Care Home: Roundstone Care Residential Home

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What the care home does well Roundstone provides a good level of care in comfortable and homely surroundings. The home is family run and managed with members of the family also being employed as staff. The home is good at making sure it can meet the needs of people who live there. The manager writes down what care is needed in a very detailed plan, which is updated regularly. People living at the home are consulted often about their care. One person said: `(The manager) comes to see us every day and is always asking us if everything is alright and if there is anything she can do to make things better.` Health care professionals are consulted about what people need to keep them well and this information is written into the plan too. One Health care professional said: `The home works well with us and acts on our advice.` People are protected by the safe way in which medicines are handled. Any complaints are listened to and something is done to put them right. One person said; `Nothing is too much trouble we have only to say and it would be seen to straight away.` People are also protected by well -trained staff who know how to treat people with respect and make sure they do not suffer from abuse of any kind. The home is well decorated and maintained and clothes are well laundered. There are enough staff on duty to make sure people get the care they need, and the correct checks are carried out to make sure new staff are suitable to work with vulnerable people. The home is well managed. People are asked about what could be made better at the home and a plan of improvement is written every year to respond to these comments. People are protected by good health and safety practices. What has improved since the last inspection? The plans of care have been greatly improved to show all areas of support required, with clear involvement of the person and the people who support them wherever helpful. All risks are now recorded and plans are written to minimise any risk areas. Medicines, including controlled drugs are now handled well and in accordance with the law. Advocacy is now available to any person living at the home with details of who to contact on display. The way in which new staff are recruited has improved, this now protects people living at the home from unsuitable staff. All accidents are now recorded and trends when they are observed are taken into consideration when reviewing the plan of care. The home also sends the commission regulation 37 reports; these are reports of any events, which might adversely affect the welfare of the person living at the home. This helps the commission to monitor what is happening in the home between inspection visits. Staff training has improved with the introduction of the in-house training system. The named residents who required a physiotherapy assessment has received this assessment and the resulting advice has been written into the care plan. What the care home could do better: The home is planning various improvements. There is a plan to improve the quality of feedback from those who use the service and the people who support them. The home also plans to offer staff better incentives to reduce the risk of high staff turnover. This takes the form of internal promotion, offering flexible hours, and funded training. The home also plans to review the quality of the information it gives to people interested in moving into the home, so that they may be better informed about what the home can offer. The home plans to improve how people living at the home are involved in decisions about refurbishment. There are also plans to formalise staff supervision in order to help set goals for training, discuss competence and training needs in order to offer an improved service to those living at the home.All the above planned improvements have been identified by the management of the home. This report has generated no requirements. CARE HOMES FOR OLDER PEOPLE Roundstone Care Residential Home 18/19 Brooklands Filey North Yorkshire YO14 9BA Lead Inspector Karen Ritson Key Unannounced Inspection 09:30 15th January 2008 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 Roundstone Care Residential Home DS0000055727.V352989.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. Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roundstone Care Residential Home Address 18/19 Brooklands Filey North Yorkshire YO14 9BA 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) 01723 513335 01723 514773 roundstone.care@btinternet.com Mrs Margaret Koralewski Mr Ray Koralewski Mrs Margaret Koralewski Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Roundstone Care Home used to be two terraced houses. The home has level access and is situated a few minutes walk from the centre of Filey, where there are rail and bus links and local amenities. It is also only about 100 metres from public gardens, which overlook the seafront. There is on-street parking. It is owned by Mr Ray and Mrs Margaret Koralewski and managed by Mrs Koralewski. The houses have been adapted to provide for a maximum of 13 residents. The registered providers can also offer accommodation on a short stay basis. At the time of this report all the residents are ladies however gentlemen are equally welcome at the home. The home has eleven single and one shared bedroom located on the ground and first floors. Two single and the shared bedroom have en-suite facilities. There is a stair lift fitted to one of the two staircases. Details provided on the 15th of January 2008 outlined the weekly fees as between £317 and £371. This does not include hairdressing, chiropody services and individual items like newspapers. Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection for this service took twelve hours. This includes time spent gathering information, examining documentation before and after a site visit. It also includes the time taken to write the report. The site visit took place on 15/01/08 between 9:30 and 15:30 Information for this inspection was gathered from the following: • • • • • • • • • • • A visit to the home. Speaking with people living at the home. Speaking with staff. Speaking with relatives, and others. Speaking with Adult and Community care staff. Case tracking three service users on the day of the site visit. Reading survey forms from service users and staff. Looking at information provided by the manager prior to the site visit. Notifications sent to the commission from the home since the last inspection. Examining policies, procedures and records kept at the home. Examining information regarding the home on the file kept by CSCI. All key standards were looked at during this inspection. The owners were both available throughout the day of the site visit, What the service does well: Roundstone provides a good level of care in comfortable and homely surroundings. The home is family run and managed with members of the family also being employed as staff. The home is good at making sure it can meet the needs of people who live there. The manager writes down what care is needed in a very detailed plan, which is updated regularly. People living at the home are consulted often about their care. One person said: ’(The manager) comes to see us every day and is always asking us if everything is alright and if there is anything she can do to make things better.’ Health care professionals are consulted about what people need to keep them well and this information is written into the plan too. One Health care professional said: ‘The home works well with us and acts on our advice.’ People are protected by the safe way in which medicines are handled. Any complaints are listened to and something is done to put them right. One person said; ‘Nothing is too much trouble we have only to say and it would be seen to straight away.’ Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 6 People are also protected by well -trained staff who know how to treat people with respect and make sure they do not suffer from abuse of any kind. The home is well decorated and maintained and clothes are well laundered. There are enough staff on duty to make sure people get the care they need, and the correct checks are carried out to make sure new staff are suitable to work with vulnerable people. The home is well managed. People are asked about what could be made better at the home and a plan of improvement is written every year to respond to these comments. People are protected by good health and safety practices. What has improved since the last inspection? What they could do better: The home is planning various improvements. There is a plan to improve the quality of feedback from those who use the service and the people who support them. The home also plans to offer staff better incentives to reduce the risk of high staff turnover. This takes the form of internal promotion, offering flexible hours, and funded training. The home also plans to review the quality of the information it gives to people interested in moving into the home, so that they may be better informed about what the home can offer. The home plans to improve how people living at the home are involved in decisions about refurbishment. There are also plans to formalise staff supervision in order to help set goals for training, discuss competence and training needs in order to offer an improved service to those living at the home. Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 7 All the above planned improvements have been identified by the management of the home. This report has generated no requirements. 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. Roundstone Care Residential Home DS0000055727.V352989.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 Roundstone Care Residential Home DS0000055727.V352989.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): 3 and 6 People who use the service experience good quality outcomes in this area. They have their needs assessed prior to admission, and they may be assured their care needs can be met. Standard 6 is not applicable. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home conducts a pre admission assessment of care needs, which covers all required areas of care with risk taken into account where necessary. This ensures that the home is able to meet care needs before offering a place. The home is in the process of revising the Service User Guide and Statement of Purpose with external support. This is to ensure contractual obligations are clarified and that the documents are as accessible as possible to prospective service users. People living at the home said they had been offered the opportunity to visit the home. Trial visits during the day or short stays are Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 10 encouraged so that people get the feel of the home and whether it is right for them. Roundstone Care Residential Home DS0000055727.V352989.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): 7, 8, 9 and 10 People who use the service experience excellent quality outcomes in this area. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive wherever possible. Their care needs are met and they are treated with respect and dignity. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Each person living at the home has a comprehensive plan of care, written by senior staff and updated on a monthly basis with the involvement of the person whose plan it is, care staff and any health care professionals involved in the care. Daily notes are very detailed; these follow a structured outline, which encourages staff to concentrate upon relevant areas of care at set time intervals. This method of recording observations makes it easy to track changes in service users’ wellbeing. The manager said this had proved very useful when informing GPs about recent health history and to help staff decide when to call for medical help. The daily notes also contain information about Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 12 mood and interests, which helps to track the welfare of each person. Staff said this had helped gain a clearer picture of each person for the planning of future care, meal choice and activities on offer. The home now keeps a separate record of all medical intervention, which has helped in situations where there have been questions about the commencement of certain medications, or when a GP or nurse has called to visit. Risk assessment forms are filled in when needed, and all areas of risk are considered in the care plan. The storage and administration of medication was examined. Records were in order, with no gaps in recording. The home does not keep any drugs classed as controlled at present; medicines such as Temazepam are kept separately in a locked cabinet within another locked cupboard and treated as controlled drugs, which is good practice. Previous concerns regarding the use Movicol have been resolved. Medicines were recorded at the time of administration. Staff who handle medication have received suitable training and all certificates were seen on staff files. Throughout the day, people living at the home were treated with kindness and respect by the staff on duty. Relatives indicated in surveys that in their experience this was always the case. People said: ‘The staff are all lovely.’ And ‘I am always treated with the utmost respect.’ Roundstone Care Residential Home DS0000055727.V352989.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): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. Services users are able to make choices about their life style. Social, cultural and recreational activities meet individual expectations. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home has a minibus to take people out for trips. Those living at the home said they got out and about often. During the day of inspection one person went out for a short walk with a member of staff and others said they could often go out shopping or visiting with staff when they wanted to. The home keeps a record of all activities enjoyed by people who live there, these include going to church, mothers union, hairdresser, bingo and coffee mornings, regular manicures, musical entertainment regularly brought into the home, a choir over Christmas time, a Christmas party and dominoes. Those living at the home said they could have visitors whenever they chose. Those who do not have many relatives to call often have friends who visit. Details on how to contact local advocacy were available. Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 14 All those living at the home said the food was very good. The chef knew their likes and dislikes and would go out of his way to make sure favourite choices were often on the menu. One person had mentioned her like of mushrooms to the chef and she was pleased to see she had been given extra mushroom at lunchtime. Although the home is only registered for thirteen service users, there was a choice of three lunch options. The home emphasises the use of fresh local foods. A midday meal was sampled and was of a high quality. The table was set attractively and people said they had choice at every meal. Special diets can be catered for, but at present there are no special diets required. The home keeps a record of food choices for each person in order to plan for future menus. The chef has undertaken food hygiene training in order to make sure the food is prepared in a safe way. Roundstone Care Residential Home DS0000055727.V352989.