Inspection on 09/08/06 for Fairhaven Lodge

This inspection was carried out on 9th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fairhaven Lodge 22/08/07

Fairhaven Lodge 08/02/06

Similar services:

Chirnside House

Emmaus House

East Croft Grange

Craignair

Croston Park Nursing Home

Conifers Nursing Home

Cloisters

Elmsdene Care Home

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

CARE HOMES FOR OLDER PEOPLE Fairhaven Lodge 7/9 Fairhaven Road St Annes Lancashire FY8 1NN Lead Inspector Lesley Plant Unannounced Inspection 1:00 9 and 10 August 2006 th th 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 Fairhaven Lodge DS0000064686.V295819.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. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairhaven Lodge Address 7/9 Fairhaven Road St Annes Lancashire FY8 1NN 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) 01253 720375 01253 720375 Dr Morgiana Muni Nazerali-Sunderji Carol Elizabeth Williams Care Home 24 Category(ies) of Dementia (24) registration, with number of places Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 24 service users in the category DE (Dementia) 8th February 2006 Date of last inspection Brief Description of the Service: Fairhaven Lodge is registered to accommodate 24 residents who have a diagnosis of dementia. The home is situated close to both the sea front and the centre of St Annes, meaning that local amenities and facilities are easily accessible. Service user accommodation is split over three floors, with a stair lift enabling access to the upper floors. Most bedrooms have their own ensuite facilities. There is space at the front of the home for parking and a small, enclosed rear garden where service users can sit out in the summer months. There is an activity programme in place, providing motivation and stimulation for those living at the home. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during two visits to the home, the first day being unannounced. All of the key national minimum standards were assessed. Time was spent talking to and observing people living at the home. All the service users have various degrees of cognitive impairment therefore some conversations were brief and limited. The inspector spoke to the manager; the care coordinator, the cook and two care assistants working at the home. Records were viewed and a tour of the building took place. Information was also gained from a pre inspection questionnaire completed by the manager. Comment cards providing feedback were received from 12 relatives, with six service users also being supported, by relatives or staff, to complete feedback questionnaires. Time was also spent observing staff and service users engaged in daily activities. The Commission for Social Care Inspection has received an application to increase occupancy at the home from 24 to 25 service users. This will be achieved by converting a small lounge into a bedroom, providing an extra ground floor bedroom. What the service does well: A great deal of positive feedback was received from relatives via questionnaires distributed prior to the inspection. The staff team have clearly built up good relationships with relatives and the individuals living at the home. Comments included; “I have no problems whatsoever with the care my mother is receiving. It is excellent”,“ the level of care my mother receives is second to none,” “I can contact or visit the home at any time and always receive a warm welcome. Should anything untoward happen they have no hesitation in contacting me”, “ staff are always helpful, reliable, trustworthy, friendly and dedicated to those entrusted to their care” and “so glad we chose Fairhaven Lodge.” The manager has extensive experience and provides strong leadership at the home. Good systems and procedures have been developed, which help the home to run smoothly and ensure that individual service user needs are met. The systems for care planning, staff recruitment and the management of individual’s money are well established and robust. Quality assurance systems are particularly effective, with relatives being regularly invited to share their views. The regular ‘preference discussions encourage service users to make choices and provide good one to one time with staff. Both the manager and the care coordinator are soon to commence the NVQ assessors’ award, which will strengthen the already good opportunities for qualification training for staff. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 6 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. Fairhaven Lodge DS0000064686.V295819.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 Fairhaven Lodge DS0000064686.V295819.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 6 Quality in this outcome group is good. The assessment process is thorough, helping to ensure that service users are only admitted to Fairhaven Lodge if their needs can be met. EVIDENCE: The assessment documents for an individual recently admitted to the home show that good information is gathered prior to admission. Both the manager and care coordinator are experienced in the assessment of new service users. This would take place in hospital or in the person’s home. Information is gathered from spending time with the individual and their relatives, as well as gaining information from other professionals e.g. hospital staff. Relatives play an important part in this process and are asked to complete a personal history, giving much useful information, such as regarding past employment, interests and hobbies. A care plan is then drawn up. People are not admitted to Fairhaven Lodge solely for intermediate care. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 and 10 Quality in this outcome group is good. Good systems of care planning and reviewing, help to ensure that health and personal care needs are met. Privacy and dignity are promoted during the dayto-day work of staff. EVIDENCE: Each person has a care plan; which addresses health, personal and social care needs. Records show that care plans are reviewed each month. In addition to this monthly review, an annual review takes place, with relatives and relevant professionals being invited to this meeting. Risk assessments are in place and these are also regularly reviewed. A key worker system is in operation. Much positive feedback was received from relatives, with comments including, “I have no problems whatsoever with the care my mother is receiving. It is excellent” and “ the level of care my mother receives is second to none.” Health care needs are addressed within care plans and the daily records kept by staff show that changing health needs are monitored and good contact is kept with health care professionals. A record is kept of each persons weight and a weekly exercise/physiotherapy session is held. Individuals were seen enjoying this session, facilitated by a physiotherapist who visits the home each week. Each person has a personal care and hygiene chart in their bedroom Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 10 detailing the support needed and completed by care staff to confirm that personal care such as shaving, has been attended to. Records and discussion with the care coordinator confirmed that advice from the district nurse regarding an individual with a pressure area, was being followed. A chiropodist regularly visits the home. Medication is only administered by senior staff who have undertaken appropriate training. A record, with sample signatures, is kept of the staff who can carry out this task. The three medication records viewed were all maintained appropriately and contained a photograph of the individual. The majority of medication comes into the home in blister packs from the pharmacist and is stored in a locked cupboard. A medication trolley has been purchased for the safe storage of the remaining medication. This will improve the current storage arrangements. Privacy and dignity are addressed with all new staff during the induction period. Screening is provided in the double bedrooms. During the inspection staff were observed responding gently and sensitively to service users. All the residents were nicely dressed, with staff clearly recognising the importance of this in relation to maintaining dignity. