Inspection on 17/04/08 for Rastrick Hall

This inspection was carried out on 17th April 2008.

CSCI found this care home to be providing an Adequate service.

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

Rastrick Hall 15/04/09

Rastrick Hall 10/10/07

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Rastrick Hall Close Lea Avenue Rastrick Brighouse HD6 3XB Lead Inspector Paula McCloy Key Unannounced Inspection 17th April 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rastrick Hall Address Close Lea Avenue Rastrick Brighouse HD6 3XB 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) 0845 6037752 rastrickhall@orchardcarehomes.com www.orchardcarehomes.com Orchard Care Homes.Com Limited Position Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Rastrick Hall DS0000070125.V362507.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 category: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 40 10th October 2007 2. Date of last inspection Brief Description of the Service: Rastrick Hall is a new purpose built home. It offers residential care for 40 older people. The accommodation is arranged over three floors. All of the bedrooms are single and have en-suite toilets and showers. There are lounges and dining rooms on each floor. All of the rooms are comfortable and nicely decorated. There is a garden area at the side of the building that can be used in fine weather. There is a car park to the front of the building. The current weekly charges range from £485 - £535 per week. Additional charges are made for hairdressing, chiropody, dry cleaning, newspapers, personal toiletries and private phone installation and calls. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Rastrick Hall opened in July 2007. At the first inspection in October 2007, the service was assessed as being poor. This was because too many people had moved in and there were not enough staff working at the home to meet their needs. Since that inspection, we have been back to the home twice and have met with some of the senior managers for Orchard Care Homes to make sure that improvements have been made. The company have taken our concerns seriously. No admissions have been made since the first inspection and staffing levels have been increased with the use of agency staff. This inspection was carried out to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home, which was carried out over one day and lasted approximately 8.5 hours. During the visit we spoke to eight people who live in the home, 1 district nurse, 9 staff and the manager. We also talked to two visiting National Vocational Qualification (NVQ) Assessors, who were assessing two staff at the home. We observed care staff delivering care, looked at various records and looked around the home. The home completed a self assessment form before the inspection in October 2007, which provided us with some very detailed information about the service. We have used some of that information in this report. Comment cards were sent to 10 people living in the home, 10 relatives, 10 staff and 5 health care professionals; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. Seven people living in the home, 5 relatives and 4 members of staff wrote to us with their comments. Their comments have been used in this report. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home needs to have a manager that is going to stay and develop the service. Staff at the home have worked hard and have made improvements. The manager knows that she needs to make sure that these are maintained and developed further. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 7 We asked people how they thought the care home could improve. These are some of the comments we received: ‘Have more consistent staff to cover the shifts.’ ‘Organise more activities and excursions.’ ‘Make sure there enough hot cooked breakfasts.’ ‘More involvement of staff with residents on a one to one basis.’ Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 8 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 Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4. (Standard 6 does not apply) People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are given information about what the service provides. Staff understand that they need to assess people before they move into the home so that they are sure there are enough staff to meet everyone’s needs. EVIDENCE: There is a service user guide available, which gives people important information about the service. We saw copies of the guide in people’s bedrooms. Staff are trying to deliver the service that is set out in this document. A copy of the resident’s contract is in the service user guide. We saw signed copies of these documents this means that people are given important information about their rights and responsibilities. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 10 Since our first inspection in October 2007, no new people have moved into the home. This is because staff needed time to get the care right for the people who were living there already and make sure that there were enough staff on duty to look after them. We talked one of the companies senior managers and manager about taking admissions to the home in the future. They are very clear that, when they go and assess someone that is thinking of moving into Rastrick Hall, they need to consider if they can meet that person’s needs, as well as continuing to meet the needs of other people living in the home, and will need to review if the staff levels need to be increased. The home does not provide intermediate care. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s health and personal care needs are being met. EVIDENCE: We looked at a selection of care plans because we wanted to see what individual needs had been identified and what action staff are expected to take to meet these needs. Since the last key inspection in October 2007, staff have worked hard to bring care plans up to date and make sure that they are being reviewed every month. Staff must make sure that they maintain these improvements. We looked at three care plans. We could see from these plans that people are receiving health care from a range of people such as doctors, district nurses, opticians and chiropodists. Details of any visits are clearly documented in the care plan together with any advice given. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 12 The care plans are detailed and set out what staff need to do to make sure that people’s needs are met. Risk assessments are in place and clearly show what action staff have taken in order to minimise any identified risks. Staff have also written summary care plans. These give staff a good overview of the support individual people. Relatives told us that staff keep them up to date about their relatives’ care and support. People said the following: ‘The staff are keen to promote contact between relatives and residents.’ ‘There have been a couple of incidents which I have been notified about.’ ‘These were dealt with through the homes procedures.’ We asked if people get the care and support they need. Relatives said the following: ‘Staff acted promptly and appropriately when my relative showed symptoms of a heart attack.’ People all looked smart and well cared for. We spoke to a visiting district nurse. She told us that staff were generally good at following instructions and doing what she asks. We did not observe a medication round. The new manager has been through all of the medication records to make sure that they are up to date and that the balances of medication held are accurate. She will be monitoring these closely to make sure staff are completing them properly. This means that people will receive the right medication at the right times. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are able to follow their own routines and there are some activities on offer to keep people stimulated. Meals at the home are good, offering choice and variety. EVIDENCE: We looked at three care plans. There was a life history on two of them, which gives staff valuable information about those people. One the other care plan staff had noted that the daughter was doing this. We looked at the social workers notes. These contained quite a lot of information about the person’s life that staff could transfer into his care plan. There was also some information on the care plans about how people like to spend their time and what they enjoy doing. People living in the home are able to follow their own routines. We saw that people get up when they want, can stay in their bedrooms or use the lounges. One the ground floor during the morning, people in the lounge were enjoying singing along to a CD. Two staff were on duty and they had time to spend with people. There was a nice relaxed atmosphere. In the afternoon staff Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 14 organised a ‘pampering session’ for the women and took one of the men out for a walk. They also arranged a quiz. People from the other floors were also asked if they wanted to attend. On the other two floors a lot of the people seem to spend the majority of their time in their bedrooms, watching TV or pursuing their own interests. Outside entertainers are visiting the home and staff said that people enjoy these sessions. The manager is aware that the activities programme and staff training in this area needs to develop. This will mean that people are offered appropriate activities and are kept stimulated. Relatives are made to feel welcome when they visit. One person said ‘my visits to the home have always been pleasant. The staff polite, helpful and welcoming. I am usually offered a cup of tea/coffee.’ People’s views about the meals were mixed. Some people told us they were good, but some people made the following comments: ‘Not very good food, often served cold. I prefer to have my meals in my room. Often I do not receive a full cooked breakfast as requested.’ ‘Food could be improved.’ ‘There seems to be some issues about quality of food and portion sizing. (Possibly due to agency staff not knowing people well enough)’ People living in the home are given a choice of meals. Staff ask them the day before what they would like for their lunch. We saw that this does cause some confusion. For example we asked one person what they were having for lunch and they told us they were having fish and chips, which was the meal they had chosen for the following day. Another person couldn’t remember what she had asked for. It would be helpful if the menu for the day was on display and that staff keep a copy of the list so they can remind people what they have ordered. We discussed the comments about the meals with the senior manager. The home have recently recruited a second permanent cook. Prior to this agency cooks were being used and the quality of the meals was variable. She is confident that meals will now be of a consistent quality. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People know who to talk to if they are unhappy or want to make a complaint. Staff know how to use the adult protection procedures which means that people are kept safe. EVIDENCE: We asked relatives if they knew how to make a complaint. Everyone said that they did. The complaints procedure is on display and is also in the service users guide. People made the following comments: ‘I have made a complaint and this was dealt with, they took on board my concerns.’ ‘Staff have responded to the concerns and addressed them the best way they can. They are aware of what needs to be improved.’ We asked staff if they knew what to do if someone wanted to raise concerns. They all said that they did and made the following comments: ‘I would inform the manager or deputy manager.’ Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 16 There is a complaints log in place where details of any complaint that is made can be recorded together with the action taken and outcome. The home has notified us and adult protection when they have needed to. Staff are aware of the adult protection procedures and are using these properly. This means that people living in the home are being kept safe. When we visited the home in February 2008 we found that complaints and adult protection issues were not being dealt with properly. Since then the senior manager who is currently spending a lot of time at the home has made sure that any outstanding complaints and adult protection issues have been dealt with. This is an area she will continue to monitor closely. We also discussed the need for staff to undertake refresher training about the home’s ‘whistle blowing’ procedure. To make sure that all staff feel safe about reporting any concerns they have about poor or unsafe practices in the home. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a safe, clean, comfortable and well maintained home. EVIDENCE: Rastrick Hall is a new home that opened in July 2007. The accommodation is arranged over three floors. Each floor has its own lounge and dining area. There is a kitchen area in each dining room. All of the bedrooms are singles with en-suite toilets and showers. The bedrooms are well decorated and comfortably furnished. There is a TV in each bedroom and lockable space, so people can keep their possessions safe. There is an assisted bathroom on each floor and an additional shower room. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 18 The kitchen has been inspected by environmental health since the home opened and was awarded 5 stars for hygiene. The laundry is well equipped. People living in the home told us that the standard of cleanliness depended on which cleaner was on duty. Two people said ‘One good cleaner. One not as thorough.’ This was discussed with the manager who is already dealing with this issue. Staff were wearing protective clothing when needed and generally infection control procedures were being followed. We did notice that there were no paper towels in the ground floor kitchen. One relative did comment that she thought infection control procedures could be better. The manager needs to look at practices in the home to make sure all staff are following the homes procedures. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are enough staff on duty to meet people’s needs. Staff are properly checked before they start working at the home to make sure they are suitable and safe to work with older people. EVIDENCE: Staffing levels at the home have improved. There are two care staff on duty on each floor throughout the day and at least one additional member of senior staff. At night there are four care staff on duty. There are still some agency staff working at the home. People living at the home had made a number of complaints about the agency staff. The manager is trying to get agency staff in that people like and who know their needs. They have recognised the problem and are trying to sort it out. The manager is aware that she must keep the staffing levels under review and increase them as people’s needs change or as more people move into the home. When we visited there were 23 people living in the home. Staff told us that there were enough staff on duty to meet people’s needs on the ground and middle floors but that in the mornings they needed 3 people on the top floor. The manager is aware of this and told us that she will address this. The atmosphere in the home was relaxed and friendly. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 20 People made the following comments about staff: ‘I like one of the senior carers. She is excellent and I can talk to her about any worries.’ ‘More permanent staff so they can get to know me.’ ‘Permanent staff are more efficient than agency staff.’ ‘The home has been open eight months and is still having staffing difficulties.’ ‘The current staff seem to have the right skills and experience. They seem to treat individuals with respect and care.’ ‘Staffing levels have been an issue.’ ‘I do think that the staffing could be increased. My relative does worry that there aren’t enough staff and therefore tries not to be a ‘nuisance.’ The provision of agency staff still worries her, because she doesn’t know them.’ Staff working at the home are now have yet another new manager. This is the fourth one since the home opened. There has been a lot of unrest cause by the previous manager that was reflected in the surveys that were sent back to us. Staff need to be supported through yet another change of manager. Training needs to continue, to make sure that all of the senior staff have the necessary skills and experience. We looked at some of the records relating to recently recruited staff to see if staff are appropriately checked before they start work at the home. Recruitment procedures are good, references are always taken up and checks are always made with the Criminal Records Bureau to ensure that new staff are suitable to work with older people. This means that people who live there are being appropriately protected. There are nineteen care staff working in the home, 10 have completed their NVQ (National Vocational Training) level 2 or 3 in care. This means that staff are trained and competent to do their job. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is being managed properly and improvements have been made. EVIDENCE: The home has been open for 9 months and is now on it’s fourth manager. The changeovers in management have been unsettling for people living in the home, relatives and staff. One person said ‘many changes in management make it difficult to know who to go.’ The current manager has only been in post for two weeks. She has previously been the registered manager in another home for older people. When she has completed her 12 week probationary period with the company, she will need to apply for registration Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 22 with us. In order to offer some continuity one of the companies senior support managers, who has responsibility for a number of homes, is based at Rastrick Hall. The manager is aware that some improvements have been made and these need to be maintained and developed further. The home needs to show that it can continue to improve the service over a period of time. For this reason, the management of the home has been assessed as adequate. The company have quality assurance systems in place to make sure that people living in the home and their relatives are consulted about the way the home is managed. The last residents and relatives meeting was held in February. The manager holds money for safekeeping for some people. We looked at the records and found them accurate. This means that people are protected from any financial abuse. The manager is monitoring all of the mandatory training to make sure all of the staff have completed moving and handling, fire safety, health and safety, infection control, first aid and food hygiene training. All of the equipment in the home is new and not due for servicing yet. The fire test records showed that weekly tests are taking place to make sure that the system is working properly. Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 2 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 13 14 15 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 2 3 3 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X 3 X X 3 Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 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. 8. Standard OP32 Regulation 10 Requirement A manager must be registered with the CSCI. This will make sure that the home is run in the best interests of the people living there. Timescale for action 31/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rastrick Hall DS0000070125.V362507.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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