Inspection on 04/04/06 for Burlington Hall Care Home

This inspection was carried out on 4th April 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Burlington Hall Care Home 30/01/07

Burlington Hall Care Home 04/10/05

Burlington Hall Care Home 26/04/05

Burlington Hall Care Home 12/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Burlington Hall Care Home 9 Station Road Woburn Sands Milton Keynes Bucks MK17 8RR Lead Inspector Mrs Caroline Roberts Unannounced Inspection 4th April 2006 09:30 X10015.doc Version 1.40 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 Burlington Hall Care Home DS0000015049.V288734.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 Older People. 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. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Burlington Hall Care Home Address 9 Station Road Woburn Sands Milton Keynes Bucks MK17 8RR 01908 289700 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) Burlington Care Homes PLC Maureen Cox Care Home 53 Category(ies) of Old age, not falling within any other category registration, with number (52), Physical disability (1) of places Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 53 older people with 1 person with a physical disability over the age of 65. 4th October 2005 Date of last inspection Brief Description of the Service: Burlington Hall is a care home for older people located in the centre of Woburn Sands. It is part of the Burlington Homes group a family run organisation that has two other care homes in Northampton. The home is ideally situated for access to the local shops and a good bus service to surrounding areas. Burlington Hall has 52 bedrooms all of which have en-suite facilities comprising of a toilet and wash basin. The home has four large lounges and additional seating areas, small kitchenettes and dining areas. The home has six bathrooms, all of which have disabled bathing facilities. The home is built over two floors with two shaft lifts at different ends of the building. The gardens are mature and well maintained. The occupancy fees range from £385.00 to £440.00 the home accept both private and local authority funded clients. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the un-announced inspection carried out at Burlington Hall on the 4th of April 2006. The majority of all inspections conducted by The Commission for Social Care Inspection will be unannounced. The lead inspector was Mrs Caroline Roberts. The inspection consisted of meeting with residents, staff and visitors, viewing records and documents pertaining to the provision of care and the running of the home. Evidence gained from this has formed the judgements for this report. The inspector toured the building, gaining permission from a number of residents to enter their bedrooms and viewing a further number from the doorway. The inspector met and discussed the inspection findings with the manager before leaving. The inspector found staff polite, helpful and welcoming, and would like to thank them for their co-operation and assistance throughout the course of the inspection. The inspector would especially like to thank the residents for their time and for allowing the inspector into their home. What the service does well: The standard of the environment within this home is good providing service users with a clean, attractive and homely place to live. A good level of interaction was noted between service users and staff. Pre-admission assessments are conducted ensuring that the home can meet the assessed needs of potential residents prior to admission. Care plans are detailed and provide staff with specific guidance on how to meet resident’s individual needs. Residents have access to a variety of health care services external to the home. Service users spoke highly of the care received in the home. Comments included: “The food is lovely and you get plenty” “The staff are great” “If you want a home this is the best” Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 6 “Maureen and John are just the best” “It never smells it is always clean, the girls do such a good job” Comments received from visitors included: “ Overall happy with the home” “Always made to feel welcome and I can stay for meals if I wish” “Staff are kind and helpful” 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. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 All of the pre admission assessments were completed and clearly demonstrated that the home was able to meet the identified needs of the individual prior to admission to the home. Residents would benefit from having an up to date statement of purpose and service user guide to aid the home choice making process. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of the case tracking process the pre-admission assessments from 2 residents were viewed, both were completed fully and provided information that the home had sought to identify the individual’s needs to ensure that the home could meet the needs prior to admission. The inspector had the opportunity to speak with both of the residents about what the admission was like for them, both confirmed that the staff had been very kind and thoughtful throughout the whole process. One family member spoken with said that she would of liked more written information about the home, as they had only been provided with a letter from the Health Care Manager, which included very brief details about the home. Further clarification evidenced that both of the residents had not been provided Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 9 with a statement of purpose or service user guide prior to admission. The manager confirmed that the home did not have one available. It is also noted that one was not available at the time of the inspection. A requirement is being served that the provider forward a copy of the homes statement of purpose and service user guide to the Aylesbury office of CSCI by 30th April 2006. One other pre-admission assessment was viewed that was not part of the case tracking, this had not been completed fully however, the staff member who conducted the assessment visit was spoken with and confirmed that he took additional notes, it is advised that these notes are attached to the assessment form. Intermediate care is not provided in this home. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Care plans, healthcare and medication administration is efficently managed to ensure that the needs of residents are met. Residents rights are respected by staff. