Inspection on 08/07/08 for The Bungalow

This inspection was carried out on 8th July 2008.

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

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.

Other inspections for this house

The Bungalow 11/05/07

The Bungalow 06/12/05

The Bungalow 12/07/05

The Bungalow 09/11/04

The Bungalow 11/06/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/11/2008.

CARE HOME ADULTS 18-65 The Bungalow 1 Short Street Brownhills Walsall West Midlands WS8 6AD Lead Inspector Kathryn Marks Key Unannounced Inspection 8th July 2008 09:00 The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 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 The Bungalow DS0000041185.V367843.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 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. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Address 1 Short Street Brownhills Walsall West Midlands WS8 6AD 01543 372333 01543 372308 admin.cch@btconnect.com 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) Chase Community Homes Kelly Richards (Temporary Manager) Care Home 7 Category(ies) of Learning disability (7) registration, with number of places The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Learning Disability 7 Date of last inspection 11th May 2007 Brief Description of the Service: The Bungalow is a Care Home that aims to provide specialised care, support and teaching for people with autism and allied conditions. There are six people living there. Accommodation within the home includes a living room/dining area, single bedrooms (all with ensuite facilities), kitchen, laundry and office. There is parking for up to three cars at the front of the building and an enclosed garden to the rear. Emphasis has been placed on a small group living enabling a high staff to resident ratio. The home opened in 2003, is domestic in nature and located at the centre of Brownhills very close to shops, markets, and post office, public houses and bus routes. The Bungalow is one of a number of homes that forms Chase Community Homes. The homes Statement of Purpose and Service Users Guide were not reviewed at this visit therefore, readers of this report may wish to contact the home for up to date information regarding Fees. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is one star. This means that the people who use this service experience adequate quality outcomes. This Unannounced Key Inspection took place on the 8th July 2008 by one inspector over 7.5 hours. We used the National Minimum Standards for Younger Adults as the basis for the inspection. We looked at all the information that we have received, or asked for, since the last key inspection. This included: The annual quality assurance assessment (AQAA) that was completed and sent to us by the service. Completion of the AQAA is a legal requirement and it enables the service to undertake a self-assessment, which focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. The previous key inspection findings. Staff working at the home or people using the service returned no surveys to us. On arrival at The Bungalow the temporary care manager three support workers and the cook were on duty and five people using the service were at home. Arrangements for the day were discussed with us to enable us to talk to or observe and engage with individuals and for them to continue with their plans for the day. We engaged via signs and body language with two people using the service and reviewed their records in detail. Two staff records were examined, we interviewed both staff and observations were made of positive interaction between staff and young people during daily events. We have not received any complaints about the service. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The AQAA told us that the curriculum had improved giving people using the service more choice throughout their daily lives. The services day centre has opened all people using the service attend. We visited this adjacent centre as part of our inspection to observe activities taking place, as people using the service were moving between the day centre and The Bungalow. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 7 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. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 8 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 The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 was reviewed at this visit. Quality in this outcome area is good. People who wish to move into the home they and their family receive all the information they require and they are assessed so that they can be assured the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Stable group of young people using the service with no new admissions to The Bungalow since the last Key Inspection visit to the home in May 2007. Assessments are carried out prior to the admission of people using the service. Care plans contained full details of assessments and how needs highlighted are to be met by staff at The Bungalow. The assessments of two people using the service were looked at these were detailed and gave staff enough information to care for individuals safely. This means that they could be assured that the home could meet their needs before they moved in. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 10 People using the service had limited understanding and lack of conversation made it difficult to ascertain from individuals if they felt that their needs were being addressed, observations of people using the service at the time of this inspection indicated they were. We actively interacted with three service users where some engagement took place by signs and body language. The AQAA told us that we have our statement of purpose our brochure of the home and a website. Service Users guide to the home, detailed assessments by professionals. During the last five years the Bungalow has expanded from a two bedded to a seven bedded home. Currently six bedrooms are in use showing that we have successfully assessed and placed four new clients into our environment. