Care Home: Chevington House

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What the care home does well People living in this home told us they were well cared for by a committed and competent care team. They were very satisfied with the care, approach of staff and the overall service provided by the home. The management take care to ensure that each persons needs are assessed before entering the home. The assessment fully involves the resident and their family. There is a weekly activity programme available that people can choose to join in with and that they said they enjoy. People said they enjoy their food, which is fresh, varied, well presented and nutritious using fresh ingredients. There was a system to show regular reviews of care are carried out, which fully involved individuals and their family carers when it was right to do so and wherever possible. There was a comprehensive programme of education and training provided for staff, which ensured that staff knew how to care and support the people who live at the home. What has improved since the last inspection? The change in ownership has been very successful and everyone we spoke with was very complimentary about the accommodation, care and support, activities, food and the management of the home. Considerable efforts have been made to improve the way the home is managed. This has lead to more people focussed care with the introduction of a key worker for each resident. The environment had been improved. This has included 4 bedrooms being redecorated one of these having a new carpet, new carpet awaiting installation in the entrance hall and ground floor corridors. The kitchen and stairway have been repainted and the lounge and dining room repainted. In addition a storage area has been provided outside the home and a pathway to increase the access to the back garden was in the process of being completed. Alcohol hand dispensers had been provided at the front of the home. A new weekly activities programme has been introduced to offer more choice and stimulation. A new initiative of a weekly film afternoon had been introduced and the home had its own cinema equipment and screen. Staff training has also been and will further be developed to ensure that staff have the skills to care and support the people living in the home. Regular internal comprehensive quality assurance procedures had been introduced. What the care home could do better: There were no requirements or recommendations from this inspection. The management carry out regular quality assurance monitoring audits and as a result of these already identify improvements, which need to take place. CARE HOMES FOR OLDER PEOPLE Chevington House 36 North Road Bourne Lincolnshire PE10 9AS Lead Inspector Tobias Payne Unannounced Inspection 22nd May 2008 08:05 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 Chevington House DS0000071217.V364975.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. Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chevington House Address 36 North Road Bourne Lincolnshire PE10 9AS Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) 0121 308 8861 www.wellbeingresidential.co.uk Wellbeing Residential Ltd Vacant but a new person had been appointed as acting manager and was to send an application to us in the near future in order to be registered by us as manager. Care Home 16 Type of registration No. of places registered (if applicable) Category(ies) of Old age, not falling within any other category registration, with number (16) of places Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC To people of the following gender: Either Whose primary needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is: 16 This was the first inspection since the home had been registered in November 2007. 2. Date of last inspection Brief Description of the Service: Chevington House is a large Edwardian two storey house, which has been extended over the years. It provides personal care for up to 16 older people. There is car parking at the front of the home for 6 cars. There is a large garden at the back of the home laid to trees and lawn together with shrubs and a patio area. The home is in the market town of Bourne, which is less than half a mile from the centre of the town, which has shops, pubs, a post office, and various churches. There are 6 single bedrooms and one double bedroom on the ground floor including 1 single bedroom which is en-suite with toilet and wash basin and 4 single and 2 double on the first floor which includes 1 single bedroom which is en-suite with toilet and wash basin. One of the double bedrooms is also ensuite with toilet, washbasin and bath. Accommodation on the first floor is served by a stair lift. There is a large lounge at the front of the home and another lounge leading to a conservatory/dining room, which overlooks the garden. The home changed ownership in December 2007 and the home is now owned by Wellbeing Residential Limited who have another 2 care homes. The owners work very closely with the acting manager and have ensured that the change of ownership had been a very smooth process. The mission statement is “to provide a home which consistently excels in every aspect of care, achieved through dedicated professional carers, working within Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 5 highly maintained homes”. The fees charged by the home for care support on the 22/5/2008 ranged from £351 to £515-77p each week. Extra charges are made for hairdressing, which was £6.50. All other services are included in the fee. Information about the home including the statement of purpose, service user’s guide and copy of this report can be obtained from the manager. Newspapers and external activities are included in the fees. Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This key inspection was unannounced and started at 8.05 a.m. It was done using a review of all the information available to us about Chevington House Care Home. The inspection visit took place over 5 hours. We also spoke with 7 people living in the home and one visitor to the home. We spoke with 5 staff members and the acting manager. We also spoke to one of the owners on the phone as a response to our inspection. The main method of inspection used on our visit was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. We also examined the annual quality assurance assessment (AQAA) that was sent to us by the manager before this key inspection. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the home. It was very clear and detailed. Before making our visit we asked the people who live there to send us comments about the support they receive. We received 6 comment cards. All comments were very positive. During our visit looked at records, spoke to staff, the people who lived in the home and one visitor and walked around the home. What the service does well: People living in this home told us they were well cared for by a committed and competent care team. They were very satisfied with the care, approach of staff and the overall service provided by the home. The management take care to ensure that each persons needs are assessed before entering the home. The assessment fully involves the resident and their family. There is a weekly activity programme available that people can choose to join in with and that they said they enjoy. People said they enjoy their food, which is fresh, varied, well presented and nutritious using fresh ingredients. There was a system to show regular reviews of care are carried out, which fully involved individuals and their family carers when it was right to do so and wherever possible. There was a comprehensive programme of education and training provided for staff, which Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 7 ensured that staff knew how to care and support the people who live at the home. 