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): 16 and 18 People who use the service experience good quality outcomes in this area. They may be assured their complaints will be dealt with and resolved. They are protected from abuse. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home has a complaints procedure, which is available to those living at the home and to any visitors. A copy is available in the entrance Hall. The policy is available in the service user guide. Relatives indicated they were aware of the procedure but none had felt the need to use it. Those living at the home said they only had to mention something and the manager would do her best to put it right. Staff are aware of the procedure if there is a suspicion of abuse and have covered abuse awareness within NVQ training or the in house induction. This ensures people are kept safe. Those living at the home said they felt very safe living there and that the staff were all kind. Roundstone Care Residential Home DS0000055727.V352989.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): 19 and 26. People who use the service experience good quality outcomes in this area. They live in a clean, well -maintained home, which they find pleasant to live in. They have a good laundry service. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home is well decorated and maintained. A regular audit is carried out regarding the environment and identified refurbishment is incorporated into the annual improvement plan. The home has had a new nurse call system fitted; the entrance keypad system is linked into the fire alarm system so that in the event of a fire people can exit through the front door without needing to know a code. The dining room has been relocated which has created a second lounge area where people can meet relatives in private. A shower has replaced one bath. The person in whose room this was said: Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 17 ’It’s a wonderful shower, a big space for me, and ideal as I am used to a shower and don’t like to get into a bath.’ Most radiator covers in the private rooms have been updated and there is a plan to replace the covers in communal areas too, although these are serviceable. The home is clean, pleasant and homely. Handrails are available in awkward areas. One person living at the home said: ‘It’s marvellous. Like being at home. I can’t fault it.’ Another said: ‘I love my room, they’ve decorated it so beautifully.’ Staff have received infection control training and the home complies with the requirements of the environmental health department. This ensures people are kept safe from the risk of cross contamination. The laundry is away from the kitchen and the facilities are suitable for the needs of a small home. The clothes worn by people at the home were well laundered and clean. One person living at the home said: ’They do very good job with our clothes.’ Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. They benefit from well trained and recruited staff in sufficient numbers to offer the care needed. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home employs sufficient staff for the needs of the people living at the home. This was evident in the comments such as: ‘We can go out often with the staff.’ And ‘There is always time for a chat, they spend time with us, not rushing about.’ This was also evident from observations made during the day of inspection, in the detail of records kept and in staff comments. One member of staff said: ‘I like to help with nails and can take people out shopping if that’s what they want.’ 50 of staff now have NVQ at level 2. The home has experienced difficulties getting external training for staff particularly in induction. As a result, the manager has devised an in -house induction booklet based on skills for care guidelines which all staff have completed since the last inspection. All staff had completed training in foundation training topics. New staff had begun this training with manual handling, infection control and fire safety with plans to Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 19 complete health and safety, first aid and food hygiene soon. This ensures that staff have the skills to offers people the care they need. Staff are recruited well, with evidence seen of application form, Criminal Records Bureau checks and Protection of Vulnerable Adults first checks. (This ensures that potential staff are checked against a list of people unsuitable to work with vulnerable people.) All staff recruited since the last inspection had two written references on file. This minimises the risk of unsuitable staff being recruited. Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience good quality outcomes in this area. They benefit from good management of the home, they may be assured their views underpin practice, and they are protected by good health and safety procedures. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager has many years experience of working in a care setting. Staff and people living at the home said she was approachable and friendly. Staff said she was supportive of them and encouraged them to gain training relevant to their role. The home is developing the quality assurance system. At present, feedback from those using the service is sought through residents meetings and questionnaires. Feedback request forms are in the entrance hall for visitors. The home has engaged the services of Peninsular for all health and Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 21 safety auditing. Quality checks around the home are carried out on a regular basis. The home plans to arrange an annual feedback meeting for people living at the home, where the results of quality assurance audits and plans for improvements are discussed. At present such feedback is informal in nature. The home creates an annual plan based on the auditing process. The home does not become involved in handling peoples’ money. The health and welfare of those living at the home is protected through robust health and safety policies and procedures. Water temperatures records, fire risk assessment, fire equipment testing records, electrical safety and gas safety certificates were examined, along with bath hoist servicing certificates. All were in date and satisfactory. Roundstone Care Residential Home DS0000055727.V352989.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 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 3 17 X 18 3 3 X X X X X X 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 X 3 X N/A X X 3 Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 23 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. 1. 2. Refer to Standard OP33 OP30 Good Practice Recommendations The provider should continue developing the quality assurance programme to show that residents are having a say in how the service runs. The manager should continue to look for training opportunities for her staff to attend formal training in ‘safe working practices’. Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Roundstone Care Residential Home DS0000055727.V352989.R01.S.doc Version 5.2 Page 25 - 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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