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home use the standex care planning system, the standard of information within the care plans was good, residents and relatives are involved in the initial care planning stage and evidence of residents signing the care plans was seen. 3 care plans were viewed (two as part of the case tracking process) each plan had very good long term information, followed by specific plans of care to cover identified needs. Care plans covered the following areas: Identified care needs with actions needed by staff. Tissue Viability assessments. Moving & Handling assessments. Risk assessments. Health and medical report forms. Daily reports. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 11 Weight charts. Review of care and audit notes from manager. The home have a good relationship with visiting healthcare professionals and health and medical intervention sheets detail any visits regarding helathcare. Individual specialist needs are sought via the district nursing team. Milton Keynes village practice and Asplands surgery provide services to the home, the manager confirmed that the home have good relationship with both surgeries. District Nurses visit daily and as needed to provide specialist care to residents, in addition they offer good support and training to staff. The Manager was clearly aware of who to contact for specialist advice i.e. diabetes care, nutrition, tissue viability. Dentist and optician visits are monitored and arranged as needed, and detailed in the care plan. Medication is well managed, with training provided for all staff prior to being allowed to take part in the medication administration process. All medication is Stored in 4 locked trolleys in two secure store rooms. No excess stock was noted. Individual medical profiles are in place for each resident. No unexplained gaps on Larchwood medication administration sheets were noted. Medications returns book is in place, which is signed by the pharmacist on collection for disposal. All medications are signed into the home for recording processes and audit. Medication Policy is available to staff. Training and audits are provided by pharmacy. Controlled drugs register is in place with two signatures for all administration. Staff observed administering medications, carried out in line with company policy and procedure. Staff were observed throughout the inspection to be promoting the dignity of residents, personal care was being provided behind closed doors, staff were observed knocking before entering residents bedrooms Observation and comments received provide evidence that residents are afforded with privacy, dignity and respect. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, The routines of daily life are varied to meet the individual likes and dislikes of residents. Social opportunities are provided for residents to join in if they so wish. Quality in this area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The home employs a dedicated activities organiser 3 days per week. A structured programme of activites is arranged for 3 days per week with any additional bought in activities taking place on other days. Church services are aranged via the local church. Routines in the home are arranged around residents needs as much as possible. The home do not have restrictions on visiting hours during the waking day, visiting during the night would need to be pre-arranged and under exceptional circumstances. Family and friends can meet in residents own bedrooms or one of the lounges, families and friends can stay for meals with prior arrangement, as was seen during the inspection. Residents and visitors confirmed to being made feel welcome and having open access re visiting hours. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 13 Evidence of residents being able to furnish their rooms with their own personal belongings was seen during the tour of the building. Residents and families are encouraged to manage their own finances, although the home do offer to safe keep small amounts of personal finance, for which procedures are followed and documented. The home has 3 dining areas all of which are pleasently decorated and offer ample room for the residents to ejoy the meal in a congenial setting. Meals can be taken in the residents own bedroom if wished. 3 cooked meals a day are offered with drinks readily made available. Menus are varied and reflective of the season. Mealtimes are unhurried and a relaxed atmosphere is promoted by staff. On the day of the inspection lunch consisted of roast chicken, roast potatoes and vegetables. Some residents had requested sandwiches and jacket potatoes which the cook then prepared. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18, The manager operates a transparent approach towards complaint investigation, the manager has a good knowledge of POVA procedures and needs to ensure that all staff have a better understanding of POVA. Quality in this outcome area is poor/adequate. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The home have received no complaints in the period under review. Although the home have a complaints policy and residents and visitors felt they could go to the manager with any problems, specific information needs to be provided for residents and families. It is anticipated that the statement of purpose and service user guide will provide the information required. One staff member made an allegation of abuse towards another member of staff this was fully investigated under Milton Keynes Protection of Vulnerable Adults Policy, records seen at the inspection evidenced this. Training profiles did not indicate that all staff have received POVA training, the manager also confirmed this. The manager had planned to facilitiate this training but due to an outbreak of illness in the home this training had been postpoined. A requirement is being served that all staff have received POVA traing by the end of May 2006. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Residents live in a safe well maintained environment. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Burlington Hall is located in the center of Woburn Sands and within easy walking distance of the shops. Burlington Hall is purpose built and has recently had a extension to provide additional bedrooms and living space. All bedrooms are single and have ensuite facilities providing a toilet and washbasin. Furniture provided by the home is of a good quality and age appropriate. The lounges are large and bright and provide plenty of day space. The Laundry is a good size and is accessed via the rear garden, it has no direct access to the home which is not ideal, but the home seem to manage with the use of wheeled trolleys. The laundry has adequate facilities to undertake the laundry of the home. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 16 The home was found to be clean and tidy, well maintained and to offer a pleasant living environment for residents. Residents and visitors spoken with confirmed that the home is always kept clean and tidy with no unpleasant odours noted. It was noted that some staff would benefit from a little training in how to make a bed properly, this was discussed with the manager who was shocked by the poor state of a bed that had been made by the night staff, she agreed to talk with the staff concerned. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staffing levels are appropriate for the assessed needs of residents however, without investment in training of the staff the standards in this home will fall. Quality in this outcome area is poor/adequate. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Folowing a requirement served at the last inspection that staffing levels be reviewed the providers have increased the staffing levels to meet the needs of residents. Rotas viewed indicated that staffing levels are maintained at 7 care staff and one dsignated duty senior at all times throughout the waking day,the manager is supernumery. Night staffing levels are 3 care staff and one designated senior. Residents spoken with confirmed that staff were always available to help them. Recruitment records are well maintained and in line with Schedule 2 of the Regulations. Training records had not been updated therefore it was difficult to evidence training provided by the home, although the manager is working on this no evidence was available to show that manadatory training has been updated following the last inspection. From cross referencing the recruitment records for new staff it became apparent that some staff were working in the home without up to date moving and handling training. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 18 The manager has arranged some distance learning training and has been allowed 10 places at the cost of £12.50 per person, more places are needed however the provider has stipulated the number of places that can be allocated at this time. From information available at this inspection it does not appear that all staff are receiving 3 paid days training per year. A requirement is served that all manadatory training is updated by 01/08/06 Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38, The home is well managed by an individual competent and experienced to run the home. Effective quality assurance would aid the manager in the development of the home. Health and safety procedures in the home are well managed. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The manager has just completed the fit persons procedure (March 2006) and has recently become the registered manager of the service, she is social work qualified and is currently undertaking her RMA and hopes to complete this by the end of the year with many sections being accredited over. The manager was clearly able to demonstrate a sound knowledge of management structures and was open and honest with the inspector throughout the inspection. Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 20 The home have not progressed with the quality assurance process, and the manager confirmed that since November 05 only one Regulation 26 visit has been conducted this information is in line with the inspectors records in relation to receiving Regulation 26 notices. Resident satisfaction surveys were sent out last year and resident meetings are now held under the new manager to discuss and share the decision making processes in the home. A Requirement is being served that the providers implement a thorough quality assurance process based on seeking the views of residents and based on a systematic cycle of planning – action and review. A Requirement is also being served that the provider ensure that Regulation 26 visits are conducted as detailed within the Regulations. A requirement was served at the last inspection that the system for the safe keeping and handling of residents money be reviewed as this was not adequatley documented. The systems for handling residents money is now computerised and all fully documented with receipts for any expenditure. Health and Safety procedures are managed by the deputy manager who has a very good knowledge in this area and ensures compliance. Records maintained and inspected on the day of inspection included: Health and Safety checks. Service contacts for lifts, hoists, boilers, fire equipment, electrical testing, gas safety and nurse call systems. One relative raised how difficult it is to take his mother out of the home as the front entrance to the home is not adequate to meet the needs of those in a wheelchair, this had previously been discussed with the manager, although not documented. The inspector had the opportunity to observe this person attempting to manoeuvre the wheelchair out through the entrance, which proved very difficult. A requirement is served that the providers make arrangements to ensure that visitors/residents needing to enter or exit the home with a wheelchair are able to do so without difficulty. Timescale for completion 01.08.06. Burlington Hall Care Home DS0000015049.V288734.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 1 x 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Burlington Hall Care Home DS0000015049.V288734.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 OP1 Regulation 4(1) & 5(1) Requirement A requirement is being served that the provider forward a copy of the homes statement of purpose and service user guide to the Aylesbury office of CSCI by 30th April 2006. A requirement is being served that the manager ensure all staff have received POVA traing by the end of May 2006. A requirement is served that the providers make arrangements to ensure that visitors/residents needing to enter or exit the home with a wheelchair are able to do so without difficulty. A Requirement is also being served that the provider ensure that Regulation 26 visits are conducted as detailed within the Regulations. A Requirement is being served that the providers implement a thorough quality assurance process based on seeking the views of residents and based on a systematic cycle of planning – DS0000015049.V288734.R01.S.doc Timescale for action 30/04/06 2 OP18 13(6) 30/05/06 3 OP38 23(1)(b) 01/08/06 4 OP33 26 04/04/06 5 OP33 24 01/08/06 Burlington Hall Care Home Version 5.1 Page 23 action and review. 6 OP30 10(1) A requirement is served that the manager forwards the training plan for staff and makes arrangements for staff to attend the identified mandatory training. Timescale for completion 01/02/06. Requirement re-served as not met from last inspection. 01/08/06 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 Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Burlington Hall Care Home DS0000015049.V288734.R01.S.doc Version 5.1 Page 25 - 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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