Care Home: Devonshire Manor Care Home

Similar services:

• Hillside
• Applegarth
• 122 Scorer Street
• Jubilee Villa Care Home
• Thornham Grove
• Beech Lodge
• 8 Thorndale Road (Homefield College)
• Hunter`s Lodge

What the care home does well People who live at the home said they have opportunities to make decisions about things they do, where they go and what they choose to wear, as well as what food they like to eat. The service provides a homely, well decorated and furnished home, which is in a good state of repair and clean. People living there said they enjoyed their surroundings, they could go out and have a cigarette in the courtyard if they wanted to, and they have their own things around them in their private rooms. People living at the home said the staff treat them with dignity and help them when they need it, and not if they don`t. They said they were able to go out and about when they pleased, and be involved in the community. What has improved since the last inspection? Assessments are carried out for new people moving into the home and are kept at the home to make sure the service can meet the person`s needs. The practice of dispensing medicines has been improved, and now only staff who have received training in administration of medicines administer this. People living at the home said they have their medicines when they should, and staff said they feel more comfortable with a trained person doing this. The duty rota showed suitably experienced staff working at all times, and people living at the home said they were very happy with the staff and the help they provided for them. People living at the home said the manager and staff listened when they had a problem, or complaint, and that there were often discussions about, "day to day things and what I liked to do, or if things could be better." CARE HOME ADULTS 18-65 Devonshire Manor Care Home 2 Devonshire Road Sherwood Nottingham NG5 2EW Lead Inspector Lee West Unannounced Inspection 3rd July 2008 12:30 Devonshire Manor Care Home DS0000002196.V368051.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 Devonshire Manor Care Home DS0000002196.V368051.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. Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Devonshire Manor Care Home Address 2 Devonshire Road Sherwood Nottingham NG5 2EW 0115 962 2538 0115 985 6111 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) Mrs Margaret Ann Webster Mrs Joanne Tatia Ault Miss Cheryl Carwin Shearman Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Margaret Ann Webster and Joanne Tatia Ault are registered to provide accommodation and personal care at Devonshire Manor Care Home, 2 Devonshire Road, Sherwood, Nottingham NG5 2EW for people aged between 18 and 65 years whose primary care needs fall within the following categories and numbers: 1: Learning disability (LD) 5. Service users accommodated at Devonshire Manor Care Home will have suffered a head injury. 4th June 2007 2. Date of last inspection Brief Description of the Service: Devonshire Manor is a care home providing personal care and accommodation for 5 younger adults who have disabilities resulting from a brain injury. The home provides short and long term care and will provide a respite service and accept emergency admissions. The home is owned by Stepforward (Nottingham), which is run as a family business. The home is located in a residential area of Sherwood, close to shops, pubs, the post office and other amenities. The home was opened in 1987 and consists of a domestic dwelling with a small extension to the rear. All of the home’s bedrooms are single, and none of the bedrooms have en-suite facilities and are located on 2 floors. The home does not have a lift. The home has a small tarmac courtyard and there is car parking available for 2 cars with further unrestricted parking available on the road. The fees for the service start from £854.34 per week, with an additional £11:07 per hour for one to one staffing, and are dependent on the care requirements of each person. Further information about the home is available in the statement of purpose or from the manager. A copy of the latest inspection report is available in the office. Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection was unannounced and involved one inspector. The main method of inspection used is “case tracking”, which involves selecting three residents and looking at the quality of the care they receive by speaking with them, observation, reading their records, and asking staff about their needs. Four members of staff were also interviewed and their records checked to make sure they had been safely recruited. Time was spent with people in the lounge areas observing their interactions with staff and each other, as well as communicating directly with them. Documents, including care plans and medication administration records were inspected to help form an opinion about the health, safety and welfare of people at the home. Information supplied to the commission by the manager, with information received by the Commission about the home, since the last inspection, were also considered, and helped the decision of which areas to focus on. What the service does well: What has improved since the last inspection? Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 6 Assessments are carried out for new people moving into the home and are kept at the home to make sure the service can meet the person’s needs. The practice of dispensing medicines has been improved, and now only staff who have received training in administration of medicines administer this. People living at the home said they have their medicines when they should, and staff said they feel more comfortable with a trained person doing this. The duty rota showed suitably experienced staff working at all times, and people living at the home said they were very happy with the staff and the help they provided for them. People living at the home said the manager and staff listened when they had a problem, or complaint, and that there were often discussions about, “day to day things and what I liked to do, or if things could be better.” What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 7 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. Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 8 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 Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 9 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, 5, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Pre-admission assessments and a welcome pack with information about the service and facilities help people make a decision about whether the service is able to meet their needs. EVIDENCE: People spoken with, said they had been given enough time and information to choose whether to live at this home and that they had been given a welcome pack which explained, “everything I need to know about living here.” The welcome pack contained information about the service, including terms and conditions, how to complain, the smoking policy, and how the service aims to help people realise their personal aspirations. The manager or one of the team leaders carried out the pre-admission assessments, and there was also an assessment completed by the healthcare trust, kept with the care plans. Devonshire Manor Care Home DS0000002196.V368051.