Care Home: Whiston House

Similar services:

• Thorndene
• Insight - Eastchurch
• Southfields
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court
• 1 Marten Road

What the care home does well The service provides a homely, clean and pleasant environment with spacious personal and communal areas. There is a highly motivated manager and staff team in place committed to promoting quality outcomes for people living in the home. People living in the home are listened to and supported by the staff team in making positive decisions about their lifestyles. What has improved since the last inspection? Since the last inspection the home has developed an action plan to address the maintenance issues identified in the previous report and has made many improvements thus far. Staff training has been ongoing to address shortfalls in mandatory requirements and other areas relevant to this user group. A review of medication procedures has taken place and loose medications are now regularly audited, hand washing and drying facilities are in place and waste disposed of appropriately. The homes Statement of purpose has been reviewed to detail any additional charges to people living in the home. The manager is currently reviewing and rationalising resident files into more manageable working documents. Health and safety checks regards fixed electrical installations, gas and fire risks have been completed.New systems for quality assurance of the service have been implemented that will involve people living in the home in assessing the responses of surveys. What the care home could do better: It is acknowledged that many improvements have been made since the last inspection but there is still a requirement to continue with ongoing maintenance of the environment and in particular safe access to the rear garden for residents. CARE HOME ADULTS 18-65 Whiston House Whiston Avenue Bethersden Ashford Kent TN26 3LA Lead Inspector Paul Stibbons Key Unannounced Inspection 9th May 2008 12:00 Whiston House DS0000065343.V363136.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 Whiston House DS0000065343.V363136.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. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whiston House Address Whiston Avenue Bethersden Ashford Kent TN26 3LA 01233 820912 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) CareTech Community Services (No.2) Ltd Sarah North Care Home 15 Category(ies) of Learning disability (0), Mental disorder, registration, with number excluding learning disability or dementia (0) of places Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care Home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - LD Mental Disorder - MD The maximum number of service users who can be accommodated is: 15 9th May 2007 2. Date of last inspection Brief Description of the Service: Whiston House is a care home that is registered to provide accommodation, personal care and support for up to 15 young adults. It is situated in the village of Bethersden, close to local amenities and approximately nine miles from Ashford. Whiston house is a listed building and the accommodation is arranged over three floors. The home has recently completed alterations to the home to allow for the residents to live in two units of six service users in a more homely environment. There is also accommodation in the ‘coach house’ within the grounds for two residents. The home has no lift. Ms S. North is Registered manager in day to day control and has been in post since March 2006. Fees for this service range between £693.80 - £1550.00 per week. A varied programme of activities is available, individual residents directly fund some of which. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection was carried out over a period of four hours. A tour of the premises was conducted and a variety of records and documents were viewed. The home had submitted a completed Annual quality assurance assessment (AQAA) prior to this site visit to the CSCI. Discussions were held with the manager and staff team and a number of residents were spoken with during the visit. What the service does well: What has improved since the last inspection? Since the last inspection the home has developed an action plan to address the maintenance issues identified in the previous report and has made many improvements thus far. Staff training has been ongoing to address shortfalls in mandatory requirements and other areas relevant to this user group. A review of medication procedures has taken place and loose medications are now regularly audited, hand washing and drying facilities are in place and waste disposed of appropriately. The homes Statement of purpose has been reviewed to detail any additional charges to people living in the home. The manager is currently reviewing and rationalising resident files into more manageable working documents. Health and safety checks regards fixed electrical installations, gas and fire risks have been completed. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 6 New systems for quality assurance of the service have been implemented that will involve people living in the home in assessing the responses of surveys. 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. Whiston House DS0000065343.V363136.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 Whiston House DS0000065343.V363136.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): 1,2,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with sufficient information on which to base an informed opinion as to whether the home can meet their expectations. People are not admitted into the home prior to a full assessment of their needs and a transition period to assess the success of the placement. EVIDENCE: The home understands the importance of having sufficient information when choosing a care home. The home has plans to develop a pictorial brochure about the home for prospective residents. The home provides a statement of purpose that is specific to the individual home and the resident group they care for. It clearly sets out the objectives and philosophy of the service supported by a service user’s guide. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 9 The Statement of Purpose and Service User guides have recently been reviewed with more pictures and symbols inserted to aid communication. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. A transition period that includes short visits and an overnight stay are offered prior to admission to assess the compatibility with existing residents whose views are sought. Documentation viewed for a recent admission evidences that robust assessments and support requirements have been written up and signed up to. Whiston House DS0000065343.V363136.