Inspection on 15/05/06 for Raola House

This inspection was carried out on 15th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Raola House 22/05/07

Raola House 14/02/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Raola House 205 Woodcote Road Wallington Surrey SM6 0QQ Lead Inspector Mohammad Peerbux Key Unannounced Inspection 15th May 2006 9:30am Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Raola House Address 205 Woodcote Road Wallington Surrey SM6 0QQ 020 8835 2258 020 8669 3533 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) Tordarrach Mrs Ayodele Obaro Care Home 6 Category(ies) of Learning disability (6), Sensory impairment (6) registration, with number of places Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 2006 Brief Description of the Service: Raola House is registered with the Commission for Social Care Inspection (CSCI) to provide residential care for up to six adults with learning disabilities and or sensory impairment. The property is situated on a busy residential road close to the centre of Wallington and is well placed for local shops and public transport links. There is ample space in the front garden for parking and the back garden, which has a patio area and large lawn, is extremely well maintained. The philosophy of care and principle objectives of Raola House are based upon the development of community-based initiatives, recognising that people with learning disabilities have the right to a normal pattern of life. The range of weekly fees is between £1200 and £2500. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s first inspection for the year 2006/07. It was an unannounced inspection and took place over three hours. Some times were spent looking at the policies and procedures, records, talking to staff and to the deputy manager. Requirements and recommendations from the previous inspection were also discussed. They are all thanked for their time and assistance. A tour of the building was also carried out. Presently there are only three service users at the home. It was difficult to gain the views of two of the service users about the care that they are receiving due to their cognitive abilities. What the service does well: What has improved since the last inspection? Service users’ care plans are now drawn up after consultation with the service user, family, friends and an advocate where appropriate. The service users’ risk assessments have been updated to identify potential risks covering all aspects of their daily living both inside and outside the home. The system for storage and administration of medications has improved. There are also up to date records and receipts of all the expenses made by the service users or on their behalf by staff. Staff recruitment process and staff supervisions have improved since the last inspection. There is now a planned menu is in place. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 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. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Raola House DS0000065735.V293128.R01.S.doc Version 5.1 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 the following standard(s): 1,2,4 and 5 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is able to demonstrate that service users needs are being properly assessed, and that the range of needs presented is being appropriately met. The necessary information and opportunity to visit the home is being made available to service users, enabling an informed choice regarding the suitability of the home to be made. EVIDENCE: The home has a comprehensive Statement of Purpose, and Service User’s Guide. Both are extremely well presented and cover all the information required by the Care Homes Regulations (2001), including the aims and objectives of the home and the facilities and services provided. It is previously recommended that the service users’ guide be made available in formats suitable for the service users for whom the home is intended (e.g. appropriate languages, pictures, video, audio or explanation). This still has to be met. Service users are only admitted to the home after a full assessment of their needs has been carried out by the home and the Placing Authority for individuals referred through Care Management, involving the prospective service user/recognised representative. It was noted that the home also carries out a very comprehensive needs assessment. Since the home’s last inspection Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 9 in February 2006, there has been one new admission. It was noted that the service user had a needs assessment in place. The deputy manager confirmed that all prospective service users are encouraged to visit the home as often as practical, to encourage a familiarisation process with the premises, its location and the other service users and staff. The deputy manager advised that all service users or their recognised representatives are provided with a costed contract/statement of terms and conditions of occupancy which are agreed between each prospective service user and/or representative and the home. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 6,7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans are comprehensive and include detailed information about service users’ needs, personal goals, wishes and risk assessments. Service users are involved in decision making about their lives, they participate and can take some risks so that they live as normal a life as possible. EVIDENCE: It was previously required that the registered manager must ensure that service users care plans are drawn up after consultation with the service user, family, friends and an advocate where appropriate. The service users’ care plans were checked and it was noted that they have been updated since the last inspection. They now clearly set out how current and anticipated needs would be met and were drawn up with the involvement of the service users and/or their representatives. It was also required that the registered manager must ensure that care plans are made available in a language and format that the service user can Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 11 understand and is held by the service user unless there are clear and recorded reasons not to do so. This remains outstanding and therefore this requirement would be repeated. The rights of service users to make decisions about their own lives is central to the ethos of the home, support and guidance is given in all areas to ensure that service users are making decisions which are in their best interests. From discussion with the deputy manager no evidence of restrictions on service users were found. It was previously required that the registered person must ensure that service users’ meeting take place on a regular basis so as to ascertain and take into account their wishes and feelings. The deputy manager stated that this is difficult due service users’ cognitive abilities. However the families and advocates of the service users are in contact with the home on a regular basis and their care needs and wishes are discussed with them. Service users’ financial records were in the main clear, accurate and appropriately maintained. This is in line with requirement made at the last inspection. Risk assessments for service users were examined. They have been updated since the last inspection and are now more comprehensive. The risk assessments give details to what action is required to minimise identified risks and hazards. Potential risks are identified covering all aspects of their daily living both inside and outside the home. The home has a confidentiality policy in respect of personal information held in relation to service users. General service user’s documentations (i.e. service user plan, medical appointments and reviews) are kept locked in the office. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 11,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are encouraged to explore opportunities to enhance their quality of life as well as maintain and participate with friends and the local community, with the aim of maximum integration. The daily routines and house rules promote service users’ rights, and ensure equality and that all rights are enjoyed by service users. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. EVIDENCE: Throughout the course of the inspection it was observed that staff actively encouraged service users to maintain and develop their independent living skills. Evidence recorded in individual care plans also indicated staff assigned Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 13 as key workers to service users, offer support, advice and other input that help to enhance and develop independent living skills. The home is very well situated for local shops and public transport - which enables participation and integration into the local community. The deputy manager reported that they accompany and support service users in undertaking a wide range of facilities, including shopping and going on day trips, etc. Service users are actively encouraged to maintain links with their families and friends. The deputy manager stated that the home has an ‘open’ visitors policy and simply recommends that visitor’s telephone to say they are coming to ensure there loved ones will be available. Service users, who were at home at the time of this inspection, appeared to enjoy some level of independence. Routines can be very flexible and are well observed to take into account all the service users individual needs. Some of the service users were spoken to however due to their cognitive ability it was difficult to seek their views regarding the care and support they receive. It was previously required that the registered manager must ensure that there is a planned menu is in place, which meet the service user’s dietary and cultural needs, and which respect their individual preferences. This is now in place. The deputy manager advised that the home is putting a picture booklet in place of different food to help service users choose what they would like to eat. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users’ personal, physical and emotional health needs are being appropriately met and reviewed. This ensures that the service users’ physical and emotional health is well maintained and therefore the quality of life experienced is also maximised. EVIDENCE: The findings indicated that service users are able to exercise some level of independence in their personal care needs with appropriate support from staff where needed. The overall impression gained from observing how service users live at the home, indicated a good culture of semi-independent living, with most users have reasonable control over their lives and support from staff where needed. Service users at the home are registered with a General Practitioner. They are supported by the staff team when attending outpatient or other medical appointments as required. They also have access to other health professionals such as opticians and dentists. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 15 A number of requirements were made at the last inspection regarding medication (standard 20). It was positively noted that all of them have been met. This will be monitored again at the next inspection. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has appropriate complaints procedure in place. The home has suitable vulnerable adult protection and abuse prevention measures in place to ensure the service users are so far as reasonable practicable, protected from abuse, neglect or harm. EVIDENCE: The current complaints procedure is good and gives clear step-by-step guide of how to make a complaint. The procedure is also available in symbol format. The deputy manager stated that one of the neighbours has complained about the level of noise and that he is dealing with them to resolve the issue. The home has a copy of London Borough of Sutton adult protection procedures. The deputy manager stated that all staff have had abuse awareness training as part of their induction. The home has an appropriate whistle blowing procedure. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 17 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 the following standard(s): 24,25,26,27,28 and 30 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home is generally hygienic, clean, homely and comfortable however fire safety issues still need to be addressed as these potentially place service users and staff at risk. EVIDENCE: The home is suitable for its stated purpose. It is accessible, meet service users’ individual and collective needs in a comfortable and homely way. Overall the home was decorated to a good standard throughout and appeared to be very comfortable, bright and warm. However the home is still not complying with fire regulations (see standard 42). Some of the bedrooms were checked. They were decorated to a good standard. The rooms contained a variety of personal furniture and fittings that reflected the individual’s personality. The home has sufficient bathroom and toilet facilities to meet the number of service users within the home. The bathrooms are lockable from the inside to ensure privacy. Toilets are located within reach of the communal facilities. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 18 The home has more than sufficient communal space that is both freely accessible to service users and is pleasantly decorated and furnished. There is ample space for all the homes service users to sit together in and receive visitors in private in either the lounge or the dinning room as they wish. The home is kept very clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 19 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,35 and 36 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The staff team at the home have a range of skills and ability, which appear to meet the needs of the service users. Morale was positive and staff professional in their manner during the inspection. The staff team have now all had Criminal Records Check, as a safeguard to offer protection to the homes service users. Care staff are receiving supervision on a regular basis, which contributes to the standards of care being provided to service users. EVIDENCE: The deputy manager stated that all staff have a job description in place. Staff get to know and develop a relationship with the service users they support, and are able to meet individual needs with particular attention to gender, age, cultural background and personal interests. The deputy manager informed that 7 staff are employed at the home. The home has a staff team, with sufficient numbers and complementary skills to support service users’ assessed needs. Three staff have NVQ level 2 in care and one staff is undertaking the course at present. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 20 It was previously required that the registered provider must ensure that staff files contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001. As part of the inspection process staff records were sampled for references, criminal record checks, application forms and copies of identification. All relevant documents were in place. The deputy manager was able to produce documentary evidence of staff attendance of a variety of different training courses that were relevant to the work staff were expected to perform. However the registered manager must ensure that all staff are up to date with their mandatory training. The staff supervision records were sampled and found that care staff are now receiving regular supervision covering good care practices and career development. This is in line with requirement made at the last inspection. The registered person is reminded that all staff must also have an annual appraisal to review their performance against their job descriptions and agree with them a career development plan. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 21 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38,39,41 and 42 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home is generally managed well however the health, safety and welfare of service users and staff are not being promoted/protected and this potentially places them at risk. EVIDENCE: Throughout the course of the inspection the deputy manager demonstrated a good competent management skills and appears to have created a skilled, positive and enthusiastic workforce. He has experience of working with this client group and displayed an insight into the relevant issues. It was obvious that service users choices were catered for and respected in the home and that the home was run to the needs of the service user. Service user spoken to on the day of the inspection seemed happy, confident and comfortable in his surroundings. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 22 There was no evidence of quality assurance system in place such as quality audit or service user’s surveys. The registered manager must ensure that there in an effective quality assurance and quality monitoring systems in place based on seeking the views of service users to measure success in achieving the aims, objectives and statement of purpose of the home. The registered manager must also ensure that an annual development plan is in place based on a systematic cycle of planning – action – review, reflecting aims and outcomes for service users. The home has in place a comprehensive selection of policies and procedures covering most of the topics set out in Appendix 3 of the National Minimum Standards for Younger Adults. All the requirements made at the last inspection with regards to standard 42 have been met apart from one. The registered manager is required to ensure that all emergency fire exit doors are openable without the use of a key whenever the premises are occupied remains outstanding and would therefore be repeated. Certificates relating to health and safety were checked. These included electrical wiring and installation, gas safety and fire safety. There was no record of legionella testing had been carried out. The registered person must ensure that legionella testing is carried out. Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 23 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 Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X 3 2 X Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 24 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 YA6 Regulation 15(2) Requirement The registered manager must ensure that care plans are made available in a language and format that the service user can understand and is held by the service user unless there are clear and recorded reasons not to do so. Previous timescale for action of 31/03/06 not met. The registered manager must ensure that all staff are up to date with their mandatory training. Timescale for action 31/08/06 2. YA35 18(1)(C) 31/08/06 3. YA39 24(1)(a)(b), The registered manager must (2)(3) ensure that there in an effective quality assurance and quality monitoring systems in place based on seeking the views of service users to measure success in achieving the aims, objectives and statement of purpose of the home. 24(1)(a)(b), The registered manager must (2)(3) ensure that an annual development plan is in place DS0000065735.V293128.R01.S.doc 31/08/06 4. YA39 31/08/06 Raola House Version 5.1 Page 25 based on a systematic cycle of planning – action – review, reflecting aims and outcomes for service users. 5. YA42 13(4) The registered manager is required to ensure that all emergency fire exit doors are openable without the use of a key whenever the premises are occupied. Previous timescale for action of 14/02/06 not met. The registered person must ensure that legionella testing is carried out. 22/05/06 6. YA42 13(4) & 23(2)(c) 31/08/06 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 YA1 Good Practice Recommendations It is recommended that the service users’ guide be made available in formats suitable for the service users for whom the home is intended (e.g. appropriate languages, pictures, video, audio or explanation). Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Raola House DS0000065735.V293128.R01.S.doc Version 5.1 Page 27 - 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!