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, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People are involved in decisions about their lives and the support they receive, but care plans are complex, not person centred, with pages which are irrelevant to care needs making it difficult to work out the individual’s care requirements and wishes. EVIDENCE: Some people living at the home said they knew about their plan of care, “it tells staff about me and what I need,” said one person. The care plans case tracked had evidence of the pre-admission assessment which had been used to develop the care plan, but the plans contained 22 pages, some of which were not related to individual care, and contain a lot of unnecessary information. For example, Care plan 6 was for people to choose the amount of furniture required, and Care Plan 4 was “non-compliance.” There was no evidence of any actions or interventions within the documentation, of what the routines were, or the person’s individual needs. Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 11 . Risk assessments seen were also generic and a number were not appropriate for the people who were case tracked. Examples of this were risk assessments for using a hoist for a person who was independently mobile, a risk assessment concerning self harm for a person whose records show this had never been a risk. Interactions between people who use the service and staff were observed to be positive, supportive and encouraging, and one person who uses the service said, “this place is great, they help me to do what I want and help me when I need it.” People spoken with said they were encouraged to be independent and selfsufficient. One said she enjoyed going into town and shopping. The staff working during this visit were very knowledgeable about the people living at the home, and were able to describe how they support them to take risks, for example supporting them to do their own laundry, how one person could be left almost unsupervised, whilst another, needs constant prompting because of poor memory. Devonshire Manor Care Home DS0000002196.V368051.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, 17, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use this service are able to make choices about their lifestyle and are supported to develop and maintain their chosen activities and relationships. EVIDENCE: People using the service said they were encouraged to be involved in the routines of the home, one said, “I have a day to do my laundry and at the weekend I like to clean my room.” Records were seen of individual programmes for people, which included the routines of the home. They also showed people were encouraged to be independent, like going shopping alone, going into town, or working as a volunteer in the community. One person said, “I love going into town and shopping” and displayed what had been bought that morning. Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 13 One person was visiting their family on home leave and records seen showed how people were encouraged to maintain family relationships. Evidence was seen which demonstrated the service’s support for people to access information and specialist guidance about intimate relationships and sexual health for those who wish to develop or maintain intimate relationships. Staff spoken with said they were aware people at the home needed opportunities to develop intimate relationships and strategies were worked out with them to support this and ensure necessary health advice was available. People said they could have friends and family visit at any time, but there was a limit on the number each time, to avoid upsetting other people living at the home. People living at the home and staff together have decided this year’s holiday would be at Great Yarmouth, last year they went to Butlins, but people said they wanted a change this year, although they said they enjoyed the last holiday. People living at the home said they really enjoyed the food and could choose what they had and the food available looked appetising and nutritious. One person wanted her cooked meal later on and just had a snack at lunchtime, as she preferred to eat her cooked meal late in the afternoon. People spoken with said they were asked about what they would like to eat and sometimes helped to prepare the food. Staff spoken with also said they supported people living at the home to prepare simple meals, to help develop their independence. Devonshire Manor Care Home DS0000002196.V368051.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, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service receive personal support in a way they prefer to meet their physical and emotional needs, and practices of administering medication have improved to protect people when dealing with medication. EVIDENCE: People spoken with were all very satisfied with the care and support they received. One said, “I love it here, I don’t need much help, but sometimes I get upset and everyone is lovely and try to help me feel better.” Staff spoken with described each person and their individual abilities. They also explained how they noticed if someone was, “just feeling a bit down,” and how they could respond to that to help them feel better. This was observed when one of the people became distressed because he wasn’t able to get outside for a smoke. The staff intervened and went with him to the courtyard where people could smoke, reducing his agitation. Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 15 Medication procedures have been improved, and there is no dispensing into small envelopes. The duty rota displayed there was a member of staff trained in medication administration working on each shift. Staff spoken with confirmed there was always a member of staff working who was qualified to administer medication. Medicines Administration Records were checked and those case tracked found to be accurately completed. Medication was stored correctly and observed to be administered safely. Devonshire Manor Care Home DS0000002196.V368051.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, 23, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are able to express any concerns, and know what happens if a complaint is made. They are also protected by staff who understand their role in safeguarding adults. EVIDENCE: People who use the service said they were sure if they had any complaints they would be taken seriously. All those spoken with said they had no cause for any complaints. Staff spoken with demonstrated their thorough knowledge of the complaints procedures, and also their role in safeguarding adults procedures. Evidence of training in this area was seen within the staff files case tracked. The complaints book had no recent complaints, however, there had been an anonymous concern referred as a safeguarding adults issue, but this had been unfounded and the person it concerned was not injured or hurt in any way. Devonshire Manor Care Home DS0000002196.V368051.