Inspection on 14/06/05 for 117 to 119 Mollands Lane

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

117 to 119 Mollands Lane 05/07/06

117 to 119 Mollands Lane 13/12/05

117 to 119 Mollands Lane 24/02/05

117 to 119 Mollands Lane 29/11/04

117 to 119 Mollands Lane 29/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Mollands Lane (51/53) 51/53 Mollands Lane South Ockendon Essex RM15 6DH Lead Inspector Bernadette Little Un-announced 22nd June 2005 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 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 Stationary 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. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mollands Lane (51/53) Address 51/53 Mollands Lane South Ockendon Essex RM15 6DH 01708 851153 01708 851153 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Estuary Housing Association Ltd Vacant CRH 8 Category(ies) of LD Learning Disability 8. registration, with number of places Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14 February 2005 Brief Description of the Service: Mollands Lane is a care home with nursing for eight service uses with learning disabilities. The home provides long-term care only. The premises is a single storey property of two interconnecting bungalows, each of which continues with some individual identity. The home is staffed and managed as a single unit. At each end of the premises there are four single bedrooms, a lounge, dining room, kitchen, laundry, bathroom and a shower room. There is a large wellkept garden to the rear of the property. Mollands Lane offers a sensory room to residents. It is situated close to local shops and it has its own transport for the use of residents. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection undertaken on a Wednesday at 9.25 am. Time was spent with the acting manager, talking with staff, sitting with residents, looking at records and documents and watching and listening to the everyday routines of the home. All the rooms in the house were also looked at. Staff and residents are thanked for their assistance, which was appreciated. What the service does well: What has improved since the last inspection? What they could do better: Estuary need to make sure that the fire doors in the house are safe but that they still allow the residents to move around easily. Some parts of the home could be cleaner and better decorated. The home could also do with some more storage space and a safe place for residents who wish to smoke. The home needs to follow their own written rules and plans for good practice to look after residents. The records need to make sure that staff are safe people to work with residents need to be in the home for inspection. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 6 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. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 4, 5 The documents that contain the information about the home need updating to ensure that they provide all the current information for interested parties. The home’s policy and procedure on pre-admission assessment and trial visits would benefit residents if followed in all cases. All residents would also benefit from a detailed statement of terms and conditions. EVIDENCE: The acting manager advised that 51-53 Mollands Lane no longer offers short term care. She advised that the statement of purpose and service user guide were being amended to reflect this change and the changes to staffing at the home. A detailed assessment format was seen for one of the more recently admitted residents. An assessment for this home was not available for another more recently admitted resident. All assessments were not dated. The acting manager advised that one resident had had several trial visits to the home according to Estuarys policy and procedure. Another resident, who had moved from another Estuary home, had been moved in a rush and had not had a full range of trial visits. A statement of terms and conditions was not available on the two resident files sampled. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9 Some of the care plans provided a detailed range of information to assist staff in the provision of care to the residents. All aspects of the plan of care for each resident reflected an assessment of risk, but this was not adequately detailed in some cases to best protect the resident. EVIDENCE: One of the care plans sampled was noted to be particularly informative and detailed. Other care plans sampled were not to this high standard of detail. The acting manager advised that the care plans will be rewritten so that they are all in the same format, and so be clearer for staff to follow. Staff advised that they were aware that managing a residents lighter could be considered an infringement of his rights. A risk assessment, protocol and recording of an infringement of rights was available, which was positive. The use of bed rails was recorded, but without a date or signature. There was no clear assessment of the risk and no evidence that their use had been assessed by an appropriately qualified person. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14,15, 17 The home supports residents to access activities both at home and in the community. Residents have opportunities to continue relationships. The home provides residents with a range of nutritious foods, but could extend this by offering residents appropriate methods of making choices. EVIDENCE: Of the day of the inspection two residents went to a local pub for lunch and a resident from another home came to visit one of the residents at this home. Discussion with staff and inspection of the records showed that residents were supported to maintain contact with their families. The acting manager advised that a limited number of residents have access to day care centres, but that this service is being phased out locally. Records sampled showed a resident’s planned attendance at college and that residents used ordinary facilities in the community such as the hairdresser. It was stated that some residents make tea, which is positive. However, no risk assessments were in place to ensure resident safety. The acting manager advised of plans to introduce picture cards for food choices, as well as a weekly programme of leisure activities for individual residents once she has established their particular preferences and enjoyments. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 Residents were supported to access appropriate health care services. Protocols for some ‘as required’ medication did not have adequate detail to best protect residents. EVIDENCE: Records sampled showed that residents attended appointments with a range of healthcare professionals. Seizure charts were maintained. Medication review was evidenced. A protocol for the administration of rectal diazepam did not contain instruction regarding resident privacy and dignity. There was no plan as to how this need was to be managed when the resident was outside the home. There was no evidence of recent training in relation to the administration of rectal diazepam. The remainder of the medication system was not inspected on this occasion. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Staff were provided with appropriate training and policies and procedures to protect the residents. EVIDENCE: Records showed that Estuary had taken appropriate steps to protect residents in a recent investigation into an alleged protection of vulnerable adult issue. The acting manager confirmed that four staff were to attend training on the protection of vulnerable adults that same week and that all other staff had had recent training on this issue. The acting manager also confirmed that several staff had recently attended training on management of challenging behaviour. Appropriate policies and procedures were in place relating to protection of vulnerable adults and whistleblowing, as well as physical intervention. There was no system in place for staff to sign to say they had read and understood these documents. The whistleblowing policy and procedure could be written in clearer language. The use of residents’ money for purchasing items of equipment and furniture needs to be reconsidered. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27, 28, 29, 30 The home provides residents with a comfortable living environment both inside and out. Attention to some areas of cleanliness, decoration, storage, access and space would enhance this further for residents. EVIDENCE: Residents’ bedrooms were personalised and well furnished, although some appeared lacking in space because of the amount of equipment in place. The decoration in some bedrooms was not in good condition. Some areas of the home, for example the laundry room and sensory room, were not clean. Some hazardous materials such as bleach were not safely stored. A risk assessment was not available in relation to outward opening toilet doors. The acting manager was not aware of the home’s policy for safe temperatures for washing wet and soiled laundry. The only place available for residents to smoke is in the laundry room. The best wheelchair access to the garden was through the laundry. There was limited storage space for specialist equipment. The acting manager advised that funding is now available for turning an inappropriately equipped bathroom into a wet room, which will benefit both staff and residents. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36 Staffing levels were adequate to meet the needs of residents. Recruitment procedures and induction training were not sufficiently robust to in all cases to best protect residents. Systems to support staff were not well established. EVIDENCE: The acting manager confirmed that there were five trained nurses working at the home, including herself. Two staff had completed NVQ 3 training and one staff is currently attending. Records showed that irregular staff meetings and supervision sessions had taken place. The home was fully staffed but, due to having three staff on long-term sick leave, had been using regular agency staff. The home’s own staff work their own shift followed by a bank shift which means staff work a long day. The roster needed to have the full name of all staff working at the home. The current staffing level was four staff on each shift during the day and two staff at night. Staff spoken with advised that this level was generally adequate, but can be somewhat limiting when trying to get residents out to activities in the community. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 15 Records showed robust recruitment procedures on one file sampled. A recruitment or staff record file was not available for the other member of staff who had transferred from another Estuary home. A one day introduction of format was available for this staff member. The acting manager confirmed that no formal induction had been recorded for the other member of staff who has been in post for approximately 3 months. One day induction records were available for agency staff. Not all of these contained a record of the person’s Criminal Records Bureau check. The acting manager confirmed that she had no other records regarding the agency staff, for example emergency contact or medical details. A training plan was available. The acting manager confirmed that not all planned training had taken place. One staff at the home had a current first aid certificate. Annual updates for all staff in relation to moving and handling practices were a month out of date. The majority of staff had had training in other mandatory subjects in the past year, which is positive, and additional training was planned. This included some specialist training, for example in relation to total communication and planned training by the speech therapist to be specific to the residents at this home. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 42 There is no registered manager at the home, which does not best protect staff and residents. Staff and residents at the home benefit from an approachable and accessible acting manager. Health and safety issues needed to be monitored and addressed on a regular basis. EVIDENCE: The acting manager advised that she would take up the role of permanent manager next week. She stated that she had appropriate qualification, ample experience of this client group and had attended relevant courses regularly. Staff spoken with said that the manager was supportive and easy to talk to. Residents and staff were seen to approach and interact with her freely. Some safety inspection certificates sampled were available, for example gas certificate, hoists and portable appliance testing. A certificate was not available for the fire alarm system, and fire and water temperature checks were not being undertaken regularly. Fire doors were being wedged open to allow service users to move around the house. This safety hazard was identified in Estuary’s own health and safety report. This must be made safe. Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 x 2 2 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 3 2 2 2 Standard No 11 12 13 14 15 16 17 x x 3 3 3 x 2 Standard No 31 32 33 34 35 36 Score 3 2 2 1 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mollands Lane (51/53) Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 x x x 2 x I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 6 Requirement The person registered must review the statement of purpose and service user guide and send a copy to the commission. The person registered must not provide accommodation to a resident at this care home until the needs of that resident have been assessed by a suitably qualified person and the person registered has confirmed in writing to the resident that they can meet his/her needs. The person registered must ensure that each resident has a contract/statement of terms and conditions. A plan of care must be available for all aspects of a residents health and welfare and must have clear instructions for staff to follow. The person registered must ensure that all unnecessary risks to the health and safety of residents are identified and as far as possible eliminated. This refers to bed rails and a residents self-harming behaviour. (Previous timescale of 04.04.05 not met). Timescale for action 15 August 2005 1 August 2005 2. 2 14 3. 5 5 (c) 1 August 2005 15 August 2005 4. 6 & 20 15 and 13 (2) 5. 9 13(4)(C) 1 August 2005 Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 19 6. 23 13(6) 7. 24 & 30 23 (2) (d) 8. 24 13(4)(a) 9. 24 23(2) (a) 10. 28 23 (2) (e) 11. 12. 13. 29 33 34 23(2)(l) 17(2) Schedule 4 Schedule 2 14. 34 17(2) Schedule 4 18 (1)(c)(i) 15. 35 The person registered must ensure that residents are protected and the use of residents money to purchase furniture and equipment is reconsidered. The person registered must ensure that all parts of the care home are kept clean and reasonably decorated. The person registered must keep all parts of the home to which residents have access free from hazards. This refers to safe storage of COSHH items. The person registered must ensure that the physical design of the premises meet the needs of residents. This refers to appropriate wheelchair access to the garden. The person registered must ensure that adequate communal space is provided to meet residents needs. This refers to the inappropriateness of residents smoking in the laundry. The person registered must ensure that there is adequate storage space for equipment. The duty roster must include the full names of all staff working at the care home. The person registered must evidence robust recruitment procedures and records must be available relating to this for all staff employed at the care home. The person registered must maintain records in the care home, required by regulation and schedule, relating to all staff employed at the care home. The person registered must ensure that all staff are provided with training appropriate to the work that they are to perform. 1 August 2005 15 August 2005 1 August 2005 15 August 2005 15 August 2005 15 August 2005 1 August 2005 1 August 2005 1 August 2005 1 August 2005 Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 20 This includes induction training. 16. 17. 35 37 13(4) 8 The person registered must make arrangements for staff to be trained in first aid. The person registered must inform the commission of the appointment of a manager at the home and make application to the commission for the managers registration. The person registered must evidence that residents are involved in reviewing the quality of care provided in the home. This is an outstanding requirement for the last inspection not assessed on this occasion. It will be carried to the next inspection. The person registered must provide a list of prices for the extras that service users have to pay for. This is an outstanding requirement from previous inspections not assessed on this occasion. It will be carried to the next inspection The home must develop an upto-date fire plan. This was required from the last inspection It was not available at the home on this occasion. (Previous timescale 04.04.05 not met). The person registered must ensure the maintenance of all fire equipment. Copies of the certificates for the fire system must be sent to the commission. The person registered must ensure the safety of residents. This refers to regular temperature checks of the water system. The person registered must ensure that fire safety is maintained in the home. This refers to wedging open the fire 15 August 2005 1 August 2005 18. 39 24(3) 1 August 2005 19. 41 17(2) Schedule 4 (8) 1 August 2005 20. 42 17(2) Schedule 4 (15) 1 August 2005 21. 42 23(4) 15 August 2005 22. 42 13(4) 1 August 2005 23. 42 23(4) 1 August 2005 Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 21 doors. 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 2 Good Practice Recommendations The reviewed procedures for admission and discharge from the home should be submitted to the commission for social care inspection. (This is outstanding for the last inspection). Prospective residents should be given opportunity for trial visits and they should form part of the assessment process. Residents should be offered a choice of food and in a format that supports them to make choices. Protocols for the administration of rectal diazepam should include reference to the residents privacy and dignity, link to a plan of care when outside the home, and indicate, with evidence, the named staff trained to undertake the procedure. The whistleblowing policy and procedure should be written in plain language. A risk assessment should be undertaken relating to the outward opening toilet doors. 50 of care staff should achieve NVQ training Staff meetings should be held regularly. Staff should not work planned long days/double shifts. Staff supervision should be provided at least six times annually. 2. 3. 4. 4 17 20 5. 6. 7. 8. 9. 10. 23 24 32 33 33 36 Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 National Enquiry Line: 0845 015 0120 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 Mollands Lane (51/53) I06-I56 S15545 Mollands Lane 51-53 V235038 220605 Stage 4.doc Version 1.30 Page 23 - 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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