Inspection on 09/08/05 for Halliday Square, 57

This inspection was carried out on 9th August 2005.

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

Halliday Square, 57 24/05/07

Halliday Square, 57 27/11/06

Halliday Square, 57 24/07/06

Halliday Square, 57 30/12/05

Halliday Square, 57 16/08/04

Halliday Square, 57 14/04/04

Halliday Square, 57 10/10/03

Halliday Square, 57 12/05/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Halliday Square, 57 Windmill Park Estate Southall Middlesex UB2 4UQ Lead Inspector Jane Collisson Unannounced 9 August 2005 at 11.30 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 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 Stationary 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. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Halliday Square, 57 Address Windmill Park Estate 4UQ Southall Middlesex UB2 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 813 8222 0208 813 8228 National Autistic Society Care Home 6 6 Category(ies) of (LD) Learning disability registration, with number of places Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16/4/04 Brief Description of the Service: 57 Halliday Square is a home for six service users with autistic spectrum disorders, including one who has an additional physical disability. The National Autistic Society manages the service and the premises are owned by Notting Hill Housing Trust. The home is located on a housing estate, at the end of a row of terraced houses, and is purpose built. The centres of West Ealing, Ealing Broadway and Southall can be reached by public transport from the nearby Uxbridge Road. There are two local shops on the estate, which is near to Ealing Hospital. The communal facilities consist of a ground floor lounge, large dining room and a kitchen. There are additional lounges of the second floor, one used as an activities area. All of the bedrooms are single and located on the first and second floors. There are three bathrooms, one on each floor. The home has its own seven seater transport. The home has an Acting Manager, who also manages a home for two service users about a mile away. There is a Service Coordinator for each of the houses and a joint staff team. The staff provide support with personal care, practical tasks and activities. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection commenced on the 9th August 2005 from 11.30am. An additional visit was made on the 17th August at 2.45pm to meet all of the service users. Four members of staff, including the Acting Manager, were met. The inspection took a total of five hours. Halliday Square is run jointly with a home for two service users in Hanwell and the service users from that home were also present on the second visit. Documentation examined included the staff and service users’ records. What the service does well: What has improved since the last inspection? What they could do better: Although risk assessments have been completed for most of the identified hazards, some are required to have further details about the level of risk and how the risks may be minimised. The fire risk assessment needs to be improved, including information regarding the service users who smokes. An examination of some of the staff records showed that not all of the employment records and references had been coordinated to show the dates of employment and gaps were noted in employment histories. The health needs of the service users appeared to be being met, with appropriate referrals and appointments. However, in one file, the outcomes of referrals could not be seen to be recorded and a system of monitoring, to ensure this is carried through, needs to be in place. Although information is in place for the service users and their representatives to know about the services and facilities provided, the Statement of Purpose could be streamlined to make it easier to read and it is recommended that this is carried out. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 6 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. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 4, 5 Information is available to the service users about the facilities and services available in the home, in formats which suit their needs. However, some streamlining of the information would make it easier to access. The needs of the service users are being kept under review to enable their changing needs to be met. EVIDENCE: The Service Users Guide is available in five pictorial formats to meet the different communication needs of the service users. A glossary of the terms used in the documentation is included to assist the service users to understand the terminology used. The information required to be included in the Statement of Purpose is contained in the organisation’s Mission Statement and has been updated to include details about the new staff and Acting Manager. In its current format, it contains more information than that required by Schedule 1 of the Care Home Regulations 2001 and, as a summary should be included in the Service Users Guide, it is recommended that it is revised to make it more user-friendly. Service users have information about the terms and conditions in the home, which are contained in the Service Users Guide and in a format which they are able to access. It is planned that some changes will take place in the home to accommodate the needs of one of the service users who requires ground floor accommodation. This will mean that the office is located elsewhere and, while the accommodation for the service user will not be any larger, easier access Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 9 will enable the service user to remain in the home. The needs of the other service users are kept under review to ensure that the home can continue to meet their needs. A comprehensive programme of training in autism enables the staff to support the special needs of the service users. Information on the admission criteria is contained in the Statement of Purpose but, as no new service users have been admitted, this was not assessed. A six month trial period is offered to new service users to ensure that the placement is suitable and this will include an assessment from the National Autistic Society. