Inspection on 22/01/07 for Langley Park Residential Home

This inspection was carried out on 22nd January 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

Langley Park Residential Home 17/11/05

Langley Park Residential Home 14/07/05

Langley Park Residential Home 24/01/05

Langley Park Residential Home 19/08/04

Langley Park Residential Home 01/03/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Langley Park Residential Home Front Street Langley Park Durham DH7 9YY Lead Inspector Mr Stephen Ellis Unannounced Inspection 22nd January 2007 2:00 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 Langley Park Residential Home DS0000007488.V325993.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. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langley Park Residential Home Address Front Street Langley Park Durham DH7 9YY 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) 0191 3735599 0191 3732674 Southern Cross Home Properties Limited Mrs Sharon Smith Care Home 46 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (22) of places Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a named individual as set out in a letter to the registered person dated 12th December, 2002, which establishes the basis for the individual’s needs to be met by the home. Where necessary, the home’s Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual who falls outside the registered category. 17th November 2005 Date of last inspection Brief Description of the Service: Langley Park is a residential care home, located in the centre of the ex-mining village of Langley Park, close to all local amenities. The home is provided by Southern Cross Homes Properties Ltd. and is registered to accommodate older persons (22) in one unit on the ground floor and older persons with dementia (24) on the first floor. It is not registered to accommodate older persons who require continuous nursing care. The home is a two-storey building, situated in its own grounds, with enclosed garden area and car parking at the rear. Personal accommodation and communal space is located on all floors. Service areas (e.g. kitchen and laundry) are located on the ground floor. There are 46 single bedrooms, all with en suite toilets and wash hand basins. All bedrooms are suitable for wheelchair users. These are all fairly spacious rooms. The weekly fees vary between £364.50 and £417. The fee covers all accommodation, meals and personal care. Hairdressing, toiletries, newspapers, plus services from private opticians, dentists and chiropodists are not included in the fee. The actual amount people pay will depend upon their individual circumstances. Langley Park Residential Home DS0000007488.V325993.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 over 3.5 hours. It included a tour of the building, examination of a number of records and discussions with 9 residents, 3 relatives and 5 staff. Comments were also received from 6 service users via questionnaires and 10 relatives via comment cards. The overall quality rating for this care home is: ‘excellent’. This judgment has been made from evidence gathered both during and before the visit to this service. What the service does well: Residents said they were well satisfied with the care and facilities provided. Typical comments included “It’s beautiful here. Everything is done for me and I couldn’t be happier. I’ve got no grumbles whatsoever and I have everything I want…The food’s beautiful and the staff are excellent and work very hard…I’m quite happy with my bedroom and it’s all spotlessly clean…The food’s lovely and we’re all ok…We’re like one big family…It’s all very good here…I’m very happy.” All the relatives said they were satisfied with the overall care provided. Typical comments included “The staff are very obliging and approachable…All the care is very good. I am satisfied with Mum’s bedroom and the staff are brilliant… It’s lovely here. My Mum has made real progress since she came here (about 6 weeks ago).” All residents said they enjoyed the meals and felt their preferences were well catered for. Residents get on well with the staff and would not hesitate to discuss any concerns or complaints with staff or management. They described a cheerful, happy environment. The home has well-equipped and attractive lounges and dining rooms on each floor, which allow residents to meet in groups of various sizes. A very good programme of social and recreational activities is provided, including baking, hair and beauty, board games, seaside trips, shopping trips, gentle chair exercises, coffee mornings, karaoke, pub and restaurant visits, mystery tours and craftwork, including making attractive cards for all occasions. The home is well maintained and well equipped. It has a number of unusual but very appropriate decorative features that help residents find their way about and feel at home. Staffing levels and staff training are very good. For example, over 85 of care staff have achieved National Vocational Qualifications (NVQ) in Care, which is commendable. There is a friendly, welcoming atmosphere. Management are keen to receive comments from residents and others about the quality of service provided by Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 6 the home. The service is well run and the information provided to residents and prospective service users is detailed and explicit. 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. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 7 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 Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 8 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): 1-6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home that will meet their needs. They have their needs assessed and a contract which tells them about the service they will receive. EVIDENCE: Comments received from residents and relatives confirmed that full assessments of needs were carried out prior to admission to the home. They confirmed that there was enough information from which to make a choice about being admitted. A service user’s guide and statement of terms and conditions of residence are supplied routinely. These are helpful documents and the content is detailed and explicit. The service user guide is also available on audiocassette. Care plans revealed comprehensive, detailed assessments of need being carried out both prior to admission and afterwards, as confirmed by members of staff and management. These assessments showed that the home only admitted people whose assessed needs it could meet. There are no intermediate care beds provided at this home. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 9 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 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Residents said that they believed their health and social care needs were well known by staff and were being fully met. They confirmed that community nurses or doctors would see them whenever required, either at the home or local healthcare centre. Their personal and social care needs were known, understood and respected by the staff team. They said that they felt they were treated with respect and sensitivity. For example, residents’ mobility needs have been well assessed and all residents who require wheelchairs have had them allocated, including electric wheelchairs where appropriate. Typical comments included “It’s beautiful here. Everything is done for me and I couldn’t be happier. I’ve got no grumbles whatsoever and I have everything I want…The food’s beautiful and the staff are excellent and work very hard…I’m quite happy with my bedroom and it’s all spotlessly clean…The food’s lovely Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 10 and we’re all ok…We’re like one big family…It’s all very good here…I’m very happy.” All the relatives said they were satisfied with the overall care provided. Typical comments included “The staff are very obliging and approachable…All the care is very good. I am satisfied with Mum’s bedroom and the staff are brilliant… It’s lovely here. My Mum has made real progress since she came here (about 6 weeks ago).” Care plans were detailed and comprehensive about service users’ health and social care needs, providing clear guidance to staff. They were subject to regular review, in keeping with National Minimum Standards. Staff training in Care (for example, National Vocational Qualifications (NVQ)) has included the important issues of privacy and dignity and over 85 of care staff have completed NVQ in care at levels 2 or 3. There are good arrangements for the safe administration of medicines. All staff members responsible for medicines have completed Safe Handling of Medicines training. There is good support from a local Pharmacist who supplies most of the medication in monitored dosage blister packs. There are good storage systems and staff thoroughly check all medication when it is received into the home. The home requires medication to be administered only from the container(s) into which the pharmacist dispensed it originally. Medication is kept securely in lockable cabinets and trolleys. Residents may attend to their own medication, but in practice most prefer to delegate this responsibility to staff. Unwanted medicines are returned promptly to the Pharmacist. The home is careful not to stockpile large quantities. Senior staff confirmed that medicine audits are carried out routinely and that the local pharmacist provides consultation and advice. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 11 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 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet residents’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Residents said they enjoyed living at Langley Park and got on well with the staff. All described the staff as being kind and helpful. They confirmed that they could choose how they spent their time and were free not to join in activities and social events if they did not wish to. A part-time activities organizer (25 hours per week) is employed. There are well-equipped and attractive lounges and dining rooms on each floor, which allow residents to meet in groups of various sizes. A very good programme of social and recreational activities is provided, including baking, hair and beauty, board games, seaside trips, shopping trips, gentle chair exercises, coffee mornings, karaoke, pub and restaurant visits, mystery tours and craftwork, including making very attractive cards for all occasions. These cards were displayed in the foyer and were available for purchase (proceeds to the residents’ funds). An informative, attractive monthly newsletter is produced and circulated. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 12 Coffee mornings are held every Wednesday. Hairdressing and Karaoke were taking place during my visit and residents were clearly enjoying both activities. Some residents enjoy cuddling toy animals or dolls and this practice is actively supported by relatives, staff and management. The home is well maintained and well equipped. It has a number of unusual, but very appropriate, decorative features that help residents find their way about and feel at home. These include very good use of colour, murals and pictures; very good use of ‘street names’ and pictures to distinguish areas on the first floor; clever use of knockers, ‘letterboxes’, service user photograph and/or name, plus ‘house numbers’ on residents’ doors; hanging baskets and globe wall-lights, plus tactile board outside one bathroom and good labelling of rooms such as toilets and bathrooms. Great imagination and creativity has been used in these features, involving staff and friends of the home in their execution. Specialist advice has been taken and service users have been carefully consulted as well. Drinks bars have recently been added to one dining room and one lounge and, although no alcohol is sold, the result has been very positive in enhancing a friendly, welcoming atmosphere that service users and relatives clearly enjoy. Residents, relatives and staff said that relatives and friends may visit at any reasonable time and are always made welcome. Most residents said they always liked the meals at the home. There was a good choice of menu and residents’ preferences were catered for wherever possible. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 13 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: All residents and relatives said that they were confident about approaching staff and management about any concerns or complaints they might have. They described the staff and management as being very approachable, helpful and friendly. A written complaints procedure is provided in the statement of purpose and service user’s guide. Staff and management are aware of the need to safeguard adults from abuse or neglect and most have undergone training in these issues. They are aware of the home’s ‘whistle blowing’ policy, which encourages staff to speak out about any suspected abuse. All staff members have had enhanced Criminal Records Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) checks carried out as required by law. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to ensure that unsuitable people are not employed to care for vulnerable adults. Staff confirmed that new staff members go through induction and foundation training so that they have the right knowledge and skills to do their jobs competently. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 14 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment, which encourages independence. EVIDENCE: There were no unpleasant odours and the home was found to be clean in all the areas inspected. All care staff members have completed training in health and safety, fire safety, food hygiene and infection control. Residents said that they were pleased with the premises, finding them comfortable and homely as well as practical. They also described the home as being clean. The home is well maintained, with repairs and servicing being carried out promptly and according to schedule. The decorations and adaptations in this home are particularly impressive, helping to promote residents’ wellbeing and independence (see preceding section). The dementia care unit has been redecorated and two drinks bars have been installed, one to each floor, plus new carpeting has been fitted to part of the first floor corridor and four bedrooms, within the past 12 months. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 15 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 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: On the day of inspection, the home had only one vacancy (on the dementia care unit). Residents and relatives said that they got on very well with staff and all felt that there were sufficient numbers of staff to meet their needs. This view was reflected in staff comments. Staff morale was reported to be good. During the day on the dementia care unit, there are 5 carers on duty from 8 am to 2 pm and 4 carers on duty from 2 pm to 8 pm. On the older persons’ unit, there are 3 carers on duty from 8 am to 8 pm. In addition, there is a dedicated activities organizer (25 hours per week) who works 5 days per week. The registered manager is full time, Monday to Friday. A senior carer heads each shift on each unit. A key worker system is in operation, whereby a named member of staff is linked to each resident. The home employs an administrator (35 hours per week) each weekday. A part time maintenance man is available each weekday (30.5 hours) and there are dedicated catering and domestic staff deployed in sufficient numbers for the needs of the home. At night (8 pm to 8 am) there is one senior carer and 3 carers on duty. A comprehensive staff training and development programme is in operation, including Safe Handling of Medicines, ‘Yesterday, Today and Tomorrow’ Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 16 (Alzheimer’s Society), Protection of Vulnerable Adults, Moving and Handling, and Care Practices. Staff confirmed that they had undergone induction and foundation training. Over 85 of care staff have completed National Vocational Qualifications (NVQ) in care at level 2 or 3, which is commendable. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 17 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, 32, 33, 35, 36 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: The registered manager is experienced and competent in her role. Residents, relatives and staff spoke well of her leadership skills and commitment to good outcomes for residents. She was described as being approachable and caring. A typical comment was “Her door’s always open for us. She respects confidentiality and is very fair.” The registered manager has completed the Registered Manager’s Award at NVQ level 4, plus Care at NVQ level 4. Staff confirmed that they participate in regular supervision sessions, as recorded in Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 18 individual staff files. The manager has planned a full programme of staff supervision sessions for 2007. Good accounting procedures are followed, with receipts and signatures obtained for all financial transactions involving residents’ personal monies, in which the home is involved, wherever practicable. Relatives look after the personal monies of many residents. In those situations where the home looks after residents’ monies, such as personal allowances, clear individual records are maintained. Comments received from staff and management confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of residents and staff. All staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. This helps reinforce the registered provider’s written policies on Health and Safety. Health and Safety issues are also discussed at regular staff meetings and in staff supervision sessions. Residents, relatives and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. They said they believed the home was safe and run in the best interests of residents. For example, there is a survey of residents’ satisfaction carried out every 6 months and the findings are reported within the home. The registered provider’s representative visits the home monthly to check on the welfare of residents and the progress of the home. The manager routinely invites comments and suggestions for improvements from both residents and visitors to the home, via regular meetings, surveys and consultations, including evening ‘surgeries’. Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 19 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 3 X 3 Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 20 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. 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. Refer to Standard Good Practice Recommendations Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Langley Park Residential Home DS0000007488.V325993.R01.S.doc Version 5.2 Page 22 - 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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