Inspection on 15/05/07 for Hothfield Manor Centre

This inspection was carried out on 15th May 2007.

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

Hothfield Manor Centre 01/06/09

Hothfield Manor Centre 02/04/09

Hothfield Manor Centre 02/03/09

Hothfield Manor Centre 15/11/05

Hothfield Manor Centre 07/06/05

Hothfield Manor Centre 11/03/05

Hothfield Manor Centre 14/12/04

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

CARE HOME ADULTS 18-65 Hothfield Manor Centre Church Lane Hothfield Ashford Kent TN26 1EL Lead Inspector Mrs Sue Gaskell Key Unannounced Inspection 15th May 2007 10:30 Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 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 Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hothfield Manor Centre Address Church Lane Hothfield Ashford Kent TN26 1EL 01233 643272 01233 611433 information@hothfieldmanor.co.uk www.hothfieldmanor.co.uk Hothfield Manor Limited Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Keith Lionel Hutchinson Care Home 21 Category(ies) of Physical disability (21) registration, with number of places Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION 4onditions of registration: 1. One older person Date of last inspection 15th November 2005 Brief Description of the Service: Hothfield Manor Centre is a care facility registered to provide accommodation, personal care and support for up to 24 adults with a physical disability. The fees range from £900 - £1400 per week. The Centre specialises in the provision of care to people who have an acquired brain injury. The accommodation is in two specific areas, these being 12 single bedrooms in the Manor House and 12 single bedrooms in terraced chalet bungalows within the grounds. Some of the bedrooms have en-suite facilities. Five of the chalet bungalows are for 2 people and 1 bungalow as been constructed to enable 2 people to experience supported independent living. The Home has well maintained garden available for residents’ use, and adequate car parking space within the grounds. The Centre is located approximately 5 miles from the town of Ashford. The Home has its own transportation and there is a shop/post office within walking distance. Staffing comprises of a Registered Manager, Assistant Managers, support staff, a cook, domestic staff, gardeners and a administrator. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 15th May 2007 between 10.30 and 15.30. There were 19 people living at the home and there are two vacancies. I spoke to five residents, the registered manager, and five members of staff. Some residents have limited communication and therefore I mixed with residents and staff for a while in order to see whether the residents appeared relaxed and comfortable. I toured the building and looked at all communal areas. Three residents showed me their bedrooms. The inspection process also consisted of information collected before and during the visit to the home, and feedback from three care managers after the site visit finished. Other information seen included pre-admission assessments, various risk assessments, care plans, medication records, the duty rota and staff recruitment and training records. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. What the service does well: The home prepares clear and comprehensive care plans, which assists staff in providing consistent and appropriate care. The food is varied, nutritious and well presented. Staff are well trained and well supported. The home provides a homely, safe, clean environment. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 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 Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People who use the service experience excellent outcomes in this area. The statement of purpose, service user guide and individual statement of terms and conditions, clearly says what service will be offered. Prospective residents can be confident that their needs will be assessed and can be met This judgement has been made using available evidence including a visit to this service. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 9 EVIDENCE: All residents have been issued with a service user guide and “welcome pack”. Residents also are issued with individual agreements stating their terms and conditions of residence. The service user guide states that the home will respect and promote the well-being or all service users, regardless of different disabilities, ages, racial, cultural, religious or sexual needs. I spoke to two residents who have been admitted to the home since the previous inspection. They said that they had been given a lot of information on the home prior to moving in and had been able to meet staff. Both resident’s files contained a detailed and comprehensive pre-admission assessment. One resident said that staff had been to visit him in his own home and then he had made several visits to the home prior to moving in. Two residents’ care managers said that the home had made every effort to help the residents settle in. Another care manager of a third resident said that the home had been very sensitive to the particular needs and circumstances of his client. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use the service experience excellent outcomes in this area. The care plans are easy to use and descriptive. Residents’ choices are respected and their decision-making is well supported. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 11 EVIDENCE: Four care plans were examined in detail. They are clearly set out and indexed. The files include residents’ personal profiles, mobility, dietary and other assessments and the residents’ likes and dislikes. There are also guidelines on how the home will assist residents in achieving their short and longer term goals. Residents have key workers who monitor their individual needs and activities. One resident said that his key-worker has helped him understand, and contribute as much as possible to, the contents of his care plan. The staff and the manager made various references to individual residents’ needs and circumstances that indicated that the home promotes and supports equality and diversity. The manager said that this is taken very seriously. eg ensuring that the dignity afforded to residents with disabilities, and to those with not such obvious ones, is irrespective of their choice of lifestyle. One member of staff said that any agreements made with residents must be realistic and achievable so that the residents may feel able to sign up to the agreement. Residents and/or their relatives are invited to the annual or six monthly reviews and are asked what they think about their care. The records showed that the care plans are updated following the reviews or as and when their care needs change. Adequate risk assessments have been prepared for each resident’s needs or activities, and include specific guidelines on how to minimise any risk. Two residents said that they are encouraged to do their own cooking, shopping and laundry as they hope to move into more independent accommodation in the near future. The records showed that staff sign to acknowledge having read any important information or guidelines. Staff confirmed that issues relating to confidentiality are addressed during the induction period. All records are stored in a lockable office and there was no public display of confidential or personal information. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 People who use the service experience excellent outcomes in this area. Daily life meets the residents’ lifestyle preferences and expectations. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. This judgement has been made using available evidence including a visit to this service. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 13 EVIDENCE: The care plans contain a list of residents’ needs, likes and dislikes and preferences. There was evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed. One resident said that his mother would be coming to visit in the next few days. The home employs a number of staff with particular skills who help the residents participate in a range of activities, eg gardening. Staff said that they have to be flexible if residents’ needs change. Residents said that they have activities in the home such as table tennis, pool, quizzes and games and also enjoy going to the cinema, and out for pub lunches, shopping trips and other days out. The home is appointee for several residents, but the manager said that residents have individual bank accounts which are regularly audited, with appropriate receipts and records kept. Staff signatures are required for monies taken out when residents spend money on social activities such as going to the pub. The cook said that meals provided are mainly based on residents’ choices, but also take into account the need for a reasonably balanced diet. The store cupboard contained a wide range of good quality food including fresh fruit and vegetables. Nutritional assessments are carried out and residents are weighed monthly. The food served on the day of the inspection appeared appetising and wholesome and the residents said that it tasted good. Staff said that there are no residents at present with different ethnic or cultural needs but former residents have been assisted in following their religious beliefs, eg at a local mosque. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 People who use the service experience excellent outcomes in this area. Residents’ choices over their care are respected. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. Illness and death are addressed with respect and sensitivity. This judgement has been made using available evidence including a visit to this service. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 15 EVIDENCE: I met with three residents either in private or when they showed me their rooms, and spoke to several more in passing. All of the residents were seen to be relaxed and comfortable interacting with staff and there was good humoured but respectful banter. Residents care plans and daily records referred to clear guidelines on providing support and monitoring health care and social care needs. There was evidence to show that residents had been referred for specialist help whenever necessary. The manager and all members of staff showed a high level of awareness of residents’ needs and referred to a variety of issues, such as the importance of ensuring that residents’ needs are treated with sensitivity or that they have a suitable room and the right equipment. One of the bungalows is equipped to make it more usable for people with a disability and residents are provided with a range of equipment, eg specialist beds and hoists, to help them be more mobile and independent. There is regular input from speech and language therapists, eg for swallowing or communication, physiotherapists, the continence advisor and the District Nurses. Residents are also referred for specialist help if they have other health care needs such as diabetes, epilepsy, or pressure areas. Staff referred to sharing further information found on the internet. The home keeps good records of GP’s and district nurses’ visits etc, together with any subsequent advice. The home has sound medication procedures. Staff confirmed that only trained may administer medication and that all staff are required to read the procedures stored in the medication file. There is a risk assessment procedure for assessing whether residents are able to store and/or administer their own medication. A staff member explained that this includes checking with residents to see whether they are aware of the type and dose of the medication and also whether the residents are able to take it at the right time. Medication is stored securely and appropriately. The medication records are clear and current and there is a system for the receipt and disposal of medication. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 16 The deputy manager explained how issues around illness and end of life are managed with great care and sensitivity. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good outcomes in this area. Residents can be confident their complaints will be listened to and dealt with appropriately and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents said that they would feel very comfortable talking to staff, are aware of what to do if they wish to complain, and would tell staff about anything they are not happy with. The home has a complaints procedure and complaints forms are available for residents and/or their families. Some of the residents have difficulty with verbal communication but the manager and staff said that every effort is made Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 18 to ensure that residents can communicate their feelings through other methods. The home has adult abuse procedures in place. The records refer to specific training on adult protection awareness training and staff confirmed that they have received training on recognising and reporting any form of abuse. The training matrix showed that eight staff have yet to complete this training. Staff said that they are aware of the company’s “whistle blowing procedures. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People who use the service experience good outcomes in this area. Residents live in a homely,comfortable and safe environment. Residents have all the equipment they require to enable them to be as independent as possible. The home is hygienic and clean. This judgement has been made using available evidence including a visit to this service. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 20 EVIDENCE: The “manor house” has a large and small lounge, dining room and other seating areas. The bungalows have a lounge/diner, kitchen and bathroom. All residents have their own single rooms where they can display their own effects such as pictures and ornaments, and have their own TV, DVD player etc. All bedrooms and living areas are furnished and decorated to a reasonable standard, and contained the type of furniture and equipment necessary to provide a homely environment. Three residents said that they are pleased with their bedrooms and said that they had been asked how they would like the furniture arranged. Although there is an on-going programme of re-decoration, some bedrooms, eg 10 and 12, would benefit from attention. There is an alarm call system throughout the buildings. The garden is attractive and well-maintained. There are various seating and patio areas provided with garden furniture that is used by the residents and their visitors. Staff showed a good awareness of health and safety issues and all areas were seen to be clean and hygienic. There is a separate laundry area with commercial type washers and driers. There are disposable hand drying towels and pump soap dispensers to reduce the risks of cross infection. The home is generally well maintained. Maintenance certificates are current and the home has recently been awarded a “gold award” by the Environmental Health Officer. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 People who use the service experience excellent outcomes in this area. Staffing, in terms of both numbers and competency, is appropriate to the current needs of the residents. Residents are protected by the Home’s sound recruitment procedures. Staff are well trained and supported and morale is high This judgement has been made using available evidence including a visit to this service. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 22 EVIDENCE: The four staff files that were examined included evidence of sound recruitment practices. Staff said that all staff must be CRB checked and have verbal and written references taken up prior to their employment. There is a comprehensive induction training for core issues and then further on-going training. NVQ training is encouraged and more than 50 of the staff either have, or are studying for, an NVQ2 or 3. Recent training has included first aid, food hygiene, fire safety, moving and handling, and medication. Staff said that they are encouraged to identify any particular training needs and referred to sourcing information for specific medical conditions. Staff confirmed that they receive regular supervision either from the manager or other senior staff, and there was evidence of this in staff files. Staffing at the time of the inspection consisted of the registered manager, deputy manager, team leader, support assistants, administrator and cook. Staff said that extra staffing has always provided if there is a necessity. The staff group has remained stable in the past twelve months and the manager said that residents have benefited from this, eg in providing a stable and consistent environment. Staff referred to the high level of team-work, and on-going support from the manager and managing director for work and personal issues affecting their work. The home has previously achieved the “investors in people” award, and the assessor for this award was carrying out interviews with staff at the time of the inspection Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use the service experience excellent outcomes in this area. The home is well run in a manner that encourages the development of clients. There are regular quality assurance and safety checks to ensure that the home is run in the best interests of the clients and their safety and welfare is protected and promoted. All areas are clean, hygienic and well maintained This judgement has been made using available evidence including a visit to this service. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager has extensive experience and recognised care and management qualifications. The management of the home and completion of records are generally of a good standard with daily records regularly checked by the registered manager. There are further checks by the managing director as part of the monthly regulation 26 reports. Staff said that the home is run for the residents and that residents are regularly asked for their views and feelings about activities, meals and how things are done. This is either through clients’ meetings or through questionnaires for residents, and/or their families, and staff. The questionnaires include questions on satisfaction with personal support, staff attitudes, complaints and the comfort and cleanliness of the environment. A report of the feedback from the questionnaires is produced and circulated to residents, visitors and staff. Residents confirmed that any suggestions or feedback are acted upon. Other quality assurance methods include an annual business plan. Staff said that the manager and managing director are supportive and that staff morale is good. The manager was very ready to praise the staff team. There were no obvious hazards around the home and there was evidence to show that health and safety issues are taken seriously eg staff ensuring that personal items were appropriately disposed of and warning signs in place for wet floors. The maintenance file contains current certificates to show that regular checks eg gas, electricity, are carried out. Risk assessments on the environment, and for activities off site involving residents, have also been prepared. Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 25 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 4 2 4 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 4 4 X 4 X X 3 X Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA23 YA24 Good Practice Recommendations Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hothfield Manor Centre DS0000023445.V326774.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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