Inspection on 31/01/07 for Cranleigh Paddock Older Persons Resource Centre

This inspection was carried out on 31st January 2007.

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

The inspector 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

Cranleigh Paddock Older Persons... 09/10/07

Cranleigh Paddock Older Persons... 29/11/05

Cranleigh Paddock Older Persons... 06/07/05

Cranleigh Paddock Older Persons... 11/01/05

Cranleigh Paddock Older Persons... 27/07/04

Cranleigh Paddock Older Persons... 05/03/04

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 Cranleigh Paddock Older Persons Resource Centre Calpe Avenue Lyndhurst Hampshire SO43 7AT Lead Inspector Mr Roy Bega Unannounced Inspection 31st January 2007 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 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.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 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. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cranleigh Paddock Older Persons Resource Centre Calpe Avenue Lyndhurst Hampshire SO43 7AT Address 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) 023 8028 3602 023 8028 4124 Hampshire County Council Mrs. Sheila May Aplin Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (34) of places Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Cranleigh Paddock is a registered care home providing personal care to 34 service users in the older person category. Hampshire County Council owns the service. Accommodation is provided on ground floor level and is divided in four units. The home is situated in Lyndhurst on the outskirts of Southampton city and close to local amenities and the New Forest. The home has enclosed gardens that are accessible from each unit and to wheelchair users. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is an assessment of how the National Minimum Key Standards for Care Homes for Older Persons were being met. Evidence has been collated from the service’s history file a returned pre inspection questionnaire and this site visit. This visit took place on 31 January 2007 between the hours of 9-30 a.m. and 4 p.m., a total of six and a half hours. Opportunity was taken to look around the home view records, observe the working environment and speak with management, staff, residents and relatives. The three requirements raised resulting from the previous inspection have been assessed as being met. There were no requirements raised resulting from this visit. What the service does well: What has improved since the last inspection? What they could do better: Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 6 Management acknowledged there are areas within care plans that need more information especially as the home is in a transition period of becoming specialist in providing dementia care. 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. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 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 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standard 3 was assessed on this occasion. This service does not provide intermediate care as defined by key standard 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information they need to make an informed choice with regards to moving into the home. EVIDENCE: An informative and well-presented welcome pack for the home was seen. It includes photographs, an introductory letter, a statement of purpose that clearly sets out the objectives and philosophy of the service supported by a resident guide that summarises the statement of purpose and provides good clear information about the home. The guide is precise in what the prospective resident can expect and gives a good detailed account of the quality of the accommodation. Also included are qualifications and experience of staff, how to make a complaint, recent CSCI inspection findings Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 9 Residents and relatives spoken with stated they were fully involved in the assessment process and provided with a copy of the home’s welcome pack. Comments from relatives and residents included, “Management and staff were so kind and helpful before, during and after the move”, “I was not rushed”, “We were encouraged to take our time in making a decision”, “Me and my family had opportunities to visit the home before making a decision”. Discussions and records seen showed admissions are not made to the home until a full needs assessment have been undertaken. The home are then able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the statement of purpose. Evidence seen and discussions confirmed assessments is conducted professionally and sensitively and has involved the family or representative of the resident. Staff spoken with informed the inspector they are made aware of prospective new residents and their needs prior to them moving into the home. Prior to admission an individual member of staff (key worker) is allocated to provide a resident information and special attention to help them settle in and adjust to their new surroundings. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 7, 8, 9 and 10 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are detailed and personal to each resident. Personal support within the home is offered in such a way as to promote and protect residents’ privacy and dignity. Residents are supported by appropriately trained staff, who follow the homes policies and procedures for the management of medicines. EVIDENCE: Since the previous inspection it was seen that the manager has ensured care plans are formulated for all residents on admission and reviewed and updated monthly to reflect any changes in their needs. A sample of four care plans was seen. They are written in plain language, are easy to understand and consider all areas of the individual’s life including health, personal and social care needs. Residents are supported to have the right of access to health and remedial services. It was seen residents have individual health care plans that give a Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 11 comprehensive overview of their general health and acts as an indicator to changing health needs. Records seen and discussions indicated the health care needs of those residents too frail to leave the home are managed by visits from local health care services. Residents’ personal aids are well maintained and the home provides the necessary aids and equipment to support both staff and residents in daily living. Discussions and observations indicated residents have the choice to shower or bath when they