Inspection on 16/10/07 for Vallance Rest Home

This inspection was carried out on 16th October 2007.

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

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

Other inspections for this house

Vallance Rest Home 11/05/06

Vallance Rest Home 25/11/05

Vallance Rest Home 03/05/05

Vallance Rest Home 07/10/04

Vallance Rest Home 18/05/04

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 Vallance Rest Home 7/9 Vallance Road Hove East Sussex BN3 2DA Lead Inspector Elizabeth Dudley Key Unannounced Inspection 10:30 16th October 2007 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 Vallance Rest Home DS0000014259.V348616.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. Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vallance Rest Home Address 7/9 Vallance Road Hove East Sussex BN3 2DA 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) 01273 326053 PF 01273 207543 Vallance Organisation Limited Mrs Maria Teresa Mirza Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is nineteen (19). Service users must be older people aged sixty five (65) years or over on admission. 11th May 2006 Date of last inspection Brief Description of the Service: Vallance Rest Home is a privately owned residential home, which has been owned and managed by the same family since 1980. The home is registered for up to nineteen older people over the age of 65 years. The present conditions of registration are in the process of being reviewed by the South East Regional Registration Team as part of the ‘Modernising registration Agenda’. The premises consist of two joined converted Victorian houses with resident’s private and communal accommodation over two floors. Resident accommodation consists of eleven single and four shared bedrooms, communal facilities consist of two interlinked lounges, a dinning room and a small rear garden. The front garden is partially paved to provide some off road parking. The home is located within walking distance of Hove sea front and the local amenities and is served by public transport. The home’s literature says that it aims to provide a warm, comfortable, secure and above all caring environment for all its residents and staff. Fees range from £276 to £650 per week; this information was provided by the management of the home on the 16th October 2007. There are extra charges for services such as hairdressing and chiropody and details of these are available from the home. Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place on the 19th October 2007 over a period of four hours and was facilitated by the deputy manager Ms Kim Munn. During the inspection the inspector was able to speak with residents and staff, tour the home and look at documentation within the home. Prior to the inspection ten questionnaires were sent to relatives or visitors of residents in the home, ten to residents and two to health care professionals. Of these ten were returned from residents and two from relatives, five questionnaires provided to the home in previous months were also received. Comments made about the home were generally positive with residents saying: “ The staff are always available”. “I always receive the care and support I need”. The majority of the residents were spoken with during the day and the inspector spent some time in the lounge with residents and saw that interaction between staff and residents was good and residents appeared content and comfortable. Thanks are extended to residents and staff for their courtesy and hospitality during the day. What the service does well: The home provides personal care for up to nineteen older people in a homely and pleasant environment. Recent redecoration and the purchase of some new furniture has added to resident’s enjoyment of the home with two residents commenting on how pleasant the home was to live in and that their rooms were ‘ very nice’. The majority of residents said that they enjoyed the food and that they had a choice of menu with two or more options being available at each meal. They said that there was ‘ always fresh tea or coffee available’ and that snacks were provided at any time. Residents spoke highly of the staff in the home and said that they were listened to and that “ staff were always prompt and caring”, and that the manager and deputy manager were always available if they wished to speak to them. Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Prior to admission to the home, the deputy manager assesses prospective residents; this should be followed up in writing to the person or their representative to inform them whether or not the home can meet their needs. Care plans should provide clear instructions on how the care given to residents is to be delivered in order to meet their needs in a manner that considers the preferences and expectations of the individual. They should be reviewed more frequently and any instructions from health care professionals included in the care planning. Residents would benefit from an opportunity to participate in a greater variety of activities offered at more frequent intervals, these should be extended to people that choose to remain in their rooms. When planning staff cover for the home, management must ensure that newly employed staff who commence with the Protection of Vulnerable Adults First Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 7 check in place whilst waiting for the Criminal Records Bureau check to come through, are able to work under supervision. 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. Vallance Rest Home DS0000014259.V348616.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 Vallance Rest Home DS0000014259.V348616.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): 1,2,3,4,5,6, People who use the service experience good quality outcomes in this area Sufficient information is provided by the home to help prospective residents to decide whether they wish to live at the home, and whether the home can meet their needs and expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents are provided with a copy of the Service User Guide on their admission to the home, this includes information on life within the home. A Statement of Purpose is available to all residents and visitors and both these documents contain the information that is required by the National Minimum Standards and the Regulations. The deputy manager said that she takes these Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 10 documents with her when she goes to visit prospective residents prior to their admission. Residents receive a copy of the home’s terms and conditions of residence following their admission to the home. Amendments are required in respect of the contact details of the CSCI, which have recently changed. The Statement of Purpose should include the limitations of admitting certain categories of resident due to the home not having a hoisting facility. The deputy manager assesses prospective residents to ensure that the home can meet their needs and expectations, the home should confirm in writing whether or not these can be met and the deputy manager gave assurances that this would be done. It is recommended that the documentation used in the assessment of prospective residents be expanded to allow this to be used as the basis of the care plan, and to give a full explanation of their needs, including social and leisure interests. Residents and their representatives are encouraged to visit the home and meet other residents and staff before they make the decision to live there. Recently admitted residents spoken with during the day of the inspection said that the deputy manager had come to see them and that they had sufficient information about the home prior to their admission. The home admits people for respite care but not for intermediate care. Vallance Rest Home DS0000014259.V348616.