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 9, were reviewed at this visit. Quality in this outcome area is good. Individuals are involved in decisions about their lives, and are enabled to play an active role in planning the care and support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We observed individual care plans in place in a modular format covering personal profile, medication, Health Care needs, General Practitioner, personal hygiene, mealtimes. Care plans also record body language and ways of communication, makaton, pictorial, and picture exchange, and activities. Care plans contained detailed risk assessments covering all aspects of daily lives and routines. All care plans are reviewed on a regular basis. We looked at care records of two service users in detail that were informative and up to date. We were told families are involved in compiling care plans and people using the service is present but not always able to express their wishes and make a constructive The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 12 input. Identified personal preferences and goals are recorded and enable people using the service to achieve goals either at home or day learning centre. We saw people being offered choices and taking decisions by body language or pictorial format. A review of the analysis of stakeholders in house surveys told us no one raised any adverse comments regarding their sons/daughters privacy, dignity and general happiness. All indicated from the questionnaire that The Bungalow was ‘good’ in this respect. This means that the staffs have the information they require to support the people using the service safely. The AQAA told us that care plans are detailed and well-structured offering detailed information about each service user and all aspects of their life and abilities. We offer alternative methods of communication, pictorial, picture exchange system and Makaton. This helps us to take a person centred approach to communication. Risk assessments are carried out to ensure that clients are not limited in their choice of activities. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16, 17 were reviewed at this visit. Quality in this outcome area is good. People using the service are given every opportunity to enjoy fulfilling lives and friendships with appropriate support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Bungalow is one of three homes that form part of Chase Community Homes, which also has its own day learning centre. All people using the service who live at The Bungalow have no or very limited verbal communication. Discussions with staff identified that they had a good understanding of the needs of people using the service and what their preferences are. Family contact is maintained by parents visiting the person using the service at The Bungalow or the person going home for weekend visits to their parents. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 14 People using the service access community facilities, visiting various venues leisure centre, local outdoor pursuits where they go climbing, abseiling, sailing at Aldridge. All attend the day learning centre at different times of day where they are involved in music sessions which we observed, hydrotherapy pool, arts which we saw samples of, cooking 121 which we saw cake made for tea, IT, keep fit, massage and foot spa, sensory room available. Parties and disco also held at this facility. The Bungalow has a nice dining room area overlooking the garden. There is a permanent cook employed who provides all home cooking and baking. People using the service are offered choices of food verbally or by pictures. There is a pictorial cookery book with basic recipes that can be simply followed with the assistance of staff. Menu seen offered a balanced and varied choice of food including salads and fruit. This means that people using the service are able with support to make choices about their lifestyle. The AQAA told us The Bungalow offers a wide range of activities in our curriculum and are very flexible. We liase with social workers, parents and guardians and schools to discuss needs of individuals and ways of ensuring they are met. We ensure the option is given to the client before any skill or activity starts. We ensure that birthday cards, Christmas cards, Easter etc are sent to family and friends in a symbol form assisted by clients. We encourage service users to access the local shopping community on a 121 basis and shop for presents and gifts based on the individual’s personal choice and taste. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19, and 20 were reviewed at this visit. Quality in this outcome area is good. The home meets the physical emotional and healthcare needs of people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care plans are in place and identify how support will be provided. There are 4 young ladies and 2 young men living at the home. People using the service maintain family contacts via weekend visits home or parents visiting the bungalow and going out with person using the service. The healthcare needs of people using the service are met by people being registered with local General Practitioner. People attend local healthcare practice when they need to see their general practitioner. There is a key worker system in place at the home and we observed key workers to be meeting the needs of individuals in a sensitive manner. Medication – Policies and procedures in place to inform staff of practices. All staff that administers medication is trained to do so, we saw training records. No person using the service is risk assessed to self-administer. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 16 Medication is securely stored and medication administration sheets were seen and signed up to date. A regular review of medication and healthcare takes place. This means the health and personal care that people receive is based on individual needs. The AQAA told us the home offers 121 support if requested or needed when carrying out personal care. Care plans have clearly stated preferences to the individual and problem areas. Independence skills are promoted and recorded. Regular medication reviews and health checks take place. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22, 23 have been reviewed on this visit. Quality in this outcome area is good. People who use the service are able to make complaints and are protected by the home’s procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observations when visiting bedrooms of people using the service were that people had a pictorial complaints procedure on the wall. One person was able to indicate that they understood the symbols to us. We saw the complaints book this contained written complaints procedure and pictorial complaints procedure. No complaints had been recorded since 2005. The manager told us that no complaints had been made to the home. We saw the protection/abuse policy and the whistle blowing policy in place when we reviewed policies and procedures. We were told 8 out of 12 staffs have completed Adult Protection training. We saw training records that confirmed this. This means that people who use the service can be assured that their views will be listened to and they are cared for safely. