Inspection on 12/07/05 for Floron Rest Home

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is 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

Floron Rest Home 08/09/06

Floron Rest Home 21/02/06

Floron Rest Home 14/03/05

Floron Rest Home 21/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Floron Rest Home 236 Upton Lane London E7 9NP Lead Inspector Anne Chamberlain Unannounced Inspection 12th July 2005 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Floron Rest Home Address 236 Upton Lane, London, E7 9NP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 472 5250 0208 655 7228 g.collison@btopenworld.com Mrs C Quarshie Collison Mrs C Quarshie Collison Care Home - PC 16 Category(ies) of OP - Old Age (16) registration, with number of places Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14th March 2005 Brief Description of the Service: Floron Rest Home is a residential home for 16 service users over the age of 65 years. It has been established since 1972. The home does not offer nursing care. There are 4 single bedrooms and 6 double bedrooms. 3 of the single rooms are ensuite and all the rooms have basins. There are two bathrooms with toilets and 1 shower room and toilet on the ground floor. Floron is situated in Upton Lane in Forest Gate and backs on to West Ham Park. It is on a main bus route and a short distance from both underground and rail stations. Floron has off street parking in front of the house, for several vehicles. There is a pleasant garden with patio area at the rear. The registered manager is also the registered provider. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out on one day. It was an unannounced inspection and last for seven hours. The inspector toured the premises and viewed a number of documents and files including six service user files and several staff personnel files. She spoke to service users and to a relative and a two members of staff as well as interviewing the registered manager/provider and the co-owner. The inspector would like to thank the service users, relatives, staff and management of the service for their co-operation with the inspection. What the service does well: What has improved since the last inspection? Staff files have been improved since the last inspection and there is now an “at a glance” key to each file. The office arrangements have been improved with a tidier office and better access to records and files. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 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. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, and 5. The needs of prospective service users are assessed and they have an opportunity to visit the home, and make an informed choice about moving there. EVIDENCE: The home has recently admitted a new resident and the manager explained the general process for assessment and introduction which was followed. In this case a referral was received from a social worker with information which the manager studied. The needs of the prospective service user were assessed by the manager. Following assessment the service user and their family visited Floron and the service user spent a half day there before deciding to move in. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 and 11. Service users have individual care plans but some need updating. Healthcare needs are well met at the home. The arrangements for the administration of medication are sound. Service users are treated respectfully and their privacy protected. Death is handled sensitively, at the home with families fully involved. EVIDENCE: Service users have an individual care plan which is written by their care manager when they are admitted to the home. The care plan is then reviewed after six weeks at the home. Thereafter reviews should be six monthly although in recent times this has been extended to annually. The individual care plan is kept on the service user file but translates into a care plan which is kept on the ‘standex’ system in the home. Generally individual care plans were out of date being dated more than one year previously There was a lack of evidence of regular annual reviews being held or care plans on the standex system being updated according to the actions of the reviews. The manager stated that Newham Social Services have a backlog of reviews and when reviews are overdue she prompts the care Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 10 manager. She also stated that care manager do not send through the minutes of the reviews to the home. The inspector suggested that files should evidence efforts to instigate a social services review and in the absence of the review the home should hold their own care review, record the decisions and establish a clear trail between the review and the updating of the care plan on the standex. The manager must ensure that the service user’s care plan is reviewed regularly to reflect changing needs. This is a requirement. Care plans on the standex lacked dates and signatures of staff. The manager must ensure that care plans are signed and dated. This is a requirement. The inspector viewed ample evidence of the health needs of service users being met. Care notes indicated that the health of service users is carefully monitored. The home requests home visits from the G.P’s of service users when they believe they are needed. The manager stated that they enjoy good relationships with the local G.P’s who have respect for the judgement of the manager and her staff. A number of health professionals call at the home, including dentist, optician, and chiropodist. A relative remarked that “nothing is missed” and “everything is kept up with”. She also said that when her mother-in-law has had to go to hospital she has been accompanied by a member of staff. There are currently no diabetic service users or service users needing special diets or with compromised nutrition. Service users are not routinely weighed but the inspector was satisfied that any unusual weight loss or gain would be observed by staff and appropriate monitoring would be put in place. Pampering sessions are included in the activity programme at the home and the inspector noticed that every time she shook the hand of a female service user the nails were beautifully manicured! The inspector observed a medication round. Medication was administered patiently and sensitively by staff. The inspector viewed the MAR sheets and balanced a random selection of medications. She also viewed the contolled drug record book, which is signed at every shift with the quantities being checked, also the record of medications returned to the pharmacy. Medications are appropriately kept in a locked ccupboard with controlled drugs in a separate locked cabinet and medications which needs to be refrigerated Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 11 being kept in a locked box within the refrigerator. No errors