Inspection on 27/07/06 for Campania

This inspection was carried out on 27th July 2006.

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

Campania 04/09/07

Campania 21/02/06

Campania 12/07/05

Campania 20/12/04

Campania 07/07/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

Broadreach

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

CARE HOMES FOR OLDER PEOPLE Park View 18 - 20 Ellenborough Park South Weston Super Mare North Somerset BS23 1XN Lead Inspector Juanita Glass Unannounced Inspection 27th July 2006 09:30 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 Park View DS0000020283.V303623.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. Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park View Address 18 - 20 Ellenborough Park South Weston Super Mare North Somerset BS23 1XN 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) 01934 626233 01934 420789 www.notarohomes.co.uk Notaro Homes Ltd Mrs Sarah Jane Emin Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate 50 Patients aged 50 years and over requiring nursing care Staffing Notice dated 18/11/1999 applies Manager must be a RN on Parts 1 or 12 of the NMC register Date of last inspection 21st February 2006 Brief Description of the Service: Park View provides nursing care for up to 50 older people. The home is an older property situated beside Ellenborough Park in Weston Super Mare. There are 44 single rooms and 3 that can be shared. Two passenger lifts ensure level access throughout the building. There is a secluded patio area to the rear of the building. Park View is approximately half a mile from the town centre, and a short walk from the sea front. The home is owned by N Notaro Homes Limited. Mr Notaro owns several other care homes in the town. They share a minibus and pool training resources for staff. Mrs Sarah Emin is the registered manager of Park View. Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Current fees: £380 to £560. This unannounced key inspection took place in the presence of the manager Mrs S. Emin. Two inspectors were present, resulting in a total of 18 inspection hours. During this inspection nine residents, four staff and two visitors were spoken to. A tour of the premises was carried out. The inspectors also reviewed documentation for care records, staff personnel records, medication, maintenance and staff training. Residents spoken to were very clear that they felt the level of care they received was good. One resident said they had been in other homes but they could not fault the staff in Park View. Another resident said they felt the staff really understood their needs. Residents agreed that staff were generally cheerful and happy to help when asked. Visitors spoken to said they always received a nice welcome and the home was always clean and tidy. A review of records found that in general staff were given clear guidance. Some areas of record-keeping clearly needed to be improved. A consistent approach to Person Centred care and resident involvement in care plans certainly needs to be developed. Overall residents were happy, settled and well groomed. They had a happy, relaxed and friendly rapport with the staff team on the day. What the service does well: What has improved since the last inspection? One of the two requirements made at the last inspection was met. Communication systems are now in place to ensure relatives are informed of significant changes in residents’ condition. Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Park View DS0000020283.V303623.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 Park View DS0000020283.V303623.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): 3 and 5 6 does not apply Quality in this outcome group was adequate. The practice of carrying out a pre- admission assessment is not always consistent. Service users are not personally consulted about their needs. Prospective residents are offered the chance to visit the home before making the final decision to stay. EVIDENCE: The care records for six residents were reviewed. Some records did not contain a clear assessment of residents needs carried out prior to their admission. These tended to be for those residents who had moved to Park View from a sister home owned by the company. Care records only contained a faxed copy of the prospective residents care plan from their previous placement. There was no evidence in care records that the prospective residents needs had been discussed with them prior to their admission. Prospective residents are offered the chance to visit the home. A family member usually takes this up on their behalf. Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 9 Two residents spoken to were happy to comment on the admission process. One resident said that they had been offered a choice of homes when they could no longer stay at the sister home due to their failing health. They did feel the home met their needs but thought they needed a residential setting rather than a nursing home at this stage in their life. The other resident said that his son had visited on his behalf. He then stated that before making the final decision he visited the home himself. He was pleased to have been offered this opportunity. • A full pre-admission assessment must be carried out. Where possible this must include the involvement of the service user. Park View DS0000020283.V303623.