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): 7,8,9,10. People who use the service experience good quality outcomes in this area. Personal care given to the residents meets their assessed needs and expectations, but care plans do not sufficiently detail the actions required to ensure that care is given in a way that meets with residents preferences or to make staff aware of the actions required to meet the needs. The standard of medication administration and recording This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans of four residents (25 ) were examined in detail, these were seen to have a full assessment of the needs of the residents, had been reviewed regularly but not at the frequency as directed by the National Minimum Standards, and most had been formed following consultation with the resident. Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 12 In some instances actions by care staff to enable the needs of the residents to be met were required and these should be detailed and personalised to ensure that the care is given in the manner that addresses the preferences of the individual. However the daily records indicated that although the instructions for care were not clear, appropriate care was been given. The daily records fully stated what care had been given and recorded visits from health care professionals and the treatment which was required, this should be added to the relevant section of the care plan. Shortfalls in the care planning system were discussed with the deputy manager who gave assurances that these would be addressed. Nutritional requirements are in place and it was shown that individual residents weights are being monitored and actions taken to address any concerns. Risk assessments were included in the care plans, which identified any risks to residents’ safety due to their condition. The home has neither a full body hoist nor a standing hoist, and discussions were held with the deputy manager regarding the moving and handling of residents who become more dependant or the moving of a resident who had fallen. She said that staff had received the relevant training to deal with these eventualities. District nurses provide nursing care, and staff can accompany residents to hospital and doctors appointments. Residents spoken with said that the staff give personal care in a manner, which maintains their privacy, and dignity and that they had a choice over when and how this took place. Comment cards said, “ The staff are excellent and caring”. “ Staff informed my family straight away when I went into hospital”. “ I am finding the care excellent”. The standard of medication administration and recording safeguards the residents. Those staff that administer the medication have had the appropriate training, which is updated as necessary, and there are policies in place to provide guidance. A policy and risk assessments are in place to ensure that those residents who wish to administer their own medication are able to do so without putting themselves at any risk, and lockable drawers are provided in their rooms for storing their medication. Medications that are treated as Controlled Drugs were suitably stored and recorded. Vallance Rest Home DS0000014259.V348616.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): 12,13,14,15 People who use the service experience good quality outcomes in this area. People living at the home are provided with a menu, which is varied and offers a choice according to their tastes. The activities provided, whilst suitable for most residents, are not always available to those who prefer to stay in their rooms. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The activities programme displayed in the lounge showed that activities take place three times a week, and include board games, sewing, films, massages and some outings. The deputy manager said that the activities arranged are mainly informal and take place on an ‘ad hoc’ basis, and that she is aware that the range of activities needs extending and to be available more frequently. Residents spoken with said that ‘ life in the home is quiet’, ‘ we do exercise and someone came into play the guitar’. Residents who prefer to stay in their Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 14 rooms said that they would like staff to have time to spend talking to them or doing things on a ‘one to one basis’. Care plans should identify the social interests of residents and how they prefer to spend their time so that individual preferences can be met. Residents said that their choices regarding how they spend their time and what time they like to get up and go to bed were respected by the staff. There are regular visits by ministers of religion to the home to individual residents and arrangements are in place to ensure residents privacy on these visits. The home allows visiting at any time and will facilitate residents phoning or writing to their relatives and friends. The majority of residents spoken with said that the standard of catering was good, that there was a choice of two options at each meal and that the home takes their tastes and preferences into account when planning meals. The meal served on the day of inspection looked appetising and was well presented and residents said that they could have more helpings if they wanted to. Coffee, tea and snacks are provided as, and when, residents wish to have them. The home has been award three stars following a recent Environmental Health Authority Inspection and all catering staff and members of care staff who prepare food have undertaken relevant training. Vallance Rest Home DS0000014259.V348616.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): 16,17,18. People who use the service experience good quality outcomes in this area Residents are safeguarded by the home’s complaints policy and staff knowledge of their responsibilities towards those in their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints policy in place which needs amending to show the new contact details of the CSCI, but residents spoken with said that they knew how to make a complaint and would take any concerns to either the manager or the deputy manager, they felt that these would be dealt with in a fair and professional manner. There have been no complaints in the past 12 months, only three minor concerns which related to the heating supply. Records of these and the actions taken to address them were seen. The home can access advocates for residents and will help residents to contact solicitors or financial advisors. Residents can take part in the civic process by postal voting. Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 16 Staff have received training in the safeguarding of adults, but the deputy manager has not received any formal training in the protocols in reporting adult safeguarding issues, but was aware of the correct procedure. Discussions were held with her regarding formalising this. There have been no adult safeguarding issues in the past year. Vallance Rest Home DS0000014259.V348616.