Inspection on 16/03/07 for Therese Care Home

This inspection was carried out on 16th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Therese Care Home 31/08/07

Therese Care Home 28/11/06

Therese Care Home 27/06/06

Therese Care Home 16/01/06

Therese Care Home 28/06/05

Therese Care Home 09/12/04

Therese Care Home 29/07/04

Therese Care Home 03/12/03

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Therese Care Home 144 Gassiot Road London SW17 8LE Lead Inspector Louise Phillips Unannounced Inspection 16th March 2007 10:00 Therese Care Home DS0000010231.V341869.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 Therese Care Home DS0000010231.V341869.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. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Therese Care Home Address 144 Gassiot Road London SW17 8LE 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) 020 8767 5407 Ms Iolenta Castelino Ms Iolenta Castelino Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may provide accommodation and care for one named service user over the age of 65. The category MD (E) must be removed once this service user is no longer accommodated. 28th November 2006 Date of last inspection Brief Description of the Service: Therese Care Home accommodates three residents with a mental disorder. The home is a two-storey terrace house with a small garden to the front, and larger garden to the rear of the home. It is situated close to the busy shopping centre of Tooting Broadway and so within easy access of the public amenities and transport links served by the area. The home is owned and managed by Ms Iolenta Castelino, the Registered Person. The weekly fee charged is £350 per week. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day and was carried out by two inspectors. A tour of the premises took place and care records were inspected along with other relevant paperwork. The inspectors met with the manager of the home, all three residents and one staff member. Following the previous inspections a number of requirements were made. A meeting took place with the manager and staff from the Commission on the 11th January 2007, as the Commission was concerned at the number of requirements set which were not addressed. The Proprietor was required to submit an improvement plan as to how the outstanding requirements would be addressed. The improvement plan was received by the Commission on the 30th January 2007. This inspection therefore focused on the requirements made at the previous inspection. What the service does well: What has improved since the last inspection? A number of requirements made at the previous inspection had been addressed. The level of recording in the home has increased although there is still room for improvement. Staff meetings and individual supervision sessions are taking place regularly. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide sets out basic information about the home. The home carries out its own assessment to ensure that the home can meet the residents assessed needs. EVIDENCE: The home has a Statement of Purpose/ Service Users Guide both of which required updating. The manager stated that she had this in hand and that a revised copy would be forwarded to the Commission following the inspection. This is still outstanding. Since the last inspection there has been no new residents admitted to the home and there has been no change in the current residents care needs since the last inspection. The contracts for each resident were examined and as required at the previous inspection now contains detail of the fees charged. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 9 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): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans continue to be developed in the home and were more person centred, however this must be developed further and evidenced. EVIDENCE: Residents now have separate files. Two care plans were examined and whilst improvement was noted, plans still need to be more person centred and clearly evidence the resident’s involvement with their plan of care. Care plans seen were still quite basic and lacked detail. The inspector noted that one plan contained information regarding the person’s care including support needs, the persons likes and dislikes, interests and activities. The resident signed care plans. Reviews were seen to be taking place as well as Care Plan Approach reviews, which focus on residents mental health needs. However, decisions made at the Care Plan Approach were not seen to have Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 10 been integrated into the homes care plan. The manager reported that staff are aware of these review meetings and their outcomes. Risk assessments are in place but these are basic and mainly focus on keeping people who use the service safe. One resident who spoke to the inspectors had mixed feelings about restrictions placed on him but confirmed that he liked living at the home and got on well with all the staff who he described as “lovely ladies”. This resident told inspectors that he would like to do more outside of the home and felt that they were capable of doing much more with his life. He was advised to talk to his care manager. This was fed back to the manager of the home who stated why restrictions were in place. Inspectors stated that this must be kept under review and clearly evidenced in the persons care plan. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 11 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): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally staff are aware of the need to support residents to develop their skills, including social, emotional, communication, and independent living skills, however the process could be improved. Residents must be further encouraged and supported to access the community. Opportunities are available for residents to be involved in the shopping and the preparation of meals. EVIDENCE: The inspectors met all three residents, one of whom was going to attend Mass at the local church. This is a regular occurrence for this resident who is able to go out to known places. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 12 All three residents were appropriately dressed and a relaxed atmosphere in the home was very apparent. One resident was watching television and did not wish to speak to the inspectors. The manager stated that this resident chooses to stay at home and watch television, despite numerous attempts to engage him in activities. The third resident said that he enjoyed living at the home, got on well with the staff. He currently attends a group at Springfield hospital one morning a week and enjoys art. He also spends a lot of time drawing in the home and several of his pictures are displayed in the home. He said that he had no complaints about the home and described it as “paradise” compared to his last place. The manager is endeavouring to support him get involved in a gardening project. In discussion with this resident he stated that he would like to do more as he has a lot of time on his hands. The manager is aware of this and is in discussion with his social worker as to appropriate activities. This resident attends to the garden at the house, which was well kept. Residents have access to a communal lounge. The television and music equipment is in the dining room. One resident confirmed that he could help himself to drinks and food in the kitchen although he tended to wait until offered by staff. Meals tended to be prepared by staff although the resident said that they could access the kitchen when they wanted during the day to prepare snacks of their choice. The manager stated that she often took residents out for the weekly food shop and consulted with them regarding home furnishings where possible. The kitchen remains locked at night. A risk assessment dated October 2003 states that this is due to ‘health and safety regulations’, due to absent staff, despite the home being staffed at night. A second sheet of paper states that ‘if and when staff are present during the night the kitchen is still locked at 10:30pm for H&S (health and safety) reasons’. There is no evidence that this has been reviewed since 2003. There was also no evidence in the care files that any resident would be at risk if the kitchen was not locked. However inspectors noted that residents have agreed to this practice. One resident said he has no need for anything from the kitchen at night. This practice should be included in the homes Statement of Purpose and Service User Guide. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 13 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): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The records do not clearly demonstrate that the personal and healthcare needs of the residents are appropriately met. A medication procedure is in place, however medication records were not up to date with gaps in the recording on the Medication Administration Records sheets. The current practice and lack of adequate recording puts people who use the service at risk. EVIDENCE: The care plans indicate that the residents generally attend to their personal care needs. The manager stated that residents have access to baths when they wanted and appropriate encouragement would be given where residents were seen to be neglecting their personal care. A record is kept of appointments with GPS, dentists and CPN’s, care managers. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 14 Medication which was to be dispensed today was already signed as given although was in the dossette box. Individual boxes of medication were not individually labelled. Dispensed creams for two residents were not detailed on the medication Administration chart. Staff require external training in the administration of medication in order to ensure residents are not placed at risk. The requirement made at the previous inspection has been repeated. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 15 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): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a complaints procedure at the home. Safeguarding of adults guidelines have been updated to ensure that appropriate action will be taken in the event of abuse being identified or alleged. EVIDENCE: The home has a complaints policy that provides suggestions of different people that a resident can complain to, such as the home manager, social worker or the CSCI. Staff had all received training in protection of vulnerable adults and evidence of this was seen on staff files examined. Wandsworth Inter- agency guidelines were available in the home. There is no policy or procedure at the home to detail the practices regarding resident’s monies and financial affairs. The current arrangement for one resident is that his personal allowance is paid into the Managers account and she provides him with a daily allowance. However, despite the resident agreeing with this practice, this should be reviewed with the resident and his social worker and an account opened in the resident’s name. The other two residents have their own accounts and are sole signatories. The manager looks after their bank books. Again both residents have signed to state that they are Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 16 in agreement with this arrangement. The Social Worker of one is also aware of this and maintains that this is practical given the needs of their client. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well decorated throughout. EVIDENCE: The home is well decorated, bright and clean and hygienic throughout. Areas identified in the previous inspection report had been addressed. Each bedroom was observed to be well maintained and were personalised. Two residents confirmed that they liked their rooms and that staff respect their privacy when in them. At the previous inspection a new door had been installed in the rear lounge. This was observed to have a crack in the window. This door was still wedged open, as were all doors throughout the home. The manager was informed that Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 18 door wedges must be removed and consideration given to installing magnetic doorstops. The Registered Person stated that the fire officer had agreed to using the type of door wedge at the home. The manager must provide the Commission with written evidence from LFEPA that they are satisfied with the arrangement in place. Therefore the requirement made at the previous inspection has been repeated. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, 35 & 36 Quality in this outcome area adequate. This judgement has been made using available evidence including a visit to this service. Recruitment checks are in place. Staff development and training must be given a higher profile within this home to ensure that staff understand the complexity of the residents needs in order, to ensure that they can be fully met. EVIDENCE: Four staff files were examined which included the newest staff member. Criminal Bureau checks were seen to have been carried out for all staff. References for the newest staff member was brief and included a character reference. A job description was seen and an employment contract was in place as well as a photograph of the staff member. A staff training programme was seen which included all statutory training, however not all courses were certificated .In view of the needs of the residents at the previous inspection it had been required that staff receive additional training in specific areas in relation to residents care needs. Evidence of this Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 20 was not seen and the requirement made at the previous inspection has been repeated. The manager stated that her staff were not forthcoming in undertaking the NVQ qualification and none of the staff currently hold a care qualification. The manager must address this shortfall via her training and recruitment of staff. Supervision records were also seen and inspectors noted an improvement in this area. A new supervision form was in place. The manager reported that supervision took place bi- monthly. Record of supervision was brief and focussed on the following areas, responsibilities, training and personal issues. The supervisor and the supervisee signed sessions. Staff meetings were also taking place but again the record of these meetings were very brief. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 & 43 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is aware of the need to promote safeguarding and health and safety in the home, however systems in place were not always seen to be up to date. EVIDENCE: The manager has yet to undertake the Registered Managers Award. Staff designated to work alone must have appropriate knowledge, information and support they need to care for the residents. All staff who work alone must receive full training on all aspects of running the home. Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 22 Inspectors saw no evidence of the homes quality assurance policy being carried out. As stated at the previous inspection there was no evidence to show that the views of residents, relatives, friends or involved stakeholders had been considered. However CSCI have received letters to complement the care given in the home. A number of health and safety issues remain and require attention. Weekly hot water checks must be carried out. The portable appliance tests was still outstanding. COSHH (Control of Substances Hazardous to Health) assessments were not in place. Advice was provided to the manager as to how she should obtain this information and she made a commitment to address these areas. Regular fire drills were seen to be taking place regularly. The Fire alarm system was last serviced in February 2007. An assessment for risk of legionella was also in place. The landlord’s gas report was seen to be satisfactory. The budget plan for the service was not available for inspection. It is required that the all documentation relating to the financial viability of the home is supplied to the Commission within the timescale. The manager agreed to send in details. Therese Care Home DS0000010231.V341869.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 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 2 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 2 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 X 2 X X 2 1 Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 4(1)( c) Sched 1 Requirement A copy of the revised statement of purpose and service user guide must be sent to the Commission. (Previous timescale of the 28/02/07 not met) The care plans must include all areas of support and clearly state how these needs will be met and evidence the systems in place to monitor progress. Detailed Risk Assessments must be in place for each resident. A system for the recording of all medication received at the home and the handling, safekeeping, safe administration and disposal of all medicines must be put in place. (Timescale of the 31/12/06 not fully met) Written evidence from the fire officer must be submitted to the Commission regarding the use of door wedges in the home. (Timescale of the 31/12/06 not fully met) Timescale for action 30/06/07 2 YA6 YA18 YA19 15 30/07/07 3. 4. YA9 YA20 13(4)(c) 13(2) 31/07/07 31/07/07 5. YA29 13(4) 31/07/07 Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 25 6. YA35 18(1) All staff must receive statutory training as well as other training relevant to the needs of the residents. The Registered Manager must undertake the Registered Managers Award or equivalent. (Timescale of 31/03/07 not fully met) A quality assurance system must be put in place, which seeks written feedback about the home from relevant stakeholders involved with the service and action taken by the home. (Timescale of the 31/03/07 not fully met) Health and safety issues detailed in the report must be addressed. The manager must supply a financial plan for the service to the Commission. This must include details of the budget and how this is broken down into the running costs for the home. The Registered Person must ensure that a training plan is developed to ensure all staff receives training in continence care, customer service, understanding mental health, alcohol abuse, suicide and self harm as a minimum. The training planned for staff must be evidenced. (Timescale not fully met) 31/08/07 7. YA37 9(2)(b)(I) 30/09/07 8. YA39 24 30/09/07 9. 10. YA42 YA43 13, 23 25 31/08/07 30/09/07 23. YA35 18(1) 31/03/07 Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Care plans should be more person centred and relevant to the service and the residents. Residents who wish to participate in the community must be encouraged and supported. The Registered Person should ensure that all care staff at the home undertake the NVQ level 2 in Care qualification. 2 3. YA13 YA32 Therese Care Home DS0000010231.V341869.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Therese Care Home DS0000010231.V341869.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!