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 and 10 Quality in this outcome group was adequate. Each resident has a care plan. The practice of involving residents in the development and review of the plan is variable. Care plans lack information for specific areas of need. Residents have access to healthcare services that meet their assessed needs both within the home and in the local community. The home has a medication policy, which is accessible to staff. Staff in the home do not demonstrate an awareness of this policy. Staff are aware of the need to treat residents with respect and to consider dignity when delivering personal care. EVIDENCE: A review of resident care plans showed, in general, that clear guidelines were being identified for staff. They did however lack consistency. Some appeared generic, whilst others showed an understanding of Person Centred Care Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 11 identifying personal needs. It was noted that existing care plans lacked some key details, such as the management of Challenging Behaviour and Dementia Care. Residents identified as having a dementia type illness did not have the appropriate care plans identifying their personal needs. It was clear from discussions with residents that they had not been consulted or involved in drawing up their own plan of care. One resident said they would have liked to know what staff had agreed. Many of the residents in Park View could be involved in some way in determining the level of care they receive. Other residents stated that they felt staff were aware of their needs and met them very well. Staff also demonstrated an awareness of the needs of individual residents. Care records also showed that the home enables residents to attend health care services such as the dentist, optician and chiropodist. Residents are assisted to attend outpatient clinics and to maintain contact with diabetes and audiology clinics. The home has also forged strong links with the local Mental Health Team even though they do not have a mental health registration. The home has clear policies for the receipt, administration and storage of medication. An audit on the day of the inspection found there were no errors in administration. It was noted that qualified staff were making handwritten entries without signing. Also of some concern was the large number of creams, ointments and Fletchers enemas on the premises, which were past their expiry date. This was discussed with the manager who agreed that this did not demonstrate good practice. It was also bought to the managers attention that creams and ointments had been found in bedrooms with no date of opening and the wrong name for the resident in a room. Residents spoken to praised care staff highly. One resident said they always showed they cared. Whilst another said they know whats needed and do it. A third resident said they had been in another care home and the staff in Park View were the best. One resident said they worked very hard but always had a smile. Staff were observed through the day to approach residents politely and respectfully. One visitor said they always come across cheerful even when under pressure. • • • • • • Care plans containing clear guidelines for staff, must be drawn up for specific needs such as Dementia and Challenging Behaviour. Service users where possible must be involved in drawing up an agreed care plan. Hand written MAR sheets must be signed by the person making the entry. Qualified staff must be aware of the shelf life of medication kept within the home. Qualified staff need to date creams and ointments when opened. Staff need to ensure that creams and ointments are only used by the person they are prescribed for. Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 12 Park View DS0000020283.V303623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome group was good. Residents have access to a full programme of meaningful activities. Residents are encouraged to maintain contact with family and friends. Residents are assisted to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet. EVIDENCE: During the inspection residents were not observed to be taking part in any meaningful activities. The activities organiser was not in the home and staff did not organise any alternative activities for residents. Residents spoken to said that they did have plenty to do during the day. They commented on a full programme of activities, which also included walks in the park and trips out. It was generally felt that younger residents in the home needed more direction on a daily basis. The home does have links with Weston College and courses have been arranged for those younger residents who were interested. Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 14 Visitors spoken to said they had always been made very welcome in the home and that they could visit whenever they liked. Residents said that their families had never been prevented from visiting and they were encouraged to maintain contact with families and friends. Residents spoken to said they felt they could still make personal choices within the home. Younger residents said they could understand the need for some constraints in a care home but on the whole they felt they had freedom of choice. Resident records showed that they went to bed and got up at varied times. Some residents had chosen to remain in their room, whilst five ladies wished to sit in the bay window watching the children in the park. Residents spoken to said the meals were always good. One resident said they had put on weight since moving into the home. The meal provided was both appetising and well balanced. Nutritional assessments were seen in all care records. Residents were observed to be offered help in a friendly and unhurried manner Park View DS0000020283.V303623.