Inspection on 30/08/05 for Maison Moti

This inspection was carried out on 30th August 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Maison Moti 28/09/07

Maison Moti 04/01/07

Maison Moti 09/02/06

Maison Moti 28/02/05

Maison Moti 31/08/04

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

CARE HOME ADULTS 18-65 MAISON MOTI 200 Chase Side Southgate London N14 4PH Lead Inspector Jackie Izzard Unannounced 30 August 2005 @ 10:00 am 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Maison Moti Address 200 Chase Side, Southgate, London, N14 4PH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8440 7535 Mrs Maya Mahtani of Maison Moti Ltd PC Care Home 15 Category(ies) of MD, MD(E) registration, with number of places MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specific service user who is over 65 years of age and has mental health needs may be accommodated in the home. 2. This condition will need to be removed at such times as the service user vacates the home. Date of last inspection 28/2/05 Brief Description of the Service: Maison Moti is registered to provide accommodation and care for fifteen people under the age of sixtyfive who have a ‘mental disorder’ (mental health problems). A condition of registration has been approved for a service user who is over the age of sixtyfive to remain at Maison Moti, as long as the home can meet her needs.The home is situated in Southgate, on a residential street, and blends in well with the other local houses. All the amenities of Southgate are short walk away and the home is well situated for bus and underground transport. Maison Moti Ltd operate this care home and four supported living projects for people with mental health problems. At the time of this inspection, there were 14 people living at Maison Moti. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 30 August 2005 and the home had no warning that the inspection was going to take place. The inspector stayed at the home for four and a half hours. The inspector met the managing director, deputy manager, two support workers and thirteen of the fourteen residents of the home. One resident was in hospital at the time of the inspection. The inspector spoke with most of the residents individually and four residents as a group. The communal rooms and two bedrooms were inspected along with records, policies and procedures. The manager of the home has recently left and the home is being managed to temporarily by the deputy manager, operations manager and managing director of Maison Moti Ltd. The managing director, Mr Manoj Mahtani, said that the company is trying to recruit a new manager as soon as possible. What the service does well: What has improved since the last inspection? The home increased staffing levels by employing a cook, although the cook has now left. A new way of writing down how staff should meet each resident’s needs in a care plan has been introduced, which will be better than the previous care plans when it is finished. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 6 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. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 People thinking of moving into this home can be assured that their needs and aspirations will be assessed before they move into the home and once they have moved in. EVIDENCE: The records of a person who has recently moved into the home were inspected. The inspector saw that the home had received a comprehensive assessment from this persons last placement. In addition, staff from Maison Moti have carried out an individual assessment of the person’s needs. There was also a record of a meeting between the managing director and the persons family which clearly indicated the family’s views and aspirations for their relative whilst living at this home. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Service users are not currently familiar with their individual care plan as these are in the process of being changed and updated. A requirement is made that each service user has an updated care plan, detailing all their needs in two months time. EVIDENCE: Requirements have been made in the last two inspection reports regarding service user care plans to make sure that all their personal, social and healthcare needs are addressed. This requirement has still not been fully complied with. The inspector looked at four peoples files and saw that a new care plan format has been introduced. Three had a care plan but none were completely finished. One had no goals and a lack of individualised information. Important goals in this persons previous care plan has not been repeated in the new format. All three appeared to be in draft form. The requirement is restated for the second time at the end of this report and the managing director assured the inspector that all residents would have an up-to-date care plan by 31 October 2005. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 17 Some service users take part in valued activities and use local community resources. The home should improve the quality of opportunities for other residents to go out more and find activities they find fulfilling. The diet offered is adequate and the home is currently striving to improve the quality of meals offered. EVIDENCE: The home employs an activities organiser who works at the home approximately 10 hours a week. In the month of August, small groups of three or four people went out to Bingo, Trafalgar Square, cinema, the Tate Modern and McDonalds. This is very positive. On the day of this inspection, the activities organiser at was going to Broomfield park with a group of residents. Sometimes residents will watch a video together in the home. A large number of the residents do not take part in activities organised by the activities organiser. There was a recent outing to the coast which all residents were able to go on if they wished. Some improvement had been made in the amount of activity offered to residents since the last inspection. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 11 One resident told the inspector that his/her leisure needs were met by attending a day centre and taking part in various outings and social activities there. Two said they were happy with the amount of activity they were doing. These two people usually went out with the activities organiser. Two other people told the inspector they did not have much to do. The inspector was informed that another person spent long periods of time alone in his/her bedroom. Some residents receive funding for a certain number of one to one hours each week. At the previous inspection of the home, the inspector noted that seven people were allocated one-to-one staffing hours but were not generally receiving those individual hours. At this inspection, the inspector looked at the record of one-to-one sessions, which indicated that most people were still not receiving those one-to-one hours. A recommendation made at the last inspection for more individual activities is restated as the majority of people living at this time do not have any day service, job or education to go to during the week. It is of concern that there is no obvious improvement in this area. The inspector also advised that the staff should not undertake their administrative key work duties at times when they could be spending individual time and taking part in activities with residents. Staffing levels are minimal and this is addressed elsewhere in this report. After a requirement was made by the Commission for Social Care Inspection, a cook was employed to prepare the main meal. The cook has now left. The inspector looked at a sample of the weeks menu which was adequate in terms of a balanced diet. It was noted that some service users’ cultural food preferences were not reflected in the menu. The inspector asked eight residents for their views on the food provided at the home. Two people said they liked the food, one of whom said the food was” lovely and fresh”. Two said they didnt like the food, one of whom said “some staff can cook, some cant”. The other four residents said that the food was okay. The inspector was aware that the managing director was planning to employ a new cook which he hoped would lead to improvements in the menu. The registered person, Mrs Mahtani, is planning to come into the home for two weeks in the near future to offer support with cooking. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 Some people have said they are satisfied with the way they receive personal support. Improvements are needed in the recording of healthcare appointments and addressing all the healthcare needs of the service users to ensure that their physical health needs are met. EVIDENCE: The inspector spoke to three residents about the personal support offered to them by staff. All three received support from staff with their personal care and said that the staff help them. One said that staff take her to the hairdressers. The other two said that staff help them with washing their hair and other personal care tasks and that they were satisfied with the help that they got. One person appeared to have some dental hygiene needs but did not to have a toothbrush in his/her bedroom. A requirement is made to address this persons dental needs. One resident said that the staff were” nice girls, they look after me”. Staff at the home monitor residents’ weight and blood pressure on a regular basis which is very positive. The inspector looked at the healthcare records for four of the residents at the home. Two of the four were asked if they felt their health needs were being met. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 13 Two said that staff accompanied them to health appointments and they felt their health needs were met. The inspector saw that one person had attended a dental appointment and smear test which were not recorded in her file, another had no dentist appointments recorded nor reasons why s/he had not been to a dentist, one persons care plan recorded his medical appointment needs but the risk assessments stated that this person refused to attend any medical appointments. The care plan therefore needed to be updated. The other person had attended all relevant medical appointments and these were recorded appropriately. A requirement was made in the last inspection report that by 1 May 2005 appointments must be recorded in residents’ files. It was also required that if an appointment is missed, the reason for this must be recorded along with what action will be taken next. The requirement was also made that all residents’ health needs are fully met by supporting them to attend appointments with a dentist, optician, GP, chiropodist or any other health practitioner. These requirements have been restated in this report as these records are still not all up-to-date. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home’s complaints procedure is designed to ensure people’s views are listened to. People say their views are listened to, but some raised a concern that they had not raised with the managing director so the inspector passed this concern on to be dealt with. EVIDENCE: The home has a satisfactory complaints procedure. People living at the home can send a complaint to head office without staff at the home knowing, if they wish. There was evidence in the last monthly inspection of the home by one of the managing directors that service users’ views are listened to. Four people told the inspector that they were not happy with the arrangements for drinks in the home. Hot drinks are available at specific times and they said that their tea consumption is limited to those times. They also said that squash was only served at mealtimes and that if they wanted cold drinks in between meals, other than water, they were expected to buy these for themselves. Another concern reported to the inspector was that people are not allowed in the kitchen after 9pm and are not allowed to have a drink from 9pm to 7am. The inspector did not know whether this was true so passed this to the managing director who said he would immediately investigate this concern. The people who raised these concerns said they had not complained to the company about this issue. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 30 The home is comfortable and people are satisfied with the rooms and facilities. The company has written plans for improving the environment and addressing maintenance issues to further improve living conditions for the residents. EVIDENCE: An inspection was carried out on the ground floor dining room, lounge, kitchen, smoking room, garden, toilets and bedrooms. These rooms were all clean, satisfactorily furnished and tidy. The inspector did not look at all bedrooms in the home as the managing director has carried out an audit of all rooms on the 5 August 2005. This audit identified a number of issues which need attention and action that the company intended to take. This report also indicated that staff have been asked to pay closer attention to maintenance issues. The inspector is therefore satisfied that the company is paying attention to improving the physical environment. A fire exit door in the lounge was locked and was not able to be unlocked. The managing director said he would deal with this as a matter of urgency. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 16 A requirement to replace carpets in the lounge and corridors by 1/9/05 has not been met but the inspector was assured that this was to take place within two weeks of this inspection. One of the freezers had no record of being checked for safe temperature for the last two months. Other fridges and freezer temperature records were up to date. The inspector asked six people how they felt about their room. All six said they were happy with their room. Two women who share a room both confirmed that they like sharing with each other and do not want to move to a single room when one is available. A request from the residents for a bigger tea urn was passed on to the deputy manager and managing director. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 The service offered to individual people living at Maison Moti could be developed further if staffing levels increased. Service users are protected by a thorough recruitment procedure. EVIDENCE: A requirement was made at the last inspection to increase staffing by either employing a cook or having three staff on duty on each shift. The company did employ a cook who has since left. The cook had not yet been replaced and staffing levels have not increased since she left. Staffing levels are minimal in that two staff work each shift (this excludes the deputy manager who is carrying out management tasks) with an extra staff for activities for approximately ten hours per week. The two staff on duty are expected to cook a meal for fifteen people, clean the kitchen afterwards as well as supporting residents with day to day tasks such as doing their laundry, personal care, attending appointments, etc. Staff therefore do not spend as much time on individual interaction with residents or activities. One resident said that a staff member helps her to bake cakes regularly which is very positive. There are other people who do not attend any dayservice, college or leisure activities who may benefit from more structured individual support from staff to stop them becoming too isolated. The managing director agreed to increase staffing levels to three staff on each shift from 1 October 2005. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 18 The inspector did not meet with the staff on duty on this occasion. The inspector looked at two staff files to see if the home was following a thorough recruitment procedure. Both files had an enhanced CRB disclosure as required and two references. Staff files were well organised and contained all the required information. The inspector has seen every staff member’s CRB within the last year and can confirm that all have satisfactory CRB disclosures. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42 Residents’ views are sought and listened to by the managing director. The health, safety and welfare of residents is protected. EVIDENCE: The registered manager has recently left the home and the deputy manager and managing directors are jointly managing the home on a temporary basis while a new manager is being recruited. The last monthly report on the home by the managing director showed evidence of consultation with people living at the home, listening to their views and acting on them. The inspector asked three people whether they felt their views were listened to and whether action was taken if they requested it. All three said that they felt they were listened to by the managing director. One said that he had not spoken to the managing director about a concern he had and said he would do so after the inspection. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 20 Some people said they felt their views were not respected regarding access to drinks. This is addressed earlier in this report. The inspector saw the fire risk assessment for the home and was informed that a new risk assessment is currently being undertaken. This will be inspected at the next inspection. Smoking is restricted at night for certain smokers who are seen to be at risk of causing a fire. Quality assurance and health and safety will be looked at further at the next inspection of the home this year. MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 2 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 MAISON MOTI Score 2 1 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 15(1)(2)( c) Requirement The registered person must review the current service user plans to ensure that each service users global needs are addressed, detailing all aspects of personal and social support and health-care needs as set out in standard two of the national standards for care homes for adults. This requirement is restated. Previous timescales of 30/1/05 and 1/6/05 not met. Each care plan must be completed and signed by the service user. The registered person must ensure that all service users health needs are fully met by supporting them to make and attend medical appointments with necessary health practitioners. All health appointments must be recorded in the service users file. If an appointment is missed,the reason for this must be recorded, along with what action will be taken next. This requirement is restated. Previous timescale of 1/5/05 not met. Timescale for action 31 October 2005. 2. 19 13(1)(b) 31 October 2005 MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 23 3. 18, 19 4. 22 5. 24 6. 24 7. 24 8. 33 The registered person must ensure that a specified service users dental needs are addressed. 22 The registered person must address service users concerns regarding access to drinks and record the outcome. 16 (2) (c) The registered person must provide a new carpet for the lounge and corridors in the home. This requirement is restated. Previous timescale of 1/9/05 not met. 23(5) The registered person must ensure that fridge and freezer temperatures are regularly checked to ensure that food continues to be stored at safe temperatures. 23(4)(c)(ii The registered person must i) ensure that all fire exit doors are able to be opened without the use of the key at all times. 18(1) (a) The registered person must increase staffing levels by employing a cook or a third support worker on each shift. This requirement is restated. Previous timescale of 30/4/05 not met. 13(1)(b) 31 October 2005 1 October 2005 31 October 2005 1 October 2005 1 October 2005 1 October 2005 9. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 12 19 Good Practice Recommendations The registered person should ensure that individual activities are planned on a weekly basis as soon as possible. The registered person should arrange for an audit to take place of all service users health needs. G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 24 MAISON MOTI MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection North London Area Office Solar House, 1st Floor 282 Chase Road London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI MAISON MOTI G59 S10639 Maison Moti V232454 30.08.05 Stage 4.doc Version 1.30 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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