Inspection on 13/06/07 for Hailey House

This inspection was carried out on 13th June 2007.

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

Hailey House 07/08/08

Hailey House 13/07/06

Hailey House 06/10/05

Hailey House 14/04/05

Hailey House 04/11/04

Hailey House 20/05/04

Hailey House 28/01/04

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

CARE HOMES FOR OLDER PEOPLE Hailey House Highlands Drive London Road Maldon Essex CM9 6HY Lead Inspector Jane Greaves Key Unannounced Inspection 13th June 2007 09:40 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 Hailey House DS0000017840.V343278.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. Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hailey House Address Highlands Drive London Road Maldon Essex CM9 6HY 01621 854132 01621 842477 haileyhouse@hotmail.co.uk 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) Mr Frank Stanley Churchill Kam Mrs Susan Jane Hibberd Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 22 persons) 13th July 2006 Date of last inspection Brief Description of the Service: Hailey House is a fully detached property, set in compact grounds in a wholly residential area, approximately a quarter mile from the centre of Maldon. The home is registered to accommodate twenty-two elderly people (over the age of 65). Accommodation is provided in 14 single and 4 shared rooms on all three levels of the home. Access between levels is provided by stair lifts. Hailey House is a listed building and planning restrictions prohibit the installation of a shaft passenger lift. Communal space available comprises an L shaped lounge/dining room with an adjoining conservatory style area at the far end of the lounge. Visitor car parking is available at the main entrance of the property where there is also a small, enclosed garden for residents’ use. At the rear of the home there is a small patio style area with seating. Fees for the home range between£410.76 and £538.65 weekly depending on the accommodation provided and the dependency of the resident. Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, covering the key National Minimum Standards and the intended outcomes of these, took into account all the information CSCI had received about Hailey House since the last inspection. An unannounced visit to the home took place on 13th June 2007 lasting 6 hours. The inspection process involved • • • • • • • Speaking with people living and working at the home Speaking with the person in charge Speaking with healthcare professionals Speaking with family members at the home and over the telephone Looking all round the home Observing how people were supported Sampling records. Some shortfalls were identified resulting in 3 requirements and 5 good practice recommendations. What the service does well: What has improved since the last inspection? The Laundry door has been fitted with a self-closing device in line with fire regulations. The laundry flooring has been replaced with adhesive floor tiling to ensure it can be cleaned thoroughly. Each person living at the home has a recent photograph within their care plans. Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hailey House DS0000017840.V343278.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 Hailey House DS0000017840.V343278.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): 3. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People’s needs are fully assessed prior to admission so the individual and the home can be sure the placement is appropriate. EVIDENCE: On the day of this visit family members of a person considering moving into Hailey House visited, they were given a brochure and documents detailing facilities provided and fees payable and were given a guided tour of the premises including bedrooms that were available. From discussion with the manager it was evident that families of prospective residents usually made the initial contact and visited the home as most admissions came from hospital. The registered manager reported she visited people considering moving into Hailey House either at home or in hospital to make a detailed assessment to ensure that the home was able to meet the individual’s needs. This Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 9 assessment combined with the Social Services assessment of needs (COM5) formed the basis of the individual’s care plan. Residents reported that whilst the process of leaving their own home was a traumatic experience the kindness and understanding of the manager and staff at Hailey House made the process easier to bear. People told the inspector they remembered staff spending time sitting with them and discussing individual likes and dislikes and providing comfort for them. Hailey House DS0000017840.V343278.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): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care people receive is individualised and based on their assessed needs. EVIDENCE: The care plans for the people living at Hailey House covered all areas of the care and support necessary to keep individuals safe and comfortable. The daily recording provided far more information about how individuals wished their personal support to be delivered. For example daily records for one person living at the home included detail that the person liked to have the bedside light left on at night, preferred to have a duvet than blankets and where the commode should be positioned. This information had not been transferred into the care plan. Areas of personal care that had historically been an issue were identified in the initial assessment. Files contained good detail of where specific support was required such as one person was ‘anxious’ in the bath. The care plan included Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 11 information as to exactly how this person needed to be reassured and ways to minimise and manage any distress. The daily records and care plans were maintained separately, this meant it was difficult for the care plans to be used by the care staff as effective working documents. The layout of the home limited the amount of space available, care staff were writing daily records in the kitchen. Records relating to healthcare appointments and visits were contained in the care plans. People living at the home with confirmed that they receive regular chiropodist treatment and are supported to see the GP or optician when the need arises. Relatives reported that the home kept them informed of any healthcare issues. Healthcare professionals praised the staff team for the care delivered to the people living at the home and reported that there had never been any concerns with the care provision at the home. People living at the home gave positive feedback regarding the personal care provided. One person said, “They work very hard – I have no complaints about the staff at all. They seem to know what they are doing.” The home operated a key working system. The key workers undertook the monthly reviews of individuals care plans; there was evidence of relatives input into the care plans in some cases. The medication policy covered ordering, storing, administering and disposal of medication and had been developed since the previous inspection visit to include guidance on ‘homely remedies’ and the covert administration of medication. Senior carers administered medication and all had recognised medication administration training and competency assessment before undertaking the task. The Medication Administration Record sheets had gaps in recording meaning that it was not always possible to be sure that individuals had received their medication. When the medicine trolley was not in use it was stored in a locked clinic room where there was a refrigerator for medication requiring a lower temperature. Community nurses did insulin injections and dressings. Hailey House DS0000017840.V343278.