Inspection on 07/11/06 for Flower Park Nursing Home

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Flower Park Nursing Home 09/10/07

Flower Park Nursing Home 01/05/07

Flower Park Nursing Home 08/06/06

Flower Park Nursing Home 13/10/05

Flower Park Nursing Home 11/05/05

Flower Park Nursing Home 09/03/05

Flower Park Nursing Home 19/10/04

Flower Park Nursing Home 15/12/03

Flower Park Nursing Home 20/05/03

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

CARE HOMES FOR OLDER PEOPLE Flower Park Nursing Home Rossington Street Denaby Doncaster South Yorkshire DN12 4BT Lead Inspector Sarah Powell Key Unannounced 7 November 2006 09:15 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 Flower Park Nursing Home DS0000015860.V312455.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. Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Flower Park Nursing Home Address Rossington Street Denaby Doncaster South Yorkshire DN12 4BT 01709 863327 01709 860303 NONE www.fshc.co.uk Four Seasons Health Care (England) Limited (wholly owned subsidiary of Four Seasons Health Care Ltd) David John Hutton Care Home 40 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) Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24), Old age, not falling within any other category (16) Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service may admit up to four persons between the age of 60 to 65 years within the category of Dementia (DE) and Mental Disorder (MD). One specific service user under the age of 65 (Mental Disorder), named on variation dated 22nd August 2006, may reside at the home. 8th June 2006 Date of last inspection Brief Description of the Service: Flower Park is a purpose built home situated in Denaby near Doncaster it is set in a residential area with shops, a market and other amenities nearby. The home is on two floors the upper floor is for service users with dementia and mental disorder over 65 years and has lift access, the ground floor accommodates nursing service users over 65 years. Flower Park can accommodate up to forty service users. All rooms are single and the majority are en-suite with toilet and wash hand basin. The home has a suitable number of lounges, dining rooms, toilet and bathing facilities. The gardens are well maintained and easily accessible to the service users on the ground floor, access is limited for the service users on the first floor. The fees at Flower Park Care Home range from £410 - £470 free nursing care. (Nursing care bands are £40 low £83 medium and £133 high) Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second key inspection in the year 2006/07 it was unannounced and took place over one day on 7th November 2006 at 09.15 and finished at 17.00 two inspectors carried out the inspection. The home has also had two random inspections in this inspection year one on 25th April 2006 this was to determine that staffing levels had been increased to meet the needs of the residents and the other on 19th October as part of an adult protection investigation. As part of the inspection process the inspectors spoke to 8 residents, 6 staff and the Manager. A tour of the building took place, observing environment, staff and practices. A number of records were examined these included medication, two service users care plans, fluid charts, menus, staff rotas, recruitment, service users finances and quality assurance systems. Feedback was given to the Manager when the visit was completed. What the service does well: What has improved since the last inspection? What they could do better: Many areas have been identified in this report that require improvement to ensure service users needs are met. Care plans remain out of date and poor, service users needs are not clearly identified. Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 6 Social and recreational activities still do not include all service users. The environment was found in a poor state bathrooms all require an upgrade, service users bedding needs replacing including mattress covers and pillows. Staff training is still not up to date and fails to protect service users. Environmental risk assessments are still to be carried out. 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. Flower Park Nursing Home DS0000015860.V312455.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 Flower Park Nursing Home DS0000015860.V312455.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 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The assessments were out of date and lacked detail. EVIDENCE: Two service users were case tracked as part of the inspection process and the assessments were found to be out of date and did not reflect the service users needs and did not determine if the home was able to meet those needs. Observations of care practices especially in the upstairs lounge indicated that service users were not having their needs met in a timely manner. They were kept waiting for long periods before being supplied with food and drink. On occasions they were kept waiting long periods before being given assistance they clearly needed. Flower Park Nursing Home DS0000015860.V312455.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 & 10 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans were extremely poor and service users needs were not being met EVIDENCE: The care plans looked at were poor lacking information and detail they did not identify service users needs. The home had put new documentation in place since the last inspection for the plans of care and the plans had been reorganised, however not all sections were completed and none looked at during the visit had been reviewed monthly. One service user had two pressure sores yet this was not identified as a problem. Health care needs of service users were not addressed, all service users had fluid charts yet these were not completed, reviewed or any action taken when inadequate fluids had been given. Many charts looked at showed service users were only offered the standard cups of tea at set times and no fluids in between and many had inadequate fluid intake for a number of days. Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 10 Service users plans stated that they had continence problems and should be offered to be taken to the toilet regularly particularly before meals. Not one service user on the upstairs unit was offered the toilet or taken to the toilet prior to the lunchtime meal, unless they asked. Other basic health care needs were not addressed while talking to service users it was observed that some service users nails were dirty, faces were not cleaned particularly around the eyes, and clothing was stained this does not promote the dignity of the service user. Another home’s manager was in Flower Park on the day of the inspection, she was carrying out care plan audits copies of these audits were given to the inspector these too showed care plans to be poor and identified similar problems, particularly with care plans for the service users on the upstairs unit with poor mental health and dementia. The requirement for the care plans to be improved and reflect service users needs has been identified in the last four reports and needs to be addressed urgently. It was stated in the last inspection that if it were not complied with by 1.9.06 CSCI would consider enforcement action. Following a random visit on 19/9/06 the manager requested an extension to this timescale, as they had not completed them due to staffing problems, an extension of six weeks was agreed. They therefore should have been completed by 6th November 2006. A management review by CSCI will take place to determine the course of action. Service users spoken to said that the staff were caring and tried there hardest at maintaining dignity and treating them with respect, but there was not always enough staff on duty and they were very busy. Care staff spoken to genuinely cared for the service users but lacked direction at times to ensure service users needs are met. This may in part be due to the large number of staff that have left in a short space of time. Medication policies and procedures had much improved safeguarding service users. Flower Park Nursing Home DS0000015860.V312455.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 & 15. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Activities organised are good but not all service users are included. Food is good with a varied choice. EVIDENCE: There are two activities coordinators doing 10 hours a week each, this is to be increased to 30 hours a week in total as of Jan 07. They are very enthusiastic and activities provided are very good. Service users spoken to said that the activity co-ordinators were good and