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Inspection on 07/11/06 for St Katherines Residential Care Home

Also see our care home review for St Katherines Residential Care Home for more information

This inspection was carried out on 7th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a homely and welcoming environment and service users spoken to all told the inspector that the homes staff provide an excellent service and comments received included "I couldn`t wish for a better place" and " the staff are wonderful". The inspector observed staff interacting with service users and it was clear that there was a good relationship between service users and staff. 2 visitors to the home spoke with the inspector and both were very happy with the care their relatives receive and said that their was always a nice atmosphere in the home and that they were always made welcome. Care plans provide clear information for staff on the support required and service users stated that the care that they received was good. Activities and leisure provided by the home to service users was based on service users individual choices and service users are encouraged and supported to participate in the home.Service users who wish to go out are supported in a range of external venues and some service users access the community alone or with family and friends. The home provides the training required by staff to meet service users needs and all staff spoken to have a good understanding of service user needs.

What has improved since the last inspection?

Since the last inspection the home has developed a quality assurance system to gain the views of service users, relatives and other interested parties on how the home is performing. The home has also implemented regular staff supervision with appropriate records being kept.

What the care home could do better:

No areas for improvement were identified on this occasion.

CARE HOMES FOR OLDER PEOPLE St Katherines Residential Care Home 9 Cobbett Road Bitterne Park Southampton Hampshire SO18 1HJ Lead Inspector Michael Gough Unannounced Inspection 7th November 2006 10:00 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 St Katherines Residential Care Home DS0000011953.V316153.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. St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Katherines Residential Care Home Address 9 Cobbett Road Bitterne Park Southampton Hampshire SO18 1HJ 023 8055 6633 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) Mr Zamir Afghan Mrs Parigul Afghan Mrs Parigul Afghan Care Home 20 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (20), Mental disorder, excluding learning of places disability or dementia (4), Mental Disorder, excluding learning disability or dementia - over 65 years of age (20), Old age, not falling within any other category (20) St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in MD and DE categories must be at least 55 years of age. 4th January 2006 Date of last inspection Brief Description of the Service: St Katherine’s is a care home situated in Southampton. The Registered providers also own another care home in Southampton and a Nursing Home in Fareham. The home provides accommodation to twenty service users within the categories of older persons, dementia and older persons with mental health issues. The home also offers accommodation to four service users within the categories of dementia or mental health who are aged over fifty five. The home offers accommodation in a range of single and double rooms over three floors. The home has a stair lift to all three levels of the home enabling service users access to the entire home. The home has a large central lounge and dining room and service users who wish to smoke must do so outside the home. To the front of the home is a car parking area and to the rear of the property is a large well maintained and pleasant garden, which is accessible to service users. The home is situated close to local facilities and is a short journey away from Southampton. Fees at the home range from £400 to £525 per week and service users are responsible for paying for their own toiletries, hairdressing, chiropody and items of a personal or luxury nature. St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the evaluation of the quality of the service provided at St Katharine’s Residential Care Home and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out on the 4 January 2006. The inspection took into account the homes pre inspection questionnaire; and comment cards received from 2 GP’s, 2 healthcare workers, and 7 relatives. Included in the inspection was an unannounced site visit to the home, which took place on the 8 November 2006. Evidence for this report was obtained from reading and inspecting records, touring the home and from observing the interaction between staff and service users. It was also possible to gain the views of people living at the home and the inspector had the opportunity to speak with 2 visitors to the home, 8 service users, 4 members of staff and by speaking with the homes providers and manager, who assisted the inspector throughout the visit. The home is registered to provide support for 20 service users but at the time of the inspection there were only 18 service users living at the home. What the service does well: The home provides a homely and welcoming environment and service users spoken to all told the inspector that the homes staff provide an excellent service and comments received included “I couldn’t wish for a better place” and “ the staff are wonderful”. The inspector observed staff interacting with service users and it was clear that there was a good relationship between service users and staff. 2 visitors to the home spoke with the inspector and both were very happy with the care their relatives receive and said that their was always a nice atmosphere in the home and that they were always made welcome. Care plans provide clear information for staff on the support required and service users stated that the care that they received was good. Activities and leisure provided by the home to service users was based on service users individual choices and service users are encouraged and supported to participate in the home. St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 6 Service users who wish to go out are supported in a range of external venues and some service users access the community alone or with family and friends. The home provides the training required by staff to meet service users needs and all staff spoken to have a good understanding of service user needs. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. St Katherines Residential Care Home DS0000011953.V316153.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 St Katherines Residential Care Home DS0000011953.V316153.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6: Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. New service users have a needs assessment undertaken prior to moving into the home this allows both the home and the service users to see if the home can meet the service users needs. The home does not provide intermediate care. EVIDENCE: 3 Service user files were inspected and these contained detailed assessments that were carried out before service users moved into the home. Assessments from local authorities were also available and service users spoken to confirmed that someone from the home had visited them prior to moving in and that they had visited the home to see if their needs could be met. St Katherines Residential Care Home DS0000011953.V316153.