Care Home: Stonehaven

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What the care home does well The home is well maintained and is comfortably furnished so that people feel relaxed and settled in their home. Bedrooms are personalised to suit peoples` individual taste and interests. Good systems for record keeping are in place that safeguard people living in the home and staff. Information is securely stored to ensure that confidentiality is maintained.The care plans provide good information for staff about peoples` needs and how these will be met. Changes are updated as they occur. Daily tasks are allocated efficiently which helps staff to make sure everything has been done and that all residents needs have been met. Staff training has exceeded minimum standards and arrangements are in place for regular updating training to take place. Residents are involved in all aspects of care planning and attend reviews of their care. There are a good variety of activities available to residents, which means that there is something of interest for everyone to do. People have one to one time arranged to suit their individual needs. What has improved since the last inspection? Bedrooms have been redecorated and new carpets fitted. People have been involved in choosing the colour scheme and soft furnishings in their bedrooms. The results are attractive and homely. There is a vegetable plot and herb garden that provides fresh produce for the household. There is regular use of clip art pictures to provide people living in the home about the service and its policies and procedures including the complaints procedures. What the care home could do better: The peoples` records would be improved by archiving some of the information that is not in day-to-day use. This would make finding information much easier and quicker. The grouting in the tiles in the bathroom needs replaced as it is discoloured and mould is beginning to grow. CARE HOME ADULTS 18-65 Stonehaven Stonehaven The Willows Red Row Northumberland NE61 5AX Lead Inspector Anne Urwin Brown Key Unannounced Inspection 14th August 2008 09:00 Stonehaven DS0000000558.V370047.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 Stonehaven DS0000000558.V370047.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. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stonehaven Address Stonehaven The Willows Red Row Northumberland NE61 5AX 01670 - 760692 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 Elsie Hazel Dixon Mrs Elsie Hazel Dixon Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 residents with a learning disability/mental disorder Date of last inspection 15th May 2006 Brief Description of the Service: Stonehaven is a small care home providing personal care and accommodation for three younger adults with learning disabilities. The house is a bungalow located in the rural Northumberland village of Red Row. There is easy access to the village amenities and good transport links to Amble and Newcastle. All bedrooms are single and service users have access to landscaped gardens with sea views. The home’s fees range from £655.42 to £699.07. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of this service is 2 star. This means that people using this service experience good quality outcomes. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 15th May 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 14th August 2008 and a further visit was made on 21st August 2008. A total of six hours was spent at the house. During the visit we: • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. • • We told the manager/provider what we found. What the service does well: The home is well maintained and is comfortably furnished so that people feel relaxed and settled in their home. Bedrooms are personalised to suit peoples’ individual taste and interests. Good systems for record keeping are in place that safeguard people living in the home and staff. Information is securely stored to ensure that confidentiality is maintained. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 6 The care plans provide good information for staff about peoples’ needs and how these will be met. Changes are updated as they occur. Daily tasks are allocated efficiently which helps staff to make sure everything has been done and that all residents needs have been met. Staff training has exceeded minimum standards and arrangements are in place for regular updating training to take place. Residents are involved in all aspects of care planning and attend reviews of their care. There are a good variety of activities available to residents, which means that there is something of interest for everyone to do. People have one to one time arranged to suit their individual needs. 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. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1, 2, 5 Quality in this outcome area is (excellent, good, adequate or poor) This judgement has been made using available evidence including a visit to this service. Good information is available about the service provided at Stonehaven and comprehensive assessments are undertaken to make sure that prospective service users’ needs can be met. EVIDENCE: The home’s Statement of Purpose and the Service Users’ Guide both contained the full range of information required. Records showed that a comprehensive needs assessment is undertaken before someone is admitted to the service. The home obtains a care management assessment and care plan before admission. Staff carry out their own assessment and information is used to determine whether or not the person’s needs can be met and to draw up a care plan. Individuals are supported and encouraged to take part in the admission process. Information is collected from a range of sources including professionals working with the person and from pre-visits to the service by the individual. Staff said that they do get information before someone is admitted, but sometimes more information would be helpful. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 9 Each person has a written contract that details the terms and conditions of residence. The contract is produced in pictorial form (clip art) where necessary to help people understand it. Stonehaven DS0000000558.V370047.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): Standards 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives and are encouraged to take an active role in planning the care and support they receive. EVIDENCE: Care plans show that people using the service are encouraged to make decisions about their care. Each person has a care plan that is based on the initial assessment. The assessment is added to during their placement and the plan is developed with the person concerned. Plans include reference to equality and diversity issues relevant to each person. There is clear information to show the development of plans and people’s changing needs. Information about people’s health care needs is clearly recorded. Staff encourage people using the service to contribute to their care plans so that their views are taken into account and respected. Care plans are up to date and monthly reviews provide up to date information about any changes. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 11 Copies of care management reviews were also on file for each of the service users. Staff were well informed about people’s needs and a key worker system is in place. Copies of reviews were available and these showed that people are assisted to be involved in the process and in planning for the future. Each plan included comprehensive risk assessments that were up to date and clear. The service has a positive view towards risk assessments that focuses on supporting people to live the life they want to lead. Records show that assessments are regularly updated. Any limitations on freedom, choice or facilities are in people’s best interests and these are well documented and agreed with the person and/or their representatives. Stonehaven DS0000000558.V370047.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): Standards 11, 12, 13, 15, 16 and 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 the service are able to make choices about their lifestyle, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. EVIDENCE: At Stonehaven people are encouraged to live a normal life appropriate to their preferences in both the home and local community. Staff recognise the importance of enabling people to follow their own interests and to take an active part in life in the local community. People living at the home are able to enjoy full and stimulating lives that suit their preferences and routines. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 13 Each person has a weekly planner that identifies their activities for the week and staff support them to develop and maintain social and independent living skills. One relative said “I feel they (the staff) give the clients a choice to live quite an independent life.” People are encouraged to access education and other community activities that is appropriate to their skills and interests. Outcomes for people are positive and records confirm this. Residents were relaxed and looked happy during the inspection, two people said that there was always plenty to do and staff supported them well. Staff were respectful in their approach to people living in the home. Staff said that service users have good links with the local community where they access banks, post office, shops, pubs, cafes and college. People’s interest include gardening, craftwork, art and visits to the local sports centre. On the day of the inspection two people were going out in the afternoon and one person was going shopping with the handyman. Two people said that they were happy with the activities on offer. Visitors are always welcome at any time and links with family and friends are supported and encouraged. One relative said in the questionnaire “we regularly receive a newsletter telling us about all the activities taking place at Stonehaven.” People living in the home are encouraged to help to plan, shop for food and help with preparation of meals. They said they enjoy regular baking sessions. They can make themselves a snack when they like. Menus show that meals are well balanced and nutritious and are based on healthy eating principles. Alternatives are available for people so that there is a choice, although individual likes and dislikes are well known to staff. Particular dietary needs are identified within individual care plans. Residents said that the food is good and that they can ask for something different if they do not want the food available. Stonehaven DS0000000558.V370047.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): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good arrangements are in place to ensure that the health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Individual plans provide good information about the support provided to each person living at Stonehaven. Staff demonstrated a good knowledge of peoples’ preferences and personal needs. Support is organised to suit the preferences of each individual for example rising and retiring times, bathing and other activities. Specific staff training has been provided to ensure that staff are able to effectively meet individual needs. One relative said “Staff are very caring and will do anything to help.” Records show that people’s health needs are identified and met. Records show that service users have access to the specialist support from healthcare professionals that they need. Evidence was available that people’s health care needs are monitored and potential problems identified and treatment sought. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 15 One person has recently returned from hospital and records confirmed that staff were continuing the treatment recommended. People living in the home are encouraged and supported to attend health screening on offer and records are kept when this is refused. Staff training in epilepsy has been provided. Staff provide a good level of personal support to service users in line with their needs and preferences. Levels of support are decided after assessments are carried out and these are reflected within care plans, which are reviewed regularly. Privacy and dignity is respected at all times. There are good procedures and policies in place to protect service users receiving medication. Arrangements for the administration of medicines protect people living in the home. Records are well maintained and arrangements for the storage of medicines are satisfactory. Training in administration of medicines has been provided for all staff. Stonehaven DS0000000558.V370047.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): Standards 22 and 23 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 are able to express their concerns and access an effective complaints procedure, and are protected from abuse. EVIDENCE: Clear information is available about dealing with complaints and this is easy to understand. Staff have devised a clip art (picture) form of the complaints procedure to help people who find this easier to use. People living in the home are made aware of how to express concerns and encouraged to put forward their views. Staff know people well and are alert to changes in behaviour or mood that may indicate dissatisfaction with something. At reviews staff people are reminded about the complaints procedure and how to make a complaint or express a concern. There have been no complaints since the last inspection. There is a good system in place to ensure any complaints, the investigation and outcome are well recorded. There have been no safeguarding referrals have been made since the last inspection. Policies and procedures are in place for safeguarding adults. Staff at the home demonstrated that they are aware of what the procedure is and how to respond. They have received appropriate training and staff records confirm this. Individual risk assessments protect residents from potential selfharm. Stonehaven DS0000000558.V370047.