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): 6,7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from having an individual plan of care that reflects their assessed and changing needs. People living in the home are encouraged to participate in all aspects of life in the home and supported to take risks as part of an independent lifestyle. People living in the home can be confident that information about them is secure and handled appropriately. EVIDENCE: Three care plans viewed evidence that the service involves individuals in the planning of care that affects their lifestyle and quality of life. Staff members Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 11 understand the importance of residents being supported to take control of their own lives and individuals are encouraged to make their own decisions and choices. Care plans are person centred and are agreed with the individual. Plans are written in plain language, are easy to understand and look at all areas of the individual’s life and includes information about risk assessment, how they keep safe, their goals and aspirations, how they communicate, their skills and abilities and how they make choices in their life. The plans include information about their healthcare needs, social support and personal care. Each care plan includes a comprehensive risk assessment, which is reviewed regularly. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. Where there are limitations, the decisions have been made with the agreement of the person or their representative and are accurately recorded. Support plans contain a lot of information and the Quality and performance manager is currently working with a focus group consisting of residents, staff and managers to review and change care plan formats into a more accessible and person centred format. Information of a confidential nature is securely stored within the home. Whiston House DS0000065343.V363136.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 living in the home have the opportunity to participate in a range of activities both within the home and the wider community. People living in the home benefit from being supported in maintaining contacts with friends and families. People living in the home benefit from a varied and healthy diet that is of their choosing. EVIDENCE: Residents are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. They have been fully involved in the planning of their lifestyle and quality of life. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 13 During the visit residents were engaged in activities within the home and a ball game was being played in the garden. The rear garden is in need of some maintenance and this was scheduled to start mid-April but to date has not been progressed. Daily records viewed evidence activities participated in include swimming, shopping, day centre, cinema, trips out, horse riding and photographs of activities and visits are on display in some areas. Staff members spoken with state they encourage residents to be involved in day to day tasks such as laundry, cooking and cleaning. Residents can access and enjoy the opportunities available in their local community, such as using the local pub, and local leisure facilities. The service is committed to the principles of inclusion and promotes and fosters good relationships with neighbours and other members of the community. People living in the home are supported in maintaining relationships with friends and family and the home has transport to facilitate home visits. Menus viewed were varied and healthy and residents spoken with confirmed they liked the food and made choices. Whiston House DS0000065343.V363136.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): 18,19,20,21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical and emotional needs of people living in the home are met by a multidisciplinary team and they receive personal care in the manner they require. People living in the home are protected by the homes policies and procedures for dealing with medication. The ageing, illness and death of people is handled with respect and as the individual would wish. EVIDENCE: Personal support is responsive to the varied and individual needs and preferences. The delivery of personal care is individual and is flexible, Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 15 consistent, reliable, and person centred. Staff members respect privacy and dignity and are sensitive to changing needs. Staff members have received training in diabetes, epilepsy and acquired brain injury since the last inspection to further support these identified needs. Residents have access to healthcare and remedial services. Staff members support those who are fit and well enough to attend regular appointments and visit local health care services. The health care needs of residents unable to leave the home are managed by visits from local health care services. Residents have the aids and equipment they need and these are well maintained to support them and staff in daily living. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. Regular management checks are recorded to monitor compliance and the home has implemented regular audits of loose/liquid medication. The home respects and understands the rights of residents in the area of health care and medication. They work with individuals regarding any refusal to take medication. If individuals prefer or where they lack capacity, care staff can manage medication on their behalf. The staff team work to clear and robust practices when caring for individuals who have degenerative conditions and terminal illnesses, there is evidence in records of “Best interest” meetings being held where the home can no longer meet the needs of the resident. When residents die family and friends can help with the arrangements if this is what the resident had agreed to. Staff members support both the family and the home’s other residents during the bereavement process as evidenced by a recent death. The home seeks out guidance and support of care for individuals who are dying and learns from best practice. Whiston House DS0000065343.V363136.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 living in the home know their views will be listened to and acted on. People living in the home are protected from abuse, neglect and self-harm. EVIDENCE: The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. Residents have 1-1 talk times and resident meetings and several have access to advocacy services and family that gives them the opportunity to raise any issues they may have. Residents spoken with state they have no issues about raising concerns with staff members. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Staff working at the service know when incidents need external input and who to refer the incident to. There is a clear system for staff to report concerns about colleagues and managers. Staff that ‘blow the whistle’ on bad practice are supported by the service. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 17 The home understands the procedures for safeguarding adults and will always attend meetings or provide information to external agencies when requested. There are a low number of referrals made as a result of lack of incidents, rather than a lack of understanding about when incidents should be reported. Only one AP referral has been made since the last inspection and was found to be unfounded. The outcomes from any referral are managed well and issues resolved to the satisfaction of all involved. Training of staff in safeguarding is regularly arranged by the home and the manager states the majority of staff have received training to date. Other training around dealing with physical and verbal aggression is also made available to staff as needed. Two Staff members spoken with understood what restraint is and alternatives to its use in any form are always looked for. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 18 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): 24,25,28,29,30 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, comfortable and safe environment with ample personal and communal space for their needs. People living in the home have the specialist equipment they require to maximise their independence and meet their needs. Residents’ benefit from living in a home that is clean and hygienic. EVIDENCE: The home provides a physical environment that is appropriate to the specific needs of the people who live there. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 19 The coach house was not viewed on this occasion as the resident in situ was reluctant to allow access. The home is a very pleasant, safe place to live and the bedrooms and communal rooms meet the NMS or are larger. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. Most bedrooms have en-suite facilities and the bedrooms viewed during this visit had personal possessions on display that reflected the interests and lifestyles of individuals. Specialist equipment has been obtained for residents with changing needs and where equipment was purchased by an individual from their own funds this has been documented. There is evidence of equipment having been serviced appropriately. The home has in place a maintenance action plan with timescales, some work has been completed on time but the rear garden is still requiring attention before people living in the home can benefit from its use. The home was clean and tidy on the day of this visit and staff were observed using appropriate personal protective equipment when carrying out personal care. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 20 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): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home, are supported by a competent, qualified staff team in sufficient numbers to meet their needs. People living in the home are protected by the homes robust recruitment policies and practices. EVIDENCE: Observations indicated that people living in the home have confidence in the staff who care for them. Rotas viewed show that the home is staffed efficiently, with particular attention to the changing needs of the people who use the service. In particular additional staff were on duty for the last days of a terminally ill resident. Staff members undertake external qualifications beyond the basic requirements and the manager states that 50 of staff have attained NVQ 2 in Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 21 care. The home puts a high level of importance on training and staff report that they are supported through training to meet the individual needs of people in a person centred way. Training has included diabetes, epilepsy and brain injury. There is a good recruitment procedure that clearly defines the process to be followed including the appropriate checks for references and CRB/POVA. This procedure is followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Records viewed evidence that staff meetings take place regularly and supervision sessions are held monthly. Staff members spoken with state that they find supervision helpful with a focus on improving outcomes for people using the service. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 22 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): 37,38,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in a well run home where their views underpin all self-monitoring and development by the home. The health, safety and welfare of people living in the home is promoted and protected. EVIDENCE: The homes manager has successfully been registered with the CSCI and has the necessary qualifications and experience to run the home well. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 23 Staff members spoken with feel there have been many improvements since the last inspection and that the manager’s approach is open and inclusive. The manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. The home works to continuously improve services and provide an increased quality of life for residents with a strong focus on equality and diversity issues and promoting human rights, especially in the areas of dignity, respect and fairness. There has been a lot of input from other healthcare professionals and training for staff members is focused on person centred thinking, with residents shaping service delivery. Observations and discussions demonstrated there is a strong ethos of being open and transparent in all areas of running of the home. The manager leads and supports a strong staff team who have been recruited and trained to a high standard. The manager is aware of current developments both nationally and by CSCI and plans the service accordingly. The AQAA contains clear, relevant information that is supported by a wide range of evidence. The AQAA lets us know about changes the home has made and where they still need to make improvements. It shows clearly how they are going to do this. The data section of the AQAA is accurately and fully completed. There is also evidence of organisational monitoring by corporate providers. Records viewed during the visit are of a good standard and are routinely completed. The manager ensures risk assessments are fully completed and health, safety and welfare of residents is taken into account in planning the care and routines of the home. The home has access to professional business and financial advice and has all the necessary insurance cover to enable it to fulfil any loss or legal liabilities. Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 24 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 3 5 X 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 2 25 3 26 X 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 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 3 3 3 3 X X 3 X Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 25 Yes 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 YA24 Regulation 23(2)(b) Requirement The registered provider to ensure that the premises are of sound construction and kept in a good state of repair externally and internally. In this context ensure ongoing maintenance of the home and garden as per action plan submitted is completed. Previous timescale 30/06/07 Timescale for action 09/08/08 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 Whiston House DS0000065343.V363136.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Whiston House DS0000065343.V363136.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!