Inspection on 28/07/08 for Valerie Manor Care Home

This inspection was carried out on 28th July 2008.

CSCI found this care home to be providing an Good service.

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

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Valerie Manor Care Home Henfield Road Upper Beeding West Sussex BN44 3TF Lead Inspector Annie Taggart Unannounced Inspection 28th July 2008 11:30 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 Valerie Manor Care Home DS0000071434.V367772.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. Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Valerie Manor Care Home Address Henfield Road Upper Beeding West Sussex BN44 3TF 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) 01903 812105 zoe@homecarehome.co.uk Home Care Home ltd Miss Zoe Jane Bates Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 15. Date of last inspection Brief Description of the Service: Valerie Manor is a private care home registered for fifteen residents aged 65 years and older. It is a large, detached historic manor house, which has been converted into a care home. There is ample parking space and a large secluded garden set one acre of grounds. The home is located close to the village of Bramber, and the small town of Steyning where there are shops and other amenities. Upper Beeding has a pharmacy, newsagent and small supermarket. The home is close to a local bus route for Steyning, Shoreham, Worthing, and Brighton. The owner, Ms. Zoe Jane Bates is also the Registered Manager Current fees are from £338 to £650 per week Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. In order to plan for this unannounced visit, an Annual Quality Assurance Assessment (AQAA) was sent to the manager for completion and satisfaction surveys were sent to service users and professionals involved with the home. The AQAA was returned before the date it was due and contained good information about the services on offer in the home. Eleven service users, three professionals and three staff surveys were returned and all made very positive comments about the care and support being provided. Comments from surveys have been used in this report. The unannounced inspection was carried out on 28th July 2008 and lasted for 4.hours. During the visit we spent time talking to service users both in communal areas and in their private bedrooms and we spoke to the staff on duty and observed staff practice and interactions with service users. We tracked four care plans and all supporting documents such as daily records and health plans and we spoke to the staff on duty about how they were aware of the needs and wishes of the people they are supporting. We also saw the main meal of the day being prepared and served. We looked at four recruitment files, staff training files and evidence of supervision and we asked the staff about the training and support they receive. Records for the running of the business were seen and these included complaints and comments, incident and accident recording, fire records, health and safety records and the home’s insurance and registration certificate. The Registered Manager, Ms Bates was present and received feedback following the visit. What the service does well: Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 6 Valerie Manor offers an attractive, comfortable and homely environment for the people who live there and people tell us they are very happy living in the home. People’s needs and wishes are assessed and recorded and there are good care plans in place that give clear information for the staff team to follow. Activities and outings are provided, visitors are made welcome at any time and a variety of fresh homes cooked meals is on offer. People tell us they receive good healthcare support and surveys from professionals tell us that they are happy with the service being provided by the home. In order to protect people, there is a clear complaints process in use, staff receive safeguarding training and there are robust staff recruitment procedures and staff training in place. The people living in the home tell us that the manager and staff team are kind and caring and a family member told us, “ Valerie Manor has a lovely homely atmosphere with regular members of staff who the residents have developed relationships with. I visit my mum every day at different times and have never seen any treatment of residents that I am not happy with”. A service user said, “ I have lived here for many years and the care is wonderful, I would not stay here if I was not so happy”. What has improved since the last inspection? What they could do better: The home should continue to expand on the good quality service currently being provided for service users and also continue with the updating of the environment. Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 7 Daily records and records of individual activities undertaken by each person should be improved to give clearer evidence of outcomes for service users. 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. Valerie Manor Care Home DS0000071434.V367772.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 Valerie Manor Care Home DS0000071434.V367772.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 2 3 and 6 Quality outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The home provides good information about the services on offer, people have their needs and wishes assessed and recorded and agree contracts of terms and conditions of residency. EVIDENCE: There is a Statement of Purpose and Service User Guide in use that gives good information about the facilities available in the home. The Registered manager Ms Bates also said that there is now a website in place that is updated regularly to inform people about changes in the home. To ensure that the home can meet people’s individual and diverse needs, assessments of people’s needs and wishes are carried out and we saw that service users and their families are involved in the process. Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 10 Service users told us they were able to make visits to the home before moving in and we saw contracts of terms and conditions of residency that had been signed by service users or their representatives. There is evidence in records that the home keeps people’s changing needs under review and works with service users, other professionals and families to support people if they need to move on from the home, for example to nursing home care. Valerie Manor does not provide intermediate care. Valerie Manor Care Home DS0000071434.V367772.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 Quality outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. There is good information recorded in care plans to inform the staff team of the needs and wishes of the people they are supporting. The home works well in providing healthcare support for people and medication is well managed. EVIDENCE: For each person living in the home there is a plan of care in place that gives clear information for the staff team about the way people need and wish to be cared for. The plans include personal care preferences, routines and risk assessments and also address issues such as privacy and dignity and end of life wishes for people. To ensure that people’s independence is promoted risk assessments both environmental and personal are completed and the care plans also contain an equality and diversity section to identify and address people’s individual needs. Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 12 For some people there are very good life histories in place and Ms Bates said that she is working with service users and families to include these for all of the people living in the home. We looked at the care plans for four service users and saw that they had all recently been reviewed and updated and contained current information about people’s changing needs and healthcare monitoring From looking at records and speaking to service users and staff, we also saw that the home works well with other healthcare professionals such as local doctors and district nurses and were people have specific healthcare or emotional needs, referrals are made to the relevant professionals for advice and support. In a returned survey a service user told us, “ I receive all the medical support I need, the doctor from the local health clinic is very good and will always visit if needed”. During the visit another person told us, “ they are all so very kind here and look after you very well indeed if you are unwell”. A healthcare professional commented in a survey, “ the home is very caring and if I see or pick up on any problems they always respond and listen to advice”. Daily records are completed by the staff team at the end of each shift but these are very basic and often say, “all care given” or “ had a good day” without explaining how these statements could be supported. This was brought to the attention of Ms Bates who said she would discuss it with the staff team at the next team meeting. Policies and procedures are in place regarding the administration and recording of medication and we saw that all staff have attended a short course with the local pharmacist and three people are completing NVQ 2 in medication administration. The medication is dispensed in a Dosette box system and is currently stored in a locked cupboard in the kitchen of the home. The cupboard was small and felt very warm and Ms Bates told us that she is in discussion with the local pharmacy for advice on providing better storage facilities. Medication was well managed and records were current and in good order. There are some controlled medications in use in the home and these are correctly stored. We checked two medications against the records and they were correct. Valerie Manor Care Home DS0000071434.V367772.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 Quality outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The home provides activities and outings for people, visitors are made welcome at any time and there are a variety of fresh, home cooked meals on offer. EVIDENCE: There is a programme of activities in place to provide stimulation and interest for service users and this includes, board games, music sessions, craft and occasional outside entertainers. The home also has a mini bus and this can be used for outings or to take people to appointments. There is a large library of books about the home and people told us that they could have their newspapers delivered and were encouraged to treat the home as “their own home”. Two returned surveys said that they felt that more outings and entertainment could be provided and Ms Bates said that she would speak to service users again about their preferences. Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 14 There is a newsletter that gives up to date information about the home and an Internet “blog” is updated weekly. People told us that their families and friends are made welcome at any time and in a survey completed on behalf of their relative a family member told us, “ We make visits to the home unannounced most weeks. It is always friendly and there is an excellent relationship between the residents, staff and visitors”. A service user told us, “ Every day here I find there is plenty to do. We sometimes have outings and I enjoy scrabble, bingo and the exercise games in the lovely gardens”. One person is also able to have their small dog living with them. Observation of staff practice showed us that people are treated with dignity and respect and there was a good relationship between service users and the staff on duty. The home provides a variety of fresh home cooked meals and service users were very complimentary about the choice of menus. Comments such as, “ the food is lovely” and “ you can’t fault the quality of the food here” were said by all of the people we spoke to and people also said that they were given a choice or an alternative if they did not want the meals on offer. Nutritional assessments form part of the care plans and as the day was very hot we saw people being encouraged and supported to drink cool drinks regularly. We saw lunch; the main meal of the day being prepared and it looked fresh and appetising and was attractively served. Valerie Manor Care Home DS0000071434.V367772.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 Quality outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The people living in the home can be confident that their concerns and complaints will be listened to and acted upon and the home’s policies, procedures and working practices are designed to protect people from risk of abuse or harm. EVIDENCE: There is a complaints procedure in place a copy of which is included in the Service User Guide and also posted in the main hall of the home. The people living in the home told us that they felt they had nothing to complain about but if they did have any concerns or suggestions the staff on duty or the manager dealt them with straight away. In a survey a service user told us, “ there is always someone to listen to if you have any complaint, this is a happy home thanks to the caring staff and a caring manager”. Ms Bates told us that no formal complaints have been received and she told us that that outcomes from suggestions to improving the service are recorded in the home’s newsletter. Staff training records showed us that the staff team have attending safeguarding training and the “No Secrets” abuse awareness booklet is given Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 16 to new staff and also to the families of service users. Ms Bates told us that she is also developing a link to abuse awareness information on the home’s website. One Safeguarding referral has been made by Ms. Bates and this has appropriately been dealt with. The staff on duty were aware of their responsibilities and said that they would report any suspected abuse straight away. Valerie Manor Care Home DS0000071434.V367772.