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, 30, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a homely, safe, comfortable and well maintained environment. EVIDENCE: People living at the home said the environment suits them. They said the home is very pleasant and they feel safe in their own room. The areas shared by everyone were comfortable and well maintained with enough space for people to meet their family or friends. Cleaning was part of the staff’s duty, with people living at the home taking care of their own rooms, with support, supervision and assistance when needed. One person said, “I like cleaning my room at the weekends.” All areas of the home, including the kitchen area were clean, well maintained and hygienic. Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 18 In the Annual Quality Assurance Assessment report (AQAA) the manager informed the commission that most staff had achieved certification in infection control, staff working confirmed they had achieved this and certificates were seen in the staff files case tracked. Upstairs the office was being refurbished and the outside of the home was being pointed and the windows painted. Inside, the décor and furnishings were comfortable and suitable for the people using them. The laundry is in the basement, which is reached via a locked door. Some of the people living at the home do their own laundry, with staff supervision, and said they were able to get up and down the stairs safely. Two people gave permission for me to visit their rooms, which were clean and comfortable, and had their personal possessions around them. One had his room arranged with a sitting area and a sleeping area, with electronic equipment and television in the sitting area. Devonshire Manor Care Home DS0000002196.V368051.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): 32, 34, 35, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living at the home are supported and protected by suitably recruited staff, who are competent and trained to carry out their roles and responsibilities. EVIDENCE: People living at the home said they felt safe and confident that staff working at the home, “know what they are doing and help us when we need it.” The duty rota shows changes made in the staffing levels to help meet the requirements of the people living there, who said there were enough staff working to help them. Three staff files were checked and all had the proper recruitment records, two professional references, Criminal Records Bureau checks, evidence of identification and previous experience, as well as copies of training certificates and recorded supervision sessions. Staff had received training in the Mental Capacity Act, and the manager was attending the training during the afternoon. One has almost completed the Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 20 National Vocational Qualification in Care at Level 4, and one, who had achieved National Vocational Qualification at Level 3, received confirmation of funding for her to undertake the Level 4 during this visit. Discussions with staff working enabled them to demonstrate their depth of knowledge about the people who use the service, and what assistance and encouragement they need to be independent. This knowledge was seen as positive and supportive of the well being of the residents, when observing interaction between staff and people using the service, during the afternoon. One staff member said, “I have worked here for a number of years and just want to protect people but encourage them to be independent as well.” Devonshire Manor Care Home DS0000002196.V368051.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, 39, 42, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect, the manager is developing quality assurance systems to support and include views of the people living at the home. EVIDENCE: People living at the home were observed interacting with the manager, there was a lot of laughing and banter between them, as well as quiet support for one person who needed that. When spoken with they all said they were happy with the manager and that she was easy to get along with. They said she always put them first and always treated them with respect. One person said, “I can tell Cheryl anything and if I need help she is always there.” Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 22 People using the service said they were encouraged to make decisions about things around the home, like decorating, where they wanted to go on holiday, if they had any problems, but there was no formal system in place for reviewing the quality of care and support for them, to find out if there are any areas where standards need to be improved to maintain the mental and physical well-being of the people living at the home. Management systems, particularly management of administration of medication had been improved, to protect people who need to take medication from any errors. The Annual Quality Assurance Assessment report contained information about the dates of all the required health and safety checks, and servicing of equipment. An example was the Portable electrical equipment which had been tested in April 2008 and the premises electrical circuits in May 2008, records of which were seen in the home. Devonshire Manor Care Home DS0000002196.V368051.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 3 3 3 4 X 5 3 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 X 26 X 27 X 28 X 29 x 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 3 X Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1) Requirement Care planning documentation must be individualised and person centred, and contain specific actions needed to support the person using the service in the way they prefer. Risk Assessments must be relevant to the person assessed, to make sure the person assessed has the support for their identified risks, improving their freedom of choice and personal well being Residents must have opportunities to express their views on how the home is run. This will ensure that residents can have a say in how the home is run. A quality assurance and monitoring system, based on their views, using systematic planning, action and review, of the outcomes for people, must be developed and implemented to maintain and improve the quality of service provided Timescale for action 05/09/08 2. YA9 13(4)b 05/09/08 3. YA39 24(1) 05/09/08 Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 25 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 Devonshire Manor Care Home DS0000002196.V368051.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection 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 Devonshire Manor Care Home DS0000002196.V368051.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. 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!