Inspection on 14/03/06 for Hallfield Guest House

This inspection was carried out on 14th March 2006.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hallfield Guest House 26/03/07

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Hallfield Guest House 50 Hall Street Stockport Cheshire SK1 4DA Lead Inspector Kathleen Mcall Announced Inspection 14th March 2006 10:00 Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 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 Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hallfield Guest House Address 50 Hall Street Stockport Cheshire SK1 4DA 0161 456 6502 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) Independent Options (Stockport Limited) Elizabeth Cunliffe Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 6 service users to include: *up to 6 service users in the category of LD (Learning Disability). The ratios of care staff to service users must be determined according to the assessed needs of residents and in accordance with guidance issued by the Department of Health. N/A Date of last inspection Brief Description of the Service: Hallfield Guest House is a care home that is owned by Independent Options (Stockport) Limited and is one of two short stay homes that provide respite care to service users with a learning disability. Hallfield Guest House is registered to accommodate up to six service users between the ages of 18 and 65 years at any one time. Service users are referred to as guests and are encouraged to see their break at the home as a holiday. The property is a large three storey detached building. Accommodation comprises of six bedrooms with en suite facilities, five are situated on the first floor and one on the ground floor. A separate bathroom with a bath is also available for those service users who prefer a bath. The kitchen is situated on the ground floor, along with a large comfortable lounge area and a separate dining room area. There is car parking space to the rear of the property and garden areas situated to the front and side of the building. There is ramp access to the front of the property. Hallfield Guest House is situated close to the town centre with good access to cinemas, local shops, library and park. Stockport town centre, motorway network and public transport are easily accessible. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over an afternoon and early evening period. The registered manager accompanied the inspector throughout the inspection process. Care plans, assessment documentation, medicines and their storage were examined. The inspector met several residents, and two members of staff who were in the home at the time of the inspection. Seven service user comments cards were returned; all seven cards indicated that service users liked living at the home. All seven indicated that they felt well cared for, that staff treated them well and that their privacy was respected. Seven user comment cards said that the home provided suitable activities that they enjoyed the food provided. Six service users said they felt safe and one didn’t answer. Six service users said that they knew who to speak to if they were unhappy with their care and one said that they did not know who to speak to. In response to the question do you wish to be more involved in decision making within the home? Two service users said yes, three said sometimes and two did not respond. Service user comments included, ‘I love Hallfields and all the staff’. Eight relatives comment cards were returned; all eight indicated that they were satisfied with the overall care provided. All eight cards indicated that relative felt they were made welcome at the home at any time. Seven said that they could visit their relative in private and one did not answer. All felt that they were kept informed of important matters concerning their relatives. Six cards indicated that relatives were aware of the home’s complaints and two said that they did not know about the procedure. Seven had never made a complaint and one had. Six cards said that there was always a sufficient number of staff on duty, one answered no and one did not answer. Relatives’ comments included the following, ‘cannot fault anything…it is like going from home to home.’ Another said ‘ I cannot praise the staff more, they are wonderfully kind, my son really enjoys his stay’. And ‘my wife and I are very pleased with Hallfield Guest House and the quality of the staff. Our daughter…looks forward to her breaks at Hallfield. Everything is first class.’ What the service does well: Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 6 Hallfield Guest House offers comfortable, homely accommodation; service users are encouraged to enjoy their stay at the home and to view their time spent at the home as a short holiday break. The home is clean, spacious and well maintained throughout with specialist equipment in place to assist service users to maintain their independence. The staff group at the home is a trained, experienced and competent group who are supervised and supported by the registered manager. Procedures for the recruitment of staff, training and support were well established within the organisation. Assessment and care planning procedures in the home are very good. Service users were complimentary about the time they spent at the home and said that they enjoyed the food and appeared to be well cared for. 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. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 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 Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 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, 4 and 5 The arrangements for choosing to stay and confirming the terms of the stay at Hallfield Guest House were satisfactory. EVIDENCE: Independent Options had a Statement of Purpose for Hallfield Guest House and a Service User Guide, which was produced in both written and pictorial format for service users and their relatives. Service users care needs were fully assessed before they could access the services of Hallfield Guest House and risk assessments were completed as part of the process. Service users, their families and significant professionals were involved in the assessment process and social work assessments were obtained. Collectively all assessment information was reviewed to establish if the home was able to meet a service users needs. The home did not offer a place to a service user unless they were completely satisfied that they were able to meet the service users needs. As part of the inspection a selection of service user files were examined. Assessments were detailed, comprehensive and provided sufficient information in respect of each service user. Service users were able to visit the home prior to staying, visits could include the service user staying for tea or lunch. Several visits could be organised over a period of time depending on individual service users needs. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 9 ISA’s (Individual Service User agreements) were in place for those service users new to the service, these were signed by the service user or by a relative. The majority of service users at Hallfield Guest House previously accessed the services of Harwich Close. It was observed that Individual Service Users Agreements on the files of longstanding service users were several years old. The registered manager had a discussion with the inspector and advised that staff from Stockport Metropolitan Borough Councils Adult and Community Directorate and Adult Social Care did not routinely update ISA’s on an annual basis and that cases open with ongoing social work input tended to be reviewed and up dated. All service users were given a copy of the Service User Guide that detailed the terms and conditions of their stay, which for the purposes of meeting this standard was acceptable. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Service users health and personal care needs were identified through care planning and met by care staff. EVIDENCE: A total number of sixty-nine service users accessed the services of Hallfield Guest House. The registered manager was in the process of reviewing all service users care plans as part of a plan to introduce a new comprehensive and detailed style care plan. At the time of the inspection forty-two care plans had been reviewed. Care plans that had been reviewed and those recently drawn up for new service users were detailed and individualised to each service users’ care needs. Care plans were reviewed every six months or sooner depending on a service users input to service. Care staff had responsibility for reviewing care plans and this occurred when a service user was visiting the home. In addition to care plans each service user file had an ‘important points checklist’ which summarised a service users likes, dislikes, presenting risks, their weekly timetable of events ie day care attendance, arrangements for monies and a brief summary of the care plan. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 11 Care planning and assessment documentation and processes were interlinked. Service users’ were encouraged to make their own decisions and choices whilst staying at Hallfield Guest House. Service user meetings were not routinely held due to the constant change in the service user group at the home, however service users were regularly consulted during their stay on issues such as how they would like to spend their time. Staff also discussed individually with service users what food they would like at mealtimes and how they would like to spend their evening and weekends. Risks were considered and identified as part of the assessment process. Specific risk assessments were in place to address moving and handling issues, and a fire risk assessment was completed in respect of each service user. Risk assessments were reviewed every six months. Since the last inspection the registered manager had introduced new risk assessment documentation, as the previous format had not provided sufficient detail on risks and the management of risks identified. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15, 16 and 17. Service users were able to take part in appropriate leisure activities and were a healthy diet. EVIDENCE: Service users could stay at the home for up to a two-week period of respite, though frequently service users stayed for shorter periods of time. Consequently any activities engaged in prior to their admission were continued, this may be attendance at day care, adult education or one to one support from support workers. All the service users had a single room and if they wished to they could spend time alone. Service users were encouraged to continue to participate in activities that they enjoyed at home. There were a small number of service users whose first language was not English and their cultural needs were met by care staff. There were plans to install broadband for service users interested in computers and information technology. Records of what activities service users’ had participated in were recorded on care plans, continuation sheets or in the homes communication book. Letters accompanied service Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 13 users home thus informing relatives and carers of how they had spent their time during the visit. Service users who visited Hallfield Guest House for a short break usually lived with a main carer or long-term adult placement carer, consequently the time service users spent at Hallfield Guest House was as much for the carers as it was for the service user and, as such, service users may not receive visits from family and friends. The home did not have a set menu, meals were planned around the group of service users visiting the home, and it was the usual practice of the home that the meal choice was discussed with the service users. Records of choices were kept. Halal meat was purchased from an appropriate butcher to support those service users who required a Halal diet. Depending on their abilities, service users were encouraged to make drinks and snacks for themselves. At the time of the inspection service users were offered a choice of three meal options for their evening meal. Service users told the inspector that they had enjoyed their meal and that meals provided were good. Staff were on hand to assist service users during mealtimes if required. At the time of the inspection, the Inspector observed staff interacting with the service users, in a warm, relaxed and positive manner. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users received personal support in privacy and in a way in which they preferred and their health needs were met during their stay. EVIDENCE: Detailed assessments were undertaken prior to admission and information obtained was transferred to a care plan. As part of the assessment process service users likes and dislikes were recorded, and their preferred styles of receiving personal care. All service users had a single room and personal care was given in privacy. Whilst resident at the home service users had access to a GP and other health services. The home accepted pharmacy filled dosettes, nomads, and blister packs or would dispense medication directly from original packaging or bottles. Medication was stored appropriately and medication records were accurately maintained. Staff with responsibility for the administration of medication to service users needed to update their medication training. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 15 Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home responded to complaints in an appropriate manner. Staff had undertaken training in adult protection, which ensured the protection of service users. EVIDENCE: The home had a complaints policy and procedure, which responded to complaints made by service users and by relatives on behalf of service users. There had been two complaints since the last inspection. The registered manager had introduced a new complaints record that detailed the complaint and how this had been resolved. Complaints records were stored separately. The home had a policy and procedure for responding to allegations of abuse. A large proportion of the staff group had completed training in adult protection and there were plans for the remaining staff group to also complete the relevant training. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 17 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, 29 and 30. The home was well maintained and provided comfortable living accommodation for service users. EVIDENCE: The home provided comfortable, spacious accommodation and was well maintained throughout. A number of service users rooms were seen, these were also furnished and equipped to a comfortable standard. The grounds and garden areas were kept tidy, safe and accessible. At the time of the inspection the home was clean, tidy, bright and airy throughout and was free from any unpleasant odours. Service users had the use of specialist equipment if required to maximise their independence. Service users had access to the kitchen and could make light snacks and drinks if they wished. All bedrooms had ensuite shower, washbasin and toilet facilities. There was also a bathroom with a bath for those service users who prefer a bath. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 18 Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 19 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 and 36 The home was sufficiently staffed with a competent staff group that was safely recruited and trained to undertake their duties. EVIDENCE: A selection of staff files were seen at the inspection. Files seen were well organised and structured. All files contained a job description with a person specification for senior care staff positions within the organisation. Independent Options had a designated person with responsibility for training and development of staff within the organisation. Each member of staff had a training and development plan. Training completed by staff included protection of vulnerable adults, epilepsy, written communication and basic sign language. 45 of care staff employed at the home held an NVQ qualification in care or an equivalent qualification. There were sufficient staff on duty to meet the assessed needs of service users. A staff rota showing, which staff were on duty and in what capacity, was kept at the home. Several members of staff had transferred from Harwich Close to Hallfield Guest House and one member of staff said that he enjoyed Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 20 working at the new premises and that the facilities provided at Hallfield Guest House were much more pleasant to work in. Since the last inspection six new members of staff had commenced employment at the home; the registered manager had followed appropriate recruitment procedures. Staff recruitment files were also well organised, these included a full employment history since leaving school and all care staff had a contract which detailed the terms and conditions of their employment. All new staff completed and six-month induction period with a review at the end, before being offered a permanent contract of employment. Independent Options had an induction programme and policy in place. All staff that did not hold a professional qualification were expected to complete an induction and foundation portfolio. This could either be the Learning Disability Award Framework (LDAF) or the Skills for Life Induction. Staff received regular supervision to support them in their work and records of such meetings were made available at the time of the inspection. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 and 42 The home had a qualified and competent manager, who supported and directed the staff group. EVIDENCE: Ms Elizabeth Cunliffe was appointed as the registered manager on the 19th July 2005. Ms Cunliffe is responsible for the ‘short breaks service’, which includes Hallfield Guest House and 55a Beech Avenue. Ms Cunliffe is qualified, competent and experienced to run to home. She holds a Masters Degree in Social Work, a Diploma in Social Work, an assessor’s award and holds the registered managers award. Effective quality assurance programmes were in place, which sought the views of service users, their relatives and other significant stakeholders. Independent Options used the PQASSO (Practical Quality Assurance System for small organisations) to review and monitor its ongoing performance. Independent Options had a number of means of obtaining service user feedback, these included service users feedback forms that were available in word and pictorial formats. A service users forum, which was held on a Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 22 quarterly basis throughout the year and informal feedback from service users’ and families, was also taken into account. In addition to this a newsletter for staff, carers and service users was produced that provided up to date information on developments within the organisation. The service manager also undertook quality reviews of the service. A business strategy plan and an annual plan were published annually and made available to service users and significant others. A number of policies and procedures were in place and many were reviewed on an annual basis to take into account any changes in legislation. Staff had updated their training in safe handling and moving procedures, fire safety and first aid; however a number of staff needed to up date their health and safety training. The home complied with the requirements of the fire authority and maintained records in respect of fire safety at the home. The home recorded information in respect of accidents by service users. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 X 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 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 4 32 2 33 3 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 4 3 X 2 X Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 2 Standard YA6 YA20 Regulation 15 13 Requirement The registered provider must continue to update all service users care plans. The registered provider must ensure that staff with responsibility for the administration of medication to service users receive appropriate training in medication administration. The registered provider must ensure that staff update their training in health and safety. Timescale for action 14/08/06 14/10/06 3 YA42 13 14/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA32 Good Practice Recommendations The registered providers should continue to work towards 50 of care staff trained to NVQ level 2. Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Hallfield Guest House DS0000064383.V284282.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!