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 18 The AQAA told us there is a service users guide in each bedroom in symbol form. A stakeholder survey is completed every twelve months. Key Worker for each individual client. We maintain confidentiality. We have received no complaints in the last twelve months. Confidential personal information is kept locked away with authorised access. We have policies in place on Whistle Blowing, Equal Opportunities and Confidentiality. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 30 were reviewed at this visit. Quality in this outcome area is good. The Bungalow offers a good standard of en/suite accommodation to people who use the service in clean, safe homely surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Bungalow is suitable for its stated purpose, with parking for three visitors cars at the front of the home. We observed the home to be well maintained and odour free. People using the service were moving around the home with staff and carrying out various jobs. Good interaction was taking place with people using the service responding to staff who were sensitive to service users needs. There is a light bright lounge/dining room with television that people used as they wished. Individual bedrooms were personalised and reflected choices of the person occupying the room. All bedrooms had an en/suite facility. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 20 The home was clean and fresh with the smell of home baking and cooking being evident. This means that people who use the service live in a safe, well maintained and Comfortable environment. The AQAA told us that there are Individual bedrooms with en/suites. Decorated to peoples taste. That Health and Safety is taken into account. Infection control procedures are taken into account red bags and personal protective equipment (P.P.E.) is used. We had our infection control inspection and were very pleased to get 93.9 result. We have redecorated rooms as necessary or requested by clients. Rooms personalised. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 have been reviewed at this visit. Quality in this outcome area is good. A well trained and experienced staff team support the people using the service and keeps them safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has good recruitment procedures in place staff had Criminal Records Bureau and Protection Of Vulnerable Adults checks carried out and two references are taken up prior to employment commencing. Two staff files were reviewed and appropriate checks and references were on files. Two staff interviews were carried out and staff confirmed that they had received detailed induction that made them feel confident and knowledgeable to do their job. Both had received training in First Aid, Medication, Autism, Food Hygiene, Health and Safety, Fire Safety, Manual Handling and Risk Assessments and Equality and Diversity. All the above training is ongoing including refreshers for all staff. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 22 Staffing had maintained consistent levels to ensure numbers, skills and qualifications, with a presence of long serving experienced staff. Off-duty was examined, providing evidence that the home is suitably staffed in numbers, skills and qualifications to ensure the needs of the people using the service are met. The home has in place a staff-training programme and there is a staff-training plan with records maintained. All staff receives appropriate induction. Regular assessments of training needs take place with all staff receiving training specific to their post. There are twelve staff at the home four staff have NVQ Level 2, five staff are working towards this. Two staff has NVQ Level 3 and two staff is working on NVQ Level 3. This means that staff on duty at the home are satisfactory in numbers and appropriately trained to care for people using the service safely. The AQAA told us we offer a wide range of training as and when needed. Good interview process, CRB and POVA checks done on all successful applicants. Training matrix completed and updated regularly. Supervisions and appraisals carried out. More staff has been enrolled on NVQ Levels 2& 3 in the last twelve months. The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 42 were reviewed at this visit. Quality in this outcome area is adequate. The people using the service are safeguarded by management systems. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Bungalow presents as a well run home with the staff working as a team for the benefit of people using the service. There is a temporary manager at the home who is awaiting CRB clearance so she can be interviewed for the Care Manager position. The proposed Care Manager has been at the home for five years and has a good knowledge and understanding of the needs of the people using the The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 24 The proposed Care Manager has NVQ Level 3 and is currently doing the Registered Managers Award. She attends all training offered to staff to constantly update her knowledge. The home has a formal quality assurance system in place to monitor standards and ensuring that they are met. This system was seen and discussed with the proposed Care Manager. We saw records and work sheets that identified Regular servicing of equipment is carried out, PAT testing, Boilers, Heating, Legionella Testing, COSHH. Recent Infection Control Audit by Walsall NHS the home obtained 95.3 result. Health and Safety posters were displayed in the Kitchen, Care Office and Laundry providing information for staff. Proposed Care Manager told us that the service has in place a safe working practices booklet. We saw the booklet during inspection along with Health and Safety risk assessments. The AQAA told us the Proposed Care Manager and Deputy Manager has both worked for the company for five years. Proposed Care Manager has NVQ Level3 and is working towards her registered managers award. Deputy Manager has NVQ Level 2 and is working towards NVQ Level 3. Both attend all available training courses. Regular supervision takes place. Quality Assurance is maintained. Monthly owners inspections All statutory training is provided The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 25 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 X 2 3 3 X 4 X 5 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 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 2 X 3 X X 3 X The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 26 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 The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 The Bungalow DS0000041185.V367843.R01.S.doc Version 5.2 Page 28 - 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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