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. Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 8 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 Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 9 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): Standards 1, 2, 3, 4 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is information to enable people to make a decision about whether or not to come into the home. People coming into the home receive an assessment and know their needs can be met. They are also involved in this process. EVIDENCE: The new certificate was clearly displayed. In addition there was a new up to date service user’s guide and statement of purpose. These were clear and comprehensive and included the aims and objectives and philosophy of the home. There was a very clear and detailed brochure about the home. Where a new resident was admitted to the home the acting manager using a preadmission assessment would assess them. Following this written confirmation would be sent to the person confirming the home could meet their needs. We spoke to one person who was in the home for a short period. She confirmed she received a thorough assessment and received a warm welcome when she came into the home. She had fulsome praise for the home. Each person also had a detailed contract outlining the cost of their stay. Comments received Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 10 were, “the contract is very comprehensive and covers all aspects of care” and “ I have found everyone so helpful and nothing is too much for the staff”. Records showed that they had been involved in the process. Their signatures showed this. The home does not provide intermediate care. Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from being fully involved in identifying their own needs and choices. Clear care plans, created from assessments of need help to ensure that people’s health and welfare needs are fully met. People feel that staff respect their privacy and dignity and can exercise choice. Medication is safely given by staff who know what they are doing. EVIDENCE: Since the change in ownership new care records had been introduced. Each person had a care plan. This included a photograph of the person with their signed agreement. In addition, there was information about the person, details of activities of daily living, medication admission consent, records of GP and other professionals, monthly weight, moving and handling and risk assessment. Each person had a care plan which included details about their personal and social needs, mobility, hearing, oral care, foot care, eating and drinking. Records were dated, signed and well maintained. In addition each person had a comprehensive monthly review. This involved them and their relatives. Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 12 Records that we looked at were professionally maintained. At the time of this inspection visit all of the people who live at the home needed some level of support in order to take their medicines safely. Medication processes had been reviewed, a new system had been introduced and all the 7 staff who gave support with medication had received training. Records were found to well maintained and stock well controlled. Directions were clear. The last pharmacy inspection was on the 1/3/2008. The report commented, “all in good order”. It did note that that the fridge was not working. We were told that a new one was on order but was not required at the moment. Throughout our inspection visit we saw staff caring and supporting the people in the home in a kind, respectful and calm manner. The people told us that staff respected their privacy and they could choose how they spent their day. Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are encouraged and supported to make choices to take part in a variety of social activities, which ensures that individual, social and cultural needs are met at the home. People choose from and enjoy a wellbalanced nutritious diet. EVIDENCE: Since the change in ownership activities had been reviewed following discussions with the people living in the home. There was now a member of staff who involved herself in activities. There was weeks programme displayed on the notice board in the entrance hall. This showed Monday – dominoes, Tuesday – movement to music, Wednesday – film afternoon using the home’s own cinema equipment, Thursday – flower arranging, Friday – card making and Saturday – bingo afternoon. There were also details of a trip to a butterfly park, Summer Fete and Bar BQ at the home on the 20/7/2008, clothes party by visiting retailer on the 13/6/2008 and a visit to a Horse and Pony show on the 14/6/2008. Visitors were welcomed to the home and we spoke to one visitor who was very complimentary about the home and said, “I always find the staff very friendly Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 14 and helpful and can visit whenever I wish to do so”. People in the home told us without exception that they were very satisfied with the meals and catering service. We saw breakfast being prepared for those people who wanted it in their rooms. They were served on individual trays each having a card with details about what the person wanted to have for breakfast. This was very individual. We also heard staff asking the people in their home what they wanted for their breakfast. Other comments we received were, “I enjoy playing dominoes, a sing song, exercises and bingo, the meals are very good and varied” and “activities are flower arranging, card games, dominoes, she says the food is very good and she likes it”. The home received an inspection by the Environmental Health Officer for South Kesteven District Council on the 25/1/2008. As a result it was awarded 2 stars. Some concerns were raised about the hazard analysis, staff training, records being kept, health and safety, the stair lift and general risk assessments. All these issues had been addressed and we saw very clear records now being kept of food temperatures, cleaning of the kitchen as well as food records. Training had been addressed and during our visit the stair lift was serviced. In addition health and safety and risk assessments had been addressed. Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to make a complaint and feel that staff will listen to their views. The care team know how to respond to a complaint and how to act in order to protect people from abuse. People are protected from abuse by the correct recruitment procedures. EVIDENCE: There was a detailed complaints procedure in the statement of purpose, service user’s guide and on the back of each person’s bedroom door. We noticed that our address was wrong. We asked the acting manager to change this and she took action immediately. No complaints had been received by the home or us. A complaints register was being kept. None of the people or staff had any complaints about the home. All staff were to have formal training on abuse prevention in the future. We spoke to one new member of staff who knew clearly what abuse was and what she do if abuse was suspected. The home had a copy of Lincolnshire’s Adult Protection Procedures. We did advise that adult protection should be included briefly in the induction programme for all new staff. The acting manager agreed to implement this. People felt they could approach staff if they had any concerns or worries. Comments we received included “I can speak to the manager or staff on duty if I am not happy and I am very satisfied in all respects of the care provided” and “she knows who to go to if she is not happy, the manager or any of the staff”. Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 16 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): Standards 19, 20, 21, 23, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in well-maintained, comfortable, clean and safe accommodation. EVIDENCE: Since the change in ownership the environment has been improved. This has included 4 bedrooms being redecorated one of these having a new carpet, new carpet awaiting installation in the entrance hall and ground floor corridors. The kitchen and stair have been repainted and the lounge and dining room repainted. In addition a storage area has been provided outside the home and a pathway to increase the access to the back garden was in the process of being completed. Everyone commented on how clean, tidy and odour free the home was. Alcohol hand dispensers had been provided at the front of the home. Comments we received included “she says the home is always fresh and clean” and “I like my room”. We again received no negative comments. Chevington House DS0000071217.V364975.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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a safely recruited, well-trained staff team available who have the skills to meet the needs of the people living in the home. EVIDENCE: With the change in ownership there has been a review in staff training and the delivery of care. Each person was recruited correctly. We looked at the files for 2 staff. These showed separate folders for each person with an application form, Criminal Records Bureau check, 2 references obtained and a supported induction programme. This covers 3 days. We spoke with a member of staff who was on her second day of induction. She confirmed she was recruited correctly and was receiving a supported induction. She commented, “I received a very warm welcome when I came here and have felt supported throughout my induction”. The duty rota showed across the 24-hour period there were 2 staff working in the home. Concerning formal training in care (National Vocational Qualifications), no staff currently had completed this but one was very nearly complete and 7 were signed up to start and a further 3 would be doing so in the future. Refresher training had covered moving and handling, medicine administration, health and safety, fire safety and first aid. In addition, external training has taken place to provide dementia training. The acting manager also showed she had introduced a key worker for each person. Staff also received a staff handbook. We had no negative comments from staff, a visitor or any of the people living in the Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 18 home. Comments included, “staff are always helpful, Chevington House has a wonderful atmosphere and very much a home from home”, “I can’t fault anything” and “staff are very friendly”. Staff commented, “Chevington House has a wonderful atmosphere and very much a home from home and this is the best home I have ever worked in and I am very happy” and “three handovers per day, I had no induction or training with the previous owners, a training programme is now in place and I have a better incentive to work here than I had before, I am now signed up for NVQ level 2, we have 2 monthly supervision”. Chevington House DS0000071217.V364975.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): Standards 31, 32, 33, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People and staff benefit from the positive leadership of the management team. Management record systems show that residents’ health, welfare, safety and choices are promoted. The management team ensures that that residents and relatives have the opportunity to voice their views and opinions. The management uses feedback from questionnaires to make improvements. EVIDENCE: With the change in ownership there has been a change in approach and manager. The owners are actively involved in ensuring that the home is functioning well. They visit on average 3 times a week. At these visits they carry out a weekly audit of care plans, medication, complaints, monthly meetings, activities, staff appearance, cleanliness of the home, rotas and staff training. Each is scored from poor to good. In addition the acting manager Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 20 was in the process of applying to us to be registered. She had introduced formal 2 monthly supervision for each member of staff and kept clear records. She had regular meetings with the people living in the home every 6 weeks and staff. There were new comprehensive policies and procedures. Records were up to date, well maintained and available. Everyone we spoke with was very complimentary about the smooth handover and about the staff and manager. The people and their visitors commented, “She is very happy and contented living at Chevington house”, “it is a lovely home and my relatives and friends like it too and I like it here”, “I am very happy”, “I can’t fault anything” and “superb”. Staff commented, “we are brought up to date with any changes with care on a daily basis, we have supervision every 2 months and my manager works on the floor along with staff. Our manager is always close at hand to give help, support and encouragement, Chevington House cares about the clients in their care to make them have a happy and caring environment to always encourage self caring, dignity and self belief. Chevington House has a wonderful atmosphere and very much a home from home and this is the best home I have ever worked in and I am very happy”. There were health and safety procedures. Following the inspection by South Kesteven District Council a health and safety assessment had been carried out by the owners. There was also a fire risk assessment. Hot water temperatures were tested weekly and all hot water taps had temperature valves installed. There were also regular testing of fire equipment. Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 x N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 x 3 x 3 3 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 3 3 3 X X 3 3 3 Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Chevington House DS0000071217.V364975.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge CB21 5XE 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 Chevington House DS0000071217.V364975.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. 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