Inspection on 05/12/06 for Winters Park

This inspection was carried out on 5th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Winters Park 16/01/06

Winters Park 06/07/05

Winters Park 06/01/05

Winters Park 21/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Winters Park Pategill Road Penrith Cumbria CA11 8RG Lead Inspector Jenny Donnelly Unannounced Inspection 5th December 2006 10:15 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 Winters Park DS0000022701.V314588.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. Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Winters Park Address Pategill Road Penrith Cumbria CA11 8RG 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) 01768 867939 www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Mrs Jennifer Ainslie Care Home 44 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (44) of places Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 44 service users to include: up to 44 service users in the category of OP (Older people) up to 4 service users in the category of DE(E) (Dementia over 65 years of age) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 16th January 2006 2. Date of last inspection Brief Description of the Service: Winters Park is a purpose built care home and is registered to accommodate forty-four service users over the age of 65 years. The home is owned and operated by Care Homes First Limited, a wholly owned subsidiary of BUPA Care. The home is situated in a residential area of the market town of Penrith, approximately one mile from the town centre and local amenities and facilities. In addition to private bedrooms, two of which can be used, as double rooms if required, there are two large lounges adjoining each other. There is a lounge at the front of the building that can be used by residents who want to smoke. There are laundry facilities and a large kitchen on the premises. Car parking facilities are provided to the side and front of the building. There are shaded seating facilities in the courtyard. At the time of this visit the weekly fees ranged from £396.00 to £520.00 according to the level of care required. There was an annual fee increase each January, which were residents were advised of in writing. Written information about the services offered, the fee structure and copies of CSCI inspection reports can be obtained directly from the home. Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place from 10.15 to 15.30 hours. The visit comprised of touring the building, talking to residents, visitors and staff. Time was also spent with the manager, looking at staff and care records. The homes’ usual activities including a communion service and a birthday party were taking place during the day. Prior to the inspection, comment cards had been sent to the service users at Winters Park, and 12 were completed and returned. The information collected is included in this report. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 6 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 Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The admission arrangements for new residents are very thorough and serve to ensure people are well informed about the home before they move in. The assessment process ensures that people know Winters Park will be able to meet their individual personal, social and healthcare needs satisfactorily. EVIDENCE: The home offered good information to people interested in accessing their services. There was a statement of purpose, a service user guide and a welcome pack, which between them gave people sufficient information on which to base their decisions. Residents confirmed that they, or their family, had been given these documents. Previous inspection reports were on display in the home, along with the latest quality survey results. Some of the residents spoken to had visited the home prior to deciding to move in, others had been ill in hospital at the time and had relied on their families. These Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 8 people remembered the home manager coming to see them in hospital to talk about the care home, and discuss their needs and wishes. Each resident had a statement of terms and conditions for their stay in the care home. Copies of these were seen on file, and these had been signed by the resident where possible, or by their representative. The statement included the fees, what was covered by the fees and which bedroom was to be occupied. Residents said they were kept informed of the annual January fee increase by a personal letter each November, and copies of these letters were seen on file. Where there had been alterations to the terms and conditions, such as a short respite stay becoming a permanent placement, a new statement had been issued and signed. There were assessments on file showing each resident’s care needs at the time of admission. These assessments were mostly undertaken by the home manger, and served to ensure that the person’s individual needs could be met at Winters Park. These assessments included information from family members, the hospital, community nurse and/or social worker as relevant. Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents receive individual good quality health, personal and social care at Winters Park. People are valued and treated with dignity and respect. The management of medicines is safe, and where possible residents are encouraged to manage their own medicines, and maintain their independence. EVIDENCE: There was a written care plan in place for each resident, and residents had been invited to read and sign these if they wished to. I looked at three care plans in detail, and spoke at length with those three residents. The care plans were an accurate and up to date reflection of what each person needed from staff in order to meet their personal, social and healthcare needs. Care plans were individual and included those things important to each person, such as liking to have a bath in the evening, or preferring to stay quietly in their bedroom rather than sit in the lounge. There was evidence that peoples’ choices in relation to bed and rising times, food preferences and how they liked to be addressed were taken notice of. Care plans included up to date risk Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 10 assessments for moving and handling needs, risk of falls, nutrition and skin care. Residents appeared well groomed, were smartly dressed in clean clothing, with their hair done and shoes and stockings on. The men had been helped to shave and some chose to wear a shirt and tie. Residents said they got all the help they needed from staff to maintain their appearance, which was clearly important to many people. One lady said the night staff helped her to choose and put out fresh clothes for the next day, and this was part of her bedtime routine. Residents