Inspection on 18/10/07 for Huntley Close (7)

This is the latest available inspection report for this service, carried out on 18th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Huntley Close (7) 13/10/05

Huntley Close (7) 06/05/05

Huntley Close (7) 12/01/05

Huntley Close (7) 06/07/04

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Thorndene

Insight - Eastchurch

Southfields

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33 St John`s Church Road

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Huntley Close (7) 7 Huntley Close Stanwell Middlesex TW19 7DD Lead Inspector Chris Woolf Unannounced Inspection 18 October 2007 09:25 th Huntley Close (7) DS0000013531.V348151.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 Huntley Close (7) DS0000013531.V348151.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. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Huntley Close (7) Address 7 Huntley Close Stanwell Middlesex TW19 7DD 01784 254322 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) Owl Housing Ltd Anita Mundra Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1) of places Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be: 35-65 YEARS. ONE MAY BE OVER THE AGE OF 65. Date of last inspection 14th September 2006 Brief Description of the Service: 7 Huntley Close is a purpose built house, providing accommodation for up to 6 residents with a learning disability. All resident’s bedrooms are single occupancy and located on the ground floor. The office and staff facilities are on the first floor of the house. The resident’s communal areas consist of a large lounge, a quiet room and a large kitchen/dining room. There is an enclosed garden, accessible from the lounge. The home is located on the edge of a residential housing estate and has its own vehicle to provide transport for residents and staff. Owl Housing are the registered provider for this service. The current fees for the service at the time of the visit range from £1121.78 to 1220.56. Information on the Home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. There is no e-mail address currently available for the home. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on information gained from an Annual Quality Assurance Assessment (AQAA) completed by the home; questionnaires completed by 3 relatives/visitors, 1 health care professional, and 1 care manager; and a site visit to the service of just over 5 ½ hours. The people who use this service like to be known as ‘Tenants’ and this is the term used to describe them throughout the report. The site visit was unannounced which means that neither the tenants nor the service provider knew that we were coming. During the site visit we talked with 4 of the tenants, the other two were out for the day. We also talked with staff on duty and with a representative of the company’s human resources department. We inspected a variety of records, including staff files, tenants care plans, safety records, and records of medication. We also watched the way that the staff related to the tenants. What the service does well: What has improved since the last inspection? The requirements from last report regarding environmental issues, and staff records have now been met. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 6 New furniture has been placed in the large lounge. New flooring and furniture have been installed in the dining room. The bathrooms and toilet have had new flooring laid 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. Huntley Close (7) DS0000013531.V348151.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 Huntley Close (7) DS0000013531.V348151.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): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The individual needs and goals of possible new tenants’ are assessed prior to admission EVIDENCE: All possible new tenants are assessed by the home, and have a series of visits to make sure that the home can meet their needs. The home will not admit any new tenant unless they are confident that their needs can be meet. The trial visits also give the home and the current tenants the chance to be sure that the new tenant will fit in with, and will relate well to the existing tenants in the home. Pre admission assessments take into account all of the possible new tenant’s needs and goals including physical and mental health care, recreational and relationships, likes and dislikes, and equality and diversity. As all tenants are funded by social services a copy of the community care assessments and reviews are also obtained. Assessments are regularly reviewed and amended to reflect changing needs, throughout the tenant’s life at the home. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 9 Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tenants know their needs and goals are reflected in their care plans. They are encouraged to make decisions about their lives and are supported to take responsible risks as part of an independent lifestyle EVIDENCE: Each tenant, together with their key worker, is involved in completion of their own comprehensive and individual plan of care. Care plans include Health information, an Essential Lifestyle Plan, and a variety of individual risk assessments. All equality and diversity needs that are identified are incorporated into the care plan. Each tenant also has his or her own communication passport. The lifestyle plan and communications passport are produced in visual form to make them more accessible to the tenants. A relative comment card included, ‘Great importance is placed on our daughters individual needs and she is very happy in her home’. Care plans are reviewed Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 11 regularly with the tenant and their care manager. A care manager commented, ‘Very good review notes with photographs’. The homes AQAA states, ‘We have used their communication passports, healthcare plans, ELPS (Essential Lifestyle Plans) and careplans in their reviews. This has reflected a poitive image of their meetings and less stressful for the tenants as they are more involved as they hold copies and can see from the pictures how they have progressed and attained their goals from the last review’. Tenants are fully involved in making decisions about their own lives. There are monthly tenants meetings where they are able to put their points of view. Either they or their court appointee look after their own bank accounts and the staff support them to cope with their own finances safely. When staff accompany tenants to the bank they carry identification badges provided by the company. If tenants want to use independent advocacy the staff will help them to organise this. Staff support tenants to take responsible risks. All risks are assessed and documented, and strategies for reducing the risk are explored. Risk assessments include moving and handling, going out into the community, helping about the home, cot sides, and nutrition. The homes AQAA states that tenants are, ‘Encouraged to make descions and take risks to better their lifestyle. (The home) Reduce their frustration and anxiety by involving in them in what they want. Huntley Close (7) DS0000013531.V348151.