Inspection on 31/01/08 for West Heath House

This inspection was carried out on 31st January 2008.

CSCI found this care home to be providing an Excellent 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

West Heath House 07/11/08

West Heath House 26/07/06

West Heath House 17/02/06

West Heath House 04/11/05

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

CARE HOME ADULTS 18-65 West Heath House 54 Ivy House Road West Heath Birmingham West Midlands B38 8JW Lead Inspector Susan Scully Unannounced Inspection 31st January 2008 10:00 West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 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 West Heath House DS0000024906.V358788.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 Adults 18-65. 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. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service West Heath House Address 54 Ivy House Road West Heath Birmingham West Midlands B38 8JW 0121 459 0909 0121 459 0910 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) Brain Injury Rehabilitation Trust Mr Harminder Singh Kalsi Care Home 25 Category(ies) of Physical disability (25) registration, with number of places West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th September 2007 Brief Description of the Service: West Heath House is a purpose built care home for up to 25 adults with physical disabilities and acquired brain injury. The building is single storey and all bedrooms have en suite facilities. Communal areas consist of three lounges, two rehabilitation kitchens and two dining rooms. There are a number of rehabilitation staff working at the home that have office space and treatment rooms on the premises. The home is situated close to local amenities and public transport routes. The home is accessible to people that use wheelchairs and a number of aids and adaptations are provided in the home to assist them to manage their personal care. West Heath House DS0000024906.V358788.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 3 Star. This means the people who use this service experience excellent quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for the people who use the service and their views of the service provided, meaning they tell us if the home is meeting their needs, if the home is flexible and suits their life style, and if the home enables them to maintain their independence, preferences and choice of how they want to be supported. This process considers the homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development The inspection was completed over one day. The home did not know that an inspection of the service was taking place. As part of the inspection process we look at peoples files this is called case tracking this involves establishing individuals experiences of the service provided or observing practises of individual staff and how they have been trained to deliver a service that promotes the person well being and choices. We also discuss people’s care focusing on outcomes for people. Case tracking can help us understand the experiences of people who use the service. In addition to this, information is looked at during the inspection such as polices and procedures, and the general operation of the home in relation to meeting peoples needs. We also contact other professionals involved with the home such as contract monitoring officers for their views of the service provided. The home is also required to complete an annual quality assurance assessment (AQAA). The Commission sends this document to the provider before the inspection. The AQAA shows what the home is doing well and if and what the home could do better. The completion of the AQAA is a legal requirement that the provider must complete. This had been completed prior to the inspection and showed the improvements made since the last inspection. What the service does well: There is a bundle of information about the people living in the home to enable staff to ensure their needs are met. Ranging from previous history of what they use to enjoy and the way they used to live before moving in to the home. This means the people who live in the home are very well known to staff so West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 6 they have a good working relationship and can ensure their goals and aspirations are met as the person chooses. Care plan are well written with very good information about the people involved in the person care. There are individual care plans that are person centred meaning the person living in the home have constant reviews of the care provided. At all points of care delivery each person is consulted about their needs and how they want to be supported on a daily basis. The staff team demonstrated a full understanding of peoples needs and were observed to be friendly and respectful. The people living in the home are supported to keep in touch with their families and friends. People receive their personal care according to their needs and preferences. Relatives are aware of the procedure for making complaints and have made positive comments about the way care is given. What has improved since the last inspection? What they could do better: Care plans are very detailed, but on occasions lack the personal details such as why a person needs bed rails. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 7 Medication management needs to identify a procedure for when medications change so all staff are aware if there has been an increase or decrease in medication. 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. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are policies and procedures in place to ensure people wishing to live in the home have the information they need to make a decision. The assessment process shows how the home will meet people’s needs, by obtaining all the information required before people move into the home. This means people needs are known and can be met. EVIDENCE: The care file of the most recently admitted person was reviewed to evidence whether pre-admission assessments are undertaken and to review the documentation used during this process. Standardised documentation is used and that seen was fully completed and easy to read and understand. Additional notes made by the manager were also available. When a person moves into West Heath House it is normally due to the person suffering a brain injury. This sometimes means that the people are unable to make a decision for themselves. In this instant a variety of healthcare professionals are involved to form part of the pre-admission process. Sufficient information is gathered before agreeing a placement at West Heath House. This includes assessments from hospitals, doctors, psychologist, occupational therapist, relatives and the person history, this enables a decision West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 10 to be made to ensure West Heath House is right for the person moving into the home. Information obtained during the pre-admission process is then transferred onto initial care plans. The manager confirmed that people and their relatives are invited to look around the Home, stay for a meal and meet staff and other people living in the home. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People needs and choices are recorded and planned for so that people are provided with the support they want in the way they like it provided. EVIDENCE: Three people’s care plans were examined. The care plans contain good levels of information about people’s needs and provide satisfactory guidance for staff to follow to support people correctly. The care plans include information about people’s preferred routines so that staff can fit in with people and meet their needs in the way they like them met. This is a good way of enabling people with cognitive impairment to have their choices and preferences known and understood by staff. People’s files contain risk assessments identifying hazards associated with everyday living and related to people’s specific needs. Moving and handling risk assessments are in place including guidance for staff to follow when assisting a person at the home to use a hoist safely. Additional protocols and management guidelines have been devised where necessary to support safe West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 12 care practices, e.g. safe management of moderate behaviour challenges. The home has made use of the Speech and Language therapist to carry out assessments where required. “Support plans” have been devised for people, summarising their main support needs in a more accessible format with pictures and illustrations to aid people’s understanding. Each person has a daily routine so staff and the person will know what is required on a daily basis. This provides continuity of care for each individual and a person centred approach to people living in the home. Entries in people’s notes demonstrate that their immediate care needs are being monitored. Meetings are being regularly held with people at the home to keep them informed of changes so that they can take part in everyday decisions that affect them, such as activities, holidays and menus. People’s bedrooms are personal with personal belongings. People living in the home are not always able to communicate verbally; the home uses pictorial aids to support these people to make choices about activities and meals. Symbols are placed around the home to assist the people that live there. The key principle of the home is that people using the service are in control of their lives and they direct the service. Staff are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible. People using the service are supported to make their own informed decisions and have the right to take risks in their daily lives. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to take part in activities they enjoy and keep in touch with their friends and relatives. The people living in the home enjoy their meals and opportunities are provided for individuals to prepare their own food as a means of developing independence. EVIDENCE: The people living in the home are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The home has sought the views of the each person and considered their varied interests when planning their daily routines. The home arranges activities both in the home and the community. Routines are very flexible and people can make choices as to regards to the care and support required when they participate in activities. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 14 The routines, activities and plans are person centred, individualised. This means staff support people in a way they choose. Care plans and routines are regularly reviewed to ensure the care provided enables the person to be independent within their capabilities. One resident said “it is pretty perfect here, I can do pretty much what I want there are no problems at all. I can get up when I want, go to bed when I want, I have as much choice as possible in this setting. They encourage you to be independent but help whenever you need”. People living in the home can choose to cook for themselves with support from staff as part of their daily routine. The dining area is spacious enabling people to also socialise. Meals are provided with a breakfast and sandwich for lunch and a main meal in the evening. The cook said the people living in the home prefer it this way as it allows them to go out during the day but have a hot meal in the evening. The menu sampled showed a balanced diet is offered including meals for people of different cultures and people who need special diets on health grounds. The dining areas had aids and adaptation for people who require special seating such as raised chairs and utensils for eating. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. People are well supported by staff and provided with access to health professionals so that their personal care and healthcare needs are met. EVIDENCE: People’s care plans contain good levels of information about people’s preferred personal care routines and the way they like their care provided. Comments by staff indicated a satisfactory awareness of the needs of people at the home and of the support they are required to give them. Staff showed a friendly caring attitude in their approach to the people who live at the home, who were observed to look happy and relaxed in their company. Records seen were very detailed about other health care professionals involved in the care of the people living in the home. People’s records demonstrate that they are supported to receive routine check ups and treatment where necessary, such as dental, optical, chiropody, flu vaccinations and well person checks. Aids and equipment are provided to encourage maximum independence for people using the services; these are regularly reviewed and replaced to West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 16 accommodate changing needs. Specialist advice is sought by the home to ensure effective use of equipment. Medication records showed regular reviews with the persons General Practitioner to ensure people were not taking medication unnecessarily. Medication systems ensure people are administered medication safely by staff that have been trained in the safe handling and administration of medication. Where possible the people are supported to self-administer their own medication and systems are in place to ensure they do this safely by regular consultation with each person. The manager completes regular audits of all medication that has been received into the home, including audits for people who self administer their own medication. Copies of prescriptions are retained so staff can check the correct medication has been received from the chemist. Where people are administered prescribe medication (PRN) as required, a protocol is in place stating when and why the medication was given or taken so staff can monitor if the medication is needed regularly and consult other healthcare professionals if required to ensure there is not a health problem occurring. When sampling the records for one person it was identified that the medication that was being taken had increased. The Mar Chart (medication administration records) did not identify that the person had received this medication. The manager said he would look into this immediately. The manager must ensure when a person medication changes that all staff who administer medication are aware to ensure the person receive the correct dose. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home know how to make a complaint and can be confident that their views will be listened to and acted on. Arrangements are sufficient to ensure that people are cared for safely and protected from abuse, neglect or harm. EVIDENCE: There are procedures in place to investigate all complaints or concerns. The complaints procedure is in different formats that are suitable to people needs, so people have access to the complaints procedure and know how to complain if they feel they have any concerns. Reviews with each person are undertaken regularly where concerns can be raised and action taken quickly, this ensures people have access to different sources to make a complaint if the wish. There had been no complaints from the people who use the service received in the home or at the Commission for Social Care Inspection (CSCI) since the last inspection on 15 September 2007. Care plans and risk assessments have detailed information of how to support people safely ensuing people are protected from injury or harm. The home has a written policy that covers all relevant aspects of adult protection, which is complimented by the No Secrets document issued by the Department of Health. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 18 The home has a rolling programme of staff training in respect of adult protection that ensure people are looked after safely. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a homely, comfortable, safe and clean environment that meets their needs. EVIDENCE: West Heath House is a purpose built single storey building that, in the main has good facilities for people with a physical disability. The home is situated close to local amenities and has a large car park at the front of the building. The premises are not domestic in style, although effort has been made to personalise service users bedrooms and some communal areas. A tour of the building included viewing people’s bedrooms, the main kitchen and communal areas. Bedrooms were personal to the individual person and clean. One inspector was invited into a person room; this room had a fridge, a personal laptop and Internet facilities. The person said that staff were good and he liked his room, as it was his. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 20 The person also said that he was very particular how he wanted his room kept and staff respected this. The main kitchen was clean and facilitates available to ensure peoples different dietary needs could be met. The decor in the home was clean and fresh. There has been no change to the rear Gardens since the last inspection and still consists of a gravel surface. The manager said that at present there had been discussion about a grassed area however no conclusion had been reached. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good recruitment, training and vetting procedures in place so that suitable experienced staff supports people safely. EVIDENCE: All staff receives training on a regular basis so they are suitable qualified and experienced. The training records sampled showed staff had received training in first aid, food hygiene, manual handling, (Birt) basic and intermediate, fire safety, the protection of vulnerable people, administration of medication, and have NVQ Level 2 in care or above, so people who live in the home are cared for safely. The home employs a mix of staff from different cultural backgrounds to meet the needs of each person. A full induction takes place that is in line with skills for care, which ensures all aspects are covered to enable staff to have adequate knowledge of their roles and responsibilities. The three staff files examined revealed that all necessary checks are carried out before employment commenced, such as references, application forms, medical clearance, previous employment history, education and experiences. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 22 POVA checks (Protection of Vulnerable Adults), CRB (criminal Records Checks) are completed to ensure the people who use the service are safe from harm. The staff have regular meetings to discuss issues that may effect the running of the home, peoples needs, such as risk assessments, care plans, complaints, how staff can improve the service further. Ideas and suggestion are shared with the people living in the home for their views. The number of staff on duty at the time of the inspection was satisfactory to enable people to access the community and receive the level of support and supervision required. The manager said people regular go out with support from staff to enables each person to lead an activity lifestyle. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. The Health and Safety arrangements ensure that people are protected from harm and live safely in a home that is well run. EVIDENCE: The manager is experienced and possesses the skills to oversee the day-today management of the home and communicates a clear direction so people needs are known and met. The manager is very focused on ensuring peoples needs are met and ensure people rights and choice are respected. The organisation has a quality assurance audit process, which includes, visits by the director of brain injury services or divisional manager who completes, health and safety checks, financial audits, training audits, and management reviews. People who live in the home are provided with questionnaires so they can give feedback on the service provided. Regular meetings take place with West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 24 management, staff and the people who use the service to assess how they can improve the service further so it is run in the best interest of the people who use the service. There is a good quality assurance system in place. Health and safety checks in the home are carried out regular on equipment used in the home such as fire alarm safety checks, electrical equipment, Gas safety, manual handling equipment, although the water outlets in the home are regulated, the home re enforces health and safety by completing periodic checks on water temperatures. Fire drills are completed regularly so people who live in the home know how to evacuate safely. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X 4 X X 3 X West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 26 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. 1 Refer to Standard DO10 Good Practice Recommendations It is recommended when staff complete handover that any change in medication is passed on and recorded as such. West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 West Heath House DS0000024906.V358788.R01.S.doc Version 5.2 Page 28 - 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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