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome group was adequate. The home has a satisfactory complaints policy and procedure. Recording of the response to and the outcome of complaints needs to be improved. The home has clear guidance for the protection of vulnerable adults. All staff spoken to demonstrated a clear awareness of adult protection issues. EVIDENCE: The home has clear policies and procedures for action to be taken following a complaint. The existing policies still refer residents/relatives to the Aztec West office if contact with the CSCI is desired this must be updated. A copy of all complaints received is maintained. The record does not show a clear account of the action taken and the eventual outcome with the complainant. The home has robust policies procedures in place for the protection of vulnerable adults and whistle blowing. All staff have attended in-house training in abuse and the protection of vulnerable adults. Staff spoken to were aware of the procedures to follow and who to contact if they felt they could not approach management. • The complaints policy and procedure must be updated to include the new CSCI address. DS0000020283.V303623.R01.S.doc Version 5.2 Page 16 Park View • The complaints record must include details of the investigation, action taken and outcome. Park View DS0000020283.V303623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome group was adequate. Residents live in a comfortable, well-maintained environment. During the inspection some safety issues were identified. The home is clean, and hygienic. There were some identified areas of malodours. Some staff need to attend an update in infection control EVIDENCE: Park View provides a homely atmosphere for residents. There were obvious areas needing refurbishment and maintenance. It was noted that rooms were being refurbished and a maintenance programme was in progress. During a tour of the home some areas were noted to be slightly malodorous. The manager was aware of the areas in question and steps were being taken to counteract the smell. Wardrobes in several rooms were noted to be unstable and could put residents at risk of harm. The manager was informed Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 18 and the maintenance person had started to secure wardrobes to walls before the end of the inspection. Residents spoken to said the home was always bright and cheerful. One resident said the cleaners worked hard and kept the home looking clean. Residents have not been able to use the Primrose Lounge due to the heat wave. They said they were happy to spend mornings in the Primrose Lounge and afternoons in the other lounge areas. During the tour of the premises a member of staff was observed changing bed linen. Soiled linen had been thrown onto the landing floor. Bed linen was also noticed on the bedroom floor whilst the bed was being remade. This is not good infection control practice and could also contribute to malodours in the landing carpet. • • All staff must be made more aware of the importance of following infection control guidelines. The securing of wardrobes to walls needs to be completed. Park View DS0000020283.V303623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome group was adequate. Residents’ benefit from adequate numbers of staff to meet their individual needs. The home is committed to meeting the 50 requirement for NVQ training. The service needs to review its recruitment procedure with regard to obtaining references. The service recognises the importance of training. Records maintained do not reflect the training staff have received. Some areas of training need to be updated in. EVIDENCE: Staffing rotas in the home showed that there were adequate numbers of staff to meet the needs of the current resident group. Residents and staff confirmed that there were adequate numbers on duty so that they could work without feeling pressurised. The skill mix of qualified and unqualified staff was appropriate. Care staff would benefit from training in Dementia Care and Managing Challenging Behaviour. Staff spoken to felt they had a lack of understanding in these areas. Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 20 Eight of 20 carers have attained the NVQ In Care. Three carers are still in the process of studying the course. When they have completed the NVQ In Care the home will meet the standard for 50 care staff to be qualified in NVQ two or equivalent. The home shows a commitment to achieving this goal. Recruitment procedures followed in the home reflect company policy. Personnel records showed that the manager had followed these policies accurately. It was noted that staff personnel records contain to whom it may concern reference letters. Accepting these letters without confirming their origin with the referee is not good practice and places residents at risk of harm or abuse. Training records for staff had not been well maintained so it was difficult to evidence staff had received the appropriate training. This was discussed with the manager who agreed that she had not kept the records up to date. The manager was able to fill in the gaps identified by the inspectors. She confirmed that most of the staff had attended all mandatory training. It was noted that of the 10 qualified staff, 5 had not attended a manual handling update. Five members of staff had not received a fire prevention update three of these had their last update in 2004. Staff spoken to felt they had adequate basic training but did not feel they had the training to care for people with dementia or challenging behaviours. • • • The manager must request references direct from referees, rather than accepting ‘to whom it may concern letters.’ Staff must receive training in Dementia Care and Challenging Behaviour. Clear records must be maintained to evidence staff training. Park View DS0000020283.V303623.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome group was adequate. Residents’ benefit from an experienced, knowledgeable manager. Systems are in place for relatives, visitors and residents to comment on the running of the home. Resident’s financial interests are safeguarded. Residents are protected by the health and safety checks in place, however the insecure placement of wardrobes was noted. EVIDENCE: Mrs Emin has been manager at Park View for approximately one year. She continues to hold regular staff, residents and relative meetings. Staff and residents spoken to confirmed that they were able to approach the manager at Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 22 any time. Mrs Emin confirmed that she had almost completed the Registered Managers Award. Systems are in place for residents, visitors and relatives to comment on the running of the home. Copies of questionnaires seen showed that residents and relatives are happy with the running of the home. Residents said they could express their views at anytime and felt the manager was always prepared to act on their suggestions. The Notaro group have expressed an interest in piloting the quality assurance process CSCI will be putting in place in 2008, this will enable them to carry out their own quality assurance within the group. The Notaro group maintains a secure system for safeguarding resident’s finances. All health and safety checks were in place and up-to-date. The fire risk assessment for the building is available for inspection and the firelog showed that all recommended checks were being carried out. Accident records were maintained these also included a record of the follow-up carried out by staff to identify outcomes. A clear audit trail was evident for maintenance work being carried out in the home. Service records were up to date and the Portable Appliances Test (PAT) was due the week of the inspection, a date was booked in the diary. As previously mentioned the secure fixing of wardrobes to walls was discussed with the manager. Also staff training in Manual Handling and Fire Prevention does need to be maintained on a regular basis. • • Identified members of staff must attend Manual Handling up dates. Identified members of staff must attend Fire Prevention updates. Park View DS0000020283.V303623.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 X X 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 24 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 OP3 Regulation 14.1(a)(c) Requirement A full preadmission assessment must be carried out. Where possible this must include the involvement of the service user. A specific care plan must be provided for each area of identified need. Previous date of 21/03/06 was not met 3 OP7 15.1 Service users, where possible must be involved in drawing up agreed are plans. All handwritten entries on MAR sheets must be signed by the person making the entry. Staff must keep track of expiry dates on medication. The complaints policy and procedure must be updated to include the new CSCI address. The complaints record must include details of the investigation, action taken and outcome. All staff, through training, must be made more aware of the DS0000020283.V303623.R01.S.doc Timescale for action 21/09/06 2 OP7 15.1 21/09/06 21/09/06 4 5 6 7 OP9 OP9 OP16 OP7 13.2 13.2 22.7(a) 17.2 Sch4 (11) 13.3 21/09/06 21/09/06 21/09/06 21/09/06 8 OP26 21/09/06 Park View Version 5.2 Page 25 9 OP29 19.1(b)(c) Sch 2 10 11 12 OP30 OP38 OP38 18.1(c) 13.5 23.4 (d) importance of following Infection Control procedures. The manager must request references direct form referee rather than accept ‘to whom it may concern letters,’ even if received from employment agency Staff must receive training in Dementia Care and managing challenging behaviour. Identified members of staff must attend Manual Handling up dates. Identified members of staff must attend Fire Prevention updates. 21/09/06 27/11/06 21/09/06 21/09/06 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 2 4. 5. Refer to Standard OP9 OP9 OP19 OP30 Good Practice Recommendations Staff need to ensure that creams and ointments are only used by the person they are prescribed for. Qualified staff need to date creams and ointments when opened. The securing of wardrobes needs to be completed.4 Clear records need to be maintained to evidence staff development and training. Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Park View DS0000020283.V303623.R01.S.doc Version 5.2 Page 27 - 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!