Inspection on 17/02/06 for 58 Worlds End Road

This inspection was carried out on 17th February 2006.

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 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

58 Worlds End Road 07/02/08

58 Worlds End Road 24/01/07

58 Worlds End Road 26/08/05

58 Worlds End Road 17/12/04

58 Worlds End Road 29/07/04

58 Worlds End Road 18/02/04

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Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

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Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Worlds End Road, 58 Handsworth Wood Birmingham West Midlands B20 2NS Lead Inspector Gerard Hammond Unannounced Inspection 17th February 2006 10:35 Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 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 Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 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. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Worlds End Road, 58 Address Handsworth Wood Birmingham West Midlands B20 2NS 0121 523 5493 0121 523 5493 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) londonroad@tiscali.co.uk Milbury Care Services Limited Ms Elizabeth Brown Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residents must be aged under 65 years. To accommodate one named person with a physical disability, subject to regular review of her care needs. 26th August 2005 Date of last inspection Brief Description of the Service: 58 Worlds End Road provides accommodation, care and support for three adults with learning disabilities. The house is a domestic scale, semi-detached property situated in a well-established residential neighbourhood in the Handsworth Wood area of Birmingham. There is a range of community facilities within the immediate locality, including shops, places of worship, GP surgery and parks. Main public transport routes are within walking distance. On the ground floor of the house, there is a lounge to the front, and a kitchen and separate dining room at the back. There is also a laundry room, an assisted bathroom with w.c., and one residents single bedroom on this floor. Upstairs are two further bedrooms, another bathroom with w.c. and a small room used as an office. To the rear of the property is an enclosed garden with ramped access and handrails and small paved area. The drive at the front of the house can accommodate one vehicle, but there is parking on the road outside. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was the second in the current inspection year and was unannounced. This report should be read in conjunction with the one written following the inspection carried out on 26 August 2005. Direct observation and sampling of records (including personal files, care plans, previous inspection reports and safety records) were used for the purposes of compiling this report. Both residents were seen but it was not possible to seek their views directly due to their communication support needs and learning disabilities. The Registered Manager was formally interviewed, and a tour of the premises completed. What the service does well: What has improved since the last inspection? What they could do better: Residents’ assessments should be reviewed, updated and summarised, to support future care planning. Care planning continues to be in need of further development. In particular, plans should include residents’ goals, showing what the desired outcomes are and how these can be measured. These should then be looked at when the plan is reviewed, and decisions made about what has Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 6 worked and what might need to be changed. Risk assessments continue to be in need of development, and should be cross-referenced with care plans. Information management is still in need of improvement. This will be improved if files are archived appropriately, and indexed effectively. Activity planning and recording requires continuing development, and good work already done towards this should now be built upon. Health Action Planning and the use of person-centred approaches should be encouraged and developed. Some environmental issues require attention, and these are detailed in the requirements section of this report. A staff training and development assessment is required, and formal supervision is still not yet up to standard. Documents required by regulation should be maintained on the files of each person working in the home. Quality assurance and monitoring activity should demonstrate how the views of people using the service have been taken into account. 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. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 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 Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 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 the following standard(s): 2, 4 Residents’ needs have been assessed, but current statements of needs and aspirations should be produced, following review. Prospective residents have the opportunity to visit and try out what the service has to offer, prior to any decision on placement. EVIDENCE: There have been no admissions since the last inspection. Sadly, one resident passed away recently after long periods of ill health, so there are two residents living in the home at present. Key Standard 2 was assessed at the last inspection and met in full. It was recommended that detailed assessment information already collated should be reviewed, so as to provide an accurate statement of individuals’ strengths and support needs, as a firm basis on which to update people’s care plans. (See Standard 6 also.) Statements of need should also include their individual aspirations, and a recommendation was made that person-centred approaches should be promoted in order to support this. Condensing existing information into a summary of needs and strengths may also assist in this process. Conversations with the Manager and prior knowledge of the Organisation provides evidence that appropriate systems are in place to ensure that any prospective resident would have the opportunity of trial visits, so as to support appropriate decision-making with regard to future placement. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 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 the following standard(s): 6, 9, 10 Care plans and risk assessments continue to need further development, as previously reported. Care plans should reflect residents’ personal goals, and these should be evaluated and reviewed appropriately. Responsible risk taking is encouraged, but risk assessments need to be linked more clearly to statements of need and care plans. Information about residents is appropriately handled in general, but some practices need to change. EVIDENCE: Key Standards 6, 7 and 9 were all assessed at the last inspection: Standard 7 was met in full, and Standards 6 and 9 partially met. Requirements made in relation to these standards remain outstanding, though it should be acknowledged that some work has been done towards trying to address issues raised (refer to report of inspection carried out 26 August 2005). It should also be acknowledged that the intervening period of time since the last inspection Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 10 has not been easy for staff or people living in the house, having to deal with the illness and death of one of the residents. Information management would improve by organising files better. As previously observed, old material should be archived or disposed of. Accurate use of indices would make it much easier to locate important information quickly. Care plans and risk assessments should be numbered and crossreferenced, so that it becomes simple to track from one to the other. There was limited evidence that this process has been started, and this should now be completed. Care plans should include people’s goals, and the outcomes for goals set should be clearly measurable. These should be evaluated at review. Care plans sampled had records of review, but goal setting was very limited and there was no record of whether or not previous goals had been achieved. One person had a goal to “monitor weight regularly”. It is suggested that this might also indicate how often, indicate that written records are kept and suggest a target weight range to be achieved or maintained. Individuals’ detailed communication guidelines remain in need of further development. As previously reported, existing knowledge of how residents express themselves and make their needs known should be recorded in detail and incorporated into individual care plans. It was noted that the staff communication book contained personal information relating to named residents: this does not comply with current data protection legislation. Entries in this book relating to individual residents should signpost the reader to the appropriate personal file – e.g. “refer to appointments sheet / daily record / etc. on A.B.’s file.” Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 Residents are able to take part in appropriate activities and to access the local community, but opportunities continue to be in need of development, and recording needs to improve. Some action has been taken to begin to address these issues. EVIDENCE: All of the Key Standards were assessed at the last inspection. Standards 15, 16 and 17 were met in full, and Standards 12 and 13 partially met. In the last inspection report it was suggested that the support of the Occupational Therapy service might be sought, to assist in developing ways to improve residents’ opportunities for activities. A referral has been made, and an Occupational Therapist is now actively engaged with people living in the house. Assessment work is currently ongoing and evidence was seen of activity preparation and planning records. Staff now have some good tools to help them plan and prepare activities, and this should be of significant assistance in making the necessary improvements to residents’ activity opportunities, and quality of life. This initiative should be Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 12 commended and work already started should be encouraged and developed further. It is important that activity recording is expanded and improved upon. Using the new tools appropriately should be a major help in this. There should be clear links between the activities people undertake and their assessed needs, care plans, and agreed goals. Detailed and high-quality recording should prove to be of significant benefit when it comes to reviewing plans, setting goals and guiding the provision of future activity opportunities. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 The illness and death of one of the residents has been handled with sensitivity and respect. EVIDENCE: Key Standards were assessed at the last inspection, so these standards were not fully assessed on this occasion. Residents’ personal grooming and general appearance provided evidence that individuals continue to receive a good standard of basic personal care. Interactions between members of the care team and people living in the house were seen to be warm and friendly and appropriately respectful. It was reported at the time of the last inspection that care plans were in need of development in this area to include more detail of precisely how support should be given. Evidence was seen that some work has been done to improve this, and this should be acknowledged. It is also recommended that individuals’ Health Action Plans are developed, as well as the use of person-centred approaches, and this will be assessed in full at the next inspection. As noted above, one of the residents passed away since the time of the last inspection. Conversations with the Manager indicated that this has been a difficult time for both residents and staff, but issues have been dealt with sensitively and support given to all those concerned as appropriate. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 14 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 the following standard(s): EVIDENCE: Key Standards 22 and 23 were assessed at the time of the last inspection, and met in full. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 24, 25, 26, 30 Residents enjoy living in a house that is comfortable, safe and homely. People’s bedrooms are appropriate to their needs and support the promotion of their personal identity and independence. The house is generally clean and tidy, and a good standard of hygiene maintained. EVIDENCE: As previously reported, 58 Worlds End Road is a domestic scale house, with the “feel” of an ordinary family home. The property is generally well maintained, and fixtures and fittings are of a generally good standard. Residents’ bedrooms are individual in style, and it is clear that the staff team have worked hard to help people make their rooms personal and comfortable. Individual possessions and personal effects are very much in evidence. It was noted previously that the kitchen was in need of refurbishment, and the Manager advised that it has been surveyed recently, with a view to carrying out work to upgrade it. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 16 It was also noted that the extractor fan in the downstairs bathroom is still in need of cleaning, and that it is very noisy in operation. This should now be attended to, as previously required. The sluice washing machine in the laundry is also not working properly, and an immediate requirement was made that this should be repaired without delay. The house is kept generally clean and tidy, and a good overall standard of hygiene maintained. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35, 36 A staff training and development assessment is still required in order to make appropriate judgements about the qualifications, competence and training needs of the care team. Opportunities for formal supervision of each member of the staff team should now be brought up to the required standard. EVIDENCE: Key Standard 34 was assessed at the time of the last inspection and met in full. The Manager indicated that two senior members of staff are qualified to NVQ level 3, and that two other members of the care team are currently working towards achieving NVQ level 2. A requirement was made at the time of the last inspection that a staff training and development assessment should be provided remains outstanding. As previously indicated, this should show, for each member of staff, details of all training completed and qualifications gained. It should highlight any gaps (including refreshers) and indicate when outstanding training is scheduled, and who is to deliver it. It is known that the Organisation provides a rolling programme of training for staff in all its homes. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 18 It was also noted that recent photographs have not yet been placed on all staff members files, as previously required, and this matter should now be dealt with. The Manager advised that senior staff members have now been delegated to undertake formal supervision duties, and it is anticipated that this will have a positive effect on bringing this up to standard. This will be more fully assessed at the next inspection. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 In general, the Home is run to a satisfactory standard. A report is required of quality assurance and monitoring activity undertaken in the home. General practice promotes the health, safety and welfare of people living in the house. EVIDENCE: The Manager advised that she is qualified to NVQ level 4 and has completed the Registered Manager’s Award, but has yet to receive her certificates. Copies of these should be forwarded to CSCI. Copies of reports of visits required under Regulation 26 (Care Homes Regulations 2001) have been received at CSCI, but it should be noted that such visits are required to be carried out at least once a month and that these are unannounced. The Registered Provider should produce a report of quality Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 20 assurance and monitoring activity in the home, demonstrating how this has been underpinned by the views of the residents. The fire alarm and emergency lighting systems have been tested and maintained and a record kept, as appropriate. The fire risk assessment has been reviewed and fire evacuation drills completed as required. Fridge and freezer temperatures have been tested and recorded appropriately, and it was noted that packages of food stored in the fridge had been labelled with the date of opening. Recording of the tests of cooked food temperatures was variable, and this needs to improve. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 2 2 LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X 3 3 X 2 X X 3 X Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 22 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 YA6 Regulation 15 (1-2) Requirement Care plans should be developed to include individuals’ personal goals, as indicated in the main body of this report. Whole plan reviews should take place at least every six months, with written records showing who takes part and how decisions are made. (Partially met) Risk assessments need developing so that hazards are identified correctly, and control measures are incorporated into individual care plans appropriately. Risk assessments should be cross-referenced to the care plan(s) to which they relate, and vice versa. Recording relating to residents’ activity opportunities should be developed to indicate what the purpose of each activity is, and to include sufficient detail to support judgements about how successful it has been in achieving that purpose, so as to inform future planning. Activity opportunities should be clearly linked to individuals’ assessed DS0000016931.V284202.R01.S.doc Timescale for action 30/04/06 2 YA9 13 (4) 30/04/06 3 YA12YA13 16 (2m-n) 30/04/06 Worlds End Road, 58 Version 5.1 Page 23 needs and care plans. 4 5 6 7 YA24 YA24 YA30 YA34 23(2) 23 (2) 13 (4) 17(2) 19(4) S2 S 4(6) 18 (1c) Plans to refurbish the kitchen should now be put into practice. Clean and maintain the extractor fan in the downstairs bathroom. Outstanding since 02/09/06 Repair or replace the sluice washing machine. Ensure that all required documentation is retained on the personal files of all people working in the home. Outstanding since 31/10/05 Forward to CSCI a current staff training and development plan as indicated in the main body of this report. Outstanding since 31/10/06 Ensure that all staff receive formal supervision on a minimum of six occasions in any twelve-month period. Outstanding since 30/11/05 The Registered Manager should forward copies of her certificates of qualification (NVQ 4 and RMA) to CSCI The Registered Provider must ensure that visits and reporting required under Regulation 26 (Care Homes Regulations 2001) are carried out at least once every month. A report of Quality Assurance and monitoring activity should be forwarded to CSCI, and this should reflect how residents’ views have been taken into account. Ensure that core temperatures of all cooked foods are tested and recorded as required. 31/05/06 31/03/06 18/02/06 30/04/06 8 YA35YA32 30/04/06 9 YA36 18 (2) 30/04/06 10 YA37 9 (2) 31/05/06 11 YA39 26 24 (2) 30/04/06 12 YA42 13 (4c) 30/04/06 Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 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 Develop residents’ Health Action Plans and the use of person-centred approaches and incorporate both into individuals’ care plans. Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Worlds End Road, 58 DS0000016931.V284202.R01.S.doc Version 5.1 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. 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. 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