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14 and 15. Quality in this outcome group is good. Social contacts and activities are encouraged and visitors are made welcome. The menu is varied and service users enjoy the meals provided. EVIDENCE: Regular weekly activities at the home include a physiotherapy/exercise session, hairdressing, beautician and a church minister visiting each Sunday. Other activities include games, drawing and singing. Group activities are not always successful, however staff were observed spending time talking individually with service users. The home is well placed for accessing local amenities such as the nearby beach café. There is a key worker system in place and staff work hard to spend additional time with those few individuals who do not receive regular visitors. Files give good information regarding past interests and hobbies. Concerts and carol singing are arranged during the Christmas period. During the inspection it was clear that visitors are made welcome at the home and can pop in at any time. The relatives who completed feedback comment cards all responded positively about visiting arrangements. Comments included, “I can contact or visit the home at any time and always receive a warm welcome. Should anything untoward happen they have no hesitation in contacting me.” Service users can entertain visitors in their bedroom, the dining room or in one of the lounges. The small visitors lounge is to be Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 12 changed into a bedroom. Although this room is rarely used the manager should consider providing an alternative quiet accessible area, for individuals to chat to visitors. The service users at Fairhaven Lodge all have a diagnosis of dementia resulting in various degrees of cognitive impairment. A relative will usually take responsibility for financial affairs and make any necessary decisions on their behalf. Information regarding advocacy is available. People are able to bring their own personal possessions with them to the home. The regular ‘preference discussions’ encourage individuals to make choices, which are recorded. Staff were observed supporting individuals to make choices, such as what to drink and were sensitive in their response to another person who was reluctant to change from her nightwear until later in the morning. Feedback from relatives confirms that they are kept informed of important matters and one commented, “Staff value the independence and individuality of each resident.” Menus show a good variety of meals provided, with the main meal being served at lunchtime. Tea consists of a choice of sandwiches, soup and light snacks. The cook knows the food preferences of individuals and is also aware of any particular health/dietary needs, including allergies. Birthdays and special occasions are celebrated and party food provided. Service users were observed enjoying their meal and staff provided support and assistance in a sensitive manner. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 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 the following standard(s): 16 and 18 Quality in this outcome group is good. There are good procedures in place for responding to concerns. Policies, procedures and good practice promote the protection of those living at the home. EVIDENCE: There is a complaints procedure in place, which is given to relatives when an individual is admitted to the home. Good records are kept of any concern and these show that any such matter is treated seriously and quickly responded to. The six monthly management reviews look at various aspects of the service provided and includes a formal review of any concerns raised and how this was addressed. The relatives who completed feedback comment cards all responded that they have never had reason to complain, but were aware of the procedure to follow if they did have cause to complain. Appropriate protection and whistle blowing policies are in place. Staff read these and discuss their content as part of their introductory training at the home. Abuse/protection is also addressed within the NVQ programmes. The manager has a copy of the No Secrets in Lancashire guidance and is aware of the correct vulnerable adults procedures. Recruitment files show that appropriate checks are undertaken prior to staff being employed at the home. There are good arrangements in place for the safekeeping of service users money. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 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 the following standard(s): 19 and 26 Quality in this outcome group is adequate. Some furnishings and parts of the home are in need of attention and do not provide an attractive place for people to live. The home is clean. EVIDENCE: Some redecoration and refurbishment has taken place since the last inspection. These improvements are clearly appreciated, with one relative commenting; “ The home has been recently decorated in a style that is beneficial to all residents. Cheerful and bright.” This improvement programme must continue. Areas such as bathrooms and a number of the bedrooms need attention, with some bedrooms requiring new flooring. Stair gates have been fitted in order to prevent accidents. Although this is generally not deemed appropriate it is acknowledged that the stairs in the home may pose unacceptable risks to service users. The manager is aware that individuals must still be afforded access to their bedrooms and that staff support must always be available for those wishing to do so. The inspector has contacted the local fire service, requesting that they visit the home to provide advice regarding access on the top floor, access to the kitchens and the use of the stair gates. Access to the kitchen areas was discussed with the manager of the Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 15 home and it was agreed that a review of the associated risk management arrangements should take place. The redecoration/refurbishment of the bedrooms identified during this inspection must be given priority in the improvement programme. The laundry facilities are sited in the basement and are only accessible to staff. At present the care staff are also responsible for domestic duties at the home and a daily cleaning schedule is in place. Some specific additional staffing is allocated for cleaning carpets. The home appeared clean and reasonably fresh smelling. The manager is advised to review and improve the laundry arrangements for bedding, as some bed covers appeared unironed. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 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 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 is good. The home is staffed appropriately and NVQ (National Vocational Qualification) training is promoted, providing opportunity for staff to develop further skills in their work. Recruitment procedures promote the protection of service users. EVIDENCE: Observation during the inspection and the viewing of staff rotas confirm that adequate staffing levels are maintained. During the day and early evening there are at least three care staff plus the manager or care coordinator on duty. A cook is also on duty and there are two staff on working duty during the night. Eleven of the twelve relatives who completed feedback questionnaires responded that there were always enough staff on duty and that they were available when required. One relative stated “ Staff are always helpful, reliable, trustworthy, friendly and dedicated to those entrusted to their care.” The number of staff having achieved level 2 NVQ has increased and now 50 of the team are qualified. A new training provider is now being used and the manager is keen to maintain or increase the levels of qualified staff at the home. Both the manager and the care coordinator are soon to commence the NVQ assessors’ award, which will strengthen the already good NVQ opportunities for staff. The recruitment documentation for two recently appointed staff showed that good procedures are in place. Records include an application form, two references, criminal records bureau disclosures, a contract and a confidentiality Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 17 statement. Staff are supplied with a copy of the General Social Care Council code of conduct. The manager has recently engaged a new training organisation that will provide the majority of training for staff at the home. At present new staff undergo an induction/introduction to the home, carried out by one of the senior managers. This addresses immediate issues such as fire safety. There is then a structured training schedule whereby staff read key policies and procedures and the corresponding training papers. Staff then have to answer a number of questions to demonstrate their understanding. Staff also attend external courses covering areas such as food hygiene, moving and handling, infection control and dementia. There are some staff who have not completed all of the core training, particularly infection control and dementia training, and the manager is keen to address this shortfall. The two care staff spoken to both said that they were happy with the training opportunities available and that the manager or care coordinator were always available for advice and support. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 18 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 is good. Service users benefit from living in a well managed home. Policies, procedures and good practice help to ensure that the quality of the service is monitored, service users financial interests are safeguarded and health and safety of service users and staff is promoted. EVIDENCE: The manager has extensive experience, is registered with the CSCI and provides strong leadership at the home. Good systems and procedures have been developed, which help the home to run smoothly and ensure that individual service user needs are met. The manager has achieved NVQ level 4 in care and is soon to complete the registered managers award. A care coordinator and a number of senior care assistants, one having additional management and administrative responsibilities support the manager. Comments from relatives included, “Fully satisfied with the management and staff. Nothing is too much trouble and my mum is getting the very best treatment that she possibly could. So glad we chose Fairhaven Lodge.” Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 19 There is a range of quality monitoring systems in place. The views of relatives are regularly invited via comment slips given out when an individual leaves the home and also via questionnaires sent to relatives every six months. Every month staff carry out ‘preference discussions’ with individuals living at the home. These cover different areas of the service provided and include a record of action that needs to be taken. The minutes of the six monthly management review meetings show that quality objectives such as more staff obtaining an NVQ are set and reviewed. The home has also achieved an external quality assurance accreditation. There are good procedures in place regarding the care of service users money. For most people a relative will manage their financial affairs, however the manager does act as benefits agency appointee for a small number of people at the home. There are arrangements in place for a small amount of money to be held in safekeeping for each person, for such things as hairdressing costs and incidental items. The records for three individuals were checked, showing that all income and expenditure is recorded and the balances corresponding with the money held. The home has a safe where cash is held. Most staff have undertaken basic core training in health and safety topics such as moving and handling and food hygiene. The gaps in this programme have been addressed within the assessment of standard 30. A fire risk assessment is in place and there is a good system of regularly assessing the knowledge of staff regarding fire safety. Fire equipment is regularly maintained and a record of fire drills is kept. The electrical wiring certificate and legionella test certificate were also viewed. Risk assessments are in place and accident records maintained. The cook carries out certain checks in the kitchen and keeps good records. Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 20 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2 Standard OP19 OP19 Regulation 16 and 23 23 Requirement Bedrooms in need of decoration/refurbishment must be attended to. Bathrooms/shower rooms in need of redecoration/refurbishment must be attended to. Timescale for action 30/11/06 31/01/07 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. 3. Refer to Standard OP19 Good Practice Recommendations The use of gates on the stairs needs to be regularly reviewed, in order to balance the need for safety with the need for service users to have access to their bedroom. The manager should review the risk management arrangements relating to access to the kitchens. All staff should receive training in the mandatory agreed topics. OP19 OP30 Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Fairhaven Lodge DS0000064686.V295819.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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