Inspection on 15/09/05 for Moreton Hill Care Centre

This inspection was carried out on 15th September 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

Moreton Hill Care Centre 12/03/09

Moreton Hill Care Centre 20/03/07

Moreton Hill Care Centre 02/03/06

Moreton Hill Care Centre 04/03/05

Moreton Hill Care Centre 30/11/04

Moreton Hill Care Centre 13/05/04

Moreton Hill Care Centre 24/02/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Moreton Hill Care Centre Standish Stonehouse Glos GL10 3BZ Lead Inspector Kathryn Silvey Announced 15 September 2005 10:00 th 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 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. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Moreton Hill Care Centre Address Standish Stonehouse Glos GL10 3BZ 01453 826000 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) Barchester Healthcare Homes Limited Mrs Jane Helen Soosalu Care Home 67 Category(ies) of Old Age (37) registration, with number Dementia - over 65 (25) of places Physical disability - over 65 (5) Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 04/03/05 Brief Description of the Service: Moreton Hill Care Centre is situated on the outskirts of the small town of Stonehouse, close to Standish hospital. The home is set high on a hill with magnificent views across the countryside to the River Severn beyond.The building consists of an old farmhouse, which has been renovated and extended. The accommodation is on various levels and is furnished, decorated and maintained to a high standard. The majority of rooms have ensuite facilities. Most rooms are for single occupancy although couples can be catered for. All areas of the home are accessible with two lifts to all floors. There are five reception rooms, which serve all levels in the home.Outside there are various sitting areas, one of which is an enclosed courtyard with raised flowerbeds, plants and shrubs. Three parking areas surround the home and the nearby fields and stables are home to a collection of farm animals. There are level pathways for service users to walk safely or use wheelchairs at their leisure. Two of the wings Severn View and Cotswold Rise have been registered to accommodate residential clients with dementia. They have their own lounge, dining and kitchen areas, which have been well decorated and furnished to meet the needs of the service users. The service users also have access to an enclosed courtyard and a garden with sensory planting. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors completed this announced inspection over seven hours. The registered manager, head of care, senior nursing staff, senior care staff in charge of the dementia units, the training officer and the activities coordinator were spoken to. Other care staff were spoken to during the inspection. Records were examined and the environment was inspected. Relatives and service users were spoken to during the day. What the service does well: What has improved since the last inspection? The activities organiser had recently completed a ‘Creative Studies’ course through Art Share. A group had visited the exhibition of Mosaics at Stratford Park in Stroud. Small collages have been made pertaining to service users history, and are used on bedrooms doors in the dementia units for service users to recognise their own room. Additional small areas about the home replicate past times, which service users can relate to. Moreton Hill Care Centre Version 1.40 Page 6 D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Barchester offer their chefs ‘Master Chef Programmes’ and diplomas through their academy. A new ‘wet’ room for use as a shower has been provided in the nursing unit. Extra care staff had been employed since the last inspection to improve the staffing level in all the units. Small lockable medication fridges have been provided on level s one and four. Barchester have recently been awarded accreditation for NVQ training, and the home has a good training unit and enthusiastic staff. 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. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 2 The home provides service users/relatives with the information required and this enables them to make an informed choice. EVIDENCE: The home has a welcome pack and this contains useful information for the new service user. It included details of staff, arrangements for meals, safety aspects, what to do if you have a problem and information about various activities. It is well presented and provided in a folder, which has a picture of Moreton Hill Care Centre on the front. There is also a Statement of Purpose, Service Users Guide, resident’s charter, contract and terms and conditions. The total information is comprehensive and written in a user friendly manner. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 Assessments of needs were well recorded and all service users had a care plan. However, care plans in the dementia units did not have specific actions by staff and measurable outcomes. Service users healthcare needs were generally well met and regular visits by healthcare professional were recorded Wound care records did not provide sufficient information to monitor healing and identify a need for specific intervention. EVIDENCE: One care plan from each dementia unit was seen. The plans contained an assessment of need and there was evidence that they are being reviewed every six months. The assessments and plans of care are written and reviewed by the Team Leader. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 10 Care is provided through the “person centred dementia care model”. It was clear that staff were competent in most of the sections, which form the practices of this model i.e. knowledge of dementia, staff training, activities and relationships. However it was felt that care planning and guidance for staff, which would formalise and deliver the care, was not always present in the individual plans which were seen. Two examples were looked at and the care referred to short team goals. Continence care although identified in the assessment of need for one resident was not identified in a specific plan. The medication administration charts were seen and there were a number of alterations made to the original chart, which had not been dated or signed. Several care plans were looked at in the general nursing units and the head of care and both nursing sisters were spoken to. The care plans, including night care, were generally well recorded and detailed and regular reviews were completed. The regular doctor visits weekly at least and these visits and healthcare professional visits were recorded in detail. Daily records were meaningful and a service user seen nursed in bed had detailed records for position change. Wound care records were again disappointing with no clear description of the wound or measurement. Appropriate records were not used and when dressings were renewed no information was given. In one example there was no differentiation between a left side wound and a right side wound which was confusing and incorrect. Polaroid photos taken were blurred and had no measuring device included assessing the progress of the wound. It is recommended that trained staff update their knowledge on wound care in particular recording procedures. Both units were calm and well managed and the service users spoken to were satisfied with the care provided and the care staffs’ attitude towards them. There were concerns by the staff of the continual ringing of call bells as the general unit call bell rang when other units were ringing and the staff had no control over this. The registered manager agreed to look into ensuring the call bell were zoned appropriately. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 &15 The home provides a range of activities and encourages and supports residents to take part in things they enjoy doing, including visits within the local community. A varied and nutritious menu is planned and service users are helped to choose the food they like and are given sensitive assistance at mealtimes when required. EVIDENCE: The home has a comprehensive range of activities and the activities organiser has recently completed a “Creative Studies” course through Art Shape. The course was found to be helpful and has given staff lots of new ideas. The competence of the staff and further training had ensured service users have the resources to enjoy appropriate activities. There is a specific activities room and this contains evidence of the varied programme at the time of the inspection. A group had just visited an exhibition of Mosaics at Stroud Park, and some service users were completing their own mosaics in the home. Art was also on display and the inspector was shown some pencil sketching. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 12 There are activities most days and they also include regular trips out in the mini bus. All residents are able to access the activities and this included residents from Cotswold Rise and Severn view. Where the needs of the residents from these Units cannot be met in the general setting, staff in the Units have identified individual needs and were seen to provide one to one activities. The next big event is a fashion show and staff and residents were busy preparing for this. The inspector was told that the show would involve resident’s, staff and relatives. Two relatives were seen and said they were always made welcome in the home. They were also complimentary about the services provided and felt comfortable about raising issues if it was necessary. The “Units” for dementia care had menus in large print and they were displayed in prominent places. Service Users have a choice for each meal and this applies to all courses. The lunch was served during the inspection and it was seen as presented in an appetising manner and of sufficient quantity to enable second helpings if required. The dining rooms in the general units were seen as attractive and care staff were seen helping to feed more dependent service users sensitively. Copies of the menus were given to the inspectors where there was evidence of the varied and nutritious meals provided. Service users spoken to enjoyed the meals at the home. Barchester offer their chefs ‘Master Chef Programmes’ and diplomas through The Barchester Learning and Development Academy. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Concerns/complaints from service users/relatives are treated seriously and fully investigated. Staff are aware of the vulnerability of the service users and are able to identify and report any potential abuse. EVIDENCE: The home has a complaints procedure and there is a copy in the Service User Guide. There have been no formal complaints since the last inspection. Copies of the complaints procedures were in Cotswold Rise and Severn View Units and whilst not all staff had read the procedure they were clear about raising any concerns with the Unit Manager. If this person was not available they would raise the matter with the nurse in charge of the nursing unit. After speaking to staff the inspector felt that if concerns were brought to the attention of staff they would respond in a prompt and appropriate manner. The home has a comprehensive procedure to protect vulnerable service users from abuse, which was updated in February 2005 and was seen by the inspectors. It gives clear guidelines on what to do when there is a suspicion of Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 14 abuse. Contact with the Adults at Risk multidisciplinary team at Gloucestershire County Council should be added to the policy. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The home was clean, free from offensive odours and well organised. The accommodation was in good decorative condition with appropriate furnishings and attractive memorabilia. EVIDENCE: With the exception of one bedroom which was locked as the service user was out, all of the accommodation in Cotswold Rise and Severn View was seen. The communal areas were pleasantly decorated and both Units have small areas, which replicate Victorian life. The dining areas were domestic and staff and service users were seen enjoying lunch on the day of the inspection. There is an adapted bath in each unit. Bedrooms had been personalised and provided private spaces, which reflected the interests of the individual person. The home is introducing small picture collages, which are placed outside each bedroom, the collage contains a brief social history of the service user. It also Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 16 offers a prompt for those who are disorientated and not sure of where their bedrooms are. The Units continue to be maintained to a high standard and provide a comfortable physical environment. The Units were found to be clean The nursing unit has a new ‘wet’ bathroom for use as a shower, replacing a bathroom. The general unit was clean and free from offensive odours, the rooms seen were well maintained and beautifully presented with many personal items. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30 Staff hours had been increased, however the staffing arrangement in Severn View did not fully meet their needs and the recorded review of staffing levels required would identify shortfall. Staff were seen as caring and competent. The home has a good training unit and enthusiastic staff. EVIDENCE: The manager stated there had been an increase in staffing hours, four hours daily in the dementia units and 12 hours daily in the nursing unit. Fiftyeight service users were accommodated, three were receiving respite care. The recorded staffing level review remains outstanding, this was discussed with the manager who agreed to look into it. Many of the service users are highly dependant and some require total care. The following comments relate to Cotswold Rise and Severn View- since the last inspection there has been an increase in staffing levels during the waking day, this consists of an extra person in one of the Units between 1000 and 1400. This is seen as useful and enables staff breaks to be covered. At the time of the inspection the third member of staff In Cotswold Rise was giving nail, and skin care to one resident. This activity was undertaken in a calm and sensitive manner and was evidently enjoyed by the resident. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 18 During lunchtime in Severn View one member of staff collected the lunch, which left the other supervising seven residents. At this time residents were asked to make their way to the dining room. At the same time one resident requested to go the toilet. This left six residents unsupervised for a few minutes. The inspector felt that this practice created a potential hazard at this time and could place the residents at an unacceptable level of risk. In view of the practice seen during this inspection the requirement, previously agreed, for service users to have for a short time only one staff member in the unit must be amended to ensure there are two. The manager agreed that in future the catering staff should deliver food to the dementia units. All staff on duty were seen and spoken to; they were seen as caring and competent and clearly had a positive relationship with the residents. This relationship gives residents a sense of security and a flexible daily life style, which meets their wishes. Staff had access to written material in the care of the demented person (University of Stirling) and the inspector spoke to staff that had attended a “positive dementia” course. The course was seen as helpful and the knowledge gained was being practiced in the Unit. The training coordinator was spoken to and the training room was seen. The Barchester Academy has accreditation now for NVQ training although it is not fully up and running at the time of the inspection and outside agencies support the home with regard to training. The coordinator hopes to have seven carers qualified to NVQ level 3 by December 2005 and eighteen to NVQ level 2. Twelve more care staff are waiting to begin NVQ level 2 in care. Since the take over of Westminster Healthcare more information is available to help the trainers. A local college has provided a comprehensive Dementia Care Course for the care staff and three carers at the home have completed it. The head of dementia care and the training coordinator have started completing sessions with the care staff to promote the ‘Memory Lane ‘ philosophy of dementia care, which includes person centred care and recording daily records appropriately. They are also attending a Barchester dementia training event in Manchester with the activities organiser and the Head of Care. The training coordinator has just completed a 14 week NEBOSH training and can now disseminate the knowledge, and will also be attending a fire training course soon with the maintenance manager. One of the nursing sisters is the manual handling trainer/co-ordinator. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The service users, their visitors and staff are in a safe environment where health and safety is promoted. EVIDENCE: The pre-inspection questionnaire completed by the registered manager provided evidence that health and safety requirements were met and equipment had been regularly serviced. Environmental Health had visited on 03/03/05 and any requirements had been met. The last Fire officers visit was on 27/07/05 and fire equipment check had been completed on 06/06/05. The record indicated that all relevant policies and procedures are in place to protect people who live and work in the home, and whom visit the home. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 20 The manager had stated that regular audits are completed for health and safety requirements. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 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 27 Regulation 18.1 Requirement The registered person must record a staffing level review, to include time/staff numbers required to meet service users needs, and provide a copy for the Commission. (This was required at the last inspection) The registered person must ensure that wound care records are sufficiently detailed. The registered person must ensure the care plans on the dementia units have suffient information . The registered person must ensure that medication is accurately recorded on the dementia unit identified. The registered person must ensure that staffing arrangments meet the sevice users needs on Severn View. Timescale for action 01/01/06 2. 3. 8 7 15.1 15.1 30/11/05 30/11/05 4. 9 13.2 30/11/05 5. 27 18.1 31/10/05 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 Good Practice Recommendations Version 1.40 Page 23 Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc 1. 2. 3. Standard 8 18 7 The registered person should ensure that nurses completing wound care have updated their knowledge, particularly for recording their findings. The registered person should ensure that the Adults at Risk team is added to the homes Protection of Vulnerable Adults procedure. The registered person should ensure the call bells are zoned. Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 24 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 Moreton Hill Care Centre D51_D03_S16505_MoretonHillCareCentre_V245626_150905_Stage4_A.doc Version 1.40 Page 25 - 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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