Inspection on 05/07/07 for James Hince Court

This inspection was carried out on 5th July 2007.

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

James Hince Court 11/12/09

James Hince Court 10/05/06

James Hince Court 23/11/05

James Hince Court 22/06/05

James Hince Court 22/03/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE James Hince Court Windsor Gardens Carlton-in-Lindrick Worksop Nottinghamshire S81 9BL Lead Inspector Richard Ramsden Unannounced Inspection 09:45 5th July 2007 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service James Hince Court Address Windsor Gardens Carlton-in-Lindrick Worksop Nottinghamshire S81 9BL 01909 733821 01909 541108 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) Nottinghamshire County Council Mrs Julie Ann Bromilow Care Home 45 Category(ies) of Dementia (35), Dementia - over 65 years of age registration, with number (35), Old age, not falling within any other of places category (10), Physical disability (5) James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 35 DE - 55 years and over (to include 35 DE(E) to be accommodated in either Rufford, Carburton, Clumber or Welbeck. 10 OP to include up to 5 PD 55 years and over to be accommodated in Thoresby. The total number of residents must not exceed 45 Date of last inspection 10th May 2006 Brief Description of the Service: James Hince Court is a purpose-built, single storey care home, providing personal care and accommodation for 45 residents. It is owned and operated by Nottinghamshire County Council Social Services. The home was opened in 1986 and is located in the middle of a housing estate in the village of Carlton in Lindrick, 3 miles north of Worksop. A day centre is attached to the home and is jointly used by social services and the local health authority as a specialist dementia assessment unit. The home is separated into five units each with its own kitchenette, dining and sitting areas, bathroom and toilet facilities. One of the units is designated to provide respite care. The home is surrounded by gardens, which are fully enclosed by fencing and provide a safe area for people to wander freely. The weekly accommodation charges for those residents who are self funding would be £377.00. A copy of the most recent inspection report is available in the home. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector completed this unannounced visit over one day it took approximately 10 hours. It included the inspection of care and other records, a discussion with the manager and a member of care staff. The inspector spoke with four residents and three relatives (one by telephone). Eight residents satisfaction questionnaires and twelve relative/advocates satisfaction questionnaires were received prior to the inspection. A partial tour of the building was also completed. Three residents were Case tracked, which means that their care plans were examined against the actual care they receive. The inspector also discussed the Commission for Social Care Inspections proposal to reduce some of the restrictions placed on the home’s registration categories. Prior to completing this visit the inspector assessed the homes service history, the Pre-inspection information provided by the home’s manager and the last two inspection reports. What the service does well: The people living at James Hince Court appear very satisfied with the services provided by the home. The residents who were able to express an opinion said that the staff are always friendly and respectful and ensure that their privacy and dignity is maintained at all times. The observed interaction between residents and staff was an excellent standard. All of the visitors who were spoken with confirmed that they could visit their friends or relatives in the home at any time. They said that the staff are always friendly and welcoming and that visitors are always offered refreshments. Two visitors stated that they are always kept fully informed about their relative’s health and welfare. Two residents said that they are very satisfied with their bedrooms and confirmed that they had been encouraged to personalise them with small items of furniture photographs etc. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 6 To residents, a member of staff and the visitors spoken with during the inspection said that the new manager is very approachable and that she cease their views about the way in which the home is run. There is an extremely high proportion of staff that have completed professional training. (This is good practice). There were many aspects of good practice highlighted in the main body of this report. What has improved since the last inspection? What they could do better: The information provided to prospective residents must contain sufficient, detailed information, to enable them to make an informed choice about whether the home will meet their needs and aspirations. The registered person must make sure that the preadmission assessment process ensures that the home will be able to meet residents cultural and communication needs. People should not be admitted to the home until a comprehensive written assessment has been completed. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 7 Minor improvements need to be made to the way in which medication is administered to ensure the health and safety of the residents. The records of all staff induction training must be available to ensure that the training is comprehensive enough to meet the needs of the residents. The home’s Fire records must be accurately maintained. 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. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3. The information provided to prospective residents does not contain sufficient information for them to make an informed choice about whether the home will meet their needs and aspirations. The pre admission assessments do not always contain sufficient information to ensure that the home will meet the needs of prospective residents. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Out of the eight resident satisfaction questionnaires received prior to this inspection seven people said that they did not receive enough information about the home before they moved in. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 10 The information provided to prospective residents was assessed during this visit; it did not contain sufficient information to enable them to make an informed choice about whether the home would be able to meet their needs and aspirations. Five residents stated in their satisfaction questionnaires that they had not received written contracts/terms and conditions of residence. All of the residents whose records were checked had a signed copy of this document on their individual personal files. It was identified that one resident’s race/ethnic origin was incorrect on the preadmission assessment, which had been completed by a social worker. The assessment did not give any information about whether this resident had any specialist cultural or linguistic needs. The manager stated that she had contacted the social worker to check these aspects of the residents needs prior to her admission to the home. However there was no written evidence to confirm this. When the inspector spoke with the resident she stated that she was very happy in the home and that she believed that the home staff are meeting all of her assessed needs. James Hince Court does not provide intermediate care. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Residents’ individual care plans appear to contain sufficient information and are updated frequently enough to ensure that staff are always aware of what support and assistance each resident requires. The home’s medication is generally well-managed and residents are treated with respect. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents’ care plans were viewed as part of this inspection, the care plans appeared to address the issues highlighted in the residents assessment process. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 12 All of the care plans had been reviewed and when necessary amended each month. Where possible residents have signed their care plans to confirm their involvement in the planning and review process. (This is good practice). Records show the residents’ health care needs are being appropriately met; this was confirmed by two of the relatives spoken with during the visit. The home’s medication systems have generally been very well maintained. None of the current residents have been assessed as safe to administer their own medication. Their records receipt and disposal of medication have all been well maintained. The medication is stored securely and an air-conditioning unit has been ordered to ensure that it will always be stored at the correct temperature. One resident’s medication administration records indicated that she had not been given one of her tablets on a number of occasions. The manager stated that this was probably because the resident was asleep and guidance for this medication suggests that a resident should not be woken to have the medication administered. The manager was advised that if medication which has been prescribed by a medical doctor, is not given for any reason, an explanation must be provided. All of the other medication records checked during this inspection, including the records of controlled medication had been well maintained. All of the residents spoken with, who were able to express an opinion, said that staff are friendly and respectful and ensure that their privacy and dignity is maintained at all times. The relatives who were spoken with during the inspection also confirmed this. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. The lifestyle experienced in the home appears to match the resident’s expectations and preferences. People are encouraged to maintain contact with their families and friends and the food provided appears wholesome and nutritious. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager stated that she is continuously looking for new activities and entertainment, which are suitable for the people living at the home. She stated that two members of staff are booked to attend specific training on providing activities for people with dementia on the 30th of June 2007. This was also confirmed by one of the members of staff spoken with during the inspection. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 14 The residents and their relatives spoken with during the inspection said that they are generally satisfied with the activities provided by the home. One relative said that a singer was booked to entertain the residents on the evening of this inspection and that he would be returning later to participate in the entertainment with his wife. Residents and their relatives confirm that visitors are made welcome at any time. One resident said that she could see visitors in her bedroom or use one of the communal areas if you wish to speak to them in private but does not wish to use her bedroom. All of the visitors stated that the staff are very friendly. The manager stated that she tries to provide an environment, which encourages residents to make choices. Individual residents’ care plans also give details of how residents can be encouraged to make decisions about their daily lives. There are regular residents meetings, minutes of which were observed during this visit. The lunch on the day of this inspection appeared wholesome and nutritious. One resident said that she is very satisfied with the food provided by the home. She confirm that there is always a choice of food and that if she does not want the meal suggested on the menu an alternative will be provided. At the time of inspection the manager was in the process of updating the recently revised menus to include pictures of the food, which would help residents to make individual choices. (This is good practice). James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. The home has a robust accessible complaints procedure and staff are ensuring that residents are protected from abuse. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is prominently displayed throughout the home. The Commission for Social Care Inspection has received one formal complaint, which was returned to the registered person to be investigated using the home’s complaints procedure. The manager had also received one formal complaint. Both of these issues had been thoroughly investigated and appropriate action taken. The manager is now keeping a record of all informal complaints and concerns to provide an overview of the nature and frequency of complaints received. (This is good practice). The residents spoken with, who were able to express an opinion, confirmed that they would contact the manager or a senior member of staff if they had James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 16 any concerns or complaints. They believe that their concerns would be dealt with appropriately. The manager stated that all members of staff receive training in safeguarding adults as part of their induction. She confirmed that all staff training was being reviewed at the time of this visit and that where necessary refresher training will be provided. The member of staff spoken with during this visit was aware of the home’s Whistle Blowing Procedure and of her responsibility to report any incidents of abuse. There have been no allegations of abuse in the home in the last 12 months. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. The accommodation has been maintained to a reasonable standard it was clean and hygienic at the time of this inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the premises was completed as part of this inspection. The purpose-built accommodation has been maintained to a reasonable standard. Shortly prior to the inspection some areas of the home had been flooded, due to the severe weather conditions. These areas were not in use at the time of inspection and some residents had been moved to alternative accommodation. Some newly fitted carpets had been damaged as a result of the flooding. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 18 One visitor said that his wife was finding it very disruptive having to move to an alternative lounge area. However he did accept that this was only a temporary measure and that she would be able to return to her usual lounge once remedial work had been completed. The residents’ bedrooms viewed during the visit were comfortably furnished and people had clearly been encouraged to personalise the rooms with photographs, ornaments and small items of furniture. All of the residents spoken with, who are able to express an opinion, stated that they liked their bedrooms and confirm that they can use them at any time. The call system was tested in one-bedroom and was answered promptly by staff. Some relatives stated that the garden area is looking poorly maintained. This was difficult to assess, on the day of inspection, due to the very poor weather conditions. The manager stated that a group of people completing community service were in the process of tidying the gardens but that there work had been hampered by the poor weather conditions. All of the residents and visitors spoken with during the inspection confirmed that the home is always clean and free from offensive odours. The home has a comprehensive infection control policy. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Sufficient staff are being employed to meet the assessed needs of the residents, the homes recruitment policies and practices are generally supporting and protecting residents. The registered person was able to demonstrate a commitment to staff training and development. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota provided prior to this inspection and to those viewed for the week of this inspection showed that sufficient staff are being provided to meet the assessed needs of the residents. One relative stated that the home sometimes appears to be short of staff however they could not identify any areas where resident’s needs were not being met. They stated that sometimes relief or agency staff do not always know all of the residents names. This was discussed with the manager who stated that wherever possible the agency staff are employed who have worked in the home on many occasions where new staff are employed they are supported by experienced members of staff. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 20 All new members of staff complete an appropriate induction-training programme. However it was noted that one member of staff who had transferred from Nottinghamshire County Councils Home Care Services did not have a copy of her induction training and consequently it was not possible to assess whether she had completed all the required elements of the training. The staff training records show that out of a total of 36 in care staff 24 have completed NVQ level 2 or above and nine people were completing the training at the time of inspection. (This is good practice). The home follows Nottinghamshire County Councils recruitment policies and procedures, which include aspects of equal opportunities to ensure that there is no discrimination. The manager did however state that they have had considerable difficulty in recruiting male members of staff. The personal records of two members of staff were assessed as part of this visit. With the exception of one person’s induction training records, the staff records had been maintained to a very good standard. The manager confirmed that staff do not commenced employment until all the required information has been obtained. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. The home is well managed and run in the best interests of the residents. Where checked the health and safety of residents and staff are generally promoted and protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A new registered manager has been appointed since the last inspection the new manager is experienced and well qualified having completed the registered managers award. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 22 Residents, staff and visitors said that the manager is very approachable and that she seeks their views about the way in which the home is run. Quality monitoring systems are in place and the manager was in the process of using the information gathered to produce a development plan for the home. The manager was reminded that the development plan must address any individual issues highlighted by residents in the quality review process. Staff do manage some residents’ personal allowances, the records were checked at random and were well maintained. The aspects of health and safety, assessed as part of this visit had generally been well maintained. The homes fire risk assessment had been reviewed in May 2007, however the records of the homes emergency lighting tests indicated that these had not been completed in February, April, May or June 2007. The inspector was informed that the tests had been carried out each month but that the records had not been completed. Nottinghamshire County Councils health and safety department complete a health and safety inspection of the home on a regular basis. James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N0 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 OP1 Regulation 5 Requirement All prospective residents must be given sufficient information about the home to enable them to make an informed choice about whether the home will meet their needs and aspirations. The information must include: 1. A copy of the most recent inspection report summary. 2. A copy of the complaints procedure. 3. The residents’ views of the home. The registered provider shall not provide accommodation to a resident at the care home unless the needs of the resident have been assessed by suitably qualified or suitably trained person. The assessment must include details of peoples cultural and linguistic needs where appropriate. Failure to provide a comprehensive assessment could result in people being admitted to the home when an appropriate DS0000035527.V336229.R01.S.doc Timescale for action 31/08/07 2. OP3 14 (a) 05/07/07 James Hince Court Version 5.2 Page 25 3. OP9 13(2) 4. OP30 18 (c) Schedule 1. (3). 5. OP38 23 (4) Schedule 4 (14) service cannot be provided. Staff must sign medication 05/07/07 administration records every time the medication has been given to the resident for whom it was prescribed. If the medication is not given for any reason, an explanation must be provided.(The use of codes is acceptable for this purpose.) The registered person must keep 05/07/07 a copy of all staff inductiontraining records to provide evidence that the training will enable the staff to meet the needs of the residents. The home’s emergency lighting 05/07/07 must be tested at least once each month & the results of the tests must be accurately recorded in the homes fire records. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 James Hince Court DS0000035527.V336229.R01.S.doc Version 5.2 Page 27 - 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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