had good access to healthcare facilities. The local doctors and community nurses visited the home regularly, and residents could access NHS or private chiropody and eye care as they chose. Residents said personal care was provided in a dignified manner, and they felt safe and comfortable in the home. Some residents were more able than others and required less input from staff; these people were encouraged to lead as independent as life as possible, whilst feeling able to call for assistance at any time necessary. One lady said, “I’m only so well as I am, because of the good care staff take of me”. The management of medicines in the home was very good, and benefited residents general health and wellbeing. A number of residents held their own medicines, mainly creams and inhalers, and had been assessed by staff as competent to do so. The medicine records were neat, legible and accurate and matched the stock balance. There was a clear ethos that this was the residents’ home. Personal space such as bedrooms, were regarded by staff as the residents’ property. Residents confirmed that personal care and intimate conversations were carried out in private and in a sensitive way. Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents were encouraged and enabled to lead independent lives as they wished. Staff respected residents’ lifestyle choices, as well as their cultural and religious needs. The provision of meals was excellent, with the home meeting the different dietary needs and preferences of the resident group. EVIDENCE: Residents commented that they were very happy and able to live their life as they liked at Winters Park. The home did not operate to staff routines, and residents were enabled to set their own daily plans as they chose. People were enabled to get up and go to bed at a time that suited them, and opt in or out of organised activities as they pleased. Staff were aware of residents interests and hobbies, as these were recorded in the care plans, and trips and events were discussed and planned at residents meetings. There was an activity organiser who arranged group activities based on residents preferences, and these included quizzes, bingo and carpet bowls. There were also one to one quiet activities such as conversation and beauty therapy pampering sessions. One of the regular church services with Communion was taking place during my visit, and this was looked forward to and attended by a Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 12 large number of residents. There was also a special a birthday celebration, in another lounge, where friends and family were being accommodated for the celebration. Some residents enjoyed outings or visits home with their family. One lady said the “staff are so nice, they are my family, and they say I am theirs’”. There were plenty of events planned for the Christmas and New Year period including visiting choirs, a music hall show, a pantomime, a party, communion and carols. These events were mostly being provided in-house at the resident’s request. Some residents attend local community groups such as Stroke Club and the Lions Club. Residents were enabled to be as independent as possible, with many managing their own finances, correspondence and appointments. The staff respected residents’ ability to manage their own affairs, and did not intervene unnecessarily. Residents said they were very happy with the food at Winters Park, saying “I like the food”, “there is always a choice of two things”, and “you order in advance what you want”. The daily menu was in a restaurant style display cabinet, and showed the options for each meal. The main meal was served at lunchtime and consisted of a fresh homemade soup, followed by a choice of two main courses and desserts. Residents had access to drinks and snacks at all times, and although BUPA had introduced a new “night bite” menu of items available through the night, the kitchen at Winters Park never closed. Residents were seen to enjoy a mid morning sherry if they wished and refreshments were available for visitors. Special diets were catered for appropriately and soft and pureed meals were served attractively. The chef personally served the meals from a hot trolley in the dining room, and checked with residents if their meal had been satisfactory. The chef also attended residents meetings, and had in the past arranged tasting sessions for residents to choose which sausage and chesses they preferred him to purchase. This is an aspect of excellent practice. The chef had recently won a BUPA award. Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The philosophy and atmosphere of the home enabled residents to raise concerns and complaints safely, and know they would be acted on. Staff were knowledgeable about safeguarding residents from abuse, and residents felt safe and protected in the home. EVIDENCE: The home had a clear and concise complaints procedure, which was on display in the entrance hall. There were also “how to complain” leaflets containing a form for submitting a written complaint. Residents said they were aware of the complaints procedure and had been provided with written information on how to complain. Most residents said they would speak to the manager at once if they experienced a problem, and felt confident the matter would be dealt with. Since the last inspection one complaint had been reported to the manager about a poor staff attitude. The manager upheld the complaint and the staff member was dismissed, to ensure this incident was not repeated. The home experiences a very low level of complaints, and this is probably because the manager maintains a highly visible presence around the home, and is readily available to residents and visitors. Staff understood that any concerns raised were to be passed onto the manager immediately. The home had policies and procedures guiding staff in what to do in the event of concerns about safeguarding vulnerable adults. Staff had received training on the policies and procedures for the protection of vulnerable adults from Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 14 abuse and whistle blowing. The manager was also in receipt of a new DVD training package on the subject, and planned to run training sessions in the New Year for all staff. Staff were aware of the homes policies and had received training on this subject either through the mental health team or as part of a National Vocational Qualification (NVQ) in care. The manager and her staff were implementing the home’s policies and procedures correctly to protect residents from harm, and to follow up any allegations thoroughly. Winters Park DS0000022701.V314588.