Inspection on 21/07/06 for Bankfield House Care Home

This inspection was carried out on 21st July 2006.

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 but made no statutory requirements on the home.

Other inspections for this house

Bankfield House Care Home 22/08/07

Bankfield House Care Home 12/01/06

Bankfield House Care Home 01/06/05

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 Bankfield House Care Home Bankfield Road Woodley Stockport Cheshire SK6 1RQ Lead Inspector Sylvia Brown Unannounced Inspection 21 July 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bankfield House Care Home Address Bankfield Road Woodley Stockport Cheshire SK6 1RQ 0161 406 6468 0161 406 6467 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) Freshfield Care Ltd Mrs Susan Pyatt Care Home 24 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (24), of places Physical disability (4) Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 24 service users to include: *up to 4 service users in the category of DE(E) (Dementia over 65 years of age); *up to 4 service users in the category of PD (Physical disability); *up to 24 service users in the category of OP (Old age not falling within any other category). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 12th January 2006 2. Date of last inspection Brief Description of the Service: Bankfield House is a large, detached, property standing in its own grounds in the Woodley area of Hyde. Its placement is secluded and private, offering residents peaceful surroundings. The home currently provides accommodation for 24 residents over the age of 65 years. There is a small conservatory for those residents wishing to smoke. Two lounges and an additional conservatory are non smoking. The dining room is used at meal times and throughout the day for visiting and activities. Bedroom accommodation offers single and double rooms. Externally, there are large gardens and lawned areas for residents use during fine weather. The home’s fees structure varies and start at £405.00 per week. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection visit took place over two days and was part of the overall key inspection process in which some service users, relatives and staff were consulted and provided with comment cards. Where relevant and applicable, comments are included within the report. On the first day, the inspection commenced as two service users were being admitted to the home. Furthermore, one resident was poorly and being cared for in bed and the registered manager was on holiday. As a consequence, the inspector had little opportunity to speak at length with staff but spent time with residents and looked around the home. On the second day the inspector spent time with the registered owners, one of whom is the registered manager. Feedback was given regarding the outcome of the inspection. The specific care of two service users recently admitted to the home was looked at. The home’s assessment and admission processes were discussed, particularly for the residents admitted on the first day of inspection. Where possible, those service users were spoken with and were observed as they went about their daily routines. Bankfield House is due to commence substantial refurbishment. This work will include a significant amount of structural work which may, periodically, impact and compromise service users’ comfort. Service users have been kept fully informed of developments and are aware of the refurbishment plans. Upon completion, all parts of the home will be improved, with most bedrooms having en-suite facilities and additional lounges and dining areas. What the service does well: Bankfield successfully provides a relaxed and caring environment for those who live there. Service users’ comment cards confirmed their satisfaction with the services and positive comments regarding the staff team were made. Newly accommodated service users are made to feel welcome and supported to settle within the home. Two service users had moved into the home several days before the inspection and they appeared relatively settled and relaxed. One new service user was observed welcoming another new person to the home and explaining about the routines in place. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 6 Without exception, all comment cards commented favourably on the services provided. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. Prospective service users and their representatives receive the information needed to enable them to choose a home which will meet their needs. They have their needs assessed prior to moving into the home. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: All prospective service users and/or their representative receive an information pack, which details the home’s service user guide and statement of purpose. The registered owners stated that the information packs have been reviewed and contain up to date and accurate information. Service users’ comment cards confirmed that they had received sufficient information prior to moving into the home. Where emergency admissions had taken place, they stated they had received information in a timely manner. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 9 Evaluation of care files identified that prospective service users are visited by the registered manager and that she completes an assessment of their needs prior to admission. The registered manager was able to demonstrate the consultation processes with service users to obtain information about them. Service users are, as far as possible, encouraged and supported to contribute to the assessment process. Through their rapid response system, Bankfield is able to accommodate service users at short notice. Such placements do not always enable pre-assessment visits, however the home was able to demonstrate their assessment process ensuring timescales for developing care plans and support services are completed in a timely manner. On the first day of the inspection two service users were admitted under the rapid response system. It was pleasing to see that on the second visit consultation was underway with professionals regarding service users’ further care and support. Those on short rehabilitation programmes have clear care plans in place and goal setting is agreed and monitored to enable an accurate assessment of the service users’ abilities prior to their return home. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 10 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 the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Medication was not managed safely. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: All service users have written care plans in place. Records demonstrated that residents’ health care needs are met, with records maintained of all visiting professionals. Service users who required physiotherapy were receiving the required treatments and were encouraged by care staff to continue with their physio routines. Service users stated that they were well looked after and received the support they needed. One stated “its exceptional care” Observations of one service user identified that she had received specific support, with a large number of pillows being provided to enable her to sit comfortably. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 11 Short term goals were detailed within care plans for those whose intention it was to return home and continue living independently within the community. Throughout the inspection service users were treated in a respectful and dignified manner. Staff were courteous and supportive, enabling service users to make informed choices and decisions. Service users were observed moving around the home and meeting with each other. Service users who preferred to remain in their room had staff designated to oversee their care and ensure that they received the support they required. All comment cards completed by service users stated they felt they were respected by staff and listened to. Feedback from a health care professional confirmed that the home communicates well with the health care centre. They are able to see service users in private and that staff act on information given. The health care professional was satisfied with the overall care provided to service users. The inspector observed that the home’s medication and treatment room was left unlocked and unattended for some considerable time, with the door open. The medication administration records identified that two service users’ records failed to detail that medication had been administered the morning of the first inspection visit. At approximately 11:45am the senior care assistant on duty commenced administering the morning medications to the two service users. On being asked about the delay, she responded that due to the busy morning there had been insufficient time to administer all the medication in the morning. When asked about the lunch-time medications, she explained she was on duty all day and would ‘move’ all their medication times to later and ensure they were given out at appropriate intervals. Inspection of the records on the second day identified that the later administration times were not recorded and that a different senior had administered medication at teatime. The registered owners could find no documentation which detailed later administration times. Records did not reflect actual practice, in that at least one resident received three amounts of medication in approximately 6.5 hours. There was no formal system for checking medication administration records, stock balances or staff competency in medication procedures. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 12, 13, 14, & 15 Quality in this outcome area is good Social, cultural and recreational activities meet residents’ expectations. Residents receive a healthy, varied diet. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Service users’ care plans and additional documentation detail their preferred daily routines and activities. Comment cards returned stated that, in the main, service users were satisfied with the home’s support to occupy them. One service user’s relative stated that they would “like more activities for their relative but understood the complexities of running a home”. The registered owners acknowledged that there had been difficulties retaining an activities coordinator who had the experience and confidence to meet the needs of older people. Notwithstanding that, a new activities co-ordinator has been employed who will be in attendance at the home three days a week. The registered owners state that the service user guide and statement of purpose detail that the home can provide personal trips out in the home’s mini bus, should communal trips not be suitable. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 13 Service users have been invited and attended the theatre and garden centres. A trip on a canal boat is also planned. The home has service user meetings which are minuted and provided to all service users and relatives which keeps them informed of issues within the home and plans for change. Arrangements are in place to have a garden party, to which all relatives and friends are invited. There is an organised relatives group ‘Friends of Bankfield’ who provide their service to support service users on trips and raise additional funds for outings. On both days of the inspection visitors were observed in the home. The home’s visitors book is maintained correctly, recording visitors as they enter and leave the building. Bankfield provides church services for service users’ enjoyment and systems are in place to support service users who wish to attend local community churches. In the main, all comment cards stated service users’ satisfaction with food and meals served. One comment made was “smaller portions would be preferred and more plain cooking”, however observations on both days of the inspection were that service users received a variety of meals which were well cooked and nicely presented. Service users were observed to be making alternative choices to the main meal with their requests being met. The day’s menu is displayed in the main corridor enabling service users to clearly see what meals are to be served. Mealtimes continue to be pleasant and relaxed periods where service users can meet together. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 16 & 18 Quality in this outcome area is good Residents have access to a robust, effective complaints procedure and are protected from abuse. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home continues to have a complaints procedure in place. The service users’ information pack contains details of the complaints procedure and how to access it should dissatisfactions arise. The home also seeks the views of service users and relatives regarding the services through their quality assurance procedures and service user meetings. The home has received two complaints since the last inspection. Both were recorded within the complaints system and detailed the action taken to resolve issues arising. The CSCI has received no complaints regarding this service. When asked, service users stated they felt safe and well cared for and that they had someone with whom they could talk to should they feel unsafe. The home has adult protection procedures in place and most staff have received adult protection training, however they may benefit from updated training. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24 & 26 The outcome of this standard is adequate. Service users live in a safe, maintained environment. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Bankfield House has obtained planning permission to substantially upgrade and refurbish the home. The registered owners have finally concluded consultation with various health and safety officials to ensure that all aspects of the upgrading have been addressed and passed. Work is due to commence in August 2006 and will be ongoing over the next several years. Significant structural work is planned in order to extend the home and increase the number of lounges and dining areas. Facilities are planned to enable residents and visitors to independently make light snacks and drinks. All bedrooms are to be upgraded, with most having en-suite facilities provided. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 16 On the day of the inspection visit, the home was clean and fairly well presented. Rooms used by service users were bright and cheery. Service users stated they enjoyed the facilities on offer and found the home to be comfortable, clean and pleasant. As part of the upgrading development, fire safety officers have inspected the premises to offer advice and carry out a fire safety inspection. A number of requirements and recommendation were made at that time. On the first day of the inspection a number of bedroom doors were observed to be wedged open. Such practice places service users at increased risk. Whilst it is understood that excessive hot weather has impacted on the home, additional risk assessments, signed agreements and revised fire safety plans need to be implemented where service users wish to have their doors retained open. Environmental health inspectors conducted and inspection of the home in October 2005 and found that cleaning schedules need to be clearly recorded and some improvements to lighting and ventilation are necessary. Domestic routines are devised around the service users and ensure, as far as possible, that they are not unduly disturbed. Most comments received were positive regarding the cleanliness of the home, with only one comment made about occasional odours. The registered owners recognise the importance of good hygiene and records demonstrated carpet and furniture cleaning and maintenance. Residents’ rooms were clean and presentable; they had their own things around them and arranged their rooms to suit their own needs. The registered owners continue to upgrade beds and mattresses as an interim measure until the final refurbishment is completed. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The outcome of this standard is adequate. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: At the time of the inspection the home had two service user vacancies. Staff were in the process of admitting two service users and supporting one resident who was being cared for in bed. Staffing levels appeared sufficient to meet the demand and service users were receiving timely support and attention. One registered owner, who is also the registered manager, was on holiday, another registered owner was on the premises. The staffing rota was looked at and found it detailed sufficient staffing levels and support staff. The home has its own bank staff for covering vacant duties, which minimises the need to employ agency staff. Staff training and development records confirmed that staff are appropriately trained. Initial induction procedures for new staff ensure that they shadow more experienced staff and that they are directly assessed by the registered manager as competent and able to work alone with service users. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 18 Recruitment and selection procedures continue to be below the required standard, in that CRB or POVA first checks are not always obtained prior to a new employee commencing duty. References, though applied for, are not always received and there was no routine system to obtain or record verbal references provided. Current photos of staff were not on file. Of the 29 staff 15 have achieved NVQ training relating to their employment position at level 2 or above. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The registered manager is also one of the registered owners; she has the qualifications and experience to manage a care home. Service users stated that she visits them each day when she is in the home and that they have confidence in her to look after them well. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 20 During discussions with the registered manager it was evident that she was knowledgeable regarding all service users and their conditions and how they should be met. Service users are consulted with and are able to influence the decision making processes within the home and develop service. Routine service user meetings are held and minutes are provided and circulated to all service users and their relatives. Advocacy services are available and information is provided when independent professional advice is required for legal matters. Bankfield House does not manage any of the residents’ finances. When expenditure occurs, residents have their own finances or are invoiced for goods purchased on their behalf by the home. The home’s annual quality assurance procedures have begun, with questionnaires being completed by service users, relatives, visitors, staff and professional agencies involved with the home. Health and safety records were looked at and found to be in order. Accidents are recorded and information filed in accordance with data protection. As stated previously within the report, fire safety and environmental health inspections have been completed by the appropriate agencies. The home’s electrical wiring has been inspected in preparation for future upgrading and gas appliances and services have also been evaluated. Lifting equipment has been serviced and was assessed as safe for use. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 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 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 3 3 x x 2 Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 Requirement Timescale for action 01/08/06 2 OP9 13 3 OP38 23(4) 4 OP29 7,9,19 & Sch 2 The registered person must ensure that the medication/ treatment room is maintained securely when staff are not present. The registered person must 01/08/06 ensure that medication is administered at the prescribed times. Where practice differs, records must be rigorously maintained and detailed to explain practice. The registered person must 30/08/06 consult further with Fire Safety officers regarding the report of the July 2006 inspection and comply with all requirements and recommendations, including ceasing to wedge doors open. The registered person must 01/08/06 ensure that rigorous recruitment and selection procedures in place are followed at all times. (Previous timescale of 01/06/05 not met). Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 23 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 OP9 Good Practice Recommendations The registered person should introduce systems which continue to confirm staff’s competency in medication management and which monitors record keeping and stock levels. Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Bankfield House Care Home DS0000062991.V298096.R01.S.doc Version 5.2 Page 25 - 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!