were found. The member of staff administering the medication advised the inspector that she had received good training for the task. The privacy of service users is upheld. There is a private telephone available for use and incoming mail is passed unopened to service users. Although twelve service users share bedrooms screens are used for privacy of personal care. G.P’s see people in their own rooms. The inspector noted that the admission details include the preferred form of address and this had been completed on all the examples she viewed. The manager is aware of the need to collect the wishes and views of service users regarding the time of their death. All the current service users have families and most are prepared to take responsibility for the making the necessary arrangements in line with the wishes of the service user. There is a space for this information on the admission details but it had not been completed in every case. The manager must ensure that the information regarding views and wishes for time of death are recorded (even if this is to say that family will be dealing with these matters). This is a requirement. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15. The home works to meet the social and cultural needs of service users. It is very supportive of relationships and contact with family and friends and welcomes representatives of the community. The staff encourage service users to make independent choices and retain control over their lives. A balanced diet of appetizing food is provided and served in a pleasant dining room. EVIDENCE: The inspector was satisfied that service users are considered as individuals and within the limitations of a small home efforts are made to meet their particular social and cultural needs. Clergy visit the home regularly. A relative advised that service users who wished to were taken to vote. There is occasional inhouse entertainment. The manager stated that until recently a group of school children were visiting. A co-ordinator visits for half a day a week offering a variety of activities including gentle exercise. Most recreation takes place within the home The feedback received by the inspector from service users and a relative was positive. A service user said that the home was “smashing”, a “lovely place”, Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 13 that the staff were “good and kind” and she could find “no faults”, although she would like to go out more. A relative (not of the above individual) said that the only negative comment she could make would be that opportunities to access the community do appear to be limited, although there is an annual outing to Southend and other special occasions are attended. The manager stated that service users are occasionally taken for wheelchair walks in the very close local park and this was confirmed by the above relative although she had personally only witnessed this very occasionally. The home was planning to take service users to a street party in a few days time. The manager acknowledged that should residents wish to, for example make a shopping trip, this would be for relatives to arrange themselves, although the home would support it. Service users at the home would benefit from more opportunities to access the community and it is recommended that the manager endeavour to facilitate this. This is a recommendation. The home has a very pleasant garden and three service users took the opportunity of a lovely day on the day of the inspection, to sit in the garden. There was evidence that the home supports and encourages relationships with family and friends. One individual regularly attends family parties and weddings. Visiting is open and families are made welcome. There were two sets of relatives visiting on the day of the inspection and documentary evidence of some families visiting virtually on a daily basis. The home is commended for the warm welcome it extends to visitors. Service users are encouraged to make choices. They can stay in their rooms if they wish and can have breakfast served in bed. They are encouraged to choose their own clothes each day. Mealtimes present more opportunities for making choices. The manager stated that when a single room becomes vacant the residents who share are asked if they would like to move into it but no-one has chosen to do this. The manager stated that records are kept in accordance with the data protection act and relatives are aware of their right to access records. Food is generally acknowledged to be a strength at this home. Feedback from service users and relatives is consistently positive. There is one main choice for lunch but alternatives are provided on request, and there are a variety of different choices available at tea time. One relative advised that staff are quite happy for special food to be brought in for service users, for example “ fish and Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 14 chips from the fish and chip shop” or a bag of doughnuts or party food for special occasions. She said that staff are happy for relatives to use the kitchen and cooker to prepare food. The inspector felt that this demonstrated a really open and flexible attitude for which the home is commended. The dining room has three large tables which are laid up for meals. Outside of meal times large vases of fresh flowers contribute to very really pleasant atmosphere. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 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 standard(s) 16 and 18. The home takes complaints seriously and protects service users from abuse. EVIDENCE: The inspector viewed the complaints policy and procedure, and complaints information which is framed and hangs in the home. Minor adjustments were made at the time of the inspection to reflect the fact that complaints can be made direct to the Commission for Social Care Inspection (CSCI) at any time. The inspector viewed the log of complaints which shows only three complaints the last being over a year ago. The manager stated that she felt complaints were avoided because they home has a policy of sharing information with families promptly This was borne out in conversation with a relative who said families are “told about everything”, for example, if a service user is “not eating or they have to go to hospital”. Having observed interaction between service users and staff the inspector felt that relations are generally comfortable and easy and service users are encouraged to express themselves and their views freely. The home has an adult protection policy which was viewed by the inspector. The policy refers to the need in some instances to contact social services. This is supported by a wall chart which shows how referrals to social services progress. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20,21,22,23,24,25,26. The home provides a safe well maintained environment with comfortable and pleasant indoor and outdoor shared spaces. There are adequate lavatory and washing facilities and equipment to maximise independence is provided. Bedrooms are shared but comfortable and personalised. Surroundings are safe, homely, clean and pleasant. EVIDENCE: The home is well decorated, bright, airy, hygienic and very clean. The furnishings are comfortable and homely. Six bedrooms are shared which would not be acceptable in a new build. The rooms are however quite large and there are personalised areas within them where residents have photographs and personal possessions displayed. The communal facilities are the dining room, the lounge and a small area between the kitchen and dining room which has a couple of comfortable chairs and makes a very handy waiting area for visitors to the home. There is in addition a very pleasant garden, with good garden furniture, well maintained by the home’s handyman, as is the front garden. It is unfortunate that due to the small nature of the Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 17 home 16 residents share one lounge. It is apparent that staff do all they can to cater to all tastes with music etc., and there is the option to spend time in one’s room. The washing, bathing and showering facilities in the home are adequate and the inspector noted the provision of equipment to promote independence in personal hygiene. The inspector also noted cushions in place to ease pressure for service users who spend much time sitting. There are currently no pressure sores among the service users at the home. Laundry facilities are adequate and regular testing of the temperatures of water from taps in the home was evidenced in records kept. Emergency lighting is in place. Lighting is domestic in character and table lamps are in place at bedsides. The home is centrally heated and there is good natural ventilation. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,and 29. The home employs an adequate number of qualified and skilled staff to meet service users needs. Recruitment is safe and staff are generally competent. EVIDENCE: The home has a stable staff group and never uses agency staff. The inspector was informed by a member of staff that there are three shifts and a minimum of two workers including a senior worker, on each shift. The night shift comprises two waking staff. The inspector viewed the staff rota which confirmed what she had been told. In addition the rostered staff are supported by the manager and co-owner who are generally present during daytimes on weekdays and on some weekend days. They are also on call. The manager stated that 50 of the staff have NVQ 2,. Additionally one staff is working towards NVQ 3 and one towards NVQ 4. Staff files evidenced a good level of NVQ achievement. The home evidenced a robust safe staff recruitment policy. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, 36, 37 and 38. The home does not support service users with their finances. Staff are supervised but one to one supervision is rather infrequent and irregular. Records are kept but there is room for improvement in this area. EVIDENCE: The manager stated that the home has no involvement in the financial affairs of service users which are managed either by their families, care manager or a solicitor. They do not draw benefits, or keep cash for service users. If a service user needs a service like chiropody or hairdressing the home will purchase this and the relatives are subsequently invoiced by the home. Records of supervision sessions in the files of staff were viewed and a list of supervisions which had taken place in 2004 and in 2005. Standard 36 states that care staff should receive formal supervision at least six times per year. The manager and co-owner feel that due to the small size of the home and the fact that they work closely with the staff three times per year is sufficient. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 20 Notwithstanding the above, evidence was not available to evidence that supervision is taking place at the rate of three times per year. It is acknowledged that the year is only half over, but the aim should be to spread supervisions evenly over the year. The co-owner suggested that this is not possible given the demands of sickness, holidays and the work of the home generally. The manager must ensure that staff are supervised regularly, not less than six times per year. This is a requirement. A selection of service users files were viewed. The information therein is divided into plastic pockets. Old standex sheets are separated in a pocket of their own, but indivdual care plans and reviews tended to be mixed up with other correspondence. The files would benefit from being kept in ring binders and further divided so that care plans and reviews are separated. They should be filed chronologically and the pages should be turned over and easily accessed and not need to be withdrawn from a punched pocket of papers. The manager must ensure that service user files are kept up-to-date and in good order. This is a requirement. The inspector viewed the various safety logs for the home, fire alarms and extinguishers, emergency lighting, portable appliances, gas and electricity. Records are kept of water temperatures and of temperatures of cooked food and of refrigerators and freezers. There is evidence that safety including the spread of infection is taken seriously in the home environment and measures are taken to protect and safeguard staff and service users. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 3 2 2 3 Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 14 Requirement The manager must ensure that service users care plans are reviewed regularly to reflect changing needs. The manager must ensure that care plans are signed and dated. The manager must ensure that the information regarding views and wishes for time of death are recorded. The manager must ensure that staff are supervised regularly, not less than six times per year. The manager must ensure that service users files are kept up to date and in good order. Timescale for action 01 September 2005 01 September 2005 01 September 2005 01 September 2005 01 September 2005 (previous timescale of01/07/20 05 not met). 2. 3. 7 11 14 17 4. 5. 36 37 18 17 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 23 Floron Rest Home 1. Standard 12 Service users at the home would benefit from more opportunities to access the community and it is recommended that the manager endeavour to facilitate this. Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 4th Floor, Gredley House 1-11 Broadway, Stratford London E15 4BQ 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 Floron Rest Home G57 G06 S22836 Floron Rest Home V238763 120705 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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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