Inspection on 04/01/07 for 51 Chapel Park Road

This inspection was carried out on 4th January 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

51 Chapel Park Road 25/11/08

51 Chapel Park Road 19/07/05

51 Chapel Park Road 22/02/05

51 Chapel Park Road 12/10/04

51 Chapel Park Road 31/01/02

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 51 Chapel Park Road St Leonards-on-sea East Sussex TN37 6JB Lead Inspector Jeanette Denereaz Key Unannounced Inspection 4th January 2007 09:30 51 Chapel Park Road DS0000021337.V325547.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 51 Chapel Park Road DS0000021337.V325547.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. 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 51 Chapel Park Road Address St Leonards-on-sea East Sussex TN37 6JB 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) 01424 201340 East View Housing Management Ltd Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of residents to be accommodated will be four (4) Residents must be aged between eighteen (18) and sixty-five (65) years on admission. Residents with a learning disability only to be accommodated Date of last inspection 19th July 2005 Brief Description of the Service: 51 Chapel Park Road is situated in a residential area of St Leonard’s on Sea. It is a short distance from local amenities and shops. The home is owned and run by East View Housing Management Limited (EVH). It is registered for up to 4 adults with learning disabilities. The building is a detached two-storey older style house. It has a reasonably sized garden to the front and side of the property. The current scales of fees range from £900 to £1200 per week. 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at 51 Chapel Park Road are referred to as ‘residents’. This report reflects a key inspection based on the collation of information received since the last inspection and an unannounced site visit conducted by an Inspector on the 4th January 2007. The site visit included a tour of the premises and an examination of various records including medication, care and staffing records. The Inspector met with the new manager, the team leader, the staff member on duty and all four residents. The residents were sent a ‘Have your say’ about 51 Chapel Park Road survey, and all were returned, and from information gathered residents were very happy with the care they received. No residents requested to see the inspector, but during the inspection visit all agreed to talk to the inspector. Their comments were very positive about 51 Chapel Park Road with one resident saying: “ I still like living here”. Another stated: “ I like my key worker”. Also a resident that has only lived in the home for six months, was also interviewed and he informed the inspector that: “It’s nice here”. Families were also contacted and asked their views about the home, and a parent commented that is son was a lucky young man to be living at 51 Chapel Park Road and stated: “I have nothing but praise for the staff”. What the service does well: 51 Chapel Park Road offers a good standard of accommodation, with one bedroom now offering an en-suite facility. The communal areas including the hallway have been decorated with new carpets fitted giving the home a welcoming entrance. Two bedrooms and the office have also been decorated since the last inspection visit. There is also an ongoing of maintenance programme and during this inspection visit the outside of the property was in the process of being painted. The home was found to provide good support to the individual residents and the management team and staff ensure the residents have a good and comfortable life. The management team of the home and the organisation’s senior management team are committed to providing a good quality of care for residents, and also ensure that staff are well supported. 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 6 51 Chapel Park Road is very good at keeping families and friends informed about the home and the staff are supporting a resident to visit his elderly parents on a regular basis. 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. 51 Chapel Park Road DS0000021337.V325547.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 51 Chapel Park Road DS0000021337.V325547.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): 1,2,3,4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose and service user guide clearly says what service will be offered. Prospective service users can be confident their needs will be assessed, and the home will meet their needs and aspirations. EVIDENCE: There have been one new resident since the last inspection. The resident had a very individual introduction to the 51 Chapel Park Road and case tracking confirmed good practice. The manger in post at the time under took a pre-assessment of the resident, he was visited in his previous placement, he in turn visited 51 Chapel Park Road on several occasions including staying for a meal and an overnight stay. The team leader confirmed that the previous home transferred very comprehensive documentation with regards to the residents care needs. The inspector had the opportunity to meet with him during this inspection visit and the resident confirmed he was very happy living at 51 Chapel Park Road. 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 9 The resident has now been living at 51 Chapel Park Road for six months and he has had a review of his placement, with care management and his family fully involved, and the outcomes to date are this is a very positive placement. Through case tracking and discussions with the resident, his interests are taken into account when looking at activities, especially his interest in horses and dogs. The home is investigating the opportunities for the resident to take up horse riding, and his love of dogs is evident from his picture collection in his bedroom. 51 Chapel Park Road DS0000021337.V325547.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. The manager and staff demonstrate their knowledge of the individual residents, and are aware of the complex needs of the residents and encourage them to have an independent lifestyle as far as possible. EVIDENCE: Staffing levels within the home have increased since the last inspection, and this was evident during this inspection visit that the increase was positive for the residents. A concern a the last inspection was when residents wanted to undertaken individual activities there were times when this was restricted due to the lack of staff. However, during this visit there were three staff on duty, therefore one resident was out in the community and two residents were being supported with tidying and sorting out their bedrooms with staff support, and the manager had the time to spend with the inspector. 