Inspection on 25/04/07 for 69 Hoarestone Avenue

This inspection was carried out on 25th April 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

69 Hoarestone Avenue 22/12/05

69 Hoarestone Avenue 24/06/05

69 Hoarestone Avenue 18/01/05

69 Hoarestone Avenue 21/12/04

69 Hoarestone Avenue 24/03/04

69 Hoarestone Avenue 27/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 69 Hoarestone Avenue 69 Hoarestone Avenue Whitestone Nuneaton Warwickshire CV11 4TH Lead Inspector Yvette Delaney Unannounced Inspection 25th April 2007 10:00 69 Hoarestone Avenue DS0000004343.V336597.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 69 Hoarestone Avenue DS0000004343.V336597.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. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 69 Hoarestone Avenue Address 69 Hoarestone Avenue Whitestone Nuneaton Warwickshire CV11 4TH 02476 327078 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) Mrs Hazel Lucas Mrs Hazel Lucas Care Home 3 Category(ies) of Learning disability (2), Physical disability (1) registration, with number of places 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd December 2005 Brief Description of the Service: Hoarestone Avenue is a family house situated in a quiet residential area of Nuneaton. It is close to all local amenities. The home provides a family home for two young men. The house is a two storey domestic dwelling, which offers ample private and communal space for the two men. The home is well maintained and suitable for the purpose. The men have their own single bedrooms one on the ground floor and one on the first floor. Both bedrooms have en suite shower facilities. A main lounge, kitchen and dining room are provided on the ground floor. Access to the first floor is by a stairway. There is sufficient garden space at the rear of the house. The garden is enclosed, and has been paved and landscaped to provide easy access for the young man who uses a wheelchair. The owner of the home has advised that the current fees for resident accommodation varies between £370 and £740 per week. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and took place on a weekday, Wednesday 25 April 2007 between the hours of 10.00 am and 12.30 pm. The registered person, her husband and both young men were present at the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. This process considers the care home’s capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. Before the inspection, questionnaires were sent to the home to be given to residents, relatives/visitors and visiting professionals to seek their independent views about the home. Completed questionnaires were received from the two people who use the service, which were completed on their behalf by friends. Two questionnaires were also received from friends of the residents. Comments received from the friends and residents express praise for the service that they receive and include: “I am happy and comfortable and I like it here.” “I have never felt that I need to question the care given and know … and … are given anything they require. They are treated no different to anybody else.” “I believe the love, care and support given to my friend especially during a number of difficult times in his life has been exceptional.” The registered person of the home completed and returned a pre-inspection questionnaire containing further information about the home as part of the inspection process. Some of the information contained within this document has been used in assessing actions taken by the home to meet the care standards. Both residents were ‘case tracked’. This involves establishing an individual’s experience of living in the care home by meeting or observing them, discussing their care with the owners, looking at their care files, and focusing on outcomes. Within the report both young men refer to the registered person and her husband as ‘mum and dad’. The reason for this is because they were 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 6 fostered from a very young age and have remained with the registered provider and her husband. Records relating to the care of the people using the service, training and health, and safety were examined. The young men living in the home were able to make active contributions during the inspection visit. The registered person and her husband are commended on the support they give to the men they care for. The inspector thanks them for their cooperation, preparation and positive attitude during the inspection. What the service does well: What has improved since the last inspection? There were no requirements made at the last inspection carried out on 22 December 2005. The registered person and her husband continue to ensure that the home is run to provide a family home for the young men. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 7 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. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 8 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 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 9 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): 5 Quality in this outcome area is good. People living in the home have information about their placement, which will support them to live comfortably within a family environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Outcome statements one to five in this section do not apply to this care home. The reason for this being that the registered person and her husband continue to provide a fostering service but do not intend to offer any further permanent placements. The two young men living in the home have lived there as family members since they were two years old, calling the owners ‘mum and dad’. A comprehensive Statement of Purpose, individual placement agreements signed by the two men was examined. Both documents have been reviewed and updated. Other information related to the conduct of the home and support available both to the people using the service and the owners were seen and read. Both men were aware of the placement agreements they had signed. 69 Hoarestone Avenue DS0000004343.V336597.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 and 10 Quality in this outcome group is good. Individuals are involved in decisions being made about their lives and play an active role in planning the care and support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information in the two care plans read was person centered and demonstrated that the owners are fully aware of the individual needs and capabilities of the young men. Care plans identified the individual needs and wishes of the men living in the home and stated how these would be met. Information to identify their personal care wishes and choices was documented. Although the physical abilities of both men are different, both are encouraged to be as independent as possible. On the day of inspection, the owners were seen to give support as needed or requested to one of the men when helping him to attend to his personal care. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 11 Both men resident in the home are involved in determining the level of risk they are able to undertake before any intervention. The care plan for one of the people who use the service show the need for help when getting out of bed and moving to and from a wheelchair. One of the men spoken with said that both him and his brother have a say on what happens in the home each day. One of the men said that sometimes he chooses to stay in his bedroom especially when he wants to watch something on television or play computer games. Information in questionnaires received and discussions with the registered person and the young men confirmed that they are able to access support external to the home, which include social services, their key worker or staff at the day centre. 69 Hoarestone Avenue DS0000004343.V336597.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): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome group is excellent. Opportunities are available in the home to ensure that people living in the home experience a daily life, which offers a positive and varied lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The two young men living in this home are encouraged and supported by the owners and their family to be independent people. Conversations with the providers, both young men and picture diaries/albums examined showed the varied day-to-day lifestyles activities, which take place both in the home and the community. The week before the inspection the family had taken a holiday to the Lake District. The registered person and her husband explained that they would normally pre-check the area where they are going on holiday. Checks made are to ensure that facilities are available for people with disabilities, that the area is as accessible as possible and can accommodate a wheelchair. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 13 The young men have access into the community either by a specially adapted van, which accommodates a wheelchair or through public transport. Both men have friends with whom they can socialise both at home or venues in the community. A number of activities or events are attended as a family examples of these include a concert for St. George’s day, the motor museum, visits to the pub, meals out, disco’s, ten-pin bowling and the cinema. Opportunities for life long learning is available and both have attended day centres. One of the men has attended pottery classes and the other goes out to work one day per week this is due to increase to two days per week. On the day of the inspection, both men were at home. During conversation, the men were able to express that their ‘mum and dad’ support them to live their lives freely with support where needed. A friend of the family commented in their returned questionnaire that: “Hazel and Brian (registered person and her husband) have always welcomed me into their home. We go out with them and the lads for their birthdays and Brian, I, and the lads go for a drink when I am available…” The registered person and her husband ensure that the men for whom they have provided a home for approximately 30 years know that they are part of an integrated family. The owner of the home explained that the families of the young men are welcome to come and visit and the men can go and visit their family if they wish. As the home operates as a family household, meals are eaten as a family with access to snacks when needed. One visitor said in their questionnaire that: “My friend receives the support to contact me whenever he wishes.” 69 Hoarestone Avenue DS0000004343.V336597.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 and 20 Quality in this outcome group is excellent. The health and personal care that people receive is based on their individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans for both men were examined these were well laid out and presented an informative assessment and recognition of each persons care needs. Care records demonstrate that advise is sought from professionals as required. Support services are accessed to meet the specific and changing needs of each young man, this includes advice on aids and adaptations. For example, moving and handling equipment, has been particularly important, as the men have got older. Support is also sort from social services for advice on social and psychological management as needed. The registered person was able to demonstrate an understanding of the safe handling of medicines and appropriate records were maintained. Medicines were contained in a locked cupboard. One of the young men is able to administer his medicines with prompting. The support needed is documented 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 15 in his care plan. The registered person and her husband understood the importance of medicines being accounted for and the possible risks to the men if they were not managed safely. All medication administered was recorded on medication administration records (MAR) charts. Day to day life in the home is flexible, both men spoken to were able to confirm that they choose when they go to bed at night and get up in the morning. Both knew the days that they attended the day centre or went to work and therefore the need to get up early. Both men felt that their privacy was respected, they were able to access their own bedrooms at all times. One visitor commented in their returned questionnaire that: “When visiting myself and … (the lads) … go and chat in private and are left alone.” The young men were well presented. Equipment and facilities available to support one of the men includes a level access en suite shower room and a specialist bed. Written statements in care plan documentation show that support is given to ensure access to hospital appointments, clinics, the GP and dental appointments. 69 Hoarestone Avenue DS0000004343.V336597.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 and 23 Quality in this outcome group is excellent. People living in this home are confident that their concerns will be listened to and acted upon in an objective and timely manner. Training attended by the owners supports the protection of residents from abuse, neglect and self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are systems in place for the men to express their concerns and make a complaint if they wish to. The complaint procedure was seen and read and both men using the service were aware of the procedure. The registered person says that there are always opportunities to sit and talk. Relationships have developed over time in that the young men will come and talk to her or her husband about any concerns they may have. The men also know that they can talk to people outside of the home, their social worker, staff at the day centre and friends. There has not been any complaints received about this home either by the home itself or the Commission. Discussion with both men demonstrated that they were aware of how and to whom to make a complaint. The resident said that if they were unhappy they would “speak to mum and dad” or to someone at the day centre. Both men commented in their returned questionnaires on friends, family, support workers and their key worker who are able to act as advocates on their behalf. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 17 Discussions with the registered person and her husband demonstrated that they had a good understanding of the young men in their care and if there were a concern they could not deal with they would involve social services. In discussions with the young men they expressed that they felt safe in the home. Observation during the course of the inspection showed that they were both relaxed and free in their environment in which they live. The registered person and her husband have both attended training related to the protection of vulnerable people. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 18 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, 29 and 30 Quality in this outcome area is excellent. The environment in which residents live provides a homely, private, comfortable and safe home, which meets their needs, individual lifestyle and level of independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This home is situated in a residential setting and the owners provide accommodation and support services for two adults with learning and physical disabilities. The home is near to shops and other local facilities. A homely spacious environment is available, which is sufficient to meet the needs of the people that live there. The young men see the home as their home they have their own bedrooms and both allowed the inspector to view their rooms. One bedroom was on the first floor and the other on the ground floor for ease of access. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 19 The young men said that they liked their bedrooms. The rooms were furnished to their individual tastes and they were able to spend as much time as they wanted to in their bedrooms. The bedroom downstairs had en suite facilities and the bedroom on the first floor has an enclosed shower cubicle in the room. The ground floor bedroom is designed to give level access to all rooms on this floor. Doors have sufficient width to accommodate wheelchair access. The garden to the rear of the home can be accessed from this bedroom via a ramp. The garden area is paved to provide easy access for the young man that uses a wheel chair. Ongoing maintenance work has been carried out in the home. Information contained in the pre-inspection detailed that double-glazing and a shower had been replaced. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 20 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): 35 Quality in this outcome group is good. People living in the home benefit from the training attended by the owners of the service, which promotes safety, consistency and continuity of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The standards in this section do not apply, as the registered person does not employ staff. The home operates as a family home, with the registered person and her husband providing care as needed to the men living in the home with support from other professionals external to the home. The outcome of criminal record checks was available and examined for the registered person and her husband. The owners of the home have also completed and made sure that they are up to date with training appropriate to help them meet the needs of the people in their care. Training attended includes moving and handling, first aid and food hygiene. Various Internet sites are also accessed to help them keep up to date. 69 Hoarestone Avenue DS0000004343.V336597.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, 40, 41, 42 and 43 Quality in this outcome group is good. Management and operation of the home ensures the safety of residents at all times, which supports and increases their self-worth and quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This home provides a homely family environment for the people who live there. There are procedures in place, which support the home to run well and ensure that all the family members have some guidance as to acceptable practices and behaviour in the home. Procedures seen and examined include safe handling of medicines and fire safety. Both men said that they felt comfortable in the home and a positive relationship was observed between all the family members present on the day of the inspection. 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 22 Support received from external agencies ensures that the individual holistic care needs of both young men living in the home are acted on, monitored and reviewed. Observation of the interaction between the family in their own environment, a tour of the home, care practices and discussion with the family evidence that the premises were safe and secure and the safety and welfare of the young men is promoted and protected. Adaptations have been made to the home to help the men to move around the home safely. The registered person and her husband are organised. Information required to support and evidence outcomes for the young men and procedures in the home are collated in folders for easy access. Fire procedures have been reviewed in the home, Mr Lucas, the husband of the registered person so that the young men are aware of what to do in the event of a fire. Smoke and fire alarms are tested weekly, and records are maintained by Mr Lucas to demonstrate this. A copy of the emergency and crisis procedure was forwarded to the Commission with the pre-inspection questionnaire. The document gave details on whom to contact in the event of an emergency. The procedure was discussed at the inspection to seek clarification on some of the contents. A quality survey from which to determine the views of people that use the service has been developed. Samples of the surveys were examined and these show that positive feedback about the services provided by the home had been received. 69 Hoarestone Avenue DS0000004343.V336597.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 N/A 2 N/A 3 N/A 4 N/A 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 4 25 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 3 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 3 3 3 3 3 3 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 69 Hoarestone Avenue DS0000004343.V336597.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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