Care Home: Danecroft Residential Home

What has improved since the last inspection? Medication systems for ordering and storage are good. However previously not all staff have been proficient in giving out medication to one person as prescribed by their Doctor. Management had acted swiftly and made changes to stop this happening again. When we audited medication at this visit everything was correct and people had received their medication when they should have. What the care home could do better: There has been significant work undertaken by the owners regarding the environment these included patio doors installed in the dining room, planting at the front of the home and also in the courtyard, redecoration of many rooms and improvement of the soft furnishings and hanging of wall paintings. In addition a main line gas has been plumbed up to the building and a new laundry system has been installed. A gas fed oven has also been installed in the kitchen. However there remain areas in the home that still need to be improved on to create a homely enviornmet throughout the building.The company are now seeking to undertake a refurbishment plan. Acknowledgement is given that the owners have made arrangements to employ a person to manage and oversee training and they are due to take up their role later in April 2009. However at the time of this visit not all staff had received the training updates that they need.Danecroft Residential HomeDS0000072821.V375078.R01.S.docVersion 5.2Page 7 Key inspection report CARE HOMES FOR OLDER PEOPLE Danecroft Residential Home 3 Dane Lane Wilstead Bedfordshire MK45 3HT Lead Inspector Katrina Derbyshire Unannounced Inspection 20th April 2009 09:30 DS0000072821.V375078.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Danecroft Residential Home Address 3 Dane Lane Wilstead Bedfordshire MK45 3HT 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) 01234 741573 01234 742608 St Andrews Care Homes Ltd Miss Teresa Margaret Day Care Home 33 Category(ies) of Dementia (33), Old age, not falling within any registration, with number other category (33), Physical disability (33) of places Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Physical Disability - Code PD The maximum number of service users who can be accommodated is 33 Not Applicable 2. Date of last inspection Brief Description of the Service: The home is situated in Wilstead, close to the bus route serving the towns of Bedford and Luton. There are 33 bedrooms, many with en-suite facilities or hand wash basins, on 2 floors. A passenger lift serves the first floor. There are 2 lounges/dining areas, 1 lounge/reception area, and a dining room. In addition to en-suite/basin facilities in bedrooms, bathroom facilities are also provided. There is a garden, and parking spaces are available to the front of the home. Information about the home can be seen on request at the home, or on the home’s website at www.standrewscarehomes.co.uk. The following information about fees charged at the home was obtained on 20th April 2009 Weekly fees are £520.00. Fees do not include hairdressing, toiletries, newspapers, or special outings. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This service submitted an application to the Commission for Social Care Inspection in 2008 to change an element of its registration to reflect a change in its ownership to a Limited company. As a result of this in accordance with our registration guidance the service from 21st October 2008, was considered a new service. However it should be noted that the home had previously been inspected and its staff, manager and systems remain the same. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This was an unannounced key inspection carried out on the 20th April 2009. The care of three people was looked at in detail and this is known as case tracking. Tracking people’s care is the methodology we use to assess whether people who use social care services are receiving good quality care that meets their individual needs. Through discussion, observation and reading records, we track the experiences of a sample of people who use a service. During the visit the communal areas of the home were seen alongside some of the individual rooms. Time was spent with many of the people who live at the home in one of the sitting areas. Observations of care practice and communication between the people living at the home and staff was also made at the inspection. The management’s submission of documentation was also considered prior to the site visit. The focus of this inspection was to look at the key standards. What the service does well: Areas that the service does well include: When staff are recruited to care homes there are safety checks that need to be done, this helps to protect the people living at the home. Management must make sure for example, that they receive at least two references and carry out a check known as a Criminal Records Bureau check, this helps them to decide if the person is going to be suitable to work with vulnerable people. This had been done, all staff before being allowed to work had these checks made about them. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 6 Staff at the home are good at making sure people receive the medical support that they may need. If someone needs to see a Doctor if they feel unwell, staff are quick to arrange this on their behalf if they need help with this. Staff will also find out if that person needs someone else to go with them, and will also arrange this. This means people living at the home receive prompt treatment and support to access medical treatment. When we last inspected this service in July 2008 people told us about the difference in the way that they receive care and support since the home had changed ownership. This is still the same. People feel that staff are encouraged to sit and spend time talking with them which they say did not happen before and this has helped them to develop good relationships with the staff team. What has improved since the last inspection? What they could do better: There has been significant work undertaken by the owners regarding the environment these included patio doors installed in the dining room, planting at the front of the home and also in the courtyard, redecoration of many rooms and improvement of the soft furnishings and hanging of wall paintings. In addition a main line gas has been plumbed up to the building and a new laundry system has been installed. A gas fed oven has also been installed in the kitchen. However there remain areas in the home that still need to be improved on to create a homely enviornmet throughout the building.The company are now seeking to undertake a refurbishment plan. Acknowledgement is given that the owners have made arrangements to employ a person to manage and oversee training and they are due to take up their role later in April 2009. However at the time of this visit not all staff had received the training updates that they need. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 7 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre admission assessments are completed to a very high standard so staff at the home have a thorough overview of each persons needs to show them the individual care and support the person will need. EVIDENCE: The statement of purpose was not displayed in the home, the manager advised that someone must have taken the copy and another one was then printed off from a computer. The document provided information on the staffing, accommodation and services available at the home. Feedback from people using the service indicated that they felt they had been given enough information, before they decided to move into the home. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 10 Assessment documentation was in place for people that had moved into the home recently. As previously assessed this showed that the social, psychological and physical needs of the person had been looked at to ensure staff would know if they had the skills and experience to meet their needs. Management through discussion confirmed that an assessment of someone’s needs was always undertaken prior to their admission. The standard of assessment and attention to detail within the entries made were very good. This resulted in a very clear picture of the individual needs of the person. One person spoken with confirmed that they had been fully involved in their assessment; they had been given the opportunity to influence their own assessment. Intermediate care is not provided at the home. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide the information needed by staff so that they are able to provide a consistent level of care and support. EVIDENCE: Each standard with the exception of standard 7 and 9 remained as previously assessed. Care plans were seen to be up to date and sufficient in their content to guide staff in how they should support the person. Person centred planning had been implemented since the previous inspection. Staff when questioned were able to describe the needs of the people living at the home. People living in the home advised that they also had been given the opportunity to be Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 12 involved in their care planning when this was possible and could sign them if appropriate. Everyone living at the home is registered with a General Practitioner. District nurses also attend the home to undertake any nursing responsibilities. Everyone is assessed each month, or more often if the person is unwell for example. Tools that are used by staff in the home include Waterlow (pressure ulcer risk assessment) and NST (Nutritional screening Tool) to identify if the person might be at risk of developing a pressure ulcer or becoming malnourished. The care plans and risk assessments identify who is at risk and what action is being taken to reduce the risk. In addition staff have undertaken risk assessments aiming to prevent falls and they submit information from an internal falls audit on a regualr basis to the National Falls Prevention Team. Records seen within the care files examined showed documents from health care practitioners, for example a dietician to demonstrate that access was gained when a person required it. People living at the home through discussion confirmed they received the medical support that they needed. Medication stocks were examined alongside the records relating to this area. The storage of medication was seen to meet national guidance in this area. Records of ordering medication were in place and provided the start of an audit trail. The medication records and balances when checked at this visit were correct. Information supplied by the service showed that there is a visiting exercise teacher who does exercises with some of the people on a weekly basis. In addition there is a visiting hand and arm aromatherapist who visits on a weekly basis offering this relaxing activity to the people. All residents are called by the name they choose, evidence in care records show that this is asked at the first point of contact with the person. All bedrooms are single occupancy. The home have recently registered with the Gold Standards Framework on a local basis and both the manager and the deputy are enrolled on a nine month programme which aims to empower them to provide optimum levels of health and personal care right up until death and then afterwards for bereaved families, friends, other residents and staff. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at this home feel that the choice of meals provided are sufficient to meet their tastes and preferences. EVIDENCE: The standards within this section were noted to be as previously assessed. Staff make daily routines as flexible as possible to enable them to provide Person Centred Care. There are no restrictions to any activity that people choose to do. The service in their written vision and values state that they recognise how important it is to the individual to continue with personal and social relationships and there is no restriction on visitors and/or residents going out to continue their involvement in community activities or to become involved with the community. On speaking with people living at the home everyone Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 14 supported this view. People that had lived at the home for many years as at the previous inspection spoke of the many changes since the new owners had taken over. They said that they encouraged the staff to speak with them and spend time with them, this had not been like this before. People when they move into the home are encouraged to bring in their personal belongings to personalise their room. When rooms need decorating people are given a choice as to the colour scheme they would like. All people spoken to stated that they enjoyed their meals. A menu board detailed the choices available. The most recent environmental health inspection found that there were sufficient standards in this area being maintained. In addition nutritional risk assessments were seen to have been undertaken for the people living at the home The home is is now a member of NAPA (National Association for Providers of Activities for Older People) which raises awareness of activities and understanding of each older person. The Home provides information about outside agencies and ways in which services assist such a advocates. The Home subscribes to Care Aware Advocacy service. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Within the statement of purpose there was information on whom to contact if you wished to make a complaint. At previous inspections records were seen at that time to show how complaints had been responded to and what action had been taken to remedy any shortfalls and this was assessed as meeting this standard. No complaints had been received by the service since our last visit. The management of complaints and concerns were seen to be important to the owners and management of the service as they felt it was another way that they could improve the service. The home had in place a policy on abuse and a copy of the most recent guidance for the Safeguarding of Vulnerable Adults that contained the correct reporting of any alleged abuse. Training records showed staff had received training in this area. During the interviewing of staff they were able to demonstrate that they knew how to report any concerns. In addition the Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 16 owner represents the independent sector on the Bedfordshire Safeguarding Adults Board. Information supplied by the service showed that people can be provided with advocacy service information and that people use the postal voting system. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The general standard of the environment is good to provide an appropriate environment for everyone living at the home. EVIDENCE: There had been a substantial amount of work undertaken by the current owners since they purchased the home. We previously reported that they had fitted adaptations to meet the needs of the people living at the home including bath hoists, grab rails and raised toilet seats; a new call system which allowed staff to respond quicker was also installed. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 18 In addition several bedroom carpets had been replaced, improved planting at the front of the building, a gas line to the home, improvements to the soft furnishings and some redecoration in some areas. The home had received funding approval for landscaping the garden. There remains a need to replace carpets in some of the corridors and further redecoration. The company have advised that when the planned changes to the building take place this will be undertaken as part of that process. All areas of the home were noted to be clean and free of any odours. Best practice in relation to infection control was seen to be carried out by the staff at both visits. Stocks of aprons and gloves were in place as was appropriate with the disposal of clinical waste. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment systems are good and protect the people living at the home. EVIDENCE: Training records that were available and plans were examined. These showed that there was a deficit in some of the areas required for staff updates. Information supplied by the service stated that the new training manager is going to be working on a rolling training programme to support learning and development, with the assistance of this programme training will be more readily available and accessible for staff. The company have also invested in a new computer system that will assist to identify any shortfalls in this area. The homes recruitment policy and procedures as previously assessed are clear and comprehensive. Examination of three staff files was undertaken to look at recruitment practices in the home. Evidence of an application form and Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 20 Criminal Records Bureau check was seen in all files alongside the relevant references. People spoken to as previously assessed felt that staff would respond to them when they needed assistance. Everyone spoken with described feeling confident in their abilities and felt the owner and manager were especially friendly and courteous to them as they were always asking if they were alright. Observation showed that positive relationships had been established between the people living at the home and staff. Conversation flowed freely with engagement between them evidencing that this was a usual pattern as previously assessed. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The quality assurance systems in the home are good and they help to identify any shortfalls in service delivery to improve standards for the people living at the home. EVIDENCE: Information supplied by the home show that the Registered manager has sevearl years managerial experience and holds the RMA certificate as well as being a Registered Nurse. Both the Manager and the Deputy are Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 22 supernummery to staff numbers. The people living at the home and staff spoke positivly about her approach and management style. The manager interacted with staff and residents throughout the inspection. A new Area Manager had been appointed since July 2008 and she supports the manager in the quality assurance systems at the home. In addition the owner undertakes Regulation 26 visits, the standard of reporting was very good for these visits. The home has a Health and Safety policy. There was evidence within the training records that some staff had undertaken fire, manual handling, food hygiene and first aid training. Risk assessments have been undertaken and were seen within the individual records examined. Records of the testing of water temperatures were maintained however the testing of the emergency lighting and fire equipment had not been undertaken as often as required. Questionaires to seek feedback had been sent out in November 2008. One comment received from a relative was ‘Theresa and her team do a great job. Mum cant tell you but seeing her at home a year ago to what you see today is all the proof I need, that choosing Danecroft was the best move we evr made’. No monies are maintained on behalf of the people living at the home. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 4 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 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X N/A X X 2 Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 24 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 Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 25 Care Quality Commission Eastern Region Care Quality Commission Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Danecroft Residential Home DS0000072821.V375078.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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