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): 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use this service can expect encouragement to maintain contact with family and friends. EVIDENCE: Those residents who were able to express an opinion reported that they had choice within their day, are able to go to bed when they wished and rise when they wished. The home had no set programme of activities and care plans did not contain detail of what activities people had enjoyed through their lives. An activities co-ordinator visited the home twice weekly and involved those residents interested in ‘velcro’ darts, beanbags, quizzes, raffles, sing-along and I spy. Sometimes residents enjoyed being read to or having their nails done. An exercise session occurred weekly and every couple of months an outside entertainer visited the home. Some residents reported to the inspector that they would enjoy being taken out in the wheelchair occasionally, as many of them were familiar with the neighbourhood. The manager reported that this sometimes did happen however was limited due to the weather and availability Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 13 of staff. There were no activities scheduled for the afternoon of this visit, those people who did not have visitors were sitting with music playing in the background. Observation showed that there were many instances where staff were in the main lounge but made no contact with people sitting there. Where there was interaction pleasure was plain to see on the faces of the residents. People living at the home reported that their visitors were encouraged to visit at any time of the day and were usually made welcome with a cup of tea. There was no choice of menu for the main meal of the day, however it was reported that if any resident was not happy with the daily meal salad was always available as an alternative. Individuals spoken with were generally happy with this arrangement although one person reported that salad would not be an acceptable alternative for them. A choice of a hot snack or sandwiches was provided for afternoon tea, one resident reported, “at least they are edible” indicating that this person did not enjoy the food provided at the home. Some people living at the home voiced the opinion that the quality of the food had fallen; on the day of the visit there was a quality issue with the meat supply. The cook had cooked the meat slowly in a bid to overcome the fact that it was tough however this had not been successful. One resident was observed to make their views known about the lunchtime meal. A member of care staff listened carefully to the feelings of this person in a respectful manner. The manager and the cook discussed possibilities of changing food supplier in a bid to increase the quality. One family member voiced concern at the lack of choices offered and that vegetarian dishes were not available. Records were kept to show if people were eating an adequate diet. Records showed that people were not always receiving the daily recommended 5 portions of fruit, vegetables or salad. Discussion was held with the registered manager around the provision of fresh fruit juice and other ways of introducing fruit and vegetables into the diet with a view to reducing the amount of laxative medication that were being taken by people living at the home. Hailey House DS0000017840.V343278.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): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living at Hailey House felt able to express their concerns however could not always be confident they were protected from abuse. EVIDENCE: There had been no complaints or concerns received by the home or the Commission for Social Care Inspection since the previous visit. A discussion was held with the registered manager about recognising complaints and using them as a positive tool to drive the quality of the service provision forward. One example being that of a carer who was observed listening respectfully to a resident who had not been at all happy with the quality of the lunchtime meal. The manager agreed that current practice would not have included this issue as a complaint. The complaints policy was seen displayed on the wall in the entrance hall. People living at the home and their families with were comfortable that they knew whom they would talk to if they were concerned about anything. Guidance was available on ‘whistle blowing’ and training records showed that some staff had received POVA training. Staff confirmed they had received information on recognising abuse and how to report any suspicions. Records provided subsequent to this visit indicated that the registered manager, one member of care staff 3 domestic/catering staff and the handyman had not Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 15 received training/refresher training in the Protection of Vulnerable Adults. Since this visit registered manager has ensured that these staff members viewed a video about adult protection and some of these staff have been booked to attend a training course at the end of July. Hailey House DS0000017840.V343278.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): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Hailey house provides a homely environment that needs some improvement to maintain the safety and the quality of life of the people living there. EVIDENCE: The building is an old grade 2 listed property and had a quirky layout with rooms on different levels. Individuals’ rooms were decorated individually and had bright duvet covers and curtains The home employed 2 handymen to cover 5 days per week; on the day of this visit minor repairs were taking place in various areas of the home. The previous report from June 2006 identified that a bathroom was being refitted, this bathroom was still out of use and the refit had not taken place at this visit. Two other bathrooms viewed were functional but tired decor with Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 17 stained flooring and not designed attractively to encourage people to use them. The carpet on the upstairs landing had stretched and there were lumps and creases that could cause a trip hazard. Some carpets in the bedrooms were stained, it was reported that these carpets had been thoroughly cleaned and the stains would not lift. It was noted during a physical tour of the building that lack of suitable storage is a big issue for the home. Zimmer frames were placed in a resident’s room whilst the hairdressing room was in use, the hallway was cluttered with wheelchairs and equipment and incontinence pads were noted piled up in people’s bedrooms. The hairdressing room was only large enough to wash hair so drying and setting peoples’ hair was done in the main lounge area. Hairspray was seen to cause discomfort to some people. Communal areas were comfortably clean and the home generally had a homely appearance and atmosphere. The people living there reported that “the home was kept very clean and there were fresh towels daily”. Hailey House DS0000017840.V343278.