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Inspection on 07/06/06 for Westlands Care Home

Also see our care home review for Westlands Care Home for more information

This inspection was carried out on 7th June 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents receive a good standard of care and support, they are treated with respect and their care and health needs are assessed and closely monitored. Health professionals confirm that staff communicate and work with them and that they have a good understanding of residents` needs. . Care plans, which provide staff with guidance about the actions they need to take to meet residents` care needs, are in place. The care plans include information about individual residents` preferences. Two residents told the inspector that they are able to have as much independence as they wish but that staff are there to support them when needed. There is a comfortable and relaxed atmosphere in the home with good relationships between staff and residents` and relatives and visitors. On the afternoon of the inspection, residents`, visitors and staff spent time outside chatting in the courtyard enjoying the warm weather and one resident was involved in some light gardening. There is choice of food available at all meals, breakfast, lunch, high tea, and evening supper and for those that wish a late snack. Residents` said that they enjoyed the meals and that there is always plenty of food. Staff training, recruitment procedures and staffing levels provide good care and protection for residents`. A high proportion of staff hold a basic care qualification and others are currently working to achieve one.

What has improved since the last inspection?

The re-arrangement of the furniture in the communal lounges gives a more homely appearance and in one of them provides more space for people with poor mobility. Work has commenced to improve the bathing facilities in the home.

What the care home could do better:

Improved storage and regular audits of items held for safe keeping for residents` would provide more security for residents` belongings.

