Inspection on 11/04/07 for 10A & 10B Station Road

This inspection was carried out on 11th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

10A & 10B Station Road 01/11/05

10A & 10B Station Road 24/11/04

10A & 10B Station Road 26/05/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 10A & 10B Station Road Hatfield Doncaster DN7 6QB Lead Inspector Andrea Leverett Key Unannounced Inspection 11th April 2007 10:00 10A & 10B Station Road DS0000060649.V330603.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 10A & 10B Station Road DS0000060649.V330603.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. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 10A & 10B Station Road Address Hatfield Doncaster DN7 6QB 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) 01302 351965 01302 351886 carol10a@fsmail.net Chris.williams@dsh.nhs.uk Doncaster & South Humber Healthcare NHS Trust Mrs Carol A Hayes Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specific service user over the age of 65, named on variation dated 26th January 2005, may reside at the home. 1st November 2005 Date of last inspection Brief Description of the Service: Station Road Hatfield Doncaster, comprises of 2 purpose built bungalows accommodating 3 service users in each and is a joint venture between Doncaster and Humberside Healthcare Trust, who provide the staffing resources, and Sanctuary Housing who own the building and are responsible for the majority of the repairs and maintenance. The home provides care to 6 younger adults with learning disabilities. Each bungalow home comprises of 3 single bedrooms, a bathroom and wc, and a separate wc, and has a kitchen and dining room, separate lounges, and separate laundries. One of the bungalows (10A has a sleeping-in - room/office, and also has an en-suite bedroom.) Externally both bungalows have a sizeable rear garden, with seating facilities for residents. The accommodation is at the rear of a row of local shops, and access can be restricted if deliveries are being made, but this happens very infrequently. The home is close to shops; residents and staff on a regular basis use bus stop post office, bank, hairdressers, general store and public house, and most of these shops. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 11th of April 2007. Two service users were spoken with as well as 4 staff members, one visiting health worker and the manager. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections for some of the service users in the report. Some judgements about quality of life and choices were taken from direct observation on the day followed by discussion with support staff and evidencing records held at the home. The inspector concluded that the service users continue to be given a good service at Station Rd, although there are concerns about some aspects of the environment such as the hot water and heating and the poor quality of the bungalows kitchens. The Home continues to provide a high standard of direct care and access to health services and the Home has met all requirements made at the last inspection. Lowest fee £ 303.98 Highest fee £ 869.46 Items not covered by fee Cost of item (£) Hairdressing Chiropody Personal activities Holidays, Transport Mileage charge Various £8.00 Various What the service does well: Service users benefit from a high standard of assessment care planning, which is well thought out, comprehensive and accessible. Service users continue to benefit from sensitive and appropriate care and support and have good access to specialist health services as needed. Service users benefit from good communication between staff and service users families. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 6 Service users benefit from having the opportunity to take part in annual holidays that meet their needs. The Home has its own transport, which helps service users access day services and the community. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 10A & 10B Station Road DS0000060649.V330603.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 10A & 10B Station Road DS0000060649.V330603.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): 1,2,3 Quality in this outcome area is excellent. Prospective Service users can be confident that they will receive good information to make an informed choice to move into the Home and that their needs will be comprehensively assessed before they do so. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home has a statement of Purpose and service user guide, which includes comprehensive information that is clear and includes all the information required by standards. The inspector met and talked with the most recently admitted service user and inspected care assessments. The service user was able to visit the Home and records showed that a detailed community care assessment was obtained before the service user moved in. The homes own assessment also included likes and dislikes, social needs and risk assessments. Records showed that the Home worked closely with health professionals to ensure a smooth transition to the Home and the inspector spoke with the service users link worker from the health team who felt that the Home had worked hard to meet the service users assessed needs. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 9 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): 6,7,9. Quality in this outcome area is good. On the whole assessments and care plans reflect service users needs but more could be done to reflect service users aspirations and goals in terms of community and leisure activities. Service users are supported to take risks as part of an independent life style. This judgement has been made using available evidence including a visit to this service. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 10 EVIDENCE: Four service user assessments and care plans were inspected. Assessments are detailed and include risk, general care and health assessments. Care plans seen reflect service users needs as detailed in their assessments and records showed that both these documents are regularly reviewed. However neither documents adequately reflected service users aspirations and goals regarding leisure and community activities and a recommendation has been made that these areas are explored as part of a person centred planning approach. The manager agreed that time would be taken at the next service users planned reviews to ensure that activities being undertaken by service users are in line with their wishes. Although the Home has a person centred approach to care, service users do not have formal person centred plans. The manager informed the inspector that it is an objective for the future that all service users will have person centred plans. Staff are being trained and one service user had a communication passport, which gave good information about the persons needs and wishes in terms of daily life and preferences. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 11 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 and 17 Quality in this outcome area is good. Service users take part in a range of activities including community activities but it is not evident that these are in line with their wishes and aspirations. Service users are supported to maintain personal and family relationships and their rights are respected. Service users enjoy a healthy diet and their needs and wishes are sort and respected in this regard. This judgement has been made using available evidence including a visit to this service. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 12 EVIDENCE: Records seen and discussions with service users and staff evidenced that service users have access to day services between three and five days a week. In addition outings are organised by the Home although it was not evident that these were frequent. Records showed that service users went out on average once a month in addition to attending day services and having opportunities to go on holidays. It is acknowledged that both staff and the manager stated that service users did go out more frequently but these were not always recorded. As stated previously it was not clear in the service user assessments or care plans that activities provided were in keeping with service users aspirations and goals and a recommendation has been made that these are assessed and recorded clearly and that records are kept to evidence activities undertaken. Opportunities to visit and be visited by family and friends are facilitated by the Home and evidence was seen to show that staff communicated effectively and sensitively with families on behalf of and in the best interests of the service users. An inspection of the homes kitchens and food storage areas evidenced that a range of healthy food was available including fresh fruit and vegetables. Discussion with one service user and assessments and care plans seen showed that the Home worked hard to ensure food provided was in keeping with service users needs and wishes. It was also clear that were appropriate service users have unrestricted access to the homes kitchens and are able to make drinks and snacks and take part in planning, shopping and preparing meals. Records also showed that health service professionals have undertaken appropriate eating and drinking assessments. One service user told the inspector that “ I like baking scones and having my fish and chips. I can cook my own tea and set the table. I go to town to buy clothes and the local shops to buy milk. I can have snacks and make myself a sandwich. I like it here I can watch all my favourite programmes. I get up when I like and go to the centre and go to bed when I like. I sometimes go to the pub round the corner. I’m still making my mind up about my holiday.” 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 13 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 and 20 Quality in this outcome area is excellent. Service users receive a high standard of personal care in the way they prefer and require and on the whole their physical and emotional health needs are also met to a high standard. Service users are protected by the homes policies and procedures for dealing with medicines. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records of assessments and care plans seen and observation and discussion with staff showed that service users receive personal care and support in the way they prefer and require. Records included guidelines for undertaking aspects of personal care and daily records and observation on the day of the site visit evidenced that preferred choices in daily living were respected. The inspector was impressed with the high quality care and sensitive individual support observed being provided on the day of the visit and a discussion with one health service professional supported this observation and stated that 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 14 “Staff are really good with the service user I visit, they have taken on board their very complex needs very quickly. Staff take on board advice and are able to manage on their own” Records seen and discussion with staff showed that access to routine and specialist health services was provided although more could be done to explore the potential benefits of aids and adaptations for one service user who is blind. It was clear that the Home had strong links with Health services and several health service professionals were observed visiting service users on the day of this unannounced visit. An inspection of the Homes medication storage and administration systems showed that medication was being stored administered and recorded appropriately. Records included staff signatures and detailed Guidelines for administering individual medications and information regarding any potential side effects. The Home does undertake some secondary dispensing in order to ensure service users can receive medication whilst attending day service and the community in general. There is a system in place to record this and appropriately labelled bottles are used to dispense medication into. Training records showed that staff are trained to administer medication. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 15 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 The quality of service in this outcome area is judged as good. Service users and their families know that their concerns will be listened to and acted upon. Service users are protected from abuse, neglect and self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home has a complaints procedure, which meets all the requirements of this standard. Discussion with staff and the manager demonstrated that concerns and complaints would be taken seriously, although no complaints have been made in the last 12 months. Records showed that staff work hard to establish service users wishes and needs. The Home has appropriate adult protection procedures and policies, 1 staff spoken to demonstrate a good understanding of Adult Protection issues and how they relate to local authority protocols. Staff spoken to also confirmed that Adult Protection training is undertaken. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 16 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): 24,30 The quality of service in this outcome area is judged adequate. Service users benefit from living in a homely environment that is clean and free from offensive odours. More could be done to improve the quality of service users environment and facilities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of both bungalows was undertaken and was clean and furnished to a good standard. Bedrooms were homely and personalized and on the whole bathrooms and communal areas were appropriately equipped and furnished. However the hot water and heating system in one bungalow is not working adequately and keeps breaking down. Maintenance records were not kept to evidence how often the boiler has broken down but the manager stated that this was at least four or five times in the last six months and between eight or 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 17 nine times since the service relocated to these properties. On one occasion service users were left with no heating or hot water in really cold weather and service users had to move into the other bungalow for the day until the problem was resolved the following day. Emergency heating was not provided on this occasion although the manager reassured the inspector that the service now has a contingency plan in place that would provide emergency heating if needed in the future. On going problems with water temperatures have been experienced. On one occasion staff had to top up the bath water with water from kettles. Staff have since been advised that this is not the appropriate action to take and what to do if a similar incident occurs. The last time the boiler broke down was two weeks ago. A requirement has been made regarding the need to ensure that adequate hot water and heating is provided in the Home. It was also noted in both bungalows that some taps on hand basins did not have clear hot and cold indicators and both the inspector and a service user was not able to establish which was which. A requirement has also been made regarding this. The bungalows kitchens have not been upgraded for several years and look tired and old. It was also noted that the floor surfaces under and around the boilers, which stand in the kitchens, do not have non-permeable floor surfaces and therefore can’t be cleaned appropriately. A requirement has been made regarding ensuring that floor surfaces can be cleaned and a recommendation is being made regarding upgrading the kitchens in general. Neither kitchens have a dishwasher and a recommendation has also been made that these are provided to ensure that kitchen utensils can be cleaned hygienically and cut down the risk of cross infection. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 18 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 and 35 The quality of service in this outcome area is judged as excellent. Service users individual and joint needs are met by an effective and appropriately trained and supervised staff team. Service users are supported and protected by the homes recruitment policy and practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An inspection of the homes rotas, daily records and discussion with staff evidenced that service users benefit from having sufficient staff to meet their needs at all times. The service has at least two staff in each bungalow during waking hours plus the manager and additional staff at key times. Both bungalows have a sleep in staff during the night. Records viewed and discussion with staff showed that staff are trained and supervised to a high standard and staff felt supported by the management team and organisation. Records and discussion with staff showed that a range of training was provided including access to NVQ training at level two and 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 19 three. In addition to supervision regular staff meetings and shift hand over meetings are held. Staff personal files are held centrally and were not seen on the day of the site visit. Additional information provided by the manager after the site visit confirmed that appropriate checks and procedures are being undertaken before staff are offered a job. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 20 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 and 42. The quality of service in this outcome area is judged as good. A staff team that is led by a competent and experienced manager enhances the care of service users. On the whole the homes are run well although improvements are needed in regards to maintaining the environment and maintenance records and the reporting have notify able incidences to the commission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observation on the day, records viewed and discussion with staff evidenced that the manager delivered an effective service user led service. Service users and staff spoke highly of her and felt that she was approachable and inclusive in her management style. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 21 Information taken from the services pre inspection questionnaire and records seen on the day showed that on the whole facilities and equipment within the Home are being services and inspected appropriately, although shortfalls have been identified in the maintenance of one of the bungalows heating and hot water facilities. It is acknowledged that the manager has consistently reported these shortfalls to Sanctuary Housing Repairs Department but more needs to be done to resolve this ongoing problem. The manager must also ensure that significant incidences that could undermine the wellbeing of service users are reported to the commission as required by regulations and records are kept to evidence maintaince work undertaken. Appropriate service user and environmental risk assessments are in place and quality-monitoring audits are carried out monthly. 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 4 3 4 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 4 X X 3 X 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 23 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. 1. 2. 3 4 Standard YA24 YA24 YA24 YA42 Regulation 23 23 17 37 Requirement An appropriate heating and hot water system must be provided in the bungalow identified. None permeable floor surfaces must be in place in both the bungalows kitchens. Records must be kept to evidence maintaince work undertaken in the homes. The commission must be notified of any significant incident that could affect the well being of service users. As from the date specified and there after. Hot and cold taps must be appropriately differentiated so that service users can identify which is which. Timescale for action 15/06/07 15/06/07 10/05/07 27/04/07 5 YA24 23 10/05/07 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations It is recommended that the Home evidence that service users social and needs in terms of community access and activities are assessed and recorded in service users care plans. It is recommended that a specialist environmental aids and adaptations assessment is sort for one service user who is blind. It is recommended that the quality of the service users environment be improved in both bungalows by upgrading the old kitchen units. It is strongly recommended that dishwashers be provided. 2. 3 YA6 YA24 4 YA24 10A & 10B Station Road DS0000060649.V330603.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 10A & 10B Station Road DS0000060649.V330603.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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