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): 19,20,21,22,24,25,26 People who use the service experience good quality outcomes in this area. Residents live in a safe, comfortable and well maintained home. Continued attention to maintenance and redecoration has ensured a pleasant environment for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The entrance hall and corridors and some residents rooms have recently been redecorated and some new furniture and two new stair lifts purchased, and further redecoration is planned. Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 18 Communal accommodation consists of two linked lounges and a dining room; these appeared comfortable and give access to a small well maintained garden. Residents said that they use the garden a lot in the summer. Residents accommodation is over two floors and consists of eleven single and four shared rooms, three of the rooms have ensuite facilities consisting of a washbasin and wc. The rooms were comfortable and homely and residents have been encouraged to bring in personal possessions to add to the homely feel in the rooms. All rooms have a lockable door and a drawer and residents are given keys if they are able to manage these. Thermoregulatory valves control the hot water supply to resident’s washbasins and baths, the temperature of the hot water is monitored and recorded on a regular basis and these records showed that they were within recommended parameters. Some rooms have a fire exit from them leading onto a fire escape and residents are risk assessed prior to being accommodated in these rooms and are aware of how to access the fire escape if necessary. Radiator guards and window restrictors are in place. Various aids to maximise resident’s independence are available and these include ramps, grab rails and assisted bathing facilities. The home does not have a full body or standing hoist. The home is clean and free from odours and staff have received training in infection control Vallance Rest Home DS0000014259.V348616.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): 27,28,29,30 People who use the service experience adequate quality outcomes in this area. Staff are provided in sufficient numbers with suitable training to meet the assessed needs of the residents. Recruitment practice does not fully safeguard the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Duty rotas show that there are two care staff in the morning and the afternoon, and one waking care staff at night. The manager and the deputy manager support care staff during the day and share on call duties at nights and weekends. Staff are supported by both catering and domestic staff, and staff spoken with said that there are enough staff on duty to meet the needs of the residents, and they do not feel hurried at work. All staff undertake a local induction course at commencement of employment, and this is followed by the ‘Skills for Care’, a recognised induction course which is undertaken over a twelve week period. Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 20 Three members of staff (44 ) have the National Vocational Qualification level 2 or 3 in care, with one more member of staff in the process of studying for this qualification. The deputy manager has the National Vocational Qualification level 4 in care and the Registered Managers Award. Other training is available for staff that includes medication administration, infection control, safeguarding adults and first aid training. Most have food hygiene certificate and all have undertaken mandatory health and safety training. There is a training matrix in place that identifies when training requires updating. Five staff personnel files were examined Recently employed staff had two references and all documentation as required by the regulations apart from newest member of staff for whom the Criminal Records Bureau check had not yet been received, this member of staff is working in situation which does not enable them and to be adequately supervised. The manager should ensure that staff without the Criminal Records Bureau check are working under supervision. The deputy manager gave assurances that this would be addressed. All staff are given a staff handbook and the General Social Care Code of Conduct handbook at commencement of their work in the home, the staff handbook gives clear guidelines for staff on all aspects of the home. Vallance Rest Home DS0000014259.V348616.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): 31,32,33,35,36,37,38. People who use the service experience good quality outcomes in this area. Management systems in place safeguard the residents, staff and visitors to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager/ owner is in the home most days on a supernumerary basis, but the deputy manager undertakes ongoing daily management of the home. Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 22 The deputy manager has the National Vocational Qualification level 4 in care and Registered Managers Award; she has been in post for 18 months and has previous experience in another care home. The ethos in the home was friendly, unhurried and relaxed, with staff saying that they could make their opinions known both during the day to day running at the home and at the staff meetings which take place four to five monthly. Staff receive regular formal supervision. The quality monitoring process includes six monthly maintenance checks, ongoing risk assessments and monitoring of the environment. Questionnaires are sent to residents and staff and it was shown that the results gained from these are used to change practice in the home. The Annual Quality Assurance Assessment (required by the CSCI to give information about the home) was received by the due date and information given accurately reflected what was happening in the home. The home is appointee for three residents and maintains personal allowances or other money for residents to use as they require. Records relating to residents money were examined and were in order, these records were also examined by the Social Services Department who expressed satisfaction with the way finances were dealt with. Policies and procedures have been reviewed recently and evidence was shown that all utilities and equipment are regularly serviced and replaced as required. There is a fire risk assessment and automatic door closure systems were in place, which activate on the fire alarm sounding. The deputy manager says that those residents who like their doors open have been provided with one of these on their doors. Vallance Rest Home DS0000014259.V348616.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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 18 3 3 3 3 3 x 3 3 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 3 3 Vallance Rest Home DS0000014259.V348616.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. 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 Vallance Rest Home DS0000014259.V348616.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local 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 Vallance Rest Home DS0000014259.V348616.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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