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 24 25 and 26 Quality outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The home provides an attractive, clean and homely environment for the people who live there and further improvements are currently being carried out. EVIDENCE: Valerie Manor is large manor house set in its own grounds in a rural area near to a local pub and garage. There is large, well-tended garden with chairs, tables and a gazebo and people told us they really enjoying sitting out in the good weather. Communal areas such as the lounge, dining area and smaller lounge areas are well decorated and furnished and are comfortable and homely. Bedrooms are all situated on the ground floor, the upper floor being the owner’s private accommodation. All bedrooms are attractively decorated and Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 18 have been personalised with furniture and belongings brought to the home by service users and there is a modern call bell system in use. People told us they were very happy with the accommodation being provided and one person said, The home is very well cared for, our rooms are cleaned every morning so they are always lovely and fresh, in fact it’s good to be here”. As the building is so old there are some difficulties with access for wheelchairs and there are several areas where there is a step down to rooms such as the dining room and in some hallways, which some people are finding difficult. Ms Bates told us that there is currently a programme of redecoration and refurbishment underway and that there is also a plan to modernise the inside of the building to make it more accessible and bring areas such as hallways, bathrooms and the kitchen more up to date. Some carpets are in need of replacement and Ms Bates says that this is being addressed. Bedrooms are redecorated and re-carpeted when they become vacant and the home was pleasant, bright, attractive and clean throughout. A recent visit from the fire officer highlighted some areas such as fire doors in bedrooms that needed urgent attention and Mrs. Bates was able to show us letters confirming that the fire department is happy with the progress being made. A recent visit by the Environmental Health Officer did not make any requirements. Valerie Manor Care Home DS0000071434.V367772.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 Quality outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The people living in the home are being supported by a caring, competent and well supported staff team and are protected by the home’s recruitment procedures. EVIDENCE: Staffing rotas showed us that there are two care staff a cook and a cleaner on duty during the day and the Registered Manager; Ms Bates also works alongside the staff team for part of each day. There is one person awake and one asleep at night. As many of the people living in the home are quite independent, this level of staffing is meeting the needs of the fourteen people currently living in the home. Service users were very complimentary about the staff team describing them as “friendly, kind and caring” and in a survey we were told, “ The staff here are a mixed bunch of both young and middle aged. There is always a member of staff available and I am very pleased with the care I get”. To ensure that people are protected, there is robust recruitment process in place, we saw the files of four members of staff, two who were new and two Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 20 who had been employed for some time and all had a current Criminal Bureau Check (CRB) and references in place. From looking at workbooks that are being completed, we saw that a Skills for Care induction is in place and new staff also receive an in-house induction to introduce them to the working practices in the home. Ms Bates told us that she is also in the process of recruiting some volunteers to provide further social opportunities for service users and references and CRB’s have also been taken up for these people. Training records showed us that the staff team attend mandatory training such as first aid, health and safety, infection control and safeguarding adults and in the AQAA Ms Bates told us that 80 of the staff team either held or were working towards the NVQ award at level 2 or 3. As some of the people living in the home have been diagnosed with short-term memory loss or early stage dementia, Ms Bates told us that training in these areas was also being accessed for the staff team. There is no formal staff supervision in place as yet but the staff on duty confirmed that Ms Bates is working alongside them, assessing their skills and competences and giving daily supervision and support. Valerie Manor Care Home DS0000071434.V367772.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 32 33 35 and 38 Quality outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The home is being run in the best interests of the people living there managed by a competent and caring manager. EVIDENCE: The Registered Manager of the home, who is also the owner, is a registered nurse who has extensive management experience and qualifications within the care sector and attends further training in order to update her skills and experience. Service users and the staff on duty were very complimentary about Ms Bates open management style and comments included that she was “approachable, friendly and very knowledgeable” and “always there when you need advice or support”. Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 22 There is good evidence from talking to service user and from surveys that the home is managed in the best interests of the people who live there and in a returned staff survey we were told, “ this home is run to provide the best care possible for service users and hopefully to meet all their needs and requirements”. As there home has been under new ownership for only six months there has not been a formal quality assurance process carried out but Ms Bates has carried out surveys with service users, staff and families and showed us that she is using the outcomes to gain information on the future development of the service being provided. We were told that the home does not hold or manage monies for service users and instead people either manage their own finances or families or financial advisors are invoiced monthly for any incurred expenditure. We looked at records for the running of the business and saw that health and safety issues are identified and addressed and as detailed earlier in this report, extensive work has been carried out to update the fire officer’s requirements and staff receive regular fire training. We also saw at each exit point there was a sealed list of service users names and bedroom numbers also detailing their mobility requirements in the event of the home having to be evacuated. The fire book showed us that fire tests are regularly undertaken and recorded. A new five year electrical wiring certificate has been gained and electrical appliance testing is still in date. Incidents and accidents are recorded and Regulation 37 reports sent to the Commission when required. No Requirements were made at this inspection visit. Valerie Manor Care Home DS0000071434.V367772.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 3 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Valerie Manor Care Home DS0000071434.V367772.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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