Inspection on 04/08/09 for Pendlebury Manor Care Home

This inspection was carried out on 4th August 2009.

CQC 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 CQC 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

Pendlebury Manor Care Home 27/01/10

Pendlebury Manor Care Home 05/08/08

Pendlebury Manor Care Home 10/01/08

Pendlebury Manor Care Home 03/07/07

Pendlebury Manor Care Home 09/05/06

Pendlebury Manor Care Home 10/01/06

Pendlebury Manor Care Home 07/06/05

Pendlebury Manor Care Home 16/12/04

Pendlebury Manor Care Home 30/07/04

Pendlebury Manor Care Home 24/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Pendlebury Manor Care Home Pendlebury Manor Care Home, Lyme Green Park London Road Lyme Green Macclesfield Cheshire SK11 0LD Lead Inspector Joan Adam Key Unannounced Inspection 4 August 2009 10:00 DS0000018805.V377221.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pendlebury Manor Care Home Address Pendlebury Manor Care Home, Lyme Green Park London Road Lyme Green Macclesfield Cheshire SK11 0LD 01260 253555 01260 251641 pendlebury.manor@virgin.net 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) Pendlebury Care Homes Ltd Manager post vacant Care Home 61 Category(ies) of Dementia (61) registration, with number of places Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 The Registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE The maximum number of service users who can be accommodated is: 61 Date of last inspection 5 August 2008 Brief Description of the Service: Pendlebury Manor provides care for up to 61 people with dementia who require personal care only. It is situated on the outskirts of Macclesfield. The home is divided into two units: the Villa and the Manor. Accommodation comprises of 53 single rooms and 4 shared rooms. There are dining and lounge areas in each unit and two passenger lifts for access to the first floor. There is adequate car parking facilities at the home. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is one star. This means that the people who use the service experience adequate quality outcomes. We made an unannounced visit to Pendlebury Manor on 4 August 2009. During our visit we spoke to the manager, some staff members and some residents and relatives. Some of the comments we received are detailed in this report. What the service does well: An assessment of people’s needs is carried out before they move into the home to make sure their needs can be met there. The health care needs of people who live in the home are recorded so that their care needs are be fully met. Pendlebury Manor has a warm atmosphere and people spoken with said, the staff are very kind and caring and “the staff are lovely. The food on offer is good and people spoken with said, “the meals are very nice” A good standard of hygiene was seen throughout the home and the standard of decor has improved so that people live in a comfortable environment. What has improved since the last inspection? What they could do better: The recruitment system in place needs to be improved to ensure that all staff employed have the correct safety checks so that the manager knows they are safe to work with elderly people. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 6 The numbers of staff on duty in the home needs to be reviewed to make sure there are enough on duty at all times to meet the needs of the people living at the home. Staff training on fire safety needs to improve so that all staff know what to do in the case of a fire. Fire safety training was a requirement at the last visit. Staff training needs to improve with regard to moving and handling so that all staff are aware of how to move people safely. Training also needs to be improved with regard to safeguarding of people who live in the home so that staff know what to do and how to recognise if abuse was taking place. The home is registered for people who have dementia, however staff records show that none of the staff employed have received some training with regard to dementia so they can look after this type of resident appropriately. Action needs to be taken to make sure that the quality assurance systems for the home are thorough and pick up problems and areas needing improvement so these can be resolved. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Pendlebury Manor Care Home DS0000018805.V377221.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 Pendlebury Manor Care Home DS0000018805.V377221.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An assessment of people’s needs is carried out before they move into the home to make sure their needs can be met there. EVIDENCE: We looked at the admission details of two residents who had recently come to live at the home. The documentation is a checklist which was completed and gave adequate information to enable the needs of the person to be assessed so that the home was sure their needs could be met there. There was evidence that information had been obtained from other health care professionals such as social services and hospital staff prior to admission. The home does not provide intermediate care so standard 6 was not assessed. Pendlebury Manor Care Home DS0000018805.V377221.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health care needs of people who live in the home are recorded so that care needs are be fully met. EVIDENCE: We looked at care plans for five people who live in the home. There was a mixture of documents in the files both handwritten and type written. These were individual and gave guidance to the staff as to how the person’s needs should be met. One care plan regarding Parkinson’s disease had been written in 2007 and this needed to be updated. This was discussed with the manager. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 10 Moving and handling risk assessments were in place so that staff would be aware of how best to move the people living at the home. A nutritional assessment was in place so staff could measure if someone was losing weight and weights were recorded monthly. Likes and dislikes of people who live in the home were recorded. The plans had been evaluated so staff know what has happened and what changes have been seen. One person had been recorded as refusing staff interventions. All the incidents were fully recorded in the daily record sheet. Daily records were very detailed and were well written. Visits by other health professionals was recorded so staff would know when these visits had taken place and why. The atmosphere in the home was pleasant and all staff were seen to be friendly and appeared to have good relationships with the people in their care. When spoken with staff were aware of people’s needs and their likes and dislikes. Residents spoken with said, the people here are very nice”. A visitor to the home said, “they look after my relative well, and always keep me informed”. One relative said, “it’s quite good, they seem to do a good job”. Medication management was looked at. All medication administration sheets (MAR) had been signed so that it was recorded when people received their medication. Some MAR sheets had been handwritten by staff and these entries had been signed and dated by two staff members. The medicines were stored correctly. Pendlebury Manor Care Home DS0000018805.V377221.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although not all people who live at Pendlebury Manor take part in the range of activities provided, the available activities have increased so people can become more active in the home. EVIDENCE: When we visited the home we found that a new activities co-ordinator had started working there and was in the process of up dating the activity programme on offer. We saw activities co-ordinator took her time to put people at ease and to find an activity that everyone wanted to join in with. One relative spoken with said “it is much better since she has come, there are things going on”. On the day of our visit, two people who live upstairs in the Lymes unit had come downstairs to join the activities going on. The other people living upstairs were sitting in the lounge with the TV on. We were told after our visit Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 12 that people had been offered the chance to join in activities in the downstairs lounge but had chosen not to. Steps should be taken to show that the people who live in Lymes unit are regularly asked to join in activities and their choice not to at any time should be noted. This may help to staff to find out what activities people would prefer to take part in. The menus on offer appear varied and the lunch looked well cooked and presented. However, more choice needs to be provided. The chef has spoken with the proprietor and it is felt that an increase in the budget is needed to provide this. The chef was aware of likes and dislikes of people living in the home. Pendlebury Manor Care Home DS0000018805.V377221.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Pendlebury Manor are confident that their complaints are listened to but staff training needs to improve so that they know what to do to protect people. EVIDENCE: The manager stated that she has not received any complaints since she had been in post. A complaints procedure was in place and up to date information on how to make a complaint was in the statement of purpose and a copy was on the wall in the entrance hall. The home had policies and procedures on the prevention of abuse and whistle blowing. The safeguarding procedure is how the local council and other agencies respond to allegations of abuse of vulnerable people. The training records we saw on the day of our visit showed that only three staff members had received any safeguarding adults training. Further information was provided after the inspection that the number of staff who had had this training was six. However, all staff need to receive this training so they know what to do to protect the people who live at Pendlebury Manor from harm and abuse. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 14 We were told that a referral had been made to social services in response to a particular incident but they had agreed that it did not need to be dealt with under safeguarding procedures. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a comfortable place to live, visit and work. EVIDENCE: We walked round the home and looked in all communal areas, bathrooms and some bedrooms, each bedroom was well personalised. A complete refurbishment has taken place on Villa and Lymes units. The Manor unit was closed at the time of our inspection as it was undergoing a total refurbishment. All areas had been decorated and furnished to a good standard. There are blinds at all windows in lounges, dining rooms and bedrooms. The long cords may be a hazard and need to be risk assessed to maintain the safety of all people living in the home. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 16 The home was clean and there were no unpleasant odours. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers are not sufficient at all times to make sure that the needs of the people living in the home can be met. Training needs to improve so that people are kept safe. EVIDENCE: When we visited we looked at the duty rotas for the week of the visit which commenced 03/08/09. They showed that there were four staff on duty from Sunday to Wednesday and five staff on duty on Thursday and Friday, three staff are on duty at night and a senior carer is on duty at all times. The home had twenty nine people living on two units on the day of our visit. Only one staff member was on duty upstairs on the Lymes unit which had twelve people living there. This meant that when the staff member was taking someone to the toilet or bathing someone the lounge area was left unattended. Only two people had gone down to join in the activities on that particular day. Consideration is needed to make sure there are enough staff on duty in the upstairs unit when more people than usual decide to stay upstairs. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 18 During lunch it was observed that some people had their lunch in their bedrooms and some in the dining area. People visiting the home said, “They always seem to be short of staff”, “I feel that there should be two staff on duty upstairs” and “I often have to change my relative’s pad when I come”. The manager said she had discussed this with the proprietor and was reassessing the needs of the people living in the home. Staff files were looked at for four people who had recently started work at the home. Three had all relevant checks in place so that the manager was aware that the staff were safe to work with elderly people. However one staff member had only one reference in place. The manager said that she would recontact the person who had not returned the reference. On the day of our visit, the information we saw showed that only two of the staff working in the home have achieved a national vocational qualification (NVQ) in care. These are nationally recognised qualifications that show the staff are competent to provide good quality care. The standards recommend that fifty percent of the staff should hold this qualification. After our visit, we received further information to show that a total of six staff hold NVQs. We saw staff training is on-going but not all staff have received mandatory training in key subjects. Eight staff out of twenty employed at the home have received training in fire safety so that they will know what to do in case of a fire. We found at our last visit to Pendlebury Manor that not all staff in the home had received fire safety training. Only nine staff had received moving and handling training so all staff may not know what to do to move people safely. Not all staff had received training on safeguarding adults to make sure they would know what to do to protect the people who live at the home from harm and abuse. The home is registered for people who have dementia, however staff records show that none of the staff employed have received some training with regard to dementia so they can look after this type of resident appropriately Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some areas of management need to improve so that the home can be well managed in the best interests of the people who live there. EVIDENCE: The manager has been in post since February 2009 and at the time of our visit had not yet applied to be registered with CQC. She is an experienced manager. Some staff meetings had taken place and minutes have been taken. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 20 The fire safety file was up to date and checks on fire alarm points and emergency lighting was recorded. Errors that had been found and actions taken were not recorded in this file. However, the new handyman produced evidence that these had been addressed. It is recommended that this is recorded within the one file so that an audit trail can be easily followed. The home should have quality assurance systems in place designed to identify strengths and areas of improvements. Some survey forms had been sent out to relatives by the home to gain their views. The staff spoken with felt that the manager was supportive. The manager has an open door policy. It was observed that the manager had a good relationship with people who live at the home and their relatives present on the day of the visit. The recruitment system in place needs to be improved to ensure that all staff employed have the correct checks obtained so that the manager knows they are safe to work with elderly people. Staff training regarding fire safety needs to improve so that all staff know what to do in the case of a fire. Fire safety training was a requirement at the last visit. Staff training needs to improve with regard to moving and handling so that all staff are aware of how to move people safely. Training also needs to be improved with regard to safeguarding of people who live in the home so that staff know what to do and how to recognise if abuse was taking place. The home is registered for people who have dementia, however staff records show that none of the staff employed have received some training with regard to dementia so they can look after this type of resident appropriately A representative of the owner visits the home unannounced every month to monitor the quality of the care and services provided. A report of the visit is produced and given to the manager of the home. These visits are to comply with Regulation 26 of the Care Homes Regulations 2001. However, the reports do not always show that problems in the home are being picked up so they can be acted upon. For example gaps in staff training had not been highlighted as a problem. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP38 Regulation 23 Requirement Adequate arrangements must be made for all staff working in the home to receive suitable training on fire safety and take part in fire drills. This is to make sure that they know what to do to protect people living in the home if fire breaks out. This is an unmet requirement with a previous timescale for compliance of 05/11/08 2 OP38 18 All staff must receive up to date moving and handling training so people living in the home are not placed at risk of possible injury. All staff must receive up to date training regarding safeguarding of adults so they know how to recognise abuse. All staff must receive training with regard to dementia care so that the needs of people living in the home can be fully met. Action must be taken to make sure there are adequate DS0000018805.V377221.R01.S.doc Timescale for action 04/09/09 30/09/09 3 OP18 18 30/09/09 4 OP30 18 30/09/09 5 OP27 18 31/08/09 Pendlebury Manor Care Home Version 5.2 Page 23 numbers of staff deployed in the home to meet the needs of the people living there. 6 OP38 24 The quality assurance system must be in place so that areas of concern or that need improvement can be highlighted and acted upon quickly. 30/09/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations The action taken to encourage people to join in activities should be recorded so that if people choose not to take part, this can be evaluated and alternatives looked at. This will help to make sure that there is a range of activities available that reflect the preferences of the people living at the home. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 Page 24 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Pendlebury Manor Care Home DS0000018805.V377221.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!