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10: Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of service users are set out in an individual plan of care, which give details of the care to be provided and also gives details on how this care should be given. The home ensures that all service users have access to all relevant health care professionals and the health care needs of service users are met. Service users are protected by the home policies and procedures for dealing with medicines and service users at the home are treated with dignity and respect and their right to privacy is upheld. EVIDENCE: Care plans were inspected for 3 service users and all contained information on dressing and undressing, washing and drying, personal hygiene, continence, diet, mobility, recreation and leisure, and mental health. All care plans had St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 10 clear information for staff on service users ability, problems and needs also the aims of the care plan and how care should be delivered. Risk assessments were in place and included information on wandering, falls, weight monitoring manual handling and actions in the event of a fire. Risk assessments were clear and gave information on the risk and how this could be minimised. Recording was clear and gave information on how the person had been during the day, there was information that one service user refused medication and for staff to monitor, also information that a service user was verbally aggressive and could not sleep, she asked to see the Dr and staff were monitoring the situation. Service users spoken with were aware that they had a care plan that helped staff look after them. Service users at the home are registered with 4 different GP surgeries and these all have a number of different GP’s, the manager said that they had a good relationship with their GP’s who visit the home regularly. The home has a policy for the receipt, storage, return and administration of medication and medication records inspected were clear and up to date. The home operates a monitored dose system from a local pharmacist and visits to the home are carried out. Currently the home has no controlled drugs however suitable storage arrangements are in place and the manager is aware of her responsibilities in this area. All staff at the home administer medication and they have all received training and specimen signatures are kept. The atmosphere in the home was relaxed and friendly and service users spoken to were very happy and cheerful and said that the care they receive at the home was excellent. They stated that they were always treated with dignity and respect and said that they had never heard anyone complain about anything. Visitors spoken to say that everyone was always cheerful and that they call regularly and they couldn’t fault the staff, they said that staff are very respectful and consult their relatives. It was clear through observations made by the inspector that the proprietors and staff know the service users very well and everyone gets on well together. St Katherines Residential Care Home DS0000011953.V316153.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15: Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. Service users are supported to exercise choice and control over their lives. The home provides a range of activities and these provide stimulation for service users. The religious and recreational interests of service users at the home are provided for. Service users are able to maintain contact with family and friends and visitors are welcome at any time and service users benefit from the homes visiting policy. Service users are provided with a wholesome and balanced diet in pleasant surroundings at times convenient to them. EVIDENCE: Care plans for service users contained information on leisure activities and also hobbies and interests and on the day of the inspection there was a communion service taking place and 9 service users were taking part, this is a regular monthly communion service and is provided from a local church. The home provides a range of activities for service users and these include, puzzles, quiz’s, skittles, foot and hand massage, flower arranging and St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 12 reminisance sessions and visiting entertainers are brought in from time to time. The majority of service users used the lounge regularly and one service user was playing the mouth organ and there was music playing throughout the inspection. Service users were spontaneously singing along. The day before the inspection a visiting clothes shop called at the home, this gave service users the opportunity to look at a selection of clothing and also to try things on, staff were on hand to assist service users with changing and service users were able to make their own decisions on what clothes they would like to buy. The inspector had the opportunity to speak with 8 service users who all stated that they were happy with the activities provided by the home some residents said they enjoyed the activities offered, other said they preferred to watch while others took part. The inspector was informed that the home is looking to employ a dedicated activities co-ordinator to assist with the homes activities programme. The home has a visiting policy and there are no restrictions on visitors and service users spoken to say that their visitors were always made welcome by the staff. The inspector had the opportunity to speak with 2 visitors who said that they were always made welcome and were very happy with the care that their relatives receive, one visitor said that their relative was moved from his previous home and was not looking forward to moving but once he had been resident for a couple of weeks he told her that it was the best thing he had done and could not be happier. Service users were able to confirm that they are able to make informed choices and were able to control their own lives as much as possible. The inspector observed staff and service users interacting and it was clear that they get on well together, service users were consulted throughout the day and staff spoken to said that they always ask service users what they want and respect their wishes and views. Staff were observed speaking to service users appropriately using their preffered form of address and also knocking on service users doors before entering. The home operates a four week rolling menu, which is changed seasonally, care plans detailed service users likes and dislikes and preferences for meals and these are incorporated into the menu. A sample of menus was forward to the CSCI prior to the inspection and the visit to the home confirmed that menus were balanced and nutritious. Service users spoken to and also visitors said that the food was home cooked and good. The home only uses fresh vegetables and staff prepare the meals. On the day of the inspection the lunchtime meal was steak pie, with roast potatoes and fresh vegetables. The alternative was an omelette with a choice of fillings. Desert was jelly and fresh fruit. St Katherines Residential Care Home DS0000011953.V316153.