Inspection on 12/07/05 for Arranmore Park Rest Home

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

Arranmore Park Rest Home 05/07/07

Arranmore Park Rest Home 24/05/06

Arranmore Park Rest Home 18/10/05

Arranmore Park Rest Home 02/03/05

Arranmore Park Rest Home 27/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Arranmore Park Rest Home 100 Square Lane Lathom Burscough, Lancashire L40 7RQ Lead Inspector Sue Hale Unannounced 12 July 2005 08:30 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Arranmore Park Rest Home Address 100 Square Lane Lathom Burscough Lancashire L40 7RQ 01704 895887 01704 895965 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Arranmore Park Limited Mrs Marion Thomson Jaworski Care Home 34 Category(ies) of OP - Old age registration, with number of places Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 34 service users requiring personal care who fall into the category of OP - Old age, not falling within any other category. 2. Staffing must be provided to meet the depedency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 3. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 2 March 2005 Brief Description of the Service: Arranmore Park provides 24-hour personal care for up to 34 older people. Arranmore Park is a detached residence, situated close to the village of Burscough in West Lancashire. The home provides both single and shared rooms, many of which have en-suite facilities on both the ground, first and second floor. The home has a passenger lift, two dining areas and three lounge areas. The home also has an enclosed patio area to the rear. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over one day in July 2005. The inspection involved discussion with the people who lived and worked at the home, examination of records, policies and procedures and a tour of the premises. As part of the inspection process the inspector used ‘case tracking ‘as a means of assessing some of the national minimum standards. This process allowed the inspector to focus on a small group of people living at the home. All records relating to these people were inspected, along with the rooms they occupied in the home. What the service does well: What has improved since the last inspection? What they could do better: The way in which information about residents was stored, made it difficult for staff to access and they were unable to find all the records requested. All forms should be fully completed, dated and signed by staff. The service user guide and statement of purpose should be revised to include the information required in the national minimum standards and care home Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 6 regulations. Consideration should be given to increasing the range of needs covered in the care plan to include all those recommended in the national minimum standards to ensure that all aspects of residents, health, personal and social care needs are met. Risk assessments particularly in relation to falls should be undertaken and reviewed regularly. The care plan and assessments should all be reviewed monthly, to ensure that residents changing needs are noted and any action necessary taken. The policies and procedures should be reviewed, and updated as necessary to provide clear information and instructions to staff on how the home should be run. Formal arrangements to supervise all staff should be put in place. The home should consult with residents about their wishes with a view to increasing the opportunities for activities within and outside the home. Consideration should be given to see if the routines of the home could be made more flexible to give residents some control over their life, and so they could exercise their choices and preferences. Information provided for residents, relatives and staff about complaints should be consistent. 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. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,5 The homes statement of purpose and service user guide required minor revision to provide all the information that should be available to prospective residents, their relatives and other professionals about the home. The way in which information is stored in the home makes it difficult to locate. EVIDENCE: The statement of purpose and service user guide had been updated and needed minor revision to include the information required by the Care Homes Regulations. All residents had been given a copy of both documents. The records of three residents recently admitted were examined. Assessment procedures could not be checked, as staff were unable to locate the information. Residents files looked at did not contain copies of the care management assessment and care plan from the funding authorities. Information about residents was contained in several files kept in different places in the managers’ office, which made access to information difficult for the staff. Residents were encouraged to visit the home and meet staff before they made a decision about whether to move into the home. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,9,11 Care plans covered in detail, some of the topics needed to ensure that all aspects of residents’ health, social and care needs were met. Some documentation was incomplete and others including risk assessments had not been done. The home ensured that residents had contact with healthcare professionals. The pharmacy inspector checked medication procedures and a separate report will be completed and available as a public document. EVIDENCE: All the residents’ files checked had a care plan that covered some of the recommended topics with good detail and clear instructions to staff on how to meet the care needs that had been identified. Residents’ health and medical needs had been met and records kept of appointments with dentists, opticians and podiatrists to ensure regular check ups and treatments were arranged. On two of the three files checked risk assessments to identify and reduce the risk of falls, had not been completed. On one file checked the care plan had not been reviewed on a monthly basis to check if the care given was still appropriate. Care plans had been signed in some cases by residents and in Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 10 others, their relatives to ensure that they agreed with the plan of care drawn up by the home. Two members of staff had attended a training course on care of the dying but policies and procedures to give staff information and instructions on how to care for people at the end stage of their lives had not been reviewed and updated as recommended in the last report. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 ,13,15 There was little opportunity for residents at the home to express their personal choice. The range of social activities available was limited, so that the expectations of people living at the home were not fully satisfied. The meals served in the home were of a high standard. EVIDENCE: There was no activities programme displayed in the home, and no activities were taking place on the day of the inspection. Staff were unable to locate a record of activities that had taken place in the home. Staff spoken to said that activities such as bingo, craftwork and dominos took place but residents said that they would like more activities within and outside the home. One resident said, ‘theres nothing much going on, its a long day’. All meals were taken in the dining room; two residents said that they weren’t offered tea in their bedroom in the morning. One member of staff spoken to said that they asked residents about what time they wanted to go to bed. However, residents spoken to were unsure if they could choose what time they got up or went to bed. One resident said, I dont know if I could stop up later’. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 12 Meals were seen to provide a wholesome balanced diet. The food served was fresh, of good quality and homemade. Mealtimes were seen to be unhurried, and support was given to residents requiring assistance. Menus changed regularly, and the cook talked to residents to find out what they would like included on the menu. Ingredients for soft/puree diets were liquidised together so that residents would be unable to distinguish between individual flavours. Residents spoken to were very satisfied with the food and commented that it had improved since a new cook had started work at the home. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 The information available in the home about complaints was not consistent. Information about local advocacy services was readily available. EVIDENCE: The information about complaints in the home was not consistent, and the procedure for staff to follow in the policies and procedures book did not meet the national minimum standards. The complaints policy in the service user guide that had been given to residents did meet the national minimum standards and gave residents details of how to complain and advised them that they are able to contact the Commission for Social Care Inspection at any stage of a complaint. The home had information on how to contact the local advocacy service, and residents were registered to vote, and would be supported by staff to do, if necessary. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,24,25,26 The home would benefit from a maintenance program that updates and replaces furniture and fittings worn through wear and tear. Residents have the opportunity to use the attractively landscaped garden. EVIDENCE: The home was tidy but there were some areas that required cleaning to bring them to an acceptable standard to provide a homely environment for residents. Some furniture was shabby due to wear and tear, particularly occasional tables and should be replaced to provide residents with a comfortable environment. The carpet in some areas was stained and required cleaning or replacement. An immediate requirement was given in respect of an area of the corridor carpet that presented a trip risk to residents. A senior carer rectified this immediately. Some residents used wheelchairs at the dining room table and did not have the opportunity to sit on a chair like other residents. Residents spoken to were satisfied with the environment in which they lived and said that their rooms were always clean and tidy. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 15 Not all residents had been offered a key to their room and risk assessments to determine if they were able to do so, had not been completed. Laundry facilities were adequate for the size of the home and infection control measures in place that were understood and adhered to by staff. People living at the home said that their clothes were always clean and returned from the laundry. Staff was unable to confirm if the premises complied with the necessary water regulations or if measures were in place to reduce the risk of legionella. The home has a paved secure outdoor space that is accessible for all residents and was enjoyed by several residents on the day of the inspection. Good quality garden furniture was provided for residents use. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 The skill mix and number of staff on duty was sufficient to meet the needs of residents. EVIDENCE: The home was staffed to the minimum required by the previous regulator. A staff rota written in pencil was in place but did not reflect the staff on duty on the day of the inspection. The manager did not have any hours designated as supernumerary to the rota as recommended in the last report. A resident spoken to said that staff didnt appear to have time to talk to them and just greeted them, particularly in the evenings. Staff files were not accessible to the staff on duty so could not be checked. The requirements and recommendations from the last inspection therefore remain outstanding. Forty seven per cent of staff were qualified to NVQ level 2 or above and a further two staff were undertaking training to ensure that the workforce of the home has the skills and experience to provide a good level of care. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,35,36,37 There was no formal system to supervise the staff working in the home. Policies and procedures required reviewing and updating. EVIDENCE: Staff spoken to said that they did not receive formal supervision but that advice and support was always available from the manager and deputy manager as necessary. The supervision policy should be revised to ensure that the supervision record covers all the topics recommended in the national minimum standards and that all staff, rather than just junior staff are included in the supervision programme. Policies and procedures that gave information to staff on how the home should be run had not been revised and updated as recommended in the last report. Records of residents weight were recorded all together in a way that breached the Data Protection Act 1998. A resident described staff as ‘lovely, very nice’. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 18 The views of stakeholders about the services the home provided had not been sought as recommended in the last report. The manager should complete a training course by 2005 to ensure they have a professional management qualification. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 x 2 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x 2 2 2 STAFFING Standard No Score 27 2 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 x 2 x 2 x 2 2 2 x Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 20 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 OP1 Regulation 22,(7)(a) Schedule (1)(14) Requirement Timescale for action 31.10.05 2. OP7 3. OP12 4. OP16 5. OP 24 6. OP 25 The Statement of Purpose must include the fire precautions and associated emergency procedures in the care home. 13(4) (c) Risk assessments in relation to falls, must be undertaken on admission and reviewed and updated as necessary. 16(2) (m) The registered person must (n) consult with residents about their social interests and make arrangements for suitable activities within and outside the home. 22(4)(7(a The registered person must ) ensure that information about complaints available for staff includes all information required in the Care Home Regulations 2001. 23(2)(c)(d The registered person must ) ensure that all furniture provided is of a reasonable standard and replaced as necesary when worn through wear and tear. 13(4)(a)(c The registered person must ensure that tests are carried out to ensure that risks from legionella are reduced. (Timescale of 31.12.03 not met). F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc 30.9.05 31.10.05 30.9.05 31.10.05 30.9.05 Arranmore Park Rest Home Version 1.40 Page 21 7. OP 27 Schedule 4 (7) 19(1) 8. OP 29 9. OP 29 Schedule 2 (4) 24 (1- 3) 10. OP 33 11. OP 36 18(2) 12. 13. 14. OP19 OP26 23(2)(d) 23(2)(d) The registered person must ensure that the staff rota is an accurate reflection of staff on duty at any time. The registered person must not employ staff at the home, unless full and satisfactory information has been obtained via a POVA First check, and that a criminal records bureau check has been applied for. The registered person must obtain evidence of any relevant qualifications for prospective employees. The registered person should ensure that the results of resident surveys are published. (Previous timescale of 13.6.05 not met) The registered person must ensure that persons working at the care home are appropriately supervised, this must include the manager and the deputy manager. The registered person must ensure that all carpets are clean and replaced as necesary. The registerd person must ensure all areas of home are kept clean. 30.9.05 30.9.05 30.9.05 30.9.05 30.9.05 31.10.05 30.9.05 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 OP1 Good Practice Recommendations Serious consideration should be given to displaying the latest inspection report so that residents and their relatives/representatives are able to access it freely. It is recommended that the complaints procedure is included in F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 22 Arranmore Park Rest Home 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. OP1 OP3 OP3 OP7 OP7 OP7 OP7,OP3 OP 11 OP12 OP12 OP15 OP24 OP 24 OP 26 OP19 OP 27 OP 28 OP 29 OP 29 the statement of purpose. The service user guide should include the views of residents. The provider should ensure that copies of the letter offering residency to service users is kept on their personal file. It is recommended that the pre admission assessment covers all topics detailed in standard 3.3 of the national minimum standards. It is recommended that the care plan covers all topics detailed in standard 3.3 of the national minimum standards It is recommended that all documentation should be fully completed, dated and signed. It is recommended that all care plans be reviewed monthly It is strongly recommended that records relating to residents are kept as far as practicable in one file for ease of access by staff. The policies and procedures on care of the dying should be further developed to cover the topics recomended in the national minimum standards. It is recommended that a record be kept of all activities undertaken in the home. Consideration should be given to discussing with residents, if the routines of the home are as flexible as practicable to fit in with residents, choices and preferences. It is recommended that in line with good practice, ingredients for very soft diets should be pureed and served separately . The manager should ensure that all residents are offered the key to their private rooms unless a risk assessment suggests otherwise. The manager should develop a risk assessment tool in relation to keys for residents private rooms. The registered person must provide evidence that the home complies with the Water Supply (Water Fittings) Regulations 1999. It is recommended that consideration is given to providing appropriate dining-room chairs for residents who use wheelchairs. It is recommended that the staff roster is completed in ink. The registered person should ensure that at least 50 of staff are qualified to NVQ level 2 by 2005. All staff should be given copies of their terms and conditions of employment and a job description. The provider should provide evidence that the homes F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 23 Arranmore Park Rest Home 21. 22. 23. 24. 25. 26. 27. OP 31 OP 33 OP 36 OP 36 OP7 OP7OP37 OP33 application form complies with equal opportunity employment legislation The manager should complete the NVQ level 4 by 2005 The registered person should ensure that the views of stakeholders in the community are sought as to how the home is performing. The manager should ensure that all staff receive formal supervision at least 6 times yearly. The registered person should ensure that the supervision record covers all topics recommended in standard 36.3. It is recommended that sit on scales are purchased to enable all residents weight to be monitored. The manager should ensure that residents weight is recorded in individual files, and not communally in a manner that breaches the Data Protection Act 1998. Policies and procedures should be reviewed regularly and updated as necessary. Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Levens House Foxhole Road Chorley, Lancashire PR7 1NW National Enquiry Line: 0845 015 0120 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 Arranmore Park Rest Home F57 F08 S61200 Arranmore Park V235927 120705 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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