Inspection on 17/07/07 for Woodcote

This inspection was carried out on 17th July 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodcote 13/11/08

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Southfields

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

CARE HOME ADULTS 18-65 Woodcote Five Ashes Mayfield East Sussex TN20 6JJ Lead Inspector Debbie Calveley Unannounced Inspection 17th July 2007 10:00 Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodcote Address Five Ashes Mayfield East Sussex TN20 6JJ 01825 830130 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) ridgewoodcareser@aol.com Ridgewood Care Services Mrs Andrea Joan Easton Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Woodcote is a care home, which provides personal care and accommodation for up to 6 younger adults with learning disabilities. It was opened in January 2007. The home is owned and run by Ridgewood Care Services who have a well-established sister home for learning disabilities in Uckfield, East Sussex. It is a detached property with accommodation on two floors. Accommodation is provided in 6 single bedrooms all of which have an ensuite facility, either a bath or a shower. There is a large lounge, spacious kitchen a dining room and a well-maintained, secure patio area and large gardens to the rear of the property. The home is well decorated and maintained throughout and has a friendly and homely atmosphere. The home employs a Registered Manager, a deputy manager and a team of care staff, all of whom work a rota, which includes one person working at night on waking duty. A further senior staff member is available on call if needed. The home provides personal care and support to residents who are funded by Social Services. The home’s minimum fee as of April 2007 is £1200.00 per person per week. Additional costs are charged for hairdressing (£6-8) some toiletries (£variable) and holidays (£variable). Prospective residents and their relatives are provided with written information regarding the services and facilities provided at the home prior to admission. A copy of the home’s most recent inspection report is available on request from the home. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. Those living and working at Woodcote were consulted about what term they felt was suitable and they wish to be known as residents, so for the purpose of this report they will be known as residents. This service was first registered in January 2007 and this was the first key inspection. This report reflects a key inspection based on the collation of information received since registration, and an unannounced site visit which commenced took place on 17 July 2007and lasted for lasted five hours. Follow-up information was sought from health professionals. The site visit included discussion with all parties present, a tour of the premises and an examination of medication, policies and procedures and care records. There were two residents living at Woodcote at the time of this inspection. During the visit, the Inspector met with the two residents and spent time with them. The Inspector spoke individually with the staff team on duty. Surveys were sent to the home following the visit What the service does well: Woodcote is a relaxed and friendly environment where residents are supported by a team of staff who are committed to meeting their needs. Residents have access to a wide range of activities, which meet both their social and physical needs. Residents are supported and enabled to access the facilities on offer within the local community. They enjoy a flexible lifestyle and are supported with making their bedrooms their own. Residents are also supported to express themselves through their appearance and are given the opportunity to have a supported annual holiday. The staff team receive appropriate training and are supervised on a regular basis. Informative handovers take place at the beginning of each shift ensuring that all relevant information is passed onto the staff coming on duty. The management of the home are open and transparent and there are systems in place to ensure the home is run in the best interest of the residents. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Information about the services offered at Woodcote is available for all prospective residents. EVIDENCE: Both the Statement of Purpose and Service User Guide were viewed. The Statement of Purpose is informative and clearly written. The address for contacting CSCI needs to be updated. The Service Users Guide was seen and was not in suitable format for the residents at present. However the Responsible Individual has since confirmed that it is available in different formats depending on the level of learning difficulty. The home has been open to residents since January 2007, and as yet have not had a full new admission. There has been interest, but the initial admission procedure highlighted the fact that it would not be a suitable placement due to the age difference with the two residents already living in the home. The two residents currently living in the home were transferred from the sister home in Uckfield. It was discussed that there was no information documented about the reasons for the transfer in either of the residents care plan and no evidence of a trial period to ensure that the two residents were settled and content about moving from their previous home. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 9 From talking to staff and viewing the training records and induction programme the home demonstrates that the staff have the necessary experience and skills to deliver the services and care offered. The contracts of the two residents were seen and are written in a pictorial format with full English written underneath. Both the contracts were for the admission to the previous home and had not been renewed to mention the transfer. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10. People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents would benefit from a person centred approach to the care planning and management of risks. Residents are supported to take risks as part of an active lifestyle. EVIDENCE: The care plans of the two residents were viewed. The care plans contain a lot of information from previous placements and whilst is of course necessary could be filed away to prevent confusion from present day documenting. There is a smaller file, which is the working document for staff to refer to. The care plans contain necessary information but are not person centred and do not mention the residents strengths and personal goals. Care plans need to provide guidance for staff to follow when supporting the residents behaviour that may be difficult or challenging and also detail guidance on proactive ways of working with residents. Some of the care plans were confusing and would Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 11 benefit from a complete review to ensure that all the needs are identified and planned for. This was fully discussed during the inspection visit with the deputy manager. The residents both have moderate to severe learning difficulties, which do not allow them to participate fully in the development of their care plan and therefore do not sign their involvement. There was no evidence of advocate or family involvement in the care plans. It was not clear from the care plans how the residents are involved in making decisions about their life and how staff communicate with the residents. The staff were aware of their different ways of communicating and this needs to be transferred to the residents care plan. The policies and procedures in the home are comprehensive, but were not seen to be available in a suitable format for the residents. Suitable ways of securing the residents involvement in the running of the home have yet to be developed. Risk assessments are undertaken for each resident in respect of all the activities they participate in. it was discussed that many of the assessments have not been updated since moving from the previous home. Residents are able to assist in the running of the home and are supported to participate in activities such as putting away their own laundry, helping to lay the table and accompanying the staff when shopping for provisions. The staff prepare the weekly activity schedule and this was seen to include a variety of activities and one to one sessions. Staff need to ensure that that the management of the risks identified are supportive rather than restrictive. Residents have both received a certificate in fire safety. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have opportunities for personal development and they are encouraged and supported to be part of the local community. Residents have their rights respected and responsibilities recognised, and benefit from a healthy diet. EVIDENCE: From discussions with staff and the examination of daily records it is evident that the residents lead an active lifestyle. Trips out are organised and photographs were seen of the residents at a zoo, public houses and they enjoyed a recent visit to the Underwater World. A supported annual holiday is provided and they are soon to go to the New Forest on a long weekend. Timetables detail all the activities that are participated in. At each shift Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 13 handover staff are allocated residents to work with and the tasks and activities that they are to support them with. There was evidence that one resident used to attend a college, but this is no longer happening and the reasons not documented or explored. Care plans did not fully specify family relationships and peer group relationships pertinent to the individual, though one staff member did say they were going to try to locate a family member of one of the residents. Staff stated that residents’ visitors are welcomed into the home. On the day of the site visit the residents were going swimming and then shopping for the provisions for the home. Menus were examined confirming that the food provided is balanced, varied and nutritious. The residents enjoyed a freshly prepared cheese salad and fresh fruit and yogurt for their midday meal. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from the provision of flexible and respectful personal and healthcare support and are protected by the systems in place to manage medication. EVIDENCE: The care records evidence that referrals are made for input from health care professionals when required and staff ensure that the residents are given support and privacy as required. Records need to be kept up to date of the dates of these visits. Guidance is provided in care plans for staff to follow in relation to supporting residents with personal care and of their preferences and capabilities. The home operates a key worker system. The staff confirmed that the lifestyle in the home is flexible and depends on the residents and can change daily. Medication practices in the home are currently being audited due to irregularities in practice being identified in-house. All staff have undergone Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 15 medication training and this has been identified as an area for further training. The manager is monitoring practices of administration. The care plans need to evidence the medication prescribed and the reasons for medication being required and then reasons for change and reduction. The medication administration charts were viewed and were completed with no gaps identified and blister packs of the medication were correct and in synch with the charts. There are guidelines in place for the staff to follow when administrating homely remedies, these are signed and agreed with the G.P. There are no residents at this time self medicating. The staff are knowledgeable about the ageing process and of how to cope with death or a dying resident, however this area needs to be supported by policies and procedures to guide staff. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from and are protected by the adult protection procedures and the open culture at Woodcote EVIDENCE: The home has a standard complaints procedure, but it is not available to the residents in a format they can understand. This need to be developed to enable the residents to have a voice. The CSCI has not received any complaints about this service since their registration in January 2007. The home have recently received a complaint regarding noise and this is currently being investigated. The home has a number of systems in place to protect residents from abuse. The policy and procedure for protecting vulnerable adults is in place and staff have either received training or about to receive training. Residents are supported to manage their finances and the records are maintained. The receipts and logging records for two residents were viewed with the staff and found to be accurately maintained. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Woodcote is clean and comfortable, residents bedrooms reflect their preferences and the home is suitable for its’ purpose. EVIDENCE: The home is a two storey property situated on the outskirts of Mayfield in East Sussex. It is situated on a busy road and transport is required. The grounds are large and work has been done to ensure it is totally safe and accessible to residents living in the home, The rear of the house has a large patio area with handrails and the residents are planting flower tubs, beyond the patio is a paddock with a lake (made safe by fencing and appropriate life buoys) and tennis courts. No fit for use at present but will be utilised at a later date. Resident accommodation is provided by six single ensuite bedrooms, two of which have been individually decorated and furnished to suit the residents. One bedroom has sensory lights that encourage the resident to relax. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 18 Communal areas comprise of a comfortable lounge, good-sized kitchen with a table and chairs and a dining room. One of the residents provided the Inspector with a tour of the home and her bedroom. There are two bathrooms, one providing an assisted bath and the other a standard bath. The laundry facilities are domestic and meet the needs of the home. The home is attractively decorated and the furniture is good quality and comfortable. The maintenance of the home is good and all the necessary maintenance checks are performed regularly. A file is maintained. The home was clean and tidy, but also homely and comfortable. The security of the home is good; attention must be made to the gate at the front entrance to ensure that it is properly locked. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 34, 35 and 36. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a robust recruitment process and a dedicated and competent team of staff. EVIDENCE: The staff confirmed that they have a job description that clarifies their role in the home. Staff records and the training plan evidence that staff are receiving the training necessary too perform their job competently and safely. Mandatory training is in place and a rolling programme will ensure that all staff receive timely updates. Further training is given in managing challenging behaviour, epilepsy and specific illnesses such as diabetes. The staffing levels are sufficient to meet the needs of the residents and the staff confirmed that extra staff are available when required. Staff recruitment, induction, training and supervision files were examined. The recruitment procedures are robust, the files well organised and all the required security and identity checks are undertaken prior to staff commencing work. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 20 However two files seen did not have the necessary two references in place. During staff interviews there was confirmation that staff are being supported by the management team to complete their National Vocational Qualification in care. All staff, including the manager, receive formal documented supervision at least 6 times a year plus an annual appraisal. Evidence was seen of regular supervision. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 and 43. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from living in home that is effectively managed and monitored. EVIDENCE: The manager has ten years experience in the care industry working in care services for adults with learning difficulties. She was a deputy manager for two years at the sister home prior to being registered as manager at Woodcote. The manager has achieved a number of qualifications relevant to her post including, a GNVQ in Health and Social Care, NVQs in Care Levels 2 and 3 Miss Easton has done a variety of health and safety training, training specific to the needs of service users with learning disabilities and management training as Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 22 well as Adult Abuse and PoVA training. She is currently studying the Registered Managers Award. The quality assurance systems in the home currently consist of just the regulation 26 visits; there is a need to develop an effective quality assurance and quality monitoring system involving the residents. Residents are safeguarded by the homes policies and procedures. Woodcote has effective systems in place for ensuring the health and fire safety of the home is maintained. The home has regular management meetings and monthly staff meetings to ensure that there is a consistency of approach to the residents. The homes records seen looked to be of a good quality and standard. Conversations with the staff and the inspection of key documents indicated a management approach that is committed to positive outcomes for residents. The home were registered in January 2007 where it was evidenced that that service was financially viable with good systems of accountability. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 2 3 3 4 2 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 3 3 LIFESTYLES Standard No Score 11 3 12 2 13 3 14 3 15 2 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 2 3 3 3 3 Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 Standard YA1 YA5 Regulation 5 (1) Requirement Timescale for action 01/10/07 2 YA2 YA4 That any changes to the agreed terms and conditions/ contracts concerning residency are documented and the contract amended. 14 (1) (c) That all residents admitted to the 01/08/07 home are assessed appropriately and involved in the process. That residents are able to have a trial visit – settling in time to ensure the transition is smooth. That the care plans are person centred and reflect their needs, strengths, personal goals and aspirations. That communication and recognition of their individual method of communicating is documented and fully explored. That residents rights to making decisions are reflected and supported by their care plan. That the homes policies and procedures, activities, communication support and services are written in a suitable format and that residents are involved and consulted wherever DS0000068743.V346235.R01.S.doc 3 YA6 YA7 15 (1) 01/10/07 4 YA8 YA40 12 (2) 01/10/07 Woodcote Version 5.2 Page 25 5 YA15 YA21 16(M) 6 YA39 24 (1) possible in the daily running of the home. That the care plans fully reflect 01/10/07 outside relationships with families, friends and advocates and how the home support residents to maintain these links. That appropriate quality 01/10/07 assurance and quality monitoring systems are developed. 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 YA21 Good Practice Recommendations That policies and procedures for ageing and death and dying are developed. Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woodcote DS0000068743.V346235.R01.S.doc Version 5.2 Page 27 - 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. 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