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 8, 9, 10 Service users are consulted about their daily lives and efforts are made to ensure that the routines that they prefer are maintained. EVIDENCE: Each service user has their care plan and a sample of these showed that all aspects of their support are considered and guidance is in place, where required, to meet specific individual needs. Targets are set for the service users to work towards and those seen included support to improve literacy and motivation. Daily notes are written in each service user’s dairy, three times a day. These indicated that the service users are involved in day-to-day activities and interests outside of the home. Activities included visits to pubs, cafes and a church and, with the LEAP day service, swimming and bowling. Consultation takes place with service users over most aspects of their lives, including the menu, activities and holidays. The service users generally enjoy regular routines and staff try to ensure these are maintained. Each of the service user has a board which shows, visually, their chosen activities for the day. A menu folder with photographs helps the service users to choose their meals. One service user chooses not to attend day services and this is respected. Service users are asked to take part in a survey to obtain their Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 11 opinions about new staff. One service user was seen to be supported to consider taking an unaccompanied walk from the home. For the service user’s safety, staff have guidance in place should the service user not return within the time agreed. Other guidelines were seen on independent travel plans. Although a variety of risk assessments are in place, not all follow the same system and some had not been completed to show the level of risk or how the risk will be minimised. For ease of use by staff, these could be standardised and need to be fully completed. Files are stored in the ground floor office, and there is a lockable cupboard in the dining room where staff have access to files that are used regularly. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15, 17 Service users have the opportunity to participate in a variety of activities and leisure pursuits and to maintain regular contact with their families. A good variety of meals of seen, with service users being encouraged to make choices by the use of visual prompts. EVIDENCE: Service users are offered the opportunities for personal development and are encouraged to participate in the running of the home, although not all choose to do so. Each has the opportunity, one day a week, to carry out individual tasks, usually with the support of their key worker. This may include personal shopping and going out to lunch. Each service user has a daily planner with details of their activities and efforts are made with visual prompts to ensure that service users are aware of what is happening in the home. The National Autistic Society provides a day service in Acton, called LEAP, which is attended by five of the service users. The Acting Manager said that it is hoped that the National Autistic Society will shortly be setting up services for service users with Asperger’s Syndrome to provide for their specialist needs. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 13 The home is located on a housing estate between West Ealing and Southall where there are limited opportunities for community involvement, although there is a local shop which is used by the service users, three of them independently. Leisure activities enjoyed by the service users include visits to the Fountain Leisure Centre for swimming. The home has its own transport. The hobbies of service users are accommodated wherever possible. A computer is available in the home which one service user particularly likes to use. One service user enjoys DIY projects and there is sufficient space for this work to take place and examples were seen. Four service users had chosen to go, with the service users from Golden Manor, to a holiday at an activity centre in September. Holidays abroad had been accessed last year. Contact with families is encouraged and several service users remain in close contact, taking holidays and outings with their relatives. There is sufficient space in the home for private meetings. A good variety of meals was seen to be provided, with the service users having input into choosing them. The menu is chosen weekly, using photographs and recipe books to encourage variety. A member of staff was cooking a meal of Indonesian beef noodles on the second visit to the home. Service users have the opportunity to help if they wish to do so and were observed to be helping themselves to snacks. Meals taken by individual service users are recorded to show the diet provided. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21 Service users’ health needs appear to be being met with appropriate referrals and appointments to health professionals being recorded. However, some further monitoring is required of all of the records to ensure that the outcome of any referral is fully documented so that it can be evidenced that these have been followed up and attended. EVIDENCE: Because of the disabilities of the service users, their emotional needs are met by the staff team working within the person’s own individual needs which are well documented. Staff were seen to discuss with service users the possible outcome of activities they wished to undertake and to support them with the decisions made. Their physical needs are met by access to community services, such as general practitioners. A psychologist is employed by the National Autistic Society to provide support where it is required. Referrals have been made to specialist services and one service user had attended a session at a pain clinic. However, in one of the service users’ files examined, the outcomes of two referrals were not seen to have been recorded. Further monitoring needs to take place to demonstrate that all referrals are followedup and that recording takes place of the outcomes. All of the service users are in a younger age group and most have family members who would be able to support them with their decisions in the event of serious illnesses. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 22, 23 Information in the Service Users Guide supports the service users to understand the complaints procedures and how they can be protected from abuse. EVIDENCE: Service users are given the opportunity to be aware of the complaints procedure by copies being displayed around the home in different formats and information contained in the Service Users Guide. There were no recorded complaints. Several of the service users have families or an advocate who could support them if there were any concerns. One possible adult protection issue was not raised with the London Borough of Ealing’s adult protection department and this procedure needs to be carried out should any future issue arise. An internal investigation concluded that it was not an adult protection matter. The Service Users Guide includes information, in accessible language, for the service users regarding the various aspects of protection and what they should expect from staff and others. Staff have received recent in-house training on adult protection. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 16 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 standard(s) 24, 26, 29, 30 The home provides a bright and pleasant environment, with communal spaces for the service users to pursue their activities and for relaxation. EVIDENCE: The home is light and spacious with sufficient communal space for the service users to enjoy varied activities if they wish to do so, although staff said that service users generally prefer to use the ground floor lounge. There is a large dining room, which overlooks the garden. The Acting Manager said that new valves has been fitted to the radiators to enable them to be turned off in warm weather, which had been a previous concern. One service user was happy to show her bedroom, which had many personal items. Staff said that service users tend to enjoy staying in their rooms and pursuing their own interests, which is respected. There are three bathrooms for the use of the six service users, two with showers, which meet the needs of the service users. All but one of the service users have good mobility. Changes are planned to ensure that the service user can remain in the home by providing a downstairs bedroom and moving the office to the top floor. The Housing Association is Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 17 requiring Occupational Therapy input to ensure the room is suitably converted but there has been difficulty in accessing this professional support. There is part-time domestic worker employed and the home was found to be clean and well maintained. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 34, 35 The staff recruitment procedures and records need to be improved to demonstrate that service users are protected by a robust recruitment process. EVIDENCE: Each shift has a member of staff responsible for overseeing the tasks, such as medication administration, which have to be completed during the shift. An examination of the staff rota showed that there are two staff on each early shift and three on the later shift. Shifts run from 7.30am to 10.30pm and, at nights, there is one waking staff member and a staff member who sleeps in. All of the staff undertake the comprehensive National Autistic Society induction which provides information on all aspects of autism and associated disabilities. The Acting Manager said bank staff are included in the training to ensure that they understand the needs of the service users. Agency staff have had to be used to cover the staff vacancies but they have tried to ensure that regular staff have been used for continuity. New staff were in the process of being employed to fill vacancies. The staff team, who provide cover at both the Halliday Square and Golden Manor homes, are managed from Halliday Square where the staff records are maintained. A sample of these were examined. The Acting Manager said that the records were in need of reorganisation and this was due to be carried out. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 19 There were employment histories which were not complete and references did not always have the dates the staff member was employed, making this difficult to identify any gaps in the work record. The references and employment histories need to be coordinated to ensure that there are no unidentified gaps in the person’s work record. Currently there is one member of staff with NVQ Level 2, who will be commencing Level 3. Three other staff had almost completed the qualification or other staff are about to start. Staff supervision takes place on a regular basis and is carried out by the Acting Manager and the Service Coordinator. The Acting Manager said that she monitors the records and will raise any relevant issues with the staff member concerned. The records were not examined on this occasion. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 42 The systems for providing better service user representation are being examined with a view to being extended and improved. EVIDENCE: The Acting Manager has worked in the home for four years but has also been involved in working for other National Autistic Society homes during this time. The Registered Manager left in 2004, and the National Autistic Society had been unsuccessful in appointing a new manager after four recruitment drives but, following this inspection, has recently appointed a manager who is due to commence in December 2005. The Acting Manager, who is one of the Senior Coordinators, has an NVQ in care, and is undertaking the Registered Manager’s Award and the A1 NVQ Assessor’s Award. The manager and staff have a good understanding of the support which is required for the service users and there is a pleasant atmosphere, with a good rapport observed between service users and staff. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 21 The Acting Manager explained that ideas for involving and representing the service users’ views are being considered at the present time and she is working with the managers of other homes to see how this can best be achieved. Although a fire risk assessment was in place, it was inadequate for all of the possible hazards, including information regarding the service user who smokes. The finances for Halliday Square and Golden Manor are jointly maintained but were not inspected on this occasion. A short development plan, for the year May 2005 to May 2006, has been produced for the two services. Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Halliday Square, 57 Score x 2 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 2 x G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 Page 23 NO 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. 1. Standard 9 Regulation 13 (4) (a) (b) & (c) Requirement Risk assessments must be completed for all areas of activity where a risk is identified, with the level of risk assessed and the action taken to minimise the risk. Further monitoring of service users files is required to ensure that the outcomes of all health issues are fully documented to show that action has been taken appropriately. All potential adult protection issues must be reported to the London Borough of Ealings Adult Protection department. The recruitment processes must be improved to ensure that full information is obtained regarding staff employment records. The fire risk assessment must be fully completed, to include information regarding the service user who smokes. Timescale for action 15/10/05 2. 19 12 (1) (a) & (b) 31/10/05 3. 23 13 (6) 15/9/05 4. 34 13 (6) 19 (1) (c) & (4) (c) 23 31/10/05 5. 42 15/10/05 Halliday Square, 57 G61-G10 s27708 Una-Halliday Square v239273 090805 Stage 4.doc Version 1.40 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. Refer to Standard 1 Good Practice Recommendations That the Statement of Purpose is revised to make it more user-friendly, and in line with Schedule 1 of the Care Homes Regulations, so that a summary can be included in the Service Users Guide. 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