Inspection on 22/11/05 for Hillside

This inspection was carried out on 22nd November 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillside 04/08/06

Hillside 03/08/05

Hillside 21/12/04

Hillside 03/08/04

Hillside 07/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hillside 82 Pinner Road Oxhey Hertfordshire WD19 4EH Lead Inspector Hazel Wynn Unannounced Inspection 22nd November 2005 9:00 Hillside DS0000019428.V271724.R01.S.doc Version 5.0 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 Hillside DS0000019428.V271724.R01.S.doc Version 5.0 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. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hillside Address 82 Pinner Road Oxhey Hertfordshire WD19 4EH 01923 245 466 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) Watford and District Mencap Mrs Amanda Richards Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 11 people with learning disability - 8 in Pinner Road and 3 in 4 Hillside. 3rd August 2005 Date of last inspection Brief Description of the Service: 82 Pinner Road This is a detached building providing personal care and accommodation for eight people who have a learning disability. Three of the service users live a more independent life in a self-contained flat that is situated on the first floor of the building. All other service users have single occupancy bedrooms in a purpose-built extension on the ground floor. The property has a small frontage with steps leading to the front door. At the rear of the property, the garden is mainly laid to patio. 4 Hillside Crescent This is a smaller mid-terrace property accommodating three service users who also live more independently. The property in close proximity to 82 Hillside Road and has a small rear garden. Both properties are managed and staffed by one staff team and is known collectively as Hillside. The home was first registered with Hertfordshire County Council in 1993. It is located close to Watford Town Centre that offers numerous amenities including Watford Town football stadium, theatres, a multi-screen cinema and a large undercover shopping mall. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 22nd November 2005. The inspector looked at records pertaining to the care and welfare of the service users and Health and safety records. A partial tour of the buildings was carried out and the inspector spoke with service users and the staff on duty. Most of the National Minimum Standards had been met. A requirement was made for Regulation 26 reports (reports of visits made by the proprietor or his representative) to be forwarded to the Commission for Social Care Inspection. One recommendation was made: To change the organisations headquarters address on the Statement of Purpose which had been updated to show the CSCI correct details after the last inspection but with the change of the organisations address will now need to be amended again and forwarded to the CSCI when printed. The staff were professional, friendly and supportive of the inspection and the service users were observed to be relaxed, content and well cared for and independently choosing to do chores and offer cups of tea. The environment was clean, fresh, homely and comfortable. This report covers both 82 Pinner Road and 4 Hillside Crescent in close proximity to the main house at No. 82; any reference that applies to one of houses only will be clearly stated as to which one the inspector is referring but in the main the report stands for both homes. What the service does well: The service supports the service users to have control over their own home and their lives and to make decisions and consider one another whilst having respect for themselves. Comprehensive, regularly reviewed care plans are in place and in a format appreciated by the service users; it is easily evidenced on reading through these that they are live documents and that all needs are met. The care staff plan in sessions known as “my time” which is one to one time when the service user can sit with their keyworker and discuss any issues or concerns they have or simply ensure they put forward their views regarding anything they wish to raise and the keyworker will then support them towards a resolve. The service users are supported to lead good quality lifestyles with using community resources to enjoy leisure opportunities on a regular basis. The opportunity to celebrate special events is optimised. Staff training, supervision and support has equipped the team with a good skill mix and competence to support both the service users and one another. Records are well maintained and Health and safety protocols are adhered to. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 6 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. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 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 Hillside DS0000019428.V271724.R01.S.doc Version 5.0 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): 1-6 Information is available to prospective service users about this service and would enable them to make an informed choice about where to live. Contracts/Agreements are provided to service users. Service users needs are fully assessed prior to placement. A service would not be offered if the assessment did not show that needs could be met. Any prospective service user and their family or representative would be invited to visit and test the home prior to accepting or being offered a placement. EVIDENCE: The service users have each been given an updated user friendly Service User Guide (this needs a correction to the organisation’s address, which has changed) as does the Statement of Purpose (which had been updated following the last inspection but now needs to show the organisation’s new address). A recommendation has been made to forward this to the CSCI when it has been amended. Where a vacancy arises, the current service users would be consulted regarding the suitability of a prospective service user living with them; the prospective service user would make frequent visits to the home (including overnight/weekend stays) as part of the assessment and transition process. Service users have a full and comprehensive assessment in place on their individual files. Service users have a copy of the Agreement on their individual files, which keyworkers have supported them to work through. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 - 10 Service users are fully involved with care planning reviews and they are supported to make their own decisions. The service users participate in all aspect of their life in the home and are supported to take risks. Confidentiality is guarded and individual records are securely stored. EVIDENCE: A sample of care plans were scrutinised at this inspection and they contained a full and comprehensive assessment of service users personal needs, goals and aspirations and these are kept reviewed. The service user is present at his or her review and notes are maintained regarding their involvement in their reviews. The care plan folders provided evidence of how the service users are supported with an individual approach to make decisions. Service users influence how the home is run; each month the service users have structured time known as ‘My Time’, during this time their views are explored and action is taken; these meetings are recorded and copies were maintained on the individual files. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 10 Risk Assessments are carried out to support service users to live fulfilling and meaningful lifestyles within a risk management framework. Service users were observed taking part in domestic activities without any prompting and also offered the inspector cups of tea. The service users were interacting with staff in a relaxed and friendly manner throughout this inspection. Information about service users was observed to be securely stored. Confidentiality is protected; training in confidentiality is in place and a recognised induction process is also in place. Data protection policies and procedures were accessible in the office. ‘My Health’ folders, which are extensive profiles of the service users individual health status and needs, have been introduced and these provide a valuable addition to the care plan and can also be used independently for health reviews and monitoring of health. Five had been completed and the remainder are in the process of being completed. Comprehensive, regularly reviewed care plans are in place and in a format appreciated by the service users; it is easily evidenced on reading through these that they are live documents and that all needs are met. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 - 17 The service promotes personal development and the service users take part in age, peer and culturally appropriate activities and leisure activities both at home and in the local community. Personal, family and sexual relationships (where the latter develop) are supported. Rights and responsibilities are recognised and respected in the service users daily lives. Mealtimes are enjoyed with the supply of healthy diets. EVIDENCE: The service users are supported to continuously develop life and social skills and this is evidenced in their progress records and care plans. Individual records contain evidence of a wide variety of activities both at home and in the local community as well as further afield and service users relayed the activities they had been enjoying recently when taking part in this inspection. One service user had been on holiday with her boyfriend supported by staff, a small group had enjoyed a holiday in Denmark whilst others enjoyed a holiday at Hayling Island and also Derbyshire. Family and friends are very much involved in the service users lives and some were planning to spend time with their families and friends over the Christmas period. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 12 The service users are supported to exercise their rights and be respectful of others; the “my time” sessions are an excellent tool for supporting the ongoing development of this area and evidence was seen at this inspection of the frequency of these sessions. The dietician visits monthly to support the service users in managing to choose a varied and healthy menu. The service users said they enjoy their meals and choose what they want to eat but like to follow a healthy diet. Dining arrangements were observed to be comfortable. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 -21 Personal support is provided in accordance with the individuals’ needs and preference. Physical and emotional needs are met. Service users are supported to retain and administer their own medication wherever possible; policies, procedures and protocols are in place to support this. Ageing, illness and death are handled with respect and in accordance with individual’s wishes. EVIDENCE: Evidence was obtained from talking to service users, studying documentation and from discussions with staff that service users are supported to be as independent as possible and to have control over their own lives. Staff approach to service users, during the inspection, was seen to be warm and appropriate. Dignity and respect was very evident throughout this inspection, from observations and documentation recorded. Dignity and respect is high on the agenda of this home and staff would ensure that service users’ health care is provided, by community professionals, with dignity and respect; the effort that has gone into diligently completing the ‘My Health’ booklets evidences this. Health care needs are clearly detailed in the individual user-friendly care plans and met in accordance with individual need; progress notes evidenced how health care needs are met. ‘My Health’ folders, are extensive profiles of the Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 14 service users individual health status and needs which have been introduced and these provide a valuable addition to the care plan and can also be used independently for health reviews and monitoring of health. Five had been completed and the remainder are in the process of being completed. Comprehensive, regularly reviewed care plans are in place and in a format appreciated by the service users; it is easily evidenced on reading through these that they are live documents and that all needs (physical, social and emotional, communication needs and developmental needs) are met. One resident has full control over her medication and another receives some assistance from staff; this is kept reviewed and policies, procedures and protocols were in place. Medication was well managed and records accurately kept. Policies and procedures are in place in relation to ageing illness and death. Staff reported on the support that they were providing for a service user who was in hospital at the time of this inspection and this support was also clearly evidenced in her personal notes. The final wishes of the service users are noted on their individual care plans. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 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 the following standard(s): 22 - 23 Service users do feel that their views are listened to and acted on and they are protected from all forms of abuse, neglect and self-harm. EVIDENCE: As evidenced earlier in this report, the service users views are listened to and acted on. Service users are actively encouraged to air their views during the one to one “My Time” sessions and action is taken as evidenced in the records for any issues to be corrected. There had been no complaints recorded since December of last year when a complaint had been dealt with appropriately and in accordance with the homes policy and procedure. Thorough risk assessments with guidance to staff were in place on the individual files scrutinised and these were part of the systems in place to ensure that service users are protected from self-harm, all forms of abuse and neglect. Staff training in abuse awareness, policies and procedures and health and safety protocols are all in place to provide safeguards. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 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 the following standard(s): 24, 25 and 30 The home is homely, comfortable and provides a safe environment. Service users’ bedrooms suit their lifestyles and needs. The home is maintained in a clean and hygienic condition. EVIDENCE: There is a programme of maintenance at the home and quotes have been obtained for some extensive work to be carried out in the laundry room used by the service users. At the last inspection the service users chose the colours for the kitchen to be redecorated in the kitchen of Hillside. New carpet was been laid in the hall, stairs and lounge approximately 12 months ago. Number 4 Hillside had a new washing machine and a fully fitted kitchen and a new hall carpet fitted last year. At the last inspection, one of the bedrooms had been decorated to the service users preference and a new fire alarm system had been installed. Fire records were scrutinised and well maintained with regular checks taking place; the fire safety system is checked and serviced appropriately by a company contracted to carry out the work and the certificates are maintained in the fire safety manual. The liability insurance was seen to be current up until 31st March 2006. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 17 There are adequate bathing and toilet facilities to meet the assessed needs of the service users and these offer sufficient personal privacy; these were seen to be clean and hygienic and well maintained and a bathing aid had been serviced. The area of the home toured were observed to be comfortable and homely. There were no mal odours and the home was clean and tidy. Risk assessments have been carried out on the environment and these are kept under review. A safe environment is maintained with sufficient safe and fully accessible shared space for activities. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 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 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 - 36 There is clarity of staff roles and responsibilities, which benefit the service users. A competent and qualified staff team provides support, to the Service users both individually and jointly. Ongoing training is appropriate to meet the needs of the service users. The home’s recruitment policies and procedures support and protect the service users. The staff team is well supported and supervised. EVIDENCE: Evidence of training was seen during the inspection. The home’s policies and procedures manual was accessible on the office bookshelves. Training was discussed with two senior care staff who reported that they were working towards level 4 NVQ and would use the evidence of supporting this inspection in their submission of competence evidence. One member of staff (the most recent recruit) has completed LDAF induction programme and is currently making progress at Level 2 NVQ. The staff stated that they were a very cohesive team that worked well together and that they enjoyed working at Hillside with the service users whom they are very fond of. There have been no new recruits since the last inspection when the staff files where checked and found to meet the regulations and National Minimum Standards. Recruitment procedures offer protection for vulnerable Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 19 adults and evidence of the robust recruitment and thorough checks was evidenced at the previous inspections. The staff stated that they receive plenty of support both from the manager and from one another and that they receive monthly supervision and annual appraisal. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 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 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 - 43 Service users benefit from a well run home that has a good ethos and leadership; the registered manager’s approach is good. The service users have a strong sense of ownership and know that their views underpin the reviews and developments of the home. The proprietor’s visit is not evidenced by the Regulation 26 reports. The service users best rights and interest are safeguarded by the home’s policies and procedures with the exception of the Regulation 26 visit reports. The health, safety and welfare of service users are promoted and protected and they are protected from the accountable and competent management, at the home level, of the service. EVIDENCE: The home has consistently been operated with a management approach that creates an open, positive and inclusive manner and this was observed to be evident at this inspection; further comments can be found under the staffing section of this report. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 21 The service users views strongly dictate how the home is run and developed and this is evidenced earlier throughout this report. The records scrutinised included: fire records, service users financial records, medication records, progress notes and care plans, progress notes and reviews, equipment serving records, insurance certificate, health journals, complaints records, fire safety records and service users financial records, training and supervision records, menus and rotas these were clear, accurate and up to date. The records have been reported more fully in various sections of this report. A sample of service users accounts and finances was checked as part of this inspection process and was found to be transparent, well recorded and accurate. See the Personal and Healthcare support section for the evidence that service users health, safety and welfare are promoted and safeguarded. The concerns, complaints and protection section of this report, provides evidence of how well they are safeguarded. The service users are supported to exercise their rights and be respectful of others; the “my time” sessions are an excellent tool used for supporting the ongoing development of this area and evidence was seen at this inspection of the frequency of these sessions. The service users family and friends/representatives are also fully involved as a unified league in the overseeing of this service and its developments. The Regulation 26 visit reports have not been regularly received this year and a requirement made at the last inspection and has again been brought forward this time. Enforcemnt action maybe considered if this requirement is not complied with by the new timescale provided. A recommendation is also made that when the amendments have been made to the statement of purpose and service user guide (showing the new address of the organisation) this should be forwarded to the CSCI. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 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 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hillside Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 1 3 3 3 3 DS0000019428.V271724.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA39 Regulation 26 (5) (a) Requirement The proprietor or his agent must provide the regulation 26 visit report after each months visit to monitor and audit as part of the quality assurance requirement. The reports must be forwarded to the CSCI. This requirement has been brought forward from the last inspection. Timescale for action 30/12/05 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 YA1 Good Practice Recommendations When the statement of purpose and service user guide has been amended to show the organisations new address, please forward this to the CSCI. Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Hillside DS0000019428.V271724.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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