Inspection on 07/05/08 for Hollywell Court

This is the latest available inspection report for this service, carried out on 7th May 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hollywell Court 27/09/05

Hollywell Court 20/04/05

Hollywell Court 11/01/05

Hollywell Court 17/05/04

Hollywell Court 24/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Hollywell Court 464 London Road Leicester LE2 2PP Lead Inspector Thea Richards Unannounced Inspection 09:30 7 and 10th May 2008 th 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 Hollywell Court DS0000006384.V364076.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. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollywell Court Address 464 London Road Leicester LE2 2PP 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) 0116 2702252 0116 2702252 carole@hollywell.biz Hollywell Care Limited Mrs Carole Garrity Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No one falling within category OP may be admitted into Hollywell Court Residential Care Home where there are 12 persons of category OP already accommodated within this home The maximum number of persons to be accommodated at Hollywell Court Residential Care Home is 12 17th July 2006 Date of last inspection Brief Description of the Service: Hollywell Court is registered to care for twelve older people in a large converted property. It is situated on London Road close to the town centre of Oadby, where residents have access to a variety of amenities and it is on a bus route into Leicester city centre. The premises consist of two floors, with access to the first floor by use of the passenger lift or stairs. The home has eight single bedrooms, five with ensuite facilities and three with hand washing facilities in a vanity unit. The two, shared bedrooms both have en-suite facilities. There are sufficient toilet and bathroom facilities on both floors for the residents who are to be accommodated. The home has a well- maintained garden and patio area to the rear of the premises for the use of the residents. There is information available in the reception area including the Registration certificate. The latest copy of the Inspection report from the Commission for Social Care Inspection is available to view in the managers’ office. The current fee level ranges from £ 350.00 to £ 550.00 p.w. There are additional costs for individual expenses such as personal toiletries, optician, hairdressing and some recreational activities. Hollywell Court DS0000006384.V364076.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 that the people who use this service experience good quality outcomes. This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we (throughout the report the use of ‘we’ indicates the Commission for Social Care Inspection), spent five hours reviewing information received by the Commission for Social Care Inspection (CSCI) since the last annual service review on 8th March 2008. We looked at the Annual Quality Assurance Audit (AQQA) that the home had sent to us. This describes the services provided at the home for the residents, how the home are hoping to improve services and statistics about the residents and the staff. We looked at the surveys that we had sent out and received from the residents, their families and staff members. The visit took place on the 7th May 2008 and lasted six hours. A further visit of an hour and a half took place on 10th May 2008 to look at the staff files. During the visit we checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called ‘case tracking’. Case tracking means that we looked at the care provided to three of the residents. To achieve this, the residents were spoken with. We spoke with the staff supporting their care and looked at the records relating to their health and welfare. With their permission the residents’ bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them were looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 6 During the visit we spoke with the registered manager, the staff and the residents and their families. We also spoke with a National Vocational Award Assessor who was visiting the home. What the service does well: What has improved since the last inspection? What they could do better: The results of the homes quality audit could be included in the Statement of Purpose, which will help prospective residents and their families have better knowledge of the care that the home provides. The care plans should be updated to reflect the current care needs of the residents’ to make sure that they are receiving the right care. With their permission, photographs of the residents should be placed onto the care plans and the medicine sheets. This will help staff in making sure that they are giving care to the right person. The hot water system should be checked to make sure that the water Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 7 temperatures are at a comfortable temperature for the residents. The carpets in the home should be replaced where they are worn and may cause a trip hazard. The frequency of formal staff supervision should be increased and documented. This allows the staff to have time with their ‘line manager’ to discuss work and training issues. 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. Hollywell Court DS0000006384.V364076.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 Hollywell Court DS0000006384.V364076.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): 1, 3, 5, 6. Quality in this outcome area is good. This judgement has been made using the available evidence. The residents’ needs are assessed and agreed with by the resident or their families, avisit is made to the home and the staff are aware of their needs before they move into the home. EVIDENCE: The Statement of Purpose and the last Inspection Report is displayed in the reception area and is available for current and prospective residents and their families so they can judge whether the home is suitable for them. The Statement of Purpose and Service Users’ Guide provide all of the required information about the services offered and the Terms and Conditions that apply, making sure that residents can get the most suitable care. These can be made available in other formats such as large print to make sure that as many people as possible can understand them. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 10 Consideration should be given to including the results of the annual quality questionaire into the statement of purpose, so that prospective residents can read the comments from the residents and their families. This will help them in making a decision about the home. There was evidence in the resident’s files of pre –admission assessments that included all the residents’ needs having been completed by the Registered Manager. The home does not offer intermediate care facilities. The staff spoken with said that they knew what the resident’s needs were before they were admitted to the home. We spoke with several residents and families on the day of the visit who all confirmed that they had had a visit from the manager before their relative was admitted and that they had information about the home. They were able to visit the home as often as they wished before they were admitted. Information from the surveys received by us from the families of the residents confirmed that they had good information about the home and visited it before their relative was admitted. These practices make sure that that the staff in the home have the the right information before the resident moves in and that they can meet their needs. It also makes sure that the resident meets someone from the home who they can recognise, which makes the move into care easier to manage for them. The home does not offer intermediate care facilities. The current registration certificate from the Commission for Social Care Inspection (CSCI) and up to date details of insurance cover are displayed in the entrance of the home. Hollywell Court DS0000006384.V364076.