the security of the room needed improving and therefore agreed to relocate the medication to a secure room within the next two days. Residents said that staff at the home respected their privacy and dignity by knocking on their doors and waiting for a response before entering. The inspector observed this practice of staff knocking on residents’ doors. Staff spoke to residents in a respectful yet friendly way and showed empathy and patience when providing personal care to the residents. The White House Care Home DS0000061514.V308708.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The majority of residents had a choice of lifestyle within the home and they were able to maintain contact with family and friends ensuring that they continued to be involved in community life. The home has an open visiting policy, which assisted in maintaining good relationships with residents’ representatives. Meals served at the home were of a good quality and offered choice to ensure residents receive a healthy balanced diet and in the main the meals were served at times convenient to residents and in pleasing surroundings. EVIDENCE: The majority of residents were able to spend their day as they wished and move freely around the home. Residents said that they were able to maintain contact with their family and friends. Relatives said that they were always made to feel welcome when they The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 13 visited and they were able to visit at any reasonable time of the day or evening. A friendly and welcoming feel was very evident in The Whitehouse. Some residents said they enjoyed some of the activities available at the home, whilst other residents said that they chose not to join in with the activities arranged. These activities were advertised around the home. The inspector observed some activities taking place. However for one group of residents it appeared that the activity was not enjoyable and some residents slept throughout the activity. The inspector was pleased to see evidence that staff had started to look at the suitability of activities and were involving the residents in this decision-making. On one unit the staff were not providing information that may help residents with orientation. The resident’s rooms did not have their name displayed on the door. The only detail displayed in the lounge was the date. Information such as the weather, the place where the residents were living or a news item may help the residents with orientation to time and place. Residents said they chose when they got up and went to bed and generally how they spent their day. Some residents said they preferred to stay in their room at certain times of the day and that the staff respected their decision. Residents said that they had a choice of food and that the quality of food served was good. Residents said that they were often served with fresh produce, which was grown in the gardens of the home. The inspector observed lunch being served in two dining rooms. In one dining room lunch was served in a pleasant relaxed manner and residents were sat at tables, which had been nicely set. Residents said that they enjoyed their lunch. However one dining room appeared crowded with the residents having only limited space in which to eat their meal. The staff were assisting several residents with their meals, however the staff had failed to provide the residents with equipment such as a plate guard that would promote residents independence and enable them to feed themselves. One residents food had not been cut up and because of this the resident was eating in a manner that did not respect their dignity. The inspector would question whether the resident’s dietary needs had been appropriately assessed and whether staff may need additional training on nutrition and the presentation of food. The White House Care Home DS0000061514.V308708.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure residents are protected from abuse. Complaints procedures are in place to enable residents and relatives to feel confident that any concerns they voice will be listened to. EVIDENCE: Complaints procedures were displayed around the home. Residents and relatives said that if they had any concerns that they would feel comfortable in talking to the manager and they knew that the problems would be dealt with immediately. Staff said they had received information and training on adult abuse and said they had read and were aware of the policies on whistle blowing at the home. The White House Care Home DS0000061514.V308708.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment within the home was well maintained and clean providing a comfortable, safe environment for residents. EVIDENCE: The grounds around the home were very welcoming and residents said that they could easily access them should they wish. The residents and their relatives were sitting outside on garden furniture in the beautiful gardens of the home. Three bedrooms were checked in detail and many others seen, all were comfortable and homely. Bed linen checked was clean and in a good condition. No unpleasant odours were noticeable in the home. Relatives and residents said that the home was always kept clean. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 16 Window restrictors were fitted to all windows checked. The hot water temperature in one bathroom checked measured a safe temperature below 45 degrees centigrade. This will assist in maintaining resident safety. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 17 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): Standards 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff were employed in sufficient numbers to meet the residents needs. The information and checks made on staff was insufficient to adequately protect the welfare of residents who lived at the home. Staff have completed training that ensures these staff have the competences to meet the residents needs. Staff undertook induction training to ensure they had the skills needed to carry out their duties. EVIDENCE: The manager stated that agreed staffing levels were being maintained and the staff rota identified agreed staffing levels had been met. Staff said staffing levels were adequate. Residents said there was always a member of staff available when they needed them. Relatives said that staff were very visible around the home when they visited. The manager said that the required 50 of care staff had achieved their level 2/3 NVQ qualification. A sample of staff files checked identified that staff had achieved their NVQ qualification. Two members of staff interviewed said they had completed their NVQ training. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 18 Two staff files were checked. The recruitment information obtained for the staff was insufficient to adequately protect the welfare of residents who lived at the home. One file did not contain a reference from the employee’s last employer, or an enhanced Criminal Record Bureau (CRB) and Protection Of Vulnerable Adults (POVA) check. The manager did say that a CRB had been applied for that the POVA checks were carried out by the staff at the company’s Head office, however the regulations do state that the information above must be “at all times available for inspection in the care home”. The manager confirmed that all other staff working at the home had completed enhanced CRB/POVA checks. There was a training and development plan for the staff. Staff said they were encouraged to attend training on various care topics and that there were good training opportunities available to them. Staff interviewed said that when they started work they received induction training in the first two months of their employment. A staff file checked identified that a member of staff had received induction training when they commenced work at The Whitehouse. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 19 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): Standards 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a positive style of management in the home. This would have a positive affect on the quality of the service the residents receive. The homes policies and procedures promoted the health, safety and welfare of residents and staff. EVIDENCE: The manager was very positive about the inspection process and was committed to improve the service of The Whitehouse and meet the National Minimum Standards and Care Home Regulations. The manager had completed her level 4 NVQ management qualification and had provided the CSCI with a copy of this certificate. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 20 Residents and relatives said that they met regularly with the manager of The Whitehouse and spoke positively about her approachability and helpfulness. Staff said that staff moral was high and that they enjoyed working at the home. The home had an active quality assurance system. There was evidence of internal auditing of the homes environment, services and records. Staff and resident meetings were held and minutes of these meetings were seen. The manager said that the home does not handle any money on behalf of residents and that the residents’ relatives or advocates handle this responsibility. This information is provided in the service user guide. Staff said they were receiving supervision on a regular basis. The inspector saw records to confirm that staff supervision had taken place. Staff said they had received recent fire safety and other health and safety training. A sample of records showed that staff were receiving this statutory training. Fire records stated that weekly testing of the fire alarm system had occurred. A sample of records showed servicing of the homes utility systems had occurred. At the time of inspection fire exits were clear and window restraints were in situ at first floor windows checked to prevent falls. Hazardous products were safely stored in the home. This will promote the safety and welfare of the service users. The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 21 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 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 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 3 3 X 3 3 X 3 The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 12, 15 Requirement Reviews of the care plans must include the wishes and opinions of the service users or their advocates. (Previous timescale of 30/03/06 not met) Resident care plans must be reviewed at least every month. Care plans must be reviewed and evaluated to ensure they identify the changing health, social and personal care needs of the residents. (G.P visits) Resident care plans must contain sufficient detail to ensure that the resident receives a consistent high standard of care. Appropriate action must be taken to maintain service users nutritional needs. (Monitoring weight) Resident’s allergies must be recorded on their Medication Administration Record. The Medication Administration Records must contain General Practitioners or two members of staffs’ signatures alongside any DS0000061514.V308708.R01.S.doc Timescale for action 01/12/06 2. 3. OP7 OP7 12,15 12,15 01/12/06 01/11/06 4. OP7 15 01/12/06 5. OP8 12,13,15 01/11/06 6. 7. OP9 OP9 13 13 01/10/06 01/10/06 The White House Care Home Version 5.2 Page 23 8. 9. OP9 OP12 13 16 10. OP12 16 11. 12. OP15 OP15 16 16 13. OP29 19 directions regarding the dosage of the medication or the time the medication is to be dispensed. Medication must be securely stored around the home. Residents must be given the opportunity for stimulation through suitable leisure and recreational activities. Arrangements must be implemented to ensure that residents are orientated to date,time and place. Residents must be served meals at a time convenient to them and in pleasant surroundings. Staff must provide residents with suitable eating utensils and aids enabling the resident to maintain independence for as long as possible. The home must obtain all relevant information and documents before new employees commence work. 15/09/06 01/12/06 01/12/06 01/12/06 01/12/06 01/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 The White House Care Home DS0000061514.V308708.R01.S.doc Version 5.2 Page 25 - 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!