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents lived in a purpose built, well maintained and very comfortable home. Residents’ personal space was respected as such, and “owned” by them. EVIDENCE: Winters Park is a purpose built care home, with the majority of residents’ accommodation situated on the ground floor. The bedrooms all have en suite facilities, and there are sufficient large bathrooms offering fully assisted baths and a walk in wet room type shower. A second walk in shower was also being fitted. There was a hair salon with a professional back washbasin and standard dryer. All except eight bedrooms had been refurbished with new decoration, new furniture and new bedding and curtains. Residents said they were asked to choose their own colour scheme for the fabrics. There was a plan to refurbish the remaining bedrooms next year. Bedrooms had been nicely personalised by the inclusion of resident’s own pictures, ornaments and Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 16 small items of furniture. Residents were encouraged to treat their bedroom as their own personal space, and staff respected this. The communal space comprised of two dining rooms, two large lounges, a smoking lounge and a corridor seating area which residents called “the crossroads”. Residents used this seating area to rest when walking around the home, or to meet up with other residents or visitors. The communal rooms were comfortable and bright, designed to gain the maximum daylight. The furniture throughout the home was of a good quality and in a good state of repair. There were two residents accommodated in upstairs bedrooms, which are only accessible by a flight of stairs. The remainder of the upstairs area is staff rooms and office space. The home was warm, and exceptionally clean and tidy throughout. Residents confirmed the home was always this clean and fresh, saying “they get full marks”. The heating and lighting throughout the building was good, and residents could adjust the heat in their bedrooms according to their own need. The home had an ample kitchen, which was refurbished five years ago and remained well equipped. There was a large laundry, with dedicated staff, industrial type machines and sound infection control procedures for handling foul or infected laundry. The exterior of the home was well maintained with accessible gardens, patio and seating areas. Residents said they liked to walk around outside and enjoyed sitting out in the summer months. The home was adequately provided with hoists and other specialist equipment to assist residents. There were call bells in all bedrooms and communal areas. Corridors and doorways were wide enough to allow easy wheelchair access. Winters Park DS0000022701.V314588.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents were supported by a dedicated, caring and well-trained staff team, who put the needs of residents first. EVIDENCE: At the time of my visit the home was staffed by the manager, and a senior carer, supported by 4 other care staff. There were also a domestic, the chef, a kitchen assistant, a laundry assistant, the administrator, the maintenance person and the activities organiser. The staffing levels provided sufficient care time and services for residents and ensured the general upkeep of the home was well maintained. The home had sound staff recruitment procedures and a review of some staff files showed the manager had adhered to these. Staff had attended for interviews and references, criminal records bureau and POVA list checks had been completed, prior to them being employed. This protects residents from having unsuitable persons working in the home. The home did not use temporary agency staff. Staff training was good, with a full induction and ongoing training updates in key areas. Attendance at training events was recorded in staff files and the manager kept a matrix of all attendance, for planning and monitoring purposes. The home had 66 of care staff with a National Vocational Qualification in care, which is an excellent achievement. Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 18 Residents spoke highly of the staff, saying “staff are nice and helpful”, “staff are like family”, “the staff are marvellous” and “we think the staff are wonderful”. These comments were echoed by a number of visitors. Winters Park DS0000022701.V314588.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 37 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well managed home, with sound health and safety arrangements and secure financial planning. The service listens to, and acts on residents’ views, as part of a continuous quality checking process. EVIDENCE: The manager, Mrs Jennifer Ainslie, is suitably qualified and experienced to manage the home. She has completed an NVQ level 4, and has recently achieved Investors in People reviewer status, as well as winning the BUPA manager of the year award 2006. Staff, residents and visitors spoke warmly about her, saying she set high standards for the home, and was always available if they needed her. Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 20 The manager undertakes ongoing quality audits, which are checked regularly by BUPA’s Quality Manager during her unannounced spot checks. These audits cover every aspect of the service. There are also annual residents surveys, the results of which are displayed on the notice board. The 2005 survey showed a 93 excellent/very good overall rating. The 2006 survey has been completed, but the results were not yet back from the quality department. The manager said she maintained a high presence around the home to continually check the quality of service, residents and visitors confirmed this, and said they felt listened to. Where the home managed residents’ money, this done in a safe way. The money was banked, and the administrator kept individual electronic records that were monitored by the finance department. Residents knew how to access their money through the homes’ administrator who kept an amount of cash on the premises for this purpose. Individual statements were printed for residents at any time on request. There was a business and financial plan showing all major and minor planned purchases and works, as well as an emergency contingency. Policies and procedures were reviewed and updated as necessary. All staff received training in health and safety issues, and the home had service contracts set up for all equipment and services within the building. The manager had supplied written confirmation that all safety checks and services were up to date and in order. Winters Park DS0000022701.V314588.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 4 4 4 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 3 4 4 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 3 3 X 3 3 Winters Park DS0000022701.V314588.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 Winters Park DS0000022701.V314588.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Winters Park DS0000022701.V314588.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!