Inspection on 30/01/07 for Kibworth Court Residential Home

This inspection was carried out on 30th January 2007.

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

Kibworth Court Residential Home 20/12/05

Kibworth Court Residential Home 13/05/05

Kibworth Court Residential Home 29/10/04

Kibworth Court Residential Home 27/05/04

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 Kibworth Court Residential Home Smeeton Road Kibworth Beauchamp Leicestershire LE8 0LG Lead Inspector Chris Wroe Unannounced Inspection 30th January 2007 10:00 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 Kibworth Court Residential Home DS0000001739.V325583.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. Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kibworth Court Residential Home Address Smeeton Road Kibworth Beauchamp Leicestershire LE8 0LG 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) 0116 2792828 0116 2793188 Firstsmile Limited Linda Robinson Care Home 40 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (40), Physical disability over 65 years of age (4) Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service user numbers. No person falling within category PD(E) to be admitted to the home when 4 persons of that category are already accommodated within the home. Service user numbers. No person falling within categories MD(E) or DE(E) to be admitted to the home when 4 persons in total of these categories/combined categories are already accommodated in the home. To be able to admit the person of category DE named in the variation number V11968 20th December 2005 2. 3. Date of last inspection Brief Description of the Service: Kibworth Court care home cares for forty older people in a purpose built property. It is set in the village of Kibworth Beauchamp, close to a variety of amenities. The premises consist of two floors, and residents have access to both floors with the use of the passenger lift or stairs. There are a variety of aids and adaptations in the home, based on individual residents assessed care needs. There are thirty-eight single bedrooms and one double bedroom, all with en suite facilities. There are additional toilet and bathroom facilities on both floors. The home has a garden to the rear of the premises. The current fee charges of the home range from £390 to £430 per week. Additional charges are made for hairdressing (from £3 to £10), chiropody (£10), newspapers, magazines and toiletries (various costs). Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection included a visit to the service. The visit was carried out by two inspectors, Chris Wroe and Helen Abel. The inspectors visited the home on 30th January 2007. The visit lasted for five and a quarter hours. The Registered Manager, Ms Linda Robinson, was not available on the day of inspection, but senior staff and a representative of the provider assisted the inspector during the visit. The inspectors used a method called ‘case tracking’ during the inspection. This means selecting a sample number of residents and looking at the care given to residents in different ways. The ways this was done are: • talking to the residents • talking to staff and the manager • watching how residents are given support • looking at written records. The inspectors spoke with a number of people who live in the home. The report includes the views of people who live in the home. In the main, residents in the home were happy about the care given by staff. They felt the home was comfortable and they have what they need. The Commission for Social Care Inspection has carried out a national pilot scheme of themed inspections in early January 2007. Kibworth Court was one home, which was randomly selected to have a themed inspection. This was carried out on 9th January 2007, and looked at the assessment process, information for residents before they come to live in the home, and complaints. For this reason, these areas were not looked at in this inspection. The information below is based only on those aspects checked in this inspection. Individual detail has been kept out of the report, to make sure it is kept confidential. What the service does well: Care plans are in place for residents, which are individually tailored to show the difference in dependency levels and in the needs and wishes of residents. Risk assessments are completed to make sure residents are kept safe. Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 6 Staff who give out medication have had training. The record keeping in relation to medication is generally good in the home. We observed medication being given to residents and recorded, and staff properly followed procedures. Residents we spoke with expressed the view that carers were sensitive to their needs. One said ‘the staff look after me well.’ Residents are able to make choices in their daily lives. There is a range of activities offered to residents. On the day of inspection the hairdresser visited the home, and in the afternoon some residents enjoyed a ‘sing-along’. Residents can have visitors to see them when they wish. Staff try to support residents to continue practising their religion if they wish to and help them to make contact with spiritual leaders from their faith. The home provides information in its Statement of Purpose about how staff will try to support people from different cultures and communities, including catering for differing dietary requirements. There is a racially diverse staff group in the home. The menus show that a varied and nutritious diet is given to residents and residents were observed enjoying a lunchtime meal. Residents mainly told the inspectors that they like the food, and that they are able to have a choice. The cook showed good attention to providing a good diet for everyone – including people with different dietary needs. The manager ensures that incidents of concern affecting residents are reported to the Commission for Social Care Inspection as required. Policies relating to protection of vulnerable adults are in place and have been reviewed since the last inspection. During the visit, the inspectors looked around at some parts of the home. We found all areas were clean and tidy with a good standard of hygiene. Residents are able to have their own possessions in their bedrooms, and residents commented that they found their rooms comfortable. There are pictures around the home to help people to orientate themselves. The manager makes sure that safety precautions and checks are carried out in the home. There is a fire risk assessment in place. Fire safety checks are carried out. There are systems in place for making sure laundry is done efficiently. The laundry is clean and in good conditions, with washing and drying machines which are fit for their purpose. Staff are recruited properly, and that the provider makes sure checks are carried out so that they can be confident that staff are safe to work with residents – such as Criminal Record Bureau checks. Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 7 There is an ongoing staff training programme in the home. Staff learn a range of different skills to help them to improve their ability to care for residents in the home. Staff have supervision to help to make sure they are carrying out their work well and are supported and trained. There has been no change in management in the home, and the manager continues to work to make improvements and review policies. Attention is paid to making sure that the quality of service provided in the home is good. Residents are asked in various ways for their views about the running of the home. The manager and the provider carry out their own quality assurance checks of different aspects of the service. The manager makes sure that any money held in the home for residents is looked after properly. Staff keep records and receipts of money spent on behalf of residents. The manager and staff make sure that the home is run properly, keeping residents safe. Staff have training in safety aspects, such as first aid, fire safety and health and safety. There are procedures in place, which tell staff how to work safely, and there are records of testing of equipment. What has improved since the last inspection? What they could do better: We noted three gaps in recording of administered medication for one resident, although this was not seen in other records checked. The manager does carry out regular checks of medication. Whilst the provider’s representative said that staff would be welcoming of people whatever their sexual orientation, there has not been attention paid to how the home might present itself as welcoming to people who are lesbian, gay, bisexual or transgender. The provider’s representative was open to ideas and advice from the inspectors about how to follow this up. It would be good if the provider took proactive steps to ensure the home was welcoming for people from all communities. One issue of concern was noted regarding a resident who had left the home in a confused state, and how this had been able to happened without staff Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 8 noticing. During the inspection, staff carried out an immediate check to make sure all alert systems were working properly, and follow up action was taken within twenty-four hours to make sure that there was no further risk to residents. One member of staff who provides occasional support in the home as a carer does not have up to date training in some legally required aspects, such as moving and handling, and some good practice areas, like dementia training – training should be provided for all staff. The provider needs to ensure that relevant training is provided to all staff who care for residents. 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. Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 9 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 Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good. This judgement has been made following a themed inspection carried out on 9th January 2007. Prospective residents at Kibworth Court would have access to a comprehensive package of information to help them decide whether or not to come and live there. Each resident at Kibworth Court has a written contract and/or a statement of terms and conditions. Before moving into Kibworth Court residents have their needs assessed. EVIDENCE: This aspect was not checked on this occasion, because a themed inspection was carried out on 9th January 2007, which looked at the key outcomes under this section. Kibworth Court Residential Home DS0000001739.V325583.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from mainly good attention to health and personal care needs. EVIDENCE: Care plans are in place for residents, which are individually tailored to show the difference in dependency levels and in the needs and wishes of residents. Risk assessments are completed to make sure residents are kept safe – in aspects such as moving and handling, and care pressure areas, and to cover individual issues of risk. There is a review sheet in each file, which is ticked monthly to confirm care plans have been reviewed. Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 12 During the inspection, two relatives raised some concerns with the inspectors. Since these were individual concerns, they have been kept confidential from the report, and have been followed up separately by the manager and provider, who gave feedback to the inspectors about how matters were resolved. Staff who give out medication have had training. The record keeping in relation to medication is generally good in the home. The manager has completed a training course in management of medication. She carries out regular audit checks of medication and records instructions for staff about any improvements needed. We noted three gaps in recording of administered medication for one resident, although this was not seen in other records checked. We observed medication being given to residents and recorded, and staff properly followed procedures. Residents we spoke with expressed the view that carers were sensitive to their needs. One said ‘the staff look after me well.’ Kibworth Court Residential Home DS0000001739.V325583.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents mainly benefit from a good lifestyle in the home. EVIDENCE: Residents are able to make choices in their daily lives. Some people like to get involved in activities such as bingo, quizzes, sing-along, and skittles. There is a weekly knitting group in the home. Some people prefer to spend time on their own or sitting with friends. One resident said she enjoyed going out in a wheelchair to the shops. Children from the local school come every week to spend time with residents. There are bigger occasional events held at the home, such as a pantomime at Christmas. During the inspection the hairdresser visited, and old time music was played in the afternoon for residents to join in with. Staff did spend some time with residents, although this may be limited at the moment because of staff numbers - resident numbers have recently increased and additional members of staff are currently being recruited. Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 14 Residents can have visitors to see them when they wish. They are able to see them in one of the lounges or in the privacy of their own rooms. Relatives were visiting residents throughout the day during the inspection, and the inspectors observed that they were made welcome. Staff try to support residents to continue practising their religion if they wish to and help them to make contact with spiritual leaders from their faith. The home provides information in its Statement of Purpose about how staff will try to support people from different cultures and communities, including catering for differing dietary requirements. There is a racially diverse staff group in the home. Whilst the provider’s representative said that staff would be welcoming of people whatever their sexual orientation, there has not been attention paid to how the home might present itself as welcoming to people who are lesbian, gay, bisexual or transgender. The provider’s representative was open to ideas and advice from the inspectors about how to follow this up. Relatives mainly handle the financial affairs of residents, or residents themselves have involvement. The menus show that a varied and nutritious diet is given to residents and residents were observed enjoying a lunchtime meal. Residents mainly told the inspectors that they like the food, and that they are able to have a choice. One person said that they felt there was a variety of food and that it was well cooked. One person said that they found the cooked vegetables too soft, and that sandwiches taken out of the fridge were sometimes too cold – the manager has looked into this and made arrangements to meet the individual’s needs. The cook showed good attention to providing a good diet for everyone – including people with different dietary needs, such as diabetes – providing the same choice of meals in an inclusive way, rather than providing a separate menu. Kibworth Court Residential Home DS0000001739.V325583.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 Quality in this outcome area is good. This judgement has been made following a themed inspection carried out on 9th January 2007. Residents, their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: Standard 16 was not checked on this occasion, because a themed inspection was carried out on 9th January 2007, which looked at the key outcomes under this section. Staff have ongoing training and awareness raising about safeguarding residents from harm and abuse. The manager ensures that incidents of concern affecting residents are reported to the Commission for Social Care Inspection as required. Policies relating to protection of vulnerable adults are in place and have been reviewed since the last inspection. One issue of concern was noted regarding a resident who had left the home in a confused state, and how this had been able to happened without staff noticing. During the inspection, staff carried out an immediate check to make sure all alert systems were working properly, and follow up action was taken Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 16 within twenty-four hours to make sure that there was no further risk to residents. Kibworth Court Residential Home DS0000001739.V325583.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a comfortable living environment. EVIDENCE: During the visit, the inspectors looked around at some parts of the home. A sample of bedrooms, bathrooms and toilets were checked. We found all areas were clean and tidy with a good standard of hygiene. Residents are able to have their own possessions in their bedrooms, and residents commented that they found their rooms comfortable. There are pictures around the home to help people to orientate themselves. Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 18 The manager makes sure that safety precautions and checks are carried out in the home. There is a fire risk assessment in place. Fire safety checks are carried out. There are systems in place for making sure laundry is done efficiently. The laundry is clean and in good conditions, with washing and drying machines which are fit for their purpose. Kibworth Court Residential Home DS0000001739.V325583.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents mainly benefit from a well-trained staff team and positive recruitment processes. EVIDENCE: The inspector checked a sample of staff records. These showed that staff are recruited properly, and that the provider makes sure checks are carried out so that they can be confident that staff are safe to work with residents – such as Criminal Record Bureau checks. There is an ongoing staff training programme in the home. Staff learn a range of different skills to help them to improve their ability to care for residents in the home. Recent training courses completed by staff include moving and handling, National Vocational Qualifications in care, and dementia awareness. One member of staff who provides occasional support in the home as a carer does not have up to date training in some legally required aspects, such as moving and handling, and some good practice areas, like dementia training – training should be provided for all staff. Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 20 Staff have supervision to help to make sure they are carrying out their work well and are supported and trained. Kibworth Court Residential Home DS0000001739.V325583.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well managed home. EVIDENCE: There has been no change in management in the home, and the manager continues to work to make improvements and review policies. Attention is paid to making sure that the quality of service provided in the home is good. Residents are asked in various ways for their views about the running of the home: for example, through questionnaires, and in residents Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 22 meetings. Relatives have written letters describing how staff have been supportive in looking after residents. The manager and the provider carry out their own quality assurance checks of different aspects of the service. The provider of the service also prepares reports for the Commission for Social Care Inspection on a monthly basis. The manager makes sure that any money held in the home for residents is looked after properly. Staff keep records and receipts of money spent on behalf of residents. The manager and staff make sure that the home is run properly, keeping residents safe. Staff have training in safety aspects, such as first aid, fire safety and health and safety. There are procedures in place, which tell staff how to work safely, and there are records of testing of equipment. Kibworth Court Residential Home DS0000001739.V325583.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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 X 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 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 3 Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP30 Regulation 18 Requirement The provider must ensure that all persons employed to work at the care home receive training appropriate to the work they are to perform Timescale for action 01/03/07 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 OP12 Good Practice Recommendations It is recommended that the provider looks proactively at ways in which to ensure the home is welcoming to people from all communities Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 25 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 Kibworth Court Residential Home DS0000001739.V325583.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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