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): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Hailey House are supported and cared for by a team of experienced and caring staff. EVIDENCE: No new staff members had been recruited since the previous visit to Hailey House as the staffing levels had remained stable, the manager reported that a recruitment drive was now underway to fill one vacancy outstanding. Care staff reported that there were sufficient staff for afternoon shifts however the people living at the home would benefit from more staff in the morning as people sometimes had to wait for support. Recruitment files for two established staff members were sampled and these contained evidence of enhanced Criminal Record Bureau disclosures and one file contained two references, the second file sampled only contained one reference. The registered manager reported that she has been undertaking an audit of all staff files and where some of the staff team had been working at the home for many years it had not been possible to obtain retrospectively some of the information required by current regulations. Family members reported that the staff team were very capable and effective. People living at the home were generally satisfied that the care they received Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 19 met their needs however some people reported there were times when they had to wait a short time for staff support and attention; this was observed to happen during this visit. A training matrix was made available subsequent to this visit that showed the training courses attended by staff. Moving and handling, fire and abuse awareness training had been provided for the care staff team. The handyman, catering and domestic staff had not been provided with training necessary to their roles such as Protection of Vulnerable Adults and Fire safety. The handyman had not received object lifting and handling, some staff responsible for food preparation had not attended food hygiene and some domestic staff had not attended infection control training. The home employed sixteen care staff; eight of these had achieved NVQ 2. It was reported that the more established care staff were not inclined to embrace NVQ 2 training. Hailey House DS0000017840.V343278.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): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Hailey House can expect to enjoy a home run in their interests and managed by a competent person with appropriately supervised staff. EVIDENCE: The manager is a qualified nurse who has undertaken a recognised certificate in management. She has worked at the home for several years and provides a stable and informal management approach. Residents, relatives, care staff and visiting professionals all speak highly of her. Quality assurance questionnaires were distributed to the people living at the home and their relatives annually. The registered manager reported that the healthcare professionals surveyed did not respond. The relatives’ questions Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 21 covered areas of environment, personal care, catering and management, more than 50 of those who responded were ‘quite satisfied’ with the service their relatives were receiving. The registered manager was not able to demonstrate how the results of this survey served to improve the quality of the service provided for the people living at the home. This appears to be a paper exercise rather than a process to continually improve the quality of the service provision. A discussion as held with the manager about including the staff team in the annual quality assurance survey. It was reported that a ‘mini’ survey had been conducted recently around the furnishings etc within the home. The registered manager was reminded that a copy of the results of the annual survey should be published and made available to current people living at the home, people considering moving into the home and submitted to the Commission for Social Care Inspection. The registered manager reported that staff supervision sessions had not been as regular as they had been and was aware that she must ensure staff receive a minimum of bi monthly supervision. Records seen of supervisions that had taken place were appropriate. Maintenance and safety certificates were inspected at random for the fixtures, fittings and equipment in the home and found to be in good order. The manager has undertaken safe working practice risk assessments. These should be kept under review. There was no evidence that policies and procedures were kept under regular review and these were not easily accessible to staff or visitors. The manager experienced difficulty finding the medications policy when it was requested at this visit. Hailey House DS0000017840.V343278.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 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 2 X 3 Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP9 Regulation 13 (2) Requirement Timescale for action 30/06/07 2 OP15 16(2)(i) 3 OP18 13 (6) When medication is administered to people living at the home it must be clearly recorded to ensure that people receive the correct levels of medication. • People should be more 31/08/07 involved in deciding what they eat. • The quality of food supplies to the home need to be monitored. • People living at the home should receive a balanced diet to include sufficient quantities of fresh fruit, salad and vegetables. All persons working at Hailey 31/08/07 House must receive training in the Protection of Vulnerable Adults to promote the safety and well being of the people living at the home. Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 Refer to Standard OP12 OP16 Good Practice Recommendations Activities should be tailored to each person’s needs and preferences. The person in charge needs to train the staff team to recognise complaints and to understand their effectiveness in improving the quality of services provided for the people living at Hailey House. Stained carpets in residents’ rooms should be thoroughly cleaned or replaced if the staining is permanent. The person in charge needs to send the commission a summary of the completed quality assurance survey together with a plan detailing the actions to be taken to improve the service provision. Staff should have one-to-one supervision at least six times a year to help with their professional development for the benefit of people living at the home. 3 4 OP19 OP33 5 OP36 Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Hailey House DS0000017840.V343278.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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