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 11 It was evident that care plans are reviewed regularly and there is a pro-active key-worker system in place. The inspector interviewed the team leader who is key worker to one of the residents. The key worker had a good understanding of the resident and throughout the interview displayed his knowledge of the resident’s recent health issues and needs. The resident, when interviewed spoke very complementary about his key worker. The new resident has a condition (syndrome), which if not managed appropriately would impact on the other residents living in the home. The manager is very aware of the condition (syndrome) and is constantly reviewing the placement. Staff have been instructed by the manager on how to work and support the individual and there is information available for staff for reference in the main office. 51 Chapel Park Road DS0000021337.V325547.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): 12,13,14,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s links the local community are good and enrich residents’ lives socially and educationally. The social life at 51 Chapel Park Road also enriches the residents’ lives, and their can choice from a variety of activities that they can enjoy and met their needs. EVIDENCE: 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 13 The residents of have variety of activity options, which include attending day services, swimming, cinema and theatre trips and the attendance to social evenings. The new resident is fully involved in the daily activities and has tried the EVH day service, but he did not enjoy going, so alternative day services are being sort. The resident family told the inspector they are very happy that the home is encouraging their son to get out and doing more walking. More staff have been employed since the last inspection, and this has impacted on the residents’ activities within the home and in the community. On the day of this inspection visit one resident was out shopping and the others were at home, with staff supporting them with domestic tasks. There was also the opportunity to go out after lunch to Hastings, which two residents choose to do. Residents special interests are also accommodated, which includes football, walking dogs, wrestling and when possible horse riding. One resident who has in the past declined most activities offered, spoke very positively about cooking with his key worker. The staff support residents to have annual holidays each year. Following the experience of one resident returning home early from the holiday last year, the staff have now reassessed his involvement in annual holidays and in the future and will be planning with him shorter breaks (long weekends) for 2007. 51 Chapel Park Road DS0000021337.V325547.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. Residents receive personal support appropriate to their physical, emotional and healthcare needs. EVIDENCE: The case tracking of the newest resident confirmed good practice. The resident has been registered with the local GP and has had a well man check up. There have also been other appointments made for him including a visit to the dentist. One resident has had health issues since the last inspection, and the home has supported him with medical appointments and with the support of the CLDT have advocated on his behalf to get expert advice and treatment. All appointments were recorded, and the home has been monitoring his health in detail. 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 15 The home is encouraging all the residents to have a more healthy lifestyle and this was evident in the healthy foods, exercise activities which include walking dogs and the walking to the bus stop and not always going by car. The medication records were in a good order. Records of the receipt and disposal of medication were clear and accurate. The pharmacist form the chemist chain that supply the medication to the home, undertook an audit in November 2006 and the medication was found to be in good order. All staff within the home, except the newest member of staff has have training in the administration of medication, and the manager confirmed they were all confident in these procedures. 51 Chapel Park Road DS0000021337.V325547.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. Residents and their relatives’ complaints would be taken seriously and investigated. The staff have the knowledge and understanding to take the correct action to safeguard residents from abuse. EVIDENCE: There are no recorded complaints or concerns since the last inspection. The home has a complaints document with individual sections for each resident, but this needs to be updated, as there are details of a resident that has moved, and the new resident does not feature. The home operates in an open and pro-active manner. The manager and staff demonstrated a sound understanding on how to prevent abuse, with most staff having relevant training in this area within their induction training, and further training has been planned by the EVH organisation. Residents interviewed during this inspection visit informed the inspector that they are very happy living at 51 Chapel Park Road and if they were unhappy they would always speak to the staff or the manager or their key worker. 51 Chapel Park Road DS0000021337.V325547.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): 24,25,26,27,28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall standard of the environment including the décor and furnishing are good and provide a homely and is now an attractive place for residents to live. EVIDENCE: The home has undergone major redecoration since the last inspection and the home is much more welcoming and the whole house was very clean and free from offensive odours. The Inspector toured communal parts of the home such including the lounge, bathrooms and kitchen. She also viewed three bedrooms following invites from the residents. The manager has a maintenance and renewal plan that will maintain this good standard, and the next area to be decorated will be the lounge. 