Inspection on 04/07/05 for White Lodge (126)

This inspection was carried out on 4th July 2005.

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.

Other inspections for this house

White Lodge (126) 27/04/06

White Lodge (126) 24/11/05

White Lodge (126) 06/01/05

White Lodge (126) 02/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 White Lodge(126) 126 Foxley Lane Purley Surrey CR8 3NE Lead Inspector Claire Taylor Announced 4 July 2005, 09:30 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 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 Stationary 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. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service White Lodge(126) Address 126 Foxley Lane, Purley, Surrey, CR8 3NE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8763 2586 020 8673 2586 whitelodge@sussexhealthcare.org.uk Sussex Health Care Miss Kelly Anne Bennett Care Home 8 Category(ies) of Learning disability (8) registration, with number of places White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 6 January 2005 Brief Description of the Service: White Lodge is registered to accommodate eight people with learning disabilities, aged between 18 and 65 yrs. The home provides a service that caters for the needs of eight young adults who display behaviours that may challenge the care services that they require. Situated in Purley, on a main road, it is well positioned to access local transport links and amenities. There is large kitchen and communal lounge/dining room and all service users have the benefit of a single room. A conservatory at the back of the house leads out to a large well-maintained garden with lawn and wooden decking area. The home has its own transport to enable service users to access community activities. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over seven hours and was arranged by advance notification. All service users, supported by their key staff, completed a questionnaire about their life in the home and several relatives used the Commission ‘s pre inspection comment card to express their views as well as one other relevant professional. Inspection time was spent examining records, talking to service users and staff, touring the building, and meeting with the home manager. One of the organisation’s operational managers also met with the inspector. Several service users were out at their respective day services or activities. Comment/ feedback cards from service users, relatives, care managers and other professionals are welcomed by the Commission for Social Care Inspection. All those who contributed are thanked for their time and assistance with this inspection. What the service does well: The service users who were in the home on the day of inspection appeared well cared for and occupied with activities according to their assessed needs and personal choices. The home tries to encourage service users to make decisions about all aspects of their lives; this includes what to eat, where to go on holiday, for days out, and what clothes to buy. The staff team remain largely unchanged resulting in valuable consistency for the service users. The manager has worked in the home for a number of years and retains good communication links with the service users’ relatives and representatives. Comment cards received prior to this inspection gave positive feedback. The home has a good programme of internal and external activities, which are enjoyed by those service users who choose to participate. The home is good at keeping records about the service users up to date and there is a lot of useful information in them. The move towards person centred planning is seen as good practice as this is a more service user focused way of meeting their needs. This home continues to work consistently to comply with the National Minimum Standards and regulations. Within the last twelve months the home has worked significantly hard to meet identified requirements resulting in a notable reduction. All of those service users spoken with commented that the food was good and that they liked the activities and staff who support them. The way the home monitors quality of care is good and an independent quality assurance company also audits the services provided. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 6 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. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Although the home undertakes an assessment of service users needs prior to admission to ensure the home environment and staff, are able to provide the care needs they require. Service users care plans must incorporate the initial assessment carried out prior to placement. EVIDENCE: The home caters for service users with learning disabilities who also have additional challenging needs. This is reflected in the admissions criteria and good information is available for prospective service users. The home ‘s needs assessment plan is detailed and covers all areas to ensure that any new service user’s needs are fully assessed prior to their admission. The same group of service users have lived at White Lodge for a number of years. Within the six files sampled, not all service users had a full needs assessment from the point of admission. Two had recent needs assessments in place from their placing care manager. An initial needs assessment must be available for all service users that have been completed by their respective care manager. During this inspection the staff demonstrated an understanding of individual users’ needs and an ability to understand their different communication patterns. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Service users’ plans of care clearly identify their needs and how they are supported to achieve their planned goals. Choice and decision making for service users is promoted to a good standard enabling their involvement and opportunities to contribute to the operation of the home. To enhance the service users independence, effective support is provided within a risk management framework although some individual plans could be improved upon. EVIDENCE: Service users each have a “communication passport” that identifies likes/dislikes, strengths, and aspirations. The document is written in a person centred format and includes detailed information about each person’s individual abilities and how they are supported. The manager explained that person centred planning for service users is due to commence. Main reviews involving the service user’s care manager occur every year and individual care plans are internally reviewed and updated monthly by keyworkers. The home should hold a formal review meeting every six months however involving the service user, relative(s) and any other significant professionals. An overall review of needs and plans of care should be discussed and minuted. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 10 Risk assessments and risk management strategies in individual service user files were sampled. It would be good practice if these were reviewed and expanded upon to fully detail what support and measures are in place to reduce risks. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16 & 17 Service users have the opportunity for self-development, are part of the local community and are able to take part in a wide range of activities. Appropriate contact between service users and their families and friends is encouraged to help them maintain relationships. Service users are offered a healthy, nutritious diet and have choices in meals offered. EVIDENCE: The local community is well used by the service users and access is assisted by the home having its own vehicle. One service user accesses the local community independently and travels by bus. Staff are available to support service users in a flexible manner according to their needs and lifestyles. Service users participate in visits to pubs, theatres, shops and dining out. Some also attend social clubs such as “Monday “ and “Saturday” clubs organised by Mencap. Indoor entertainment includes television, music centre, videos, DVDs, board games, puzzles and art and craft activities. The manager discussed other activities organised within the home including baking cakes and beauty White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 12 treatments such as manicure, pedicure, make up and facials. Holidays for service users are organised and based on personal choice. There is a conservatory where sensory stimulation activities can take place through the creation of a “snoozelin” type environment with soft music and coloured lights. Service users have the benefit of using this area for relaxation and quieter activities. There is a large garden for service users to access, weather permitting. An aromatherapist visits weekly and service users confirmed that they enjoyed these sessions. The home has arranged for a representative from “Advocacy Partners” to visit one service user who has no family links. Staff were seen to interact with service users in a respectful manner and offer choices concerning what they wanted to eat and what activities they wished to do. The home does not plan a set weekly menu and service users are supported to choose their meals on a daily basis. Service users participate in a weekly food shop for the home and are encouraged to select items of their choice. Daily records are kept of all meals with evidence of alternatives offered. Service users have the option to eat in the dining area or kitchen as they prefer and mealtimes are arranged flexibly according to service users activities and schedules. Guidelines on soft diet and a clear risk assessment were noted to be in place for one service user who can be at risk of choking. Another service user is offered plate guards to encourage independence with eating. Nutritional needs are reviewed and monitored, weight charts are maintained, and service users can be referred to a dietician through the G.P or Sussex Health Care as necessary. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 & 20 Personal care is carried out in a way that service users prefer so that dignity and choice are maintained. Promotion of health is well observed. Service users welfare is closely monitored to ensure that their physical and emotional needs are met. Medication is well managed to maintain maximised good health. EVIDENCE: Individual health monitoring plans are in place that detail health conditions and their management. These are reviewed regularly and records were in good order. All service users are offered annual health checks. The plans include details of GP involvement as well as consultant psychiatrist, dentist, community nurse from the learning disabilities team, optician etc. Information about health conditions such as epilepsy is available in the home. Staff have received training on epilepsy to enable them to fully support those service users with such specialist needs. Medication is stored in a lockable cabinet and service users each have an up to date profile of current medication. As good practice, two staff members administer medication to ensure that there is no mishandling. Five staff have undertaken medication training, a list of all staff authorised to administer medication is maintained and record charts were noted to be accurate. The home also receives regular three monthly visits from the local pharmacist. One service user is prescribed as required medication that is classed as a controlled drug and the home uses a controlled drugs register. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Arrangements for complaints and protection from abuse are well managed and ensure that service users feel listened to and safe. EVIDENCE: The complaints policy has a clear process, includes each stage and timescales and is available in a “Widgit” symbol format for the benefit of those service users who have limited communication abilities. There have been no complaints recorded at the home since the previous inspection. Comments received from both service users and relatives showed confidence that the home deals with complaints seriously and that staff are approachable and receptive to any concerns raised. Service users are aware of who to go to if they are unhappy and are provided with a summary complaints procedure. The home maintains accurate records of any incidents or accidents. There are also detailed policies and procedures in place regarding the protection of vulnerable adults. Staff records confirmed that they have received training on abuse awareness using video resources and discussion. The manager stated that staff have received formal training on adult protection but certificates were not available. The manager agreed to send copies to the Commission. Some service users may present behaviours that challenge the services they require and the home generally demonstrates an ability to meet their needs. Detailed behaviour management strategies and interventions are in place for service users who may behave in a way that puts themselves or others at risk of being physically harmed. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 & 30 Service user’s bedrooms provide privacy and reflect individual interests and preferences. To enable service users to live in a safe environment, the home is kept clean, hygienic and in a generally good state of repair although the upstairs bathroom is in need of some redecoration and the dining table and chairs need replacing. EVIDENCE: Situated in a residential area of Purley, the home is well positioned to access local transport, amenities and relevant support services. The communal areas, bathroom / toilet facilities and six of the bedrooms were viewed on this occasion. Some redecoration work has been completed since the last inspection including a refitted shower room, some repainting of bedrooms and a replacement floor in the conservatory. Well-kept records for the ongoing maintenance and redecoration of the premises are in place. Most of the furniture and fittings are well maintained and of good quality although the dining table and chairs need replacing. The bedrooms were found to be decorated to a good standard, comfortable and reflect the personalities and the individuality of each service user. Items such as family photographs, toys, ornaments, music centres, televisions and videos were present in all rooms. One service user has personalised his room in a “James Bond” theme and it White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 16 was clear that staff encourage service users to furnish their rooms according to personal preferences. Two service users showed the inspector their bedrooms and commented that they were happy with them. Electronic keypad systems are fitted to the front and rear doors to comply with current fire regulations as well as safeguarding those service users who may leave the premises without informing staff. As recommended previously, the carpet in the lounge / dining area has been cleaned and appeared much improved. As required previously, the upstairs bath trim has been replaced but there was an unpleasant odour in the first floor bathroom, surrounding the toilet area. The home is therefore required to replace the flooring. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 35 Recruitment practices need to be robust and securely managed, staff must have Criminal Record Bureau and POVA checks before commencing work to ensure the service users are protection. On the whole, appropriately trained staff, are meeting the service users’ needs although this could be improved upon. EVIDENCE: Since the last inspection, there has been little change to the staff team resulting in ongoing stability and beneficial continuity of care for the service users. The home has one part time vacancy for a carer at present. All new staff who commence work in the home undergo a thorough vetting procedure. This includes a police check (CRB) and a check against the Protection of Vulnerable Adults register. Records confirmed that all but one staff have undergone appropriate checks. The registered provider must therefore ensure that a CRB and POVA check for any future employees is obtained before they commence work. Induction and training is of a good standard and staff are fully inducted in all aspects of the home’s care practices along with some training relevant to service users needs e.g. Epilepsy. Further training is recommended that is specific to the needs of the service users. i.e. for staff to develop a better understanding/ refresh their knowledge of autism, challenging behaviours and communication for people with learning disabilities. Minutes of staff meetings were sampled and included in depth consultations about the home’s care practices and service users needs. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 18 White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The home has effective systems in place to ensure that quality of care is regularly appraised so that it can recognise where standards may have fallen and take action to resolve any issues. The health and safety, and welfare of the residents is promoted and protected. EVIDENCE: Quality assurance monitoring is well established. Tools include rotational satisfaction questionnaires for service users and their families; weekly environment check on the premises; consistent Regulation 26 visits by the registered provider; service users meetings and care plan records. White Lodge has also achieved accreditation with Investors in People and is audited three yearly by an independent quality assurance company (HQS). Health and safety guidelines appeared well observed. Records seen confirmed that good systems are in place to ensure the health, safety and welfare of the service users is consistently monitored and any issues were being dealt with as necessary. Records of regular fire drills, water, electrical and gas safety certificates were up to date. Extensive in-house training has been achieved in all key health and safety issues with further training planned for the White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 20 forthcoming year. Certificates showed that staff had received training in key topics i.e. infection control, food hygiene, fire, moving and handling and medicine awareness. Any accidents or incidents are recorded appropriately in a book and are reported to the Commission in accordance with regulation 37 of the Care standards act. Risk assessments covering safe working practices have been completed for the home to safeguard the welfare of the service users, staff and visitors. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 White Lodge(126) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 2 24 30 Regulation 14(1)(a&b ) Requirement Timescale for action 30.09.05 30.09.05 30.09.05 4. 34 Each service user must have a needs assessment completed by their care manager 23(2)(c) The dining table and chairs need to be replaced due to their poor condition. 16(2 The unpleasant odour in the first k)23(2 d) floor bathroom, surrounding the toilet area, needs to be addressed. (Timescale of 31.01.05 not met) The floor needs to be replaced. 17(2) The registered provider must sch.4(6)1 ensure that any future 9(1)(b,c)S employees obtain a CRB and ch.2 (6 & POVA check before they 7) commence work. From receipt of this report and henceforth 5. 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 6 Good Practice Recommendations The home should hold a formal review meeting every six months involving the service user, relative(s) and any other significant professionals. An overall review of needs G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 23 White Lodge(126) 2. 3. 9 35 and plans of care should be discussed and minuted. Service users individual risk plans should be written in more detail to outline preventative measures / what actions to take to reduce risks. Further training is recommended that is specific to the needs of the service users. i.e. for staff to develop a better understanding/ refresh their knowledge of autism, challenging behaviours and communication for people with learning disabilities. 4. White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 8th Floor, Grosvenor House 125 High Street Croydon CR0 9XP 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 White Lodge(126) G53-G53 S25867 whitelodge126 V179898 040705 stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!