Inspection on 25/08/06 for Woodlands

This inspection was carried out on 25th August 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Woodlands 07/02/06

Woodlands 10/08/05

Woodlands 30/03/05

Woodlands 27/10/04

Woodlands 04/03/04

Similar services:

Abbey The

Snydale Care Home

Whiteley House

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Woodlands Woolley Moor House Low Moor Lane Woolley West Yorks WF4 2LW Lead Inspector Patricia Pedley Unannounced Inspection 25th August 2006 11:30 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 Woodlands DS0000006241.V308944.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. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Address Woolley Moor House Low Moor Lane Woolley West Yorks WF4 2LW 01924 830234 01924 830019 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) John & Anne Kelly Anne Kelly, John Noel Kelly Mrs Sandra Goodall Care Home 27 Category(ies) of Dementia - over 65 years of age (27), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (27), Old age, not falling within any other category (27), Physical disability over 65 years of age (27) Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7th February 2006 Brief Description of the Service: Woodlands is a care home registered for the care for 27 older people some who may have Dementia, Mental Illness, Mental Disorder and Physical Disability. The building is set in the beautiful countryside near the village of Woolley on the outskirts of Wakefield. The views from the home are spectacular. It is a two-storey building, which is accessible by ramp. The residents have access to all parts of the home by ramp or shaft lift. There is a summerhouse where residents can sit and enjoy the view. All rooms are single occupancy and have en suite facilities. The residents health needs are provided by the local health centre and local hospitals. The inspection report is available from the manager upon request. At 25 August 2006 the range of fees was between £359 and £380. Additional charges are made for chiropody (£10) and for hairdressing (£3 – 19.) Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced full inspection of the home, which included a visit that took place over a 5-hour period. In order to carry out the inspection, questionnaires were sent to a number of residents, relatives and professionals involved with the home including GPs and social workers. Discussion took place with a good number of residents, visitors, the manager and other staff. A tour of some parts of the home took place. A number of care plans, risk assessments, staff files and other records were examined. The inspector would like to thank everyone for their assistance and the hospitality shown. What the service does well: What has improved since the last inspection? Admission processes have improved ensuring that new residents are admitted whose needs can be met. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 6 Action has been taken to amend care plans and risk assessments so that staff have a good understanding of resident’s individual needs and how to meet them. Furniture has been checked to ensure it is fire retardant to ensure resident’s safety. Staff recruitment processes now meet the required standard. Staff supervision processes have much improved and staff feel they receive the support they need to carry out their work effectively. Staff training on adult abuse, moving and handling and fire safety has been undertaken and by the end of the year all will have received this updated training and will better ensure resident’s safety. 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. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 The Statement of Purpose has been updated to update the information available to potential residents and other interested parties. The arrangement for assessing the suitability of potential residents has improved so that the home only admits those whose needs can be met. Quality in this outcome area is good. This judgement is based on evidence gathered both during and before the visit to this service. EVIDENCE: The manager said that the Statement of Purpose had been updated. This could not be examined as the new document had gone for typing. A visitor and residents who responded to the Commission’s survey said they had received good information about the home prior to their relative being admitted. The manager said that some residents look after their own contract in their room. Other resident’s contracts were seen being kept in their file in the manager’s office. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 9 The manager and deputy manager have prepared a new pre-admission assessment document. This was seen and contained a lot of detailed information. Residents files examined showed that they contained copies of the local authority assessment and care plan. The home does not provide intermediate care. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Care planning and risk management processes are continuing to improve so that staff have an increased understanding of resident’s individual needs and how to meet them. Residents are satisfied that their healthcare needs are met. Residents are pleased that staff treat them with respect and their dignity is upheld. Quality in this outcome area is good. This judgement is based on evidence gathered both during and before the visit to this service. EVIDENCE: Two care plans were examined. At the last inspection recommendations were made as to how care plans and risk assessments could be improved such as clearly identifying individual needs and any identified risk as well as identifying how staff should act to minimise such risks. It was pleasing to see that changes had been made to most care plans and although simple in nature, care plans showed the individual needs of residents and what staff needed to do to assist residents effectively. The manager said that other care plans would be changed in the near future. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 11 Those care plans examined had not been signed and dated nor had they been signed as agreed by the resident or their designated representative. It was pleasing to see that care plans showed residents choices and preferences, likes and dislikes. When carrying out a tour of the downstairs area, there were a number of electric shavers and personal razors near the sinks in the communal toilet area. The manager on being asked said that these belonged to individual residents rather than being used for all. She said that she would move these to the resident’s own room to be used in privacy. The manager said that as a matter of good practice they always send a staff escort to hospital with a resident. When an escort is needed at night, then the on call staff would meet the resident at hospital. Information from the pre-inspection questionnaire suggests that the chiropodist visits the home on a six weekly basis. Residents interviewed said that the GP is called out whenever they are ill and staff look after them very well. Two GP’s who responded to the survey said that they work in partnership with the home and that staff clearly demonstrate an understanding of resident’s needs. Three residents were being cared for in bed. The manager said that the district nursing service were very supportive. One resident being care for in bed was visited. She looked to be clean, comfortable and well cared for. It was pleasing to hear from the manager that there are no residents with pressure sores. At the time of inspection one resident needed a great deal of support from staff. From discussion with the manager and other staff and observations made on the day of the visit, this resident was being appropriately assessed and cared for with assistance from other healthcare professionals to ensure the resident’s needs were met. An examination of the home’s practice in safe storage and administration and recording of medication found the arrangements to be satisfactory. The GP responding to the survey confirmed that medication was managed appropriately. Discussion took place about how the wishes of residents in regard to their “end of life” care could be incorporated into their individual care plan. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Residents enjoy the home’s activity programme. Residents are satisfied with the choice and quality of food provided. Quality in this outcome area is good. This judgement is based on evidence gathered both during and before the visit to this service. EVIDENCE: Residents interviewed said that one of their favourite activities was joining in the “Bamboozle” quiz every morning. One said, “It helps keep my mind active.” Other residents said they had gone to the theatre and had recently enjoyed a summer fair and a visiting singer. Observations showed residents following their own interests such as watching rugby on Sky television in their room and doing jigsaws and crosswords. Several residents were engaged in conversation with one another or staff and visitors. From examining care plans, it was seen that attention has been paid to identifying and meeting resident’s religious and cultural needs. One resident spoken with said, “My life is worth living, the staff are all lovely people.” Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 13 Relatives who responded to the survey said they are always made welcome and they can see their relative in private should they wish to. One relative who visits regularly and who responded to the survey said “ We visit regularly at different times, I have always been very pleased with the care she is receiving. There is a friendly and calm atmosphere in the home.” Staff who had worked at the home a long time said that residents had much more choice open to them than in the past. Residents said they could get up and go to bed when they wanted. Staff said that residents had a good choice of food and that residents had decided that they would like to sit in the lounge for tea. The manager said that she is trying to recruit a new chef as the last chef has recently retired. Staff, including herself, are presently covering kitchen duties. Lunch was sampled. This was fish, chips and peas. The meal was of a reasonable portion size and of good quality. Residents interviewed said they had enjoyed lunch and that they enjoyed all the meals provided. An examination of the home’s menus showed that residents are offered a choice of menu. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 There are satisfactory arrangements for dealing with complaints and ensuring the safety and wellbeing of residents. Quality in this outcome area is good. This judgement is based on evidence gathered both during and before the visit to this service. EVIDENCE: Since the last inspection, the Commission had received no complaints. Records showed that two complaints had been received by the home. One was about staffing and another about healthcare. However, neither was substantiated. Residents said they knew how to make a complaint but had “nothing to complain about.” Two relatives who responded to the survey said they did not know how to make a complaint but had never had to make one. However, another responding said they did know how to make a complaint. The complaints procedures was seen to be displayed and is contained in the home’s Statement Of Purpose and Service User Guide. One visitor said that everything was fine; staff were very good and caring. She had no concerns about resident’s safety and wellbeing. Staff interviewed appeared to have a good understanding of what to do in case of an allegation being made of adult abuse. From records and discussion with the manager it was ascertained that 9 staff have attended adult abuse training with an external training agency and training was being arranged for other staff. Those who have completed NVQ Level 2 have received adult abuse awareness training as part of the course. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24 & 26 The home is well maintained providing a safe environment for residents to live in. Quality in this outcome area is good. This judgement is based on evidence gathered both during and before the visit to this service. EVIDENCE: The entrance hall was being decorated at the time of the visit. Lounges looked fresh and clean after redecoration. The manager said that the Registered Provider was considering complete refurbishment of the dining room area and hoped that this would be done before Christmas 2006. The dining room tables were nicely set out ready for lunch. A smoking area is available in the home’s conservatory. There is also a bar for residents offering a choice of drinks. The garden areas looked lovely, hanging baskets and planters were well stocked with flowering plants. Residents said the gardens always looked nice. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 16 A number of bedrooms were examined. Those examined were homely, comfortably furnished and well presented. Residents interviewed said it was good to have their own personal belongings around them. One resident spoken with said that his “bedroom was nice and homely and I have everything I need to keep me comfortable.” Some bedrooms have been redecorated since the last visit and a few have had new carpets. At the last visit it was recommended that some chairs needed to be checked to ensure they were fire retardant. The manager said some chairs had been destroyed and new chairs purchased. It was noted that the cat litter tray was near the toilet areas/ sinks used by residents near the dining room. When this was discussed with the manager, she had already moved it to a more appropriate position. All areas of the home visited were clean and well presented at the time of this unannounced visit. One resident responding to the survey said, “it is always fresh and bathrooms clean. Sometimes the dusting and hovering in the bedrooms could be more thorough.” Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The arrangements for recruiting and training staff to ensure residents are safe and that have the necessary skills to support them effectively are satisfactory. Staffing levels should be reviewed to ensure residents are not left unattended. Quality in this outcome area is adequate. This judgement is based on evidence gathered both during and before the visit to this service. EVIDENCE: According to the staff rota and discussion with the manager and staff there are normally sufficient staff numbers on duty but there are problems at the weekend. The manager is trying to recruit new staff and discussed a potential new starter during the visit. She is covering weekends whilst staffing numbers are reduced. Following the visit the manager said that one new member of staff has started for weekend cover and she is advertising for two more weekend staff. One relative responding to the survey said there was not enough staff at weekends and that staff had their break together leaving residents unattended. This was discussed with the manager who said that this was not the case, staff do not leave residents unattended and staggered breaks are in place. If staff are busy attending to residents she covers the lounge areas because of the risk of falls. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 18 As a norm, there is 4 care staff on duty in a morning and 3 in an afternoon with 2 staff during the night with on call arrangements. These numbers do not include the managers, domestic or kitchen assistant hours. The manager said that she is also looking to recruit a care worker for weekends. Two relatives who responded to the survey thought there were not enough staff on duty, one said this was mainly at a weekend as sometimes staff took their break together leaving residents unattended. Other relatives said there was a sufficient number of staff on duty. Two staff files were examined. Both included the information required through regulation. The manager said that since the last visit improvements have been made to the recruitment and selection process. New interview questions have been prepared and a new person specification and employment checklist. These new arrangements ensure that any gaps in the employment history are adequately explored. Three members of staff were spoken with. All had worked in the home for a good number of years. They said they had seen a number of improvements over the years and that the home was a much better place. They said they had attended training on palliative care, moving and handling, NVQ, medication, fire and basic food hygiene. From the pre-inspection questionnaire, 55 of the staff have completed NVQ Level 2 training. The deputy manager has completed NVQ Level 3. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 The home is well managed. Health and safety arrangements are satisfactory and ensure the wellbeing of residents and staff. Quality in this outcome area is good. This judgement is based on evidence gathered both during and before the visit to this service. EVIDENCE: The manager said that she has started the Registered Managers Award. She has already completed some units and hopes to have completed the course very soon. Staff spoken with said they worked well together as a team and that they received a lot of support from the management team. Most staff have worked together for a long time and this has helped effective team working. Relatives spoken with and who responded to the survey said they are kept informed about any issues regarding their relative’s care. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 20 The manager said she is due to conduct another staff meeting as the last one was several months ago. She said that she sees most staff, including night staff, most days. There are three handovers during the day to ensure staff are aware of their daily duties and responsibilities. Although there has not been a recent residents meeting, residents said that staff consult with them regularly. The manager said that the home does not attend to personal finances. The manager does not hold a budget for the home. The Registered Provider retains this responsibility. The manager said that the most important thing for the home was that residents received the best quality care they could be given. Relatives and two GP’s responding to the survey said they were satisfied with the overall care provided. At the last visit, it was required that the provider forward a copy of the Regulation 26 reports to the Commission. This has not been done on a monthly basis, nor is a report available in the home. Although it is understood that the provider regularly visits the home, the manager was asked to remind the provider once again that copies of the provider’s monthly visit report (Regulation 26 report) must be either sent to the Commission or made available at the home for inspection. An examination of two staff files showed they had been regularly supervised. New methodologies for recording supervision had been introduced showing the topics discussed and objectives set. The manager said that staff feel that supervision has improved and said that supervision arrangements were up to date. She said she would be starting on the staff appraisals the following month. The records seen for the testing of hoisting equipment was unclear. However, the company responsible faxed information to the home during the visit clarifying the date on which testing took place. This was seen to be satisfactory. An examination of other maintenance certificates such as those for the testing of the passenger lifts, water temperatures, water chlorination and fire equipment found them to be in date. Staff training records showed that 10 staff had attended fire training recently and another training session was to be arranged for the rest of the team soon. Five staff have recently received refresher training for moving and handling. Other staff will attend before the end of the year. The manager as attended the Intermediate Risk Assessment course. She said that she would be reviewing the home’s risk assessment now as she has Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 21 realised through the training that there areas where the current risk assessment could be improved. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X 3 3 X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 3 X 3 Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP31 Regulation 26(2) Requirement Arrangements must be made to forward copies of the monthly report to the Commission or to maintain a copy in the home, which is available for inspection. This remains outstanding from the previous inspection of 07/02/06 Timescale for action 30/09/06 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 OP7 Good Practice Recommendations Care plans and risk assessments, which have been developed by staff, should be signed and dated. Care plans should be signed as agreed by the resident or their designated representative. Personal items such as those needed for shaving should be kept and used in the resident’s own room to ensure their dignity is maintained. It would be useful for the home’s complaints procedure to DS0000006241.V308944.R01.S.doc Version 5.2 Page 24 2 3 OP10 OP16 Woodlands 4 OP26 be brought to the attention of visiting relatives and other visitors. The cat litter tray should be kept in a more appropriate area to maintain infection control. Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Woodlands DS0000006241.V308944.R01.S.doc Version 5.2 Page 26 - 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!