CARE HOMES FOR OLDER PEOPLE Westlands Care Home 48 Oxford Street Wellingborough Northants NN8 4JH Lead Inspector Mrs Kathy Jones Unannounced Inspection 7th June 2006 01:30p 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 Westlands Care Home DS0000050657.V294485.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. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westlands Care Home Address 48 Oxford Street Wellingborough Northants NN8 4JH 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) 01933 274430 01933 275882 westlands@regalcarehomes.com Regal Care Homes Ltd Ms Tracy Burke Care Home 28 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (6) of places Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One current named service user as identified in the service history log dated 14 April 2005 within the category of (PD) Physical Disability continues to be accommodated in the home. 6th December 2005 Date of last inspection Brief Description of the Service: Westlands is a care home providing personal care and accommodation for 28 older people over the age of 65 years. The home is currently registered to provide care for up to 28 older people with up to 22 older people with dementia. The home is owned by Regal Care Homes Ltd. The Home is situated close to Wellingborough town centre and local amenities, shops and the local park. There is a small courtyard area outside the Home, which is accessible to Residents and a garden, which is at present accessed by a flight of steps. Residents’ rooms are situated on all three floors of the building. A passenger lift provides access to part of the home however access to the majority of bedrooms is via at least one step. There are twenty single rooms with four having en-suite facilities and four shared rooms. The following fees were provided by the registered manager as being current at the time of submission of the pre-inspection questionnaire 24 May 2006: • Fees start at £334.11 and are dependent on the assessment of care needs. The fees include personal care, accommodation and meals. Chiropody and hairdressing services can be arranged and are charged separately. Other costs would include clothing and toiletries. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. All standards identified as ‘key’ standards and highlighted through the report were inspected. The key standards are those considered by the Commission to have a particular impact on outcomes for residents. Inspection of the standards was achieved through review of existing evidence, pre-inspection planning, an unannounced inspection visit to the home and drawing together all of the evidence gathered. The review of evidence and pre-inspection planning was carried out over the period of half a day and involved reviewing the report of statutory inspections carried out in June and December 2005 and the service history, which details all contact with the home including notifications of events reported by the home and telephone calls. A pre-inspection questionnaire submitted by the registered manager, seven comment cards from relatives/visitors, four from health professionals’, four from residents’ were also reviewed. The information gathered assisted with planning the particular areas to be inspected during the visit. The unannounced inspection visit covered the afternoon and early evening of a weekday. The inspection was carried out by ‘case tracking’ which involves selecting residents’ and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. Observations were made of residents’ general well being, daily routines and interactions between staff and residents. The management of residents’ medication and monies were reviewed. Staff training was discussed with staff and two files for newly recruited staff were reviewed to check the adequacy of the recruitment process. Communal areas and a sample of residents’ bedrooms were viewed and plans for improvements to the premises were discussed with the registered manager. Feedback on the inspection findings was given to the registered manager throughout the inspection visit. Conditions of registration were reviewed and it was agreed that the condition is no longer applicable and will therefore be removed. What the service does well: Residents receive a good standard of care and support, they are treated with respect and their care and health needs are assessed and closely monitored. Health professionals confirm that staff communicate and work with them and that they have a good understanding of residents’ needs. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 6 . Care plans, which provide staff with guidance about the actions they need to take to meet residents’ care needs, are in place. The care plans include information about individual residents’ preferences. Two residents told the inspector that they are able to have as much independence as they wish but that staff are there to support them when needed. There is a comfortable and relaxed atmosphere in the home with good relationships between staff and residents’ and relatives and visitors. On the afternoon of the inspection, residents’, visitors and staff spent time outside chatting in the courtyard enjoying the warm weather and one resident was involved in some light gardening. There is choice of food available at all meals, breakfast, lunch, high tea, and evening supper and for those that wish a late snack. Residents’ said that they enjoyed the meals and that there is always plenty of food. Staff training, recruitment procedures and staffing levels provide good care and protection for residents’. A high proportion of staff hold a basic care qualification and others are currently working to achieve one. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, Std 6 is not applicable as the home does not provide intermediate. Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The admission process provides assurances that the needs of Residents entering the home can be met. EVIDENCE: Information is provided to prospective residents’ and their families about Westlands and the services it provides. This information is in the form of a statement of purpose and a service user guide. These documents have recently been updated. Questionnaires received from residents’ confirm that sufficient information was provided to enable them to make a decision about moving into the home. Prospective residents’ and their relatives are invited to visit the home prior to making a decision to move in. A trial period of a month is then offered. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 9 Residents’ questionnaires confirm that they receive contracts and copies were found on two files checked. Review of two residents’ care files confirmed that an assessment of need is carried out prior to residents being admitted to the home and an assessment is obtained from the local authority where applicable. Care needs identified during the assessment process were incorporated in the resident’s plan of care, which guides staff in providing the correct level of support to the resident. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Residents receive a good standard of care and support, they are treated with respect and their care and health needs are closely monitored. EVIDENCE: Relatives and visitors who responded to questionnaires were satisfied with the overall care provided. They confirmed that they are consulted and kept informed about changing health and care needs. Three residents responses confirm that they always receive the care and support they need while one said they usually do. Care plans are in place for residents’, which provide a good level of information about their personal care needs, health needs and preferences. Information is specific to the individual and as changes occur or new information comes to light the care plan is updated. A care plan for a resident who had experienced several falls showed that the plan had been reviewed regularly and that health Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 11 professionals had been involved in considering if the home could continue to meet the residents’ needs. Care plans include information about residents’ religious and cultural needs however advice was given to explore these issues in a bit more depth. Records showed that health care services such as General Practitioner, Community Psychiatric Nurse, Parkinson’s Disease Nurse, District Nurse, Optician, and Chiropodist are accessed as required for residents’. Comments from health professionals in questionnaires sent out by The Commission for Social Care Inspection (CSCI) and those sent directly by the home were very positive. They were satisfied with how staff communicate with them and confirmed that staff understand the needs of residents with a particular comment about staff having a good understanding of the needs of people with dementia. A sample check of the medication system confirmed that there is a clear system in place for the management and recording of medication administered. The majority of medication is supplied in a blister pack format, which aids stock control and auditing. Records identify medication received, administered and any returned to the pharmacy. No discrepancies were identified during a sample check. Staff receive training in the administration of medication and residents’ prescribed medication was available and signed as administered in accordance with the prescription. Observations during the inspection confirmed that staff speak to and treat residents’ with respect. Their privacy and dignity is respected in that personal care is provided in the privacy of people’s rooms and staff were assisting a resident in remaining appropriately dressed. A resident was pleased with some new clothes that the registered manager had purchased at the request of a relative who was having difficulty shopping for suitable clothing. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Visitors are encouraged and welcomed into the home and residents’ are happy with the food provided. Routines are flexible and allow residents’ choices in their daily lives. EVIDENCE: Residents’ have a good level of choice and control over their lives. They are encouraged to retain as much independence as possible. Routines in relation to getting up and going to bed are flexible. One resident talked about the town centre being so close and being able to access local facilities. Another resident chooses to spend most of the time in their bedroom just joining other residents’ at meal times. An activity organiser is employed in the home and arranges various in house activities and some trips out for those who wish and are able. Activities for June displayed on the notice board included a singer who had been arranged for a residents’ birthday party, clothing party, Karaoke, a fete and details of a trip organised by the Salvation Army. On the afternoon of the inspection residents’ were encouraged to spend some time outside in the courtyard, as it Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 13 was a very warm day. Later in the afternoon a resident was doing some light weeding in the garden with a member of staff. Discussion with the registered manager identified that the activities continue to be reviewed and information gathered through a dementia care course will be implemented. Visiting arrangements are flexible and relatives and visitors confirm in questionnaires that they are made welcome in the home and that they are able to visit in private if they wish. Residents’ spoken to were happy with the meals provided. Prior to tea being served residents’ were all asked what they would like. There was a choice of sandwiches or a hot snack and residents’ were given any assistance they needed with their meals. There is a four week rotating menu, which is altered according to the season. There is choice of food available at all meals, breakfast, lunch, high tea, and evening supper and for those that wish a late snack. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The home has procedures for dealing with concerns and complaints which residents and relatives are aware of and staff are aware of their responsibilities for protecting the people in their care. EVIDENCE: The Commission for Social Care Inspection have received no complaints about the service since the last inspection. The Registered Manager confirmed that no complaints have been received by the home. Responses to residents and relatives’ questionnaires identify that the majority of people are aware of who to talk to if they have any concerns or wish to make a complaint. A copy of the complaints procedure is displayed in the hall. Staff spoken to had no concerns about how residents’ were being treated and were aware of their responsibilities to act to protect residents’. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 26 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The home was clean, comfortable and in good decorative order providing a pleasant environment for Residents. EVIDENCE: The Home is situated close to Wellingborough town centre and one resident told the inspector that this was important to them as it allowed them independent access to the town. There is a garden, which is accessed by a flight of steps and therefore not easily accessible to the majority of residents. However on the afternoon of the inspection residents’ and visitors were sitting outside in a small courtyard area where flower tubs had been planted. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 16 Communal areas consist of three lounge/dining rooms. The rooms are comfortable and homely and have recently been completely refurbished and decorated. The furniture has been re-arranged which provides more space for people with poor mobility. Music a resident had received for her birthday was playing in one of the lounges. Residents’ rooms are situated on all three floors of the building. A sample check of rooms identified that they were clean and comfortable. A passenger lift provides access to part of the home however access to the majority of bedrooms is via at least one step. There are twenty single rooms with four having en-suite facilities and four shared rooms. Some alterations to improve the bathing facilities in the home had just commenced at the time of the inspection. The home was clean and cleaning programmes are in place to address any odours. Staff receive training in infection control and protective aprons; disposable gloves and alcohol gel are available for staff to reduce the risk of transfer of infection. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Staff training, recruitment procedures and staffing levels provide good care and protection for residents’. EVIDENCE: Residents’ and relatives/visitors said there are enough staff to meet the needs of residents’. Observations confirmed this was the case at the time of the inspection. There are good relationships between staff and residents’ and relatives and they were complimentary about the staff and the care and support they provide. Records reviewed for two recently recruited staff confirms that there is a thorough recruitment process in place, which includes obtaining references and a satisfactory criminal record bureau clearance prior to someone starting work in the home. A recently recruited member of staff described the induction training for new staff, which has recently been revised and implemented in all of the company’s homes. The induction process covers care practices and focuses on ensuring that new staff are aware of residents’ individual needs and the care they require. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 18 Twelve out of seventeen care staff have achieved a National Vocational Qualification (NVQ) at level 2 and one at level 4. This exceeds the National Minimum Standards target of 50 staff being trained to a National Vocational Qualification level 2 and provides staff with a basic understanding of the care needs of Older People. Additional training to meet residents’ needs includes: continence, dementia, challenging behaviour, abuse and health and safety training. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The management and organisation of the home is good promoting the health, safety and welfare of the people living in the home. EVIDENCE: There is an experienced registered manager in post who has achieved the National Vocational Qualification Level 4 in Management and the Registered Managers Award. The registered manager has undertaken some dementia care training and is currently attending a more in depth dementia training course. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 20 Elements of a quality assurance programme are in place; relatives’, residents’ and health professional views are sought during care plan reviews and a quality survey where letters/questionnaires are sent out every three months. A sample of responses seen were very positive. Areas of the premises, which require re-decoration and refurbishment, are generally identified through regular reviews of the premises. The responsible individual carries out unannounced visits to the home each month to review standards of care. Copies of the reports of the visits identify that residents’ care records are reviewed in depth during these visits. A newly appointed training officer will be assisting with these visits focussing on standards of care and staff training needs. A sample check of monies held on behalf of residents found that money was securely stored and balances were correct. Some ‘loose’ jewellery was found in the safe and some of it appeared to have fallen out of the envelope it had been kept in. The registered manager confirmed that she would carry out an audit of the valuables record, ensure that all were safely packaged and arrange for frequent checks to be carried out of anything held on behalf of residents’. The registered manager confirmed that regular checks of the premises are undertaken to identify any health and safety issues. For example risk assessments for the presence of asbestos and checking procedures were discussed. The responsible individual has confirmed that professional advice has been sought and is being followed regarding this and that managers’ have received training on the checks to be carried out. The pre-inspection questionnaire confirms that regular servicing and maintenance checks on the premises and equipment are carried out. For example servicing of the central heating system, lift and fire equipment. Records confirm that staff receive appropriate training in safe working practices. Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A 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 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 22 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 Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westlands Care Home DS0000050657.V294485.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!