Inspection on 28/10/06 for Burnham

This inspection was carried out on 28th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Burnham 17/01/06

Burnham 23/06/05

Burnham 17/11/04

Burnham 08/06/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

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

CARE HOME ADULTS 18-65 Burnham 19 Julian Road Folkestone Kent CT19 5HW Lead Inspector Wendy Mills Unannounced Inspection 28th October 2006 09:30 Burnham DS0000023122.V300640.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 Burnham DS0000023122.V300640.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. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Burnham Address 19 Julian Road Folkestone Kent CT19 5HW 01303 221335 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) MNP Complete Care Group Care Home 5 Category(ies) of Physical disability (5) registration, with number of places Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One person with Physical Disability whose date of birth is 20/7/1939. Date of last inspection 17th January 2006 Brief Description of the Service: Burnham is a home providing care and support for up to five adults with complex disabilities. It is a large detached Victorian-style house, situated in a pleasant residential area of Folkestone. The home is near to a public park, a leisure centre, the town, shops and the sea. The MNP Complete Care Group, the registered providers, are experienced providers of care services for older people and people with physical and learning disabilities. They have other care homes in the area. The homes in the group work closely together. Accommodation at Burnham is provided on two floors. There are five single bedrooms, all with en-suite toilet and shower or bathing facilities. One of the bedrooms has it’s own front and rear access to the building. All rooms are fitted with call bells. Access to the first floor is via a passenger lift. There is a good-sized lounge/diner with a conservatory that overlooks the rear garden. The garden is large, flat and wheelchair accessible. There is a summerhouse in the garden. There is parking for up to four cars to the front of the house and on street parking in the vicinity. The fees for this home range from £750 to £1,600 and are based on the individually assessed needs of the residents. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took six hours. Mrs Sandra Payne has recently taken over as manager of the home. She assisted throughout the visit. Mrs Lorraine Harrington, a registered manager from one of the other homes in the MNP Group, was present for the feedback session at the end of the inspection. During the course of this visit, discussions were held with four relatives and four of the residents, two in the privacy of their own rooms. Two members of staff were interviewed individually and in private. Extensive discussion took place with the manager of the home and with the registered manager of one of the sister homes in the group. Documentation, including care plans and staff files, was examined and a tour of the home was made. Both direct and indirect observation was used throughout the inspection Relatives, residents and staff generally made very positive comments about the home. One relative said that she didn’t know how good care could be until her relative moved to Burnham from another home. Mrs Payne, Mrs Harrington, the residents, relatives and staff are all thanked for the warm welcome they gave and for their assistance throughout this visit. What the service does well: All the residents have complex disabilities, including significant physical and communication difficulties. Some also have medical needs. The home understands and meets the needs of the residents very well indeed. In particular, they communicate well with the residents in the home and support them to maximise their independence. Residents are able to have choices in every respect of their daily lives and have a wide range of activities in which they participate. The accommodation is of a high standard and every room has it’s own ensuite toilet and washbasin and bath or shower. The home is very well maintained, both internally and externally, and has a homely and friendly atmosphere. Care plans and risk assessments are well written and provide staff with sufficient information to ensure that the assessed needs of the residents are met. All documentation that was requested during the inspection was readily to hand, in good order and appropriately stored to ensure confidentiality. The home deals well with all aspects of staffing. There is a strong, well-trained and stable staff team. One–to-one supervision is established and training is Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 6 linked to the needs of the residents and staff. Recruitment practices are exemplary. 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. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 The quality in this outcome area is good. This judgement is based on available evidence gathered both before and during this visit. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home Appropriate pre-admission assessments are made. This ensures that only those residents who are suited to the home and whose needs can be met are admitted to the home. EVIDENCE: The home has a statement of purpose and a service user guide. The statement of purpose requires updating to reflect the current organisational structure in the home. The service user guide is comprehensive and gives good information about the home. Since the last inspection residents have signed their contracts. Relatives have signed on behalf of those residents who are unable to sign for themselves. Discussion with residents confirmed that they are aware of their rights and responsibilities whilst living in the home. There are robust admissions policies and procedures. One new resident has moved into the home since the last inspection. All appropriate pre-admission checks had been made prior to a place being offered. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 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, 7, 8, 9 & 10 The quality in this outcome area is excellent. This judgement is based on evidence gathered both before and during this visit. Residents know that their personal goals are reflected in their individual care plans, that their confidentiality is respected and that potential risks are managed. EVIDENCE: Care plans are in order and up-to-date. Since the last inspection a key worker reporting system has been introduced. Each key worker produces a monthly, written report. This means that each care plan is used as a working document on a daily basis. Staff said that this has helped them communicate better with the residents and has made their job more interesting. Residents indicated that they are able to make choices about how they spend their time and to make other decisions that affect their lives, for example, whether they wish to engage in therapy, what risks they might take and who they might visit. These choices are recorded in each care plan. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 10 Residents are encouraged to become involved in the day-to-day running of the home, for example, the time they have their meals, colour schemes for their rooms and the communal areas and how they spend their leisure time. They are also given the opportunity to meet with any prospective residents and staff when vacancies occur. As there are only five residents and each has a specific communication difficulty, the manager and staff seek their views on an individual basis. They also communicate a great deal with relatives. Residents indicated that the staff are kind and that they listen to their views. Indirect observation confirmed that the residents are discretely offered the appropriate level of assistance to carry out the activities they wish. All in the home are aware of the need to respect confidentiality. Records are stored securely. All confidential information is kept under lock and key. The office space for the manager is situated at the bottom of the stairs and the confidentiality of discussions held in this area could be compromised. The summerhouse in the garden is being refurbished at present. This will give a much more confidential area for meetings with residents, relatives and staff. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 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): 11, 12, 13, 14, 15, 16 & 17 The quality in this outcome area is excellent. This judgement is based on evidence gathered both before and during this visit. The home supports the residents to lead fulfilling lives and works to maximise their independence and minimise their disabilities. Nutrition is well managed in the home and the residents enjoy varied and appetising meals. Special diets are also provided when indicated. EVIDENCE: Goals and aspirations are recorded in the care plans. The manager and staff work hard to find out what each resident would like to do during their leisure time. Residents spoke about their interests. One was very enthusiastic about his interests and spoke about a variety of interests and activities in which he participates, including a church group, music and college. Another said he loves to go out in the local community and said he had made many friends in the area. Another said he preferred the privacy of his room and liked to listen Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 12 to music. All indicated that the staff respect their wishes and help them achieve their goals. Nearly all the residents have severe communication difficulties but staff at the home were observed to be very good at establishing their wishes. The home is very good at finding out about communication aids and working with the local HNS speech and language therapist. A physiotherapy assistant, who also works at a sister home, visits to carry out routine exercises under the direction of the local NHS physiotherapist. This helps to maintain their mobility, circulation and general well-being. There are three other similar homes in the group and residents often visit other homes to socialise. Although the Burnham does not have it’s own transport, taxis are used for those who are more able to go out independently and the minibus from a sister home close by is often used for outings. Relatives said that they are made very welcome to the home and can visit at any reasonable time. On the day of inspection four relatives were visiting the home. Indirect observation showed that they are comfortable in talking to staff and that they are made welcome. Nutrition at the home is good. Most food is purchased locally. Residents can assist with the shopping if they wish. They are consulted about the types of things they like to eat and there is always a choice. The main meal is taken at lunchtime. On the day of inspection residents had a choice of a tasty sweet and sour dish and lamb cutlets. There were plenty of fresh vegetables and produce in the home. There is a small, pleasant, dining area but some residents choose to eat in their rooms. Four of the residents said that they enjoy their food and that they have a good choice about their meals. One resident said the food was “Absolutely marvellous”; another gave it the “thumbs up”. Where special diets and feeding timetables are needed, these are managed in a knowledgeable and diligent way. Staff were indirectly observed to give assistance with meals in a discreet and unobtrusive way. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 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): 18, 19 & 20 The quality in this outcome area is excellent. This judgement is based on evidence gathered both before and during this visit. The home promotes excellence in care practice. It meets the diverse and very complex health needs of the residents very well indeed. EVIDENCE: Care plans list clearly the personal support needs of the residents. There is an excellent level of staff training in the specialist health needs of the residents. Indirect observation confirmed that personal support is given in a kindly, caring and discreet manner. Staff spoken to were all very aware of the need to respect the dignity of the residents. Written policies and procedures for the management of medicines in the home are clear and comprehensive. Staff training in the administration is up-to date. Medicines are stored appropriately and there have been no medication errors since the last inspection. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 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): 22 & 23 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The home has sound policies and procedures of the handling of concerns and complaints, and for the protection of vulnerable adults. The staff are well aware of these and this protects the residents from harm. EVIDENCE: Residents and their relatives said that they know they can talk to the staff or the manager if they have any concerns. No one has had cause to make a formal complaint since the last inspection. Residents said that they have no complaints at all. Relatives said that if they have day-to-day concerns they can talk to the manager and that these concerns are dealt with appropriately. Day-to-day concerns are recorded in the daily record but not as concerns or complaints. It is recommended that a separate record be maintained of these concerns to see if there are any recurring themes from which lessons can be learned. There is a rolling, structured induction programme for all staff within the MNP group. This includes a module on the Protection of Vulnerable Adults. There are further training sessions to update staff. All staff, including the housekeeping and maintenance staff, have attended at least one session of adult protection training. Staff interviewed were clear about their responsibilities to report any concerns and said that they would not hesitate to do so. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 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, 27, 28, 29 & 30 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The standard of the environment in the home is very good. It promotes their independence and provides the residents with an attractive and homely place to live. EVIDENCE: A tour of the home was made. All areas were well decorated, homely, pleasant and free from offensive odours. The kitchen has recently been refurbished and one of the residents showed me this area. He was clearly pleased with the result. All the residents’ rooms were viewed, with their permission. They said that they liked their rooms and the ensuite facilities. All rooms have ensuite toilets, washbasins and baths or showers. The residents said that they have adequate privacy. Each room reflects the interests and personality of the resident. One family member said that she was very pleased that her relative has had such a great opportunity to express himself in the way he has arranged his room with pictures and ornaments that reflect his interests. All bedrooms are fitted with locks on the doors. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 16 The rear garden of the home is wheelchair accessible, flat and well maintained. There is a summerhouse and a barbeque area. The summerhouse is currently being refurbished to provide a better space for activities and individual meetings. The laundry room is situated on the first floor, and is fitted with a domestic washing machine and tumble drier. It is adequate for the needs of the home and was clean and tidy on the day of inspection. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 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): 31, 32, 33, 34, 35 & 36 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. There is well-trained and enthusiastic workforce that positively promotes improvement in the quality of life of the residents. EVIDENCE: Staff said they really like working in the home. They are clear about their roles and responsibilities. They spoke enthusiastically about their work in the home. They confirmed that there are regular staff meetings and supervision and plenty of training opportunities. Staff said that they appreciate the amount of training. In addition to all mandatory training, the home achieves a very good level of specialist training. It accesses a number of organisations to provide this training as well as using in-house expertise. The home is commended for providing such a good level of specialist training. Staff said that there are regular staff meetings and that they have both annual appraisals and regular one-to-one supervision. Since the last inspection a training room has been provided on the top floor of the sister home close by. This has made it easier to arrange regular training Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 18 sessions and to invite specialist trainers. Staff from Burnham join other staff in the group for frequent training sessions. This gives all staff in the group a chance to meet up with each other and exchange ideas. It also means that it is viable to run a rolling induction programme. An induction session is held every Tuesday afternoon. The registered managers in the group take it in turn to lead these sessions. There is a very stable workforce and no agency staff has been needed as staff work together to cover annual leave. Sickness levels and staff turnover are low and staff moral is high. All appropriate pre-employment checks have been made. Since the last inspection the company has completely revised its recruitment policies and procedures. The company has now centralised its recruitment procedures. This means that there is greater consistency throughout the homes in the group and that there are greater safeguards in place. An administrator carries out the initial checks. She ensures that the application form is completed correctly, makes requests for references and CRB checks and checks the references against information given on the application form. She then ensures that the candidate is available to work the required shifts. Once these initial checks are complete, the complete application pack is forwarded to the manager of the home. The manager then makes a decision about whether to interview the candidate and whether to offer employment. This means that the manager is freed from routine paperwork and can concentrate fully on the suitability of the candidate for the post. The final decision to appoint rests with manager or registered person. The home is commended for this excellent recruitment practice that protects the residents from unsuitable staff. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 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, 38, 39, 40, 41 & 42 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home is well managed and the views of the residents are taken into consideration when decisions are made about the running of the home. This means that residents can be confident that the home is run in their best interests. EVIDENCE: The manager is experienced in care and was previously a team leader at one of the other homes in the MNP Group. She holds the NVQ IV in care and is currently undertaking the management module. Conversation with her confirmed that she is knowledgeable about best care practice. She is currently preparing her application for registration with the CSCI. She receives regular supervision and support from the registered manager of one of the other homes in the group. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 20 Staff said that they like working at the home and respect the manager. They said that they valued her leadership and felt that she supports them well. They feel that their views are listened to and acted upon when appropriate. The office is well organised and all documentation requested during this visit was readily to hand and in good order. Valid certificates were in place for all equipment used in the home, including the shaft lift, fire alarm system, fire cylinders and gas boiler. The insurance certificate was in date. Environmental risk assessments are in place and reviewed on a regular basis. No health and safety hazards were noted on the day of inspection. The registered providers submit regular reports about the running of the home to the CSCI, in accordance with regulation 26 of the Care Standards Act. They are commended for the high standard of these reports, which are both comprehensive and informative. Burnham DS0000023122.V300640.R01.S.doc Version 5.2 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 4 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 3 3 3 3 3 3 3 X Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 22 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. 1. Refer to Standard YA16 YA15 Good Practice Recommendations The home should review the visitors’ policy to ensure that it protects the rights of all residents to privacy and the freedom to move throughout the home whilst visitors are using communal areas Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Burnham DS0000023122.V300640.R01.S.doc Version 5.2 Page 24 - 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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