Inspection on 18/05/07 for Fleetwood Nursing Home

This inspection was carried out on 18th May 2007.

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

Fleetwood Nursing Home 13/05/09

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 Fleetwood Nursing Home Grange Road Fleetwood Lancashire FY7 8BH Lead Inspector Christopher Bond Unannounced Inspection 18th May 2007 09:30 18/05/07 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 Fleetwood Nursing Home DS0000068069.V334549.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. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fleetwood Nursing Home Address Grange Road Fleetwood Lancashire FY7 8BH 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 779290 01253 779290 NR & VGP Carehomes Ltd Mrs Jennifer Shaw Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 30 service users to include: *Up to 30 service users in the category of OP (Old age not falling within any other category). Date of last inspection Brief Description of the Service: This is a nursing home, which is registered for a maximum of 30 residents. It is situated in a residential area of Fleetwood. There are several shops close to the home and the promenade and sea front is only a short walk away. A doctor’s surgery is situated close to the home and there is a bus stop close by for services to Blackpool, Cleveleys, and Fleetwood town centre. There are car parking spaces at the front of the building. Most of the bedrooms within the home are single rooms and are quite large, and some of the bedrooms have en-suite facilities. There were double rooms but these were being used as single bedrooms at the time of the inspection. There is a lift to the first floor for people with disabilities and there are several aids and adaptations around the home. There are two lounges and some residents also sit in the dining area. There is a conservatory area at the back of the building, which serves as an extra lounge. The service has recently had a change of ownership, and the new owners have plans to redevelop areas of the home to include more rooms with en-suite facilities. Information relating to the home’s Service User Guide and Statement of Purpose is included in the welcome pack, which is given to all prospective residents. This information explains the care service that is offered, who the owner and staff are, and what the resident can expect if he or she decides to live at the home. At the time of this visit, (18/05/07) the information given to the Commission showed that the fees for care at the home are from £380.00 to £450.00 per week, with added expenses for hairdressing and chiropody. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection of a service that has had new owners since December 2006. As part of the inspection process this unannounced inspection took place over a total of 5 hours on the 18th May 2007. A tour of the home was carried out, which included bedrooms, lounge, dining areas, and bathrooms. All areas were clean and hygienic. The residents’ personal files and care plans were examined. Care staff records and recruitment records were also looked at. Safety certificates and medication records for the home were also examined. The manager, residents, care staff and visitors to the home were spoken to during the inspection and the lunchtime meal was sampled. The Commission for Social Care Inspection sent out survey comment cards to the residents and their families for them to express their views on the service. A number of these were returned and the results of this survey have been expressed in the report. What the service does well: Care records are professionally written and informative. Care plans are updated and reviewed on a regular basis to ensure that the standard of care remained constant. The care staff work well as a team and show a good understanding of the needs of the people living at the home. Daily routines for the people living within the home are flexible and the residents’ personal routines and lifestyles are respected. Mealtimes are relaxed and unrushed. Menus showed that there was plenty of choice available. The food that was being cooked on the day was nutritious and appealing. Several of the residents spoke of how much they enjoyed the cooking at the home. There are regular planned meetings for the residents and people are encouraged to express their views regarding the service that they receive. The residents were very complementary regarding the quality of care that the home provided. One resident said, “ I enjoy living here. My room is lovely and the girls are very good at what they do.” Almost all of the care staff either have a nationally recognised qualification in care or are working towards this. Over 50 of the staff are now qualified. This Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 6 means that the care staff are better prepared to provide care for the residents of the home. 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. The summary of this inspection report can be made available in other formats on request. Fleetwood Nursing Home DS0000068069.V334549.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 Fleetwood Nursing Home DS0000068069.V334549.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are assessed properly by the home to ensure that their needs can be fully met. People are given good information about the service so that they can make an informed decision as to whether or not the home is right for them. EVIDENCE: It was clear that all of the people who lived at Fleetwood Nursing Home had been assessed before going to live there. This means that their social, health and cultural needs had been looked at and a decision had been made as to whether the home could look after them properly and attend to all of their particular requirements. There were very detailed assessments within the personal files of the residents. One of the visitors who was spoken to said that someone from the home had visited prior to admittance to assess their relatives needs, and that they had a chance to look round the home before they made a decision as to whether it was right for their relative. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 9 Each person who wished to live at Fleetwood Nursing Home had been given a Service User Guide. This was in booklet form and told all prospective residents about the services that the home offered. This helped the residents and their families to make a decision as to whether the home was right for them. There were copies of this guide in some of the vacant bedrooms. Fleetwood Nursing Home DS0000068069.V334549.