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): 12, 13, 15, 16, & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tenants are assisted to take part in appropriate and enjoyable activities and to be part of the local community. Family relationships are encouraged, and tenants are offered a healthy diet in pleasant surroundings EVIDENCE: Tenants visit the local day centre where they meet with their peers and can take part in educational tasks. One tenant enjoys doing the sensory cooking. None of the current tenants take part in any paid employment but one does voluntary community work at a local public house, clearing rubbish and sweeping the garden. The tenants have a copy of their agreed weekly activities in their care plan, however this is just the basis of the things they do and many more activities Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 13 are arranged for them. There is photographic evidence throughout the home of a variety of visits within the local community. In addition to visits to the day centre activities include bowling, cinema, walks, theatre, visits to the pub, and holidays. One tenant said, “I went on holiday, we stayed in a big house”. Relative comment cards included, ‘The home takes residents out regularly to cinema, bowling alley, and visits to the country’ and ‘activities are well planned in consultation with residents and their relatives/friends’. A care manager comment card included, ‘Some of the residents have severe learning disabilities but choices are given and residents are encouraged to participate in community activities’. Tenants are also encouraged to follow their own hobbies and leisure activities. A tenant said, “I like music, that is my guitar, and here is my C.D”. A staff member said, “We support activities”. When tenants wish to attend church or faith meetings a member of staff will support them. Currently none of the tenants have any ethnic or cultural needs Staff support tenants to maintain, and in some cases to rekindle, links with their families and friends. Relative comment cards included, ‘Relatives and friends are always welcomed whenever they visit’. A tenant said, “I went in the house car to see my sister yesterday, we came back at 2pm”. Tenants are encouraged to take part in as much or as little of the day-to-day life of the home as they want to. Tenants said, “I like to help with the housework”, “I lay the table”, “I sometimes help in the kitchen”, and “I am going out to help with the food shopping today”. One tenant was seen going around with the Hoover. Staff said, “xxx likes to make cakes”, “xxx likes to stir things”, and “xxx helps with the menu, he likes to put the pictures up on the board”. The home promotes health eating amongst its tenants. Staff commented, “The diet is balanced and diverse, with lots of vegetables. The menu takes everyone’s needs into account”, “We get individual input from the dietician when needed”, and “They take my diversity needs into account when doing the menu”. Staff take it in turns to do the menu, with help from the tenants, and this gives added variety to the menu. At present 4 special diets are being catered for, low fat, low sugar, and slow digestion for tenants and one cultural need for a member of staff. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The staff of the home supported by a multi-disciplinary health care team meets tenants health and personal care needs. EVIDENCE: Personal support is offered to tenants in the way they prefer, as recorded in their plans of care. Tenants are supported to maintain their independence as far as they are able. A tenant commented, “Staff help me to shave but I do the rest myself”. The homes AQAA indicates that during the past 12 months they have improved by having a ‘More person centred approach in supporting personal care, and supporting and promoting indepence around their own personal care’. All tenants have a designated key worker. Support from health care professionals is sought wherever needed. Each tennant has an annual O.K. health check. Additional support is also obtained from Doctors, Opticians, Dentist, Chiropodist, Psychiatrist. Skin specialist, Dietitian, Speech and language therapist, and aromatherapist. All visits to and from health care professionals are recorded in the individual tenants care plan. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 15 The home’s policies and procedures for medication are sound and protect the tenants. Each tenant has a sheet in their health file which includes protocols for ‘as required’ medication. Currently there are no tenants who administer their own medication. All staff who administer medication have been appropriately trained. Huntley Close (7) DS0000013531.V348151.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. Tenants know their concerns and complaints will be listened to and action will be taken. Tenants are protected from abuse. EVIDENCE: There have been no complaints recorded by the home, or received by CSCI about the service, since the last inspection. The home has a clear and accessible complaints policy. An easy read version of the policy using words and pictures is available in the hallway and is also in the homes statement of purpose. The homes AQAA states, ‘We encourage family, friends and social services to feedback to us regards to complaints, concerns and compliments’. Comment cards received confirmed that tenants families know how to make a complaint. The home has sound policies and procedures for protecting tenants from abuse. All staff attends training in Protection of Vulnerable Adults and are aware of their responsibilities for reporting suspected abuse. There have been no adult protection alerts raised on this service since the last inspection. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28, & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Tenants live in a home that is clean, hygienic, comfortable, homely and well maintained. EVIDENCE: The tenants live in a homely and well-kept environment. Since the last inspection there have been a number of improvements including provision of new sofa’s in the main lounge, new flooring and new furniture in the dining room, a new drier in the laundry room, and new flooring in the bathrooms and toilet. There is a garden area at the rear of the property with a patio and seating area. The company are currently in the process of getting a landscape gardener to deal with the garden. They are also arranging for the tall trees in the garden to be lopped. One of the tenants said, “I helped to clear the leaves last weekend”. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 18 The communal space in the home consists of a large lounge, a small lounge, and a kitchen/dining room. All tenant accommodation and communal space is located on the ground floor of the building and the first floor is used for the office and staff facilities. All of the tenants’ bedrooms have been individualised to meet their needs and choices, and to reflect their personalities. The décor in the rooms is as individual as the tenants themselves. Each room is fitted with a nurse call system and a washbasin, and keys to the rooms are available on request. The home is clean and free from offensive odours. Infection control practices are good. Hand washing facilities are available in all areas where infected material or clinical waste may be handled. The laundry is clean and well maintained and is fitted with a washing machine with programming ability to meet disinfection standards. A new dryer has recently been purchased. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tenants are supported by a team of staff who have been properly recruited and who are trained to meet their needs. EVIDENCE: Staff at the home are qualified and competent to meet the needs of the tenants they care for. Currently 55.5 of the staff are trained to NVQ level 2 or above with the majority of these being trained to Level 3. All new staff receive induction training based on LDAF (Learning Disabilities Adult Framework) requirements. There is a nice atmosphere in the home and staff relate well with, and are supportive to the tenants. Staff said, “I have NVQ Level 3”, and “I have applied to do NVQ Level 3”. The Registered Manager was not available on the day of the inspection site visit and therefore a member of the Human Resources department of Owl Housing came to the home with requested staff files for inspection. 3 files were looked at and all were in order. No new member of staff starts work in Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 20 the home until an Enhanced Disclosure has been received from the Criminal Records Bureau and 2 satisfactory references are received. The company have improved their recruitment procedures in line with the latest Schedule 2 of the regulations. The company respects any equality and diversity needs of staff. The home is in the process of recruiting new staff, and tenants are involved in the selection process. Since the last inspection the home has introduced a training and development plan. However it is also recommended that a training matrix is introduced to enable the manager to see at a glance what training has taken place and when training is due for renewal. Training in mandatory subject is up to date with the exception of Infection Control and a recommendation is made that all staff are trained in this subject. During the past year staff have received additional training in Epilepsy and autism. Staff commented, “I trained the other staff in LDAF”, and “I’m the fire man” Staff have formal supervision on a regular basis and one commented, “We have regular supervision but we can always talk to the management in between if we need to”. General comments from staff included, “Every day is different”, “I like seeing the tenants achieve things, it makes me feel good”, and “We work as a team”. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Tenants benefit from a well run home and can be confident their views are taken into account in the development of the service. The health, safety and welfare of tenants and staff is promoted EVIDENCE: The Registered Manager has been absent from the home for a while. During her absence the Deputy Manager took over control of the home. The Registered Manager has now returned on a part time basis and was due to return to full time work the week after the inspection site visit. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 22 The home has developed appropriate Quality Assurance systems. Questionnaires are circulated to families and to visitors and copies are also available in the hallway for visitors to pick up and complete. Regular audits take place on a variety of topics. Tenants meetings and staff meetings are both held monthly. Minutes of tenants meetings show the involvement of the individual tenants in discussions. The home has clear health and safety policies and procedures. Staff report any concerns to the management for prompt action. There is an up to date fire risk assessment on the home. All fire safety documents are in order. Accident recording is satisfactory. Staff are trained in Health & Safety related subjects. Huntley Close (7) DS0000013531.V348151.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 X 2 3 3 X 4 X 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 3 25 X 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 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 X 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 Huntley Close (7) DS0000013531.V348151.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 2 Refer to Standard YA35 YA35 Good Practice Recommendations It is recommended that the manager compiles a training matrix to enable her to see at a glance what training has taken place and what is due for renewal It is recommended that all staff receive training in Infection Control. Huntley Close (7) DS0000013531.V348151.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 Huntley Close (7) DS0000013531.V348151.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. 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