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 18 The bathroom is adequate, and would benefit was modernising. The shower was out of order during this inspection and has been for many weeks, therefore all the residents have been only able to use the one bath, and this also includes the gentleman with the en-suite shower room. He informed the inspector that he sometimes enjoys having a bath; the manager confirmed this, and stated that he has been electing to have a bath most days in the early morning. It was evident that the residents are supported to keep their rooms clean and tidy, this was confirmed by the weekly programme of the residents which included housework activities, and on the day of this inspection visit, two residents were in the process of tiding their rooms with staff support. During this inspection visit, decorating was taking place on the outside of the home. 51 Chapel Park Road DS0000021337.V325547.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): 31,32,34,35 &36 Overall quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff employed have the skills and experience to meet residents needs and support them. However, the manager must ensure that recruitment references from the last two employers of the candidate are taken up and if the information is not clear, clarification is sort from the referee, thus safeguarding the residents. EVIDENCE: The home has had a total turnover of staff in the last few months, including the manager with only one original staff member still employed at the home. However he is very experienced and the manager stated his has a wealth of knowledge of the residents. There were seven new staff since the last inspection, and the inspector review the recruitment and induction of two staff members in-depth. 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 20 EVH has a robust recruitment policy and procedures but there had been a downfall in the procedures of obtaining references for the two staff being reviewed. Reference request had been sent out, but one was not adequate and there were references not returned. Both staff had had PoVA and CRB checks carried out and had undertaken the organisation’s induction training. Since the inspection visit the inspector has been contacted by a member the organisation’s senior management team. They have reviewed the procedures of obtaining and reviewing references for staff, and have made a managerial decision that the manager of the individual homes will take responsibility of obtaining references and following up late or absent references before the staff member take up duty. The decision was made that with a third person i.e. the head office of EVH sending out and receiving or not receiving references for all the EVH homes was not consistent, and not always following up late or absent referees and therefore not safeguarding residents. The Senior management team will be informing all the managers of this new procedure, and give advice and training in the sending, reading and interpret references. There has not been regular supervision for staff, but the new manager is in the process of setting up dates for staff supervision, and she will send a copy of the dates of the CSCI. The manager and the team leader feel there is now a good motivated staff team, and the staff member on duty during this inspection confirmed she was very happy and was enjoying her new role, and expressed how good the training was. There was a matrix of training display and it was evident all staff are involved in training, with one staff member undertaking Ldfa training (Learning disability framework award), and other undertaking NVQ training a various levels. In the last two months there have been two staff meetings and meetings with a member of staff regarding their work practices. The inspector read the minutes and found them to direct and informative and gave the reader an insight to the direction the home, and the standard and ethos excepted by the manager. 51 Chapel Park Road DS0000021337.V325547.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): 37,38,39,41 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home benefits from a well-motivated and experienced manager, who is supported by motivated senior management team and enthusiastic staff team. A safe environment is maintained for residents. EVIDENCE: Since the last inspection the home now has a new manager, she is very experienced and has had managerial positions in other care homes. She will be making application to the CSCI to become the registered manager of 51 Chapel Park Road. 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 22 Records showed that all aspects of health and safety were being met this included looking at appliance safety certificates, staff training, and accident records. All staff receive regular mandatory training and training that has taken place since the last inspection as been in Moving and Handling training, fire safety, food hygiene and Medication administration. A nominated staff member of the home, and also by the EVH organisation’s Health and Safety Officer carries out health and safely checks. The inspector saw documentation of the checks and audits. The senior management team of the EVH organisation also undertake monthly visits to the home as part of the Care Home Regulation (26), which requires a responsible person of the organisation to inspect the home, and write a report on the conduct of the home. All accidents and significant incidents are promptly reported to the CSCI. 51 Chapel Park Road DS0000021337.V325547.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 3 2 3 3 4 4 4 5 3 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 3 26 3 27 2 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X 3 3 X 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA27 Regulation 23(2)(j) Requirement It is required that the manager and the responsible individual ensure that the shower is in working order thus providing residents with suitable bathing facilities, which will meet their needs and offer sufficient personal privacy. It is required that the manager and the responsible individual ensure there are full staff records within the home and available for inspection at all times. It is required that the manager and the responsible individual ensure that before staff are employed in the home, two written references are obtained relating to the person. Timescale for action 01/02/07 2 YA34 17(2) Schedule 4 (6) 01/02/07 3 YA34 Schedule 2 (5) 01/02/07 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 51 Chapel Park Road DS0000021337.V325547.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!