wish, and are supported and facilitated to be independent in their personal hygiene. At the commencement of this visit residents were deciding to get up. Management acknowledged there are areas within care plans that need more information especially as the home is in a transition period of becoming specialist in providing dementia care. For example – Where it is stated, “Requires assistance”, detail of what the actual assistance is needs to be recorded. This needs to be especially critical Comments from residents and family members spoken with included – “Staff are so patient”, “They work hard here”, “All my needs and wishes are respected”, “I am treated with respect” and “They know what they are doing”. One resident in their appreciation of the care received showed the inspector copies of poems they have written for and given to staff. Where appropriate and where they choose residents are involved in their reviews and with agreement their family also. Management acknowledged where residents have been assessed as unable to partake in reviews or do not wish to or family do not wish to, this should be recorded. Since the last inspection it was seen management has ensured staff adhere to the procedures for returned controlled medication and the maintaining of accurate records. Evidence was also seen to show staff who manage medication have received appropriate training. The inspector was informed that any resident who wished to administer medication would be supported to do so within the home’s policy and procedures but currently there were not any. Records seen for administered medication were well maintained and up to date. Procedures for medication to be taken as required were in place. The staff member who assisted the inspector with the auditing of this standard also was able to demonstrate an understanding of the medication currently being used and appropriate storage. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 12, 13, 14 and 15 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from social, cultural and recreational activities that meet their expectations. Residents receive a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: Routines of the home are planned around the residents’ needs and wishes. The home encourages residents to take control of their lives and to be actively involved in the running of the home regardless of their mental ability. At the time of the commencement of this visit some residents of their own choosing were in bed deciding whether to get up. Throughout the day residents were observed to move freely around the home at their leisure. Minutes of monthly residents meetings (which staff attend) were seen. Discussions indicated that credence is given to issues raised. The home operates a key worker system, which enables closer resident staff relationships where likes, dislikes and needs are shared. Resources are Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 13 provided to allow time for activities and stimulation. Staff were observed to spend time with residents either engaging them in meaningful group activities or one to one discussions. External entertainers are also contracted to provide age appropriate activities. Residents spoken with informed the inspector that they like staff spending times with them and the entertainers that come in. Visitors informed the inspector that they feel welcome and know they can visit the home at any time. Observations and discussions indicated that staff always make time to talk to visitors. The layout of the home provides seating areas within the communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. Available menus indicated a varied and balanced diet is provided. A record of food provided that varies from the main menu was seen. Residents readily expressed their general satisfaction with regards to the quality, quantity, and choice of food provided. They told the inspector that they are always given a choice of two main meals for lunch and if they do not like them then an alternative is provided Residents told the inspector they are happy with the flexibility of meal arrangements and like being able to eat in their own room if they wish. Residents informed the inspector regardless of what time the get up they are always offered breakfast. This was observed to be the case on the morning of this visit. They also informed the inspector that they like the food provided and if they do not like what is on the main menu they are provided with something else. It was seen that regular drinks are made available and staff take the opportunity to make this time a social occasion. The inspector had the opportunity to observe lunch, which was well presented and taken at the pace of residents. Where residents required assistance it was provided with sensitivity ensuring residents dignity. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 16 and 18 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives have access to an effective complaints procedure. Staff awareness policies and procedures protect residents from abuse. EVIDENCE: The service has a clear complaints procedure that highlights the importance of complaining or making suggestions for improvement. The complaint procedure is provided to residents and relatives and is included within the home’s information pack. Residents and visitors demonstrated a clear understanding of how to make a complaint. They also informed the inspector that they are satisfied with the service provision and feel safe and well supported. Policies and procedures are in a place with regards to the protection of vulnerable adults. Staff spoken with portrayed a good knowledge and understanding of what action to take if they had any concern. Evidence was seen that staff have completed adult protection courses as part of the home’s training programme. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 15 The home ensures through training and supervision that care staff comply with the policies and procedures provided in relation to protecting and safeguarding the rights of the residents. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 19 and 26 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is accessible, safe, clean and well maintained. It meets residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: The home is divided into four separate living units each providing accommodation for up to nine residents. Each unit has it’s own kitchenette, dining/lounge area and other small seating areas. Management informed the inspector that there are planned alterations in converting two bedrooms into two toilets for wheelchair use and additional storage. The home provides a variety of adaptations and equipment to enable residents to maximise their independence. Residents were observed to walk freely around the home independently or with the assistance of various walking aids. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 17 A sample of three residents bedrooms were seen. They were well decorated and equipped. It was noted residents had personalised rooms with their own possessions. Bedrooms are individually and naturally ventilated with windows conforming to recognised standards. They are centrally heated with residents having the ability to control the temperature. Radiators and pipe work are guarded to prevent possible burns from hot surface temperatures. Residents told the inspector they can have the radiators as high or low as they wish. At the time of the visit the premises were clean, hygienic and free from offensive odours throughout. When incidents occurred that needed attention, staff managed them proficiently. Residents and visitors told the inspector that staff ensure the home is kept clean at all times. Systems are in place to control the spread of infection. Clinical waste is properly managed and stored. Staff spoken with have a good understanding of the home’s policy and procedures regarding infection control and have received appropriate training. During the visit staff were observed to use the appropriate protective clothing when providing personal care and assisting at meal times. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 27, 28, 29 and 30 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are trained, skilled and in sufficient numbers to meet the aims of the home and changing needs of residents. EVIDENCE: Management informed the inspector that the service is in a transition period of becoming a specialist in providing dementia care and staffing levels are being adjusted accordingly. The inspector was assured by management staffing levels will continue to be met according to changing needs of residents. Rotas seen and observations indicated the home is staffed efficiently. Records seen and staff spoken with demonstrated that the recruitment procedures followed in the home protect residents. All necessary checks were in place prior to staff commencing work. The sample of two records for the most recently recruited members of staff was seen which included a comprehensive induction-training programme. The service clearly defines the roles and responsibilities of staff through accurate job descriptions and specifications. Residents reported that staff working with them are very helpful, kind and seem to know what they are doing. This was reflected in discussions with visitors. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 19 Discussions and records indicated management encourage staff to complete external qualifications beyond the basic requirements, and recognise the benefits of a skilled, trained workforce. Evidence was seen with regards to staff being provided the National Vocation Qualification (NVQ) level 2 in care training. Staff spoken with stated they feel well supported by management and the training provided is very helpful in assisting them to understand and carry out their work. Records seen and discussion showed the following specific training has been provided. – First aid, manual handling, infection control, dementia care, care of substances hazardous to health, health and safety, food hygiene, fire safety, management of medication and adult protection. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 31, 33, 35 and 38 were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is experience and competent to run the home. Management and administration of the home is based on openness and respect. An effective quality assurance system is in place. Safeguards are in place to protect the interests of the residents. as is reasonably practicable the health, safety and welfare of residents and staff is promoted. EVIDENCE: The manager is registered with The Commission for Social Care Inspection (CSCI) to run the home. She has several years experience at a senior level and has completed the Registered Managers Award, NVQ level 4 in care and the Diploma of Higher Education in applied Social Studies. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 21 Discussions with staff and observations showed there are clear lines of accountability within the home. Also the management approach of the home creates an open, positive and inclusive atmosphere. Minutes of staff and resident meetings were available. Residents and relatives spoken with commented that the management team are very approachable, always make themselves available and readily help with any problems. Good relationships between staff on duty and staff and residents’ was evident. Staff portrayed a strong loyalty towards their work and management. Residents’ spoken with had nothing but positive comments to say about staff which included – “They are really helpful”, “Staff help me do things in my own time”, “Staff are always polite” and “You can have a joke with them”. A quality assurance and monitoring system based on seeking the views of residents, relatives, staff and professional is in place. As well as completing questionnaires, monthly resident and staff meetings respectively are held and considered as another source in obtaining views in monitoring the service. Residents say that there is plenty of hot water and the temperature in the home can be changed, on request, in their own rooms. The home is well lit, clean and tidy and smells fresh. The management has a good infection control policy. The home has up to date maintenance certificates for all equipment and systems. Fire drills and required fire safety precautions are carried out and recorded promoting the health and safety of residents. Staff training records seen showed appropriate health and safety training has been provided and updated. Where the home is responsible for resident’s money it works to a very rigorous system. Clear maintained records were seen that are routinely kept up to date and can be used to track individual residents finances. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 22 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 X 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 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? 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 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V321538.R01.S.doc Version 5.2 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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