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, 10. Quality in this outcome group is good. This judgement is made using the available evidence including a visit to the service. The staff meet the care needs of the residents as identified in the care plans with privacy, dignity and respect. EVIDENCE: The care plans for the ‘case tracked’ residents were found to contain good individual evidence of care, which reflects the care being given to the residents. There were risk assessments in place where risks to the residents have been identified. One of the care plans looked at had not been updated to reflect some recent changes in the needs of the resident. The manager told us that she would review this and the risk assessment to reflect the current situation. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 12 There are records of visits by professional staff, such as Doctors, district nurses and chiropodist. This shows that the residents are having the right medical care given to them. The residents, the families spoken with and the surveys received, all said that they were happy with the care being given and that they had medical attention whenever they needed it. ‘ I am very happy and the staff look after me well’ There are records of the residents’ weight, which makes sure that they are not losing or gaining large amounts of weight. The daily record of care is up to date which makes sure that the residents receive the right care and the staff know what has happened to them during the day or night. Staff spoken with were aware of the residents care needs. There is documented evidence of the review of the care plans involving the residents’ families; this was confirmed by the surveys and by the residents and the families on the day of the visit. When the staff were giving care and speaking with the residents they were seen to be doing so with dignity and respect. The residents spoken with were happy with the way staff treated them and said that they were very kind. Medication records were correct and the staff spoken with were fully aware of the process for the ordering, receipt, administration, storage and disposal of the medicines. The staff were seen to be giving out the medicines correctly and making sure that the residents had taken them. The staff who give the medicines have all had training to do so, this was confirmed by the staff spoken with, the manager and by the records seen. The controlled (dangerous) medicines were checked and they and the records were found to be correct. The manager audits the medicines regularly and documents the result. There is a policy in place for self -medicating, but there are no residents selfmedicating at present. There were no photographs of the residents on the care plans or on the medicine sheets. The manager said that she would get the residents’ permission and arrange to have them put on. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 13 This practice makes sure that the resident is easily identified, particularly those with some confusion. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 14 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, 15. Quality in this outcome group is good. This judgement is made using available evidence including a visit to the service. Residents have their social, spiritual and nutritional needs met. EVIDENCE: The staff were seen to be spending individual time with the residents. Many of the residents were sitting out in the garden. Two were playing chess and the others were talking, they later had a sherry out there. They were protected from the sun with a sun- shade. The T.V was on in one of the lounges, which those residents in there were enjoying. The residents spoken with were happy with the level of activities and said that they had enough to do. The families spoken with and those who responded to the survey felt that there were enough activities for the residents to do. There was evidence in the daily records and in the care plans about the activity that the residents take part in. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 15 The residents are regularly taken out to and enjoy the local amenities in Oadby. Families were seen to be taking residents out for coffee and for lunch. All the families spoken with said that they were made very welcome in the home, which we saw whilst we were there. The residents spoken with said that the food was good and that they had a choice of what they had. The menus were varied and were discussed with the residents individually. We spent time talking with the residents at lunch- time. The meal looked plentiful and well presented and the residents were enjoying it. The religious needs of the residents are met individually as requested. A hairdresser visits the home every week, which the residents enjoy. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 16 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, 18. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. There are systems in place to support and protect residents and staff are aware of the processes. EVIDENCE: There is a complaints policy in place which gives the details of how to complain and who to complain to if they needed to. This can be made available in a large print , which makes sure that as many people as possible can read it. There is thorough form for recording complaints, this makes sure that the complaint is recorded and dated to give an accurate record of how and when the complaint was handled and resolved. The residents spoken with and the families who responded to our survey were aware of the policy and were aware of how to complain and who to complain to. They were happy that their concerns would be listened to and acted on. The staff spoken with were aware of how to handle any complaints. No complaints have been received by the home or by the Commission for Social Care Inspection since the previous annual service review on 8th March 2008. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 17 All the staff spoken with were aware of Safeguarding and whistle blowing and said that they had had training in these areas. This was confirmed by the manager and by the records seen. They were confident that the manager would handle a situation properly. These practices make sure that the residents are safe from any abuse and that any concerns are handled correctly. The homes’ policy needed updating to make sure that the information on who to report an incident to was clear. This had been completed by the time we returned to look at staff files that had previously been held at the providers’ head office. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 18 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, 23, 24, 25, 26. Quality in this outcome group is good This judgement has been made using available evidence including a visit to the service. The residents are protected by the policies and procedures in the home to provide a safe environment. EVIDENCE: Hollywell Court is a converted house with ten single bedrooms on the ground and first floors with a shared bedroom on the first floor. Access to the first floor is by the stairs or a passenger lift. The home was clean and welcoming on our arrival. The lounges and dining room were bright and well decorated. The bedrooms seen were pleasant rooms that had been personalised for the residents. The residents and their families told us that they were able to bring their own belongings in and that they were very happy with their rooms. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 19 Some of the carpets in the hallways and stairs were showing signs of wear and in some places could cause a trip hazard. The manager told us that the home was to have some new carpets fitted within the next two weeks. There were carpet samples in the home that she showed us. The garden is very pleasant and has a patio area that is accessible for the residents. There were several of the residents sitting in the garden on the day of the visit, who told us how much that they enjoyed it. They were well protected from the sun by a large sunshade. The residents and the families spoken with and who responded to the survey were happy with the cleanliness of the home. There are dedicated cleaning staffing who have had training in health and safety. The care staff undertake the cooking duties and have all completed a basic food hygiene certificate. The staff spoken with, the manager and the records held confirmed this. The staff were seen to be wearing protective aprons and gloves when moving from task to task. The kitchen was found to be clean and well kept with adequate storage. The bathrooms were clear of any hazards. Hot water temps checked and documented, many of the temperatures were found to be at a low level and we were told that they had asked the plumber to call to look at the boiler and adjust the temperatures. Fire alarm testing and drills were found to be up to date. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 20 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, 30. Quality in this outcome group is good. This judgement is made using the available evidence including a visit to the service. The residents’ needs are met and the recruitment policy and the training protect their safety. EVIDENCE: The duty rota reflected the number of staff on duty. The residents, staff and families spoken with felt that there were enough numbers of staff on duty to look after their needs. The staff records were being held at the providers head office, therefore we returned to the home to look at them at a later date. We looked at three staff files and the required information was complete in all of them. This included evidence of identification, adequately completed application forms, two written references, a Criminal Records Bureau (CRB) check and a Protection of Vulnerable Adults check. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 21 The manager makes sure that all the required documentation is in place before an employee starts work. This was confirmed by the staff spoken with who told us that they could not start until they had all the paperwork in place. There was evidence of staff training including induction and the staff spoken with confirmed that they had received recent training in moving and handling. Updates in the taining in the protection of vulnerable adults, basic food hygiene and health and safety had also been arranged. Two members of staff are booked on a course for the Mental Capacity Act and will then ‘cascade’ it to the rest of the staff. This is a new act that describes peoples’ rights to have their wishes heard and acted on. The residents and the families spoken with and who responded to our survey felt that the staff were well trained to do their job. All of the staff either hold a National Vocational Qualification (NVQ) at least at level 2 or are in the process of completing it. The National Vocational Qualification is a qualification for care staff to make sure that they receive training in the needs of the resident group whom they are caring for. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 22 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, 36, 38. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. The residents live in a home, which provides for their needs, with safety systems in place and with suitable staff training. EVIDENCE: The registered manager has worked in the home for several years and has an NVQ 4 in care. The residents are seen regularly on an individual basis as are the families and discussions are held on how the home is meeting their needs. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 23 There is an annual quality questionnaire sent to the residents and their families, the residents, their families and the questionnaires that we saw on the visit confirmed this. We received positive comments from the residents, families and the surveys amongst which were that there was good communication with the home and that they always respond to any comment. Health and safety records were found to be up to date. The residents’ accounts were seen and all in order with two signatures on entries and receipts obtained for purchases. There was evidence in the records and from staff spoken with that there is some staff supervision taking place, but that it is not at the required frequency. Formal supervision of the staff gives them and their ‘line manager’ the opportunity to discuss work and training issues and needs. There are regular staff meetings held, confirmed by records held and by the staff. Hollywell Court DS0000006384.V364076.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 X X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? None 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. 3. 4. 5. 6. Refer to Standard OP1 OP7 OP9 OP19 OP19 OP36 Good Practice Recommendations The registered provider could put the results of the annual quality questionnaire into the Statement of Purpose. The registered manager should make sure that the care plans reflect the current needs of the residents. The careplans and the medication records should have identifiable photographs of the residents on them. The worn carpets in the home should be replaced. The water temperatures should be adjusted to give the residents a comfortable temperature to use. The formal supervision of the staff should take place at the required intervals. Hollywell Court DS0000006384.V364076.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hollywell Court DS0000006384.V364076.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. 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