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident health needs are met by good care planning and thorough procedures. The people in this home were looked after well and treated with dignity and respect. EVIDENCE: Everyone who lived at this home had a plan of care that documented all of their daily needs and how the staff would address these needs. There was lots of information written down. The inspector looked at five of the care plans and there was enough information in each of these plans to show that the care needs of the residents were being dealt with properly and appropriately. It was also evident that each resident had their needs assessed on a monthly basis to make sure that any changes in their condition was noted and acted upon. There was lots of good, recent information in the care plan about the health needs of the residents and how the staff at the home were addressing these needs. There was also good information written down about how the home had Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 11 asked for the involvement of health care professionals such as doctors, district nurses, psychiatrists, physiotherapists etc. Each person is assessed on a monthly basis regarding the potential for the development of pressure sores. Equipment was available for use in the home to prevent these. The inspector spoke to several residents and their relatives. One person commented, “This is my home now, I’m very happy with the care here.” Most of the people that were spoken to said that they were happy about the standard of personal care that was provided by the home. One relative said that there was sometimes not enough care staff on duty to provide adequate care. Fifteen care survey forms were filled out by the resident, carer or their families. All said that they ‘always’ or ‘usually’ received the care and support that they needed. These forms were set out as part of the Commission for Social Care Inspection process of inspection to help ensure that everyone’s views are taken into account. Only the trained nursing staff had the responsibility of helping the resident with their prescribed medication. This is important because it meant that staff had the necessary skills to ensure that residents received their medication safely as prescribed. The medication record sheets of each resident were looked at and they were completed appropriately. Everyone had a photograph attached to his or her records to help identification. Systems were in place that ensured that all medication was handled correctly and professionally ensuring the safety of service users. None of the residents were able to look after their own medication. Some of the residents were prescribed medication that was ‘controlled’ because of its content or strength. The staff at the home handled this properly and professionally. Safety procedures and policies were followed. There were some good examples seen of the care staff speaking to the residents properly, respectfully and politely. The residents who were spoken to were also complementary of the personal care that was offered by the care staff. This is very important because it shows that people were being respected and cared for well. Fleetwood Nursing Home DS0000068069.V334549.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities were varied and well planned, which contributed to the well being of the residents. Visitors were welcomed and valued family relationships were encouraged. EVIDENCE: The information that was held about people interests and hobbies in the care plans had improved a lot since the last inspection. This information is important because it helps the service to provide more individual activities for the residents. The care staff had begun to gather information about people’s families and life histories. Relatives had been asked to bring in photographs and memorabilia about the residents lives before they came to live at the service. This type of information is important because it helps the care staff to be more aware of people as individuals who have had interesting and varied lives. It also helps the residents to recall important times in their lives and improve their memories. The service also had memory games and reminiscence books about how life used to be when the residents were younger. This information provided interesting discussion topics for the care staff and residents. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 13 The families that were spoken to during the inspection confirmed that they were treated well when they visited the home and were always offered privacy so they could talk openly to their relatives. One gentleman said that he visited on a daily basis and was always asked to stay for lunch on Sundays. He commented, “I’m very happy with the standard of care here. They always look after me when I visit.” Those who filled out a care home survey provided by The Commission for Social Care Inspection said that they ‘always’ or ‘usually’ liked the meals that were provided by the home. The inspector spoke to the cook and the kitchen assistant during the inspection. Fresh vegetables were always used and the menu looked wholesome and varied. The midday meal was sampled and was found to be enjoyable. The dining area was attractively set out and there were flowers on the dining tables. The manager confirmed that there were regular activities, such as dominoes, bingo and other games. There was also an entertainer who visited the home on a regular basis. It is important that there is always lots going on in the home and that people are stimulated by regular and appropriate activities and entertainment. It was clear that the residents were able to follow their religious beliefs at the home. A Priest was visiting the home during the inspection to talk to residents. Fleetwood Nursing Home DS0000068069.V334549.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are protected by good policies, procedures and training. Complaints are treated seriously to ensure that the residents’ rights are protected. EVIDENCE: There were policy documents for the staff to read about how to ensure that people were safeguarded from harm. All of the staff that were spoken to said that they had a good awareness of this important issue and knew what to do if they were not happy about something they had seen. The manager was aware of her responsibilities and knew whom to contact should there be any question regarding how the residents were being supported and safeguarded. Recent training had taken place regarding safeguarding adults for all of the staff. It is important that all of the care staff that work at the home have access to this information as it helps to ensure that people are safeguarded from harm. Copies of all the home’s policies and procedures were available in the main office for the staff to read to help them in their roles as carers. All of the staff that were spoken to said that they knew what to do if someone was unhappy about the service. The complaints procedure was displayed in the home and was part of the Service User Guide. The manager was aware of her role regarding the complaints procedure and how complaints can be used as a quality tool to ensure that the home is run in the best interests of the residents. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 15 Those who filled out a care home survey provided by The Commission for Social Care Inspection said that they ‘always’ or ‘usually’ knew who to speak to if they were not happy with the service that was provided. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 23, 24 and 25. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are provided with a clean, hygienic and homely environment. Some residents had their comfort and safety compromised by old and poorly maintained windows. EVIDENCE: The residents’ bedrooms looked very comfortable and there were lots of personal possessions around to make the rooms more homely. This is important because residents feel more at home with their own pictures, ornaments and important memento’s around them. The home was generally well maintained throughout. The manager confirmed that maintenance tasks were generally dealt with quickly so as not to inconvenience residents. All of the rooms were well decorated and there was a nice homely feel to the bedrooms and communal areas. There were three lounge areas, one being a conservatory at the back of the house. There were Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 17 plans to add a conservatory area to the side of the house to increase the lounge space. On the day of the inspection the home was warm, clean, hygienic and fresh smelling. The communal bathrooms on the first floor were very plain and austere and needed work doing on them to make them comfortable and homely. Bath time should be a pleasant and soothing experience in relaxing surroundings. The manager said that they were rarely used and that there were plans to redesign and decorate them. There was a shower room on the ground floor that most of the residents used. Many of the windows in the home were old and needed replacing. Some were single glazed units. These would be draughty in breezy conditions. The manager confirmed that estimates had been received for the windows in the home to be renewed as son as possible. Many of the carpets within the home had been replaced and some of the rooms had been redecorated. A well decorated home makes this a more pleasant place to live in. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers of well -trained staff on duty ensure that residents needs are met. Good recruitment practices help to make sure that only suitable staff are working at the home. EVIDENCE: There were enough care staff on duty during the inspection to help ensure that the assessed needs of the residents were adequately dealt with. The staff rotas showed that staffing was good and that there were plenty of staff on each shift to ensure that people were being properly looked after. The rota also showed that the residents were being properly supported at night. There were nineteen residents living at the home at the time of the inspection and the manager had maintained levels of staffing for a higher number. Three people who filled out a care home survey provided by The Commission for Social Care Inspection said that they felt that there were only staff available ‘sometimes’ when they were needed. One visitor stated that she sometimes had trouble finding staff when visiting the home. Most of the care staff had achieved a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). There was a good induction process to help ensure that new care staff were competent before commencing their role. There was also a good training programme to ensure that the care Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 19 staff were able to improve their skill and learn new ways to care for people. There had been recent training in safeguarding adults, dementia awareness and safety aspects around the home Three of the care staff were spoken to during the inspection and it was clear that they had the knowledge, skills and abilities to provide a good standard of care for the residents of the home. Staff files were examined and were found to contain all of the information that was required by law to achieve this standard. The Manager had worked hard to ensure that each file contained the correct information. This is essential because good information helps to protect the people who live at the home because more is known about the staff. There was a photograph of the staff member and proof of their address. Recruitment procedures were good and all of the staff had the proper checks completed ensuring that only suitable staff are employed. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 36 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed in a competent and a professional manner. Good safety procedures and a well-trained staff team protect the residents. The home is being run in the residents’ best interests. EVIDENCE: The manager of Fleetwood Nursing home has a nursing qualification and a nationally recognised management qualification. This means that she is well qualified to run the home and has the necessary skills and ability to do this successfully. The care staff that were spoken to were complimentary of her management style and the way that the home was being run. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 21 It was clear that this home was being managed in the best interests of the residents who lived there. Their care was well planned and the home was run safely and professionally. Good records were being kept of safety checks within the home. These showed that professionals were checking the lift, electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. Trained maintenance people were also checking the lifting equipment in the home on a regular basis. Staff were being instructed in safety aspects within the service. They were being shown how to move those residents, who had difficulty in supporting their own weight, safely and respectfully. Other safety training included fire safety awareness, food hygiene, first aid and health and safety. All of the care staff that were spoken to were able to confirm that they had received safety training. There was evidence on the personal files of the care staff to show that everyone was being supervised properly. This means that time was set aside for regular one to one meetings with the staff to ensure that they were happy and doing their jobs successfully and professionally. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 22 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 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 X 3 3 2 X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP21 OP25 Good Practice Recommendations The first floor bathrooms should be renovated to provide comfortable and relaxing facilities for the residents of the home. Old and damaged window frames should be replaced to improve the safety and comfort of the residents. Fleetwood Nursing Home DS0000068069.V334549.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Fleetwood Nursing Home DS0000068069.V334549.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. 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