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): Standards 24, 25, 27 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users live in a very homely, comfortable and safe environment that is maintained to a very good standard. EVIDENCE: The service users live in a bungalow in Red Row that has an attractive garden to the rear of the property and ample car parking at the front. The home was very clean, well decorated and well maintained. The grounds were tidy, safe, attractive and accessible. A small vegetable plot in the garden provides some of the food and one resident is interested in helping with the herb garden. There is a rabbit in the garden, which one person helps to look after. There are also goldfish in the dining area that people have chosen and are involved in their care. The home has well- furnished and decorated sitting and dining space. All the furnishings and fittings were domestic in design and in very good condition. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 18 There is a spacious kitchen/dining area and a new cooker has been purchased since the last inspection. Lighting is good throughout the house. There is a large conservatory to the rear of the property overlooking the garden that provides additional seating and a desk, which one person regularly uses. There is sufficient space for a variety of activities to take place. The bathroom is spacious and well equipped, but the grouting around the shower is becoming discoloured and mould is beginning to affect them. Appropriate aids are available for the people living at Stonehaven. Each person has his/her own room. Rooms are above the minimum size and are well furnished and decorated to suit peoples’ individual taste. Residents said that their rooms have been redecorated and that they have been able to choose the colour scheme, carpets and soft furnishings. People can see visitors in private in their own rooms or use one of the sitting areas. Doors have privacy locks. The house has central heating and radiators are fitted with thermostatic controls and guards. There was emergency lighting throughout the home. Water temperature valves are fitted and the water temperature was satisfactory during the inspection. The home was clean and free from offensive odours. The laundry facilities are well organised and the washing machine has the specified programme to meet disinfection standards. Stonehaven DS0000000558.V370047.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): Standards 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by an adequate number of competent and trained staff. Good recruitment practices safeguard people living at Stonehaven. EVIDENCE: Staffing levels are sufficient to meet the needs of the people living at Stonehaven. Records show that individual support is provided to ensure peoples’ needs aspirations and activities are met. People living in the home said that they feel well supported by staff and that there are enough staff to meet their needs. Staff demonstrate a good rapport with residents. The staff member on duty during the inspection said she enjoyed working at the home. There is a good atmosphere in the home and residents appear well cared for with their individual needs met. Good recruitment procedures are in place and are followed. Staff records contained appropriate information. This included two references and criminal Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 20 records checks. There is evidence to confirm that all new staff received appropriate induction training when they start work. Policies and procedures are regularly reviewed and updated. There is evidence that the service keeps up to date with changes in practice and legislation. Records show that staff have appropriate training opportunities to help them with their work. All staff have received mandatory training. Staff records contain copies of training certificates. 62 of staff have completed national qualifications in care and another two staff are working towards completing their qualifications. Two staff returned questionnaires at this inspection and they said that get plenty of training opportunities and training is always up to date. They also said that they feel well supported. Stonehaven DS0000000558.V370047.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): Standards 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good system is in place for self-monitoring, review and development. The home is well maintained and the health and safety of the service users is promoted and safeguarded. EVIDENCE: The registered manager has the required qualifications and experience to run the home and meet its stated aims and objectives. She communicates a clear sense of direction and has a good understanding of the need for continuous improvement, customer satisfaction and quality assurance. She understands the need for continuous improvement that contributes to the service’s development. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 22 There is a good system of quality assurance in place that takes account of the views of people living in the home. It was apparent that people living in the home and the staff feel able to put forward their views. Relatives’ questionnaires are used as part of the quality assurance process. There are effective systems in place to ensure that there are good records of any money held on behalf of people living in the home. All transactions are recorded individually and money checked during the inspection balanced with the individual records. People living in the home are supported to manage their own money where possible. Those who don’t have the skills are encouraged to take as much responsibility as it is safe to do. All working practices are regularly reviewed. Mandatory training is provided for all staff and is regularly updated. Good systems are in place for checking on health and safety in Stonehaven. Records are kept in good order for these checks. Appropriate training is provided for staff and regularly updated. Risk assessments for the premises and for fire are in place. Fire alarm tests are carried out weekly and records were available to confirm this. Accident records are kept in good order. Stonehaven DS0000000558.V370047.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 X 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 4 25 4 26 X 27 4 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 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 Refer to Standard YA27 Good Practice Recommendations The tiles around the shower need to be re-grouted as they are discoloured and mould is starting to grow between them. Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Stonehaven DS0000000558.V370047.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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