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures protect service users for any form of abuse. EVIDENCE: There has been 1 complaint received by the home since the last inspection, this was dealt with well by the home and the complaint was resolved to the satisfaction of all concerned. Service users spoken to were confident about raising any concerns they may have and a copy of the homes complaints procedure was placed in all service users rooms, visitors to the home also confirmed that they had received copies of the homes complaints procedure. The home has a policy and procedure for dealing with any complaints and this contained all of the required information and gave details of how to contact the CSCI. Staff members spoken to were also aware of the complaints procedure. The home has a whistle blowing policy and also a copy of the Hampshire Adult Protection procedure and staff have received training on adult protection. Staff spoken to were aware of their responsibilities in this area and knew what to do should they suspect any form of abuse had taken place. St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 14 St Katherines Residential Care Home DS0000011953.V316153.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. Service users live in a safe, well maintained environment and have access to comfortable indoor and outdoor facilities and the home is clean pleasant and hygienic. EVIDENCE: The inspector toured the building and all areas of the home were clean and tidy and furniture was in a good state of repair. The home comprises of 3 floors with a chair lift to aid access. There is a large communal lounge/dining area and the majority of service users were seen to be using the lounge, which was bright and airy. The home has an enclosed rear garden, which is accessible to all service users and this was tidy and attractive. The home employs a maintenance man who carries out routine maintenance and rectifies St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 16 any defects as they arise. Decoration of the home is on a needs led basis and some service users rooms have been recently decorated. The home has a laundry with industrial washing machine with sluice facility and can wash clothing at appropriate temperatures and there is also an industrial tumble drier. Care staff at the home carry out laundry duties and all have received training with regard to infection control. All areas were clean and there were no offensive odours. St Katherines Residential Care Home DS0000011953.V316153.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The home has sufficient staff on duty to ensure service users receive the support they require. Staff were found to be well motivated and competent to do their jobs and service users are protected by the homes recruitment procedures. The home provides training for staff to enable them to carry out their roles effectively. EVIDENCE: A copy of the homes staffing rota was forwarded to the CSCI prior to the inspection and on the day of the visit the inspector looked at the staffing levels for the day of the visit and this confirmed that there are 3 staff members on duty between 0800 & 1700 and 2 staff on duty between 1700 and 2000. Between 2000 and 0800 there are 2 staff on duty with one of these able to sleep between 2200 and 0600. Staffing numbers were discussed with the homes manager and she stated that with the present numbers of service users, staffing levels were sufficient. Staff spoken to also said that staffing levels were adequate and service users said that there were always enough staff around. St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 18 The home employs a total of 10 care staff and has 3 members of staff who have NVQ and 4 staff members are due to start NVQ shortly. Recruitment records were seen for 2 members of staff and these contained all of the required information and relevant checks had been carried out. Staff training records were looked at and this showed that staff have received suitable induction and that appropriate training is provided to enable service users to carry out their jobs effectively. Training includes: The philosophy of care, care practices, dementia care, first aid, infection control, medication, health and safety, fire, adult protection, complaints, confidentiality, and moving and handling. St Katherines Residential Care Home DS0000011953.V316153.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The home is run in the best interest of service users and the homes manager is experienced and competent to run the home and service users, relatives and other interested parties are consulted about the running of the home and how it is meeting its aims and objectives. There are adequate financial procedures in place and staff receive appropriate supervision. The health safety and welfare of service users and staff are promoted and protected EVIDENCE: Staff and service users spoke positively about the homes manager and service users spoken to confirmed that the manager is available most days and that St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 20 she seeks their views about any changes to the home. The manager is a registered nurse and has been running the home for 5 years and is currently completing the Registered Managers Award. The registered manager also is one of the providers and as such has responsibility for two other premises. The home has quality assurance questionnaires and these are available for service users and visitors to the home, including health care professionals and GP’s. On audit of the completed questionnaires positive comments were found about the service provided and of the homes staff. The home does not manage any service users finances, however the manager does hold some monies for service users for safekeeping and appropriate records and receipts are kept. Individual records are maintained and any charges for extras such as hairdressing and chiropody are invoiced to relatives. The home provides supervision for individual staff members at least 6 times per year and records of supervision are kept in staff files. The home has a fire risk assessment for the building and the fire logbook was inspected and all required recording and testing had been carried out. Certificates were seen for annual tests of equipment and a new fire safety panel was installed in July 2006, stair lifts were inspected in July 06, bath hoist on 10/7/06, the gas safety inspection was carried out in September 06 and the electrical wiring was last tested in March 2003. St Katherines Residential Care Home DS0000011953.V316153.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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 St Katherines Residential Care Home DS0000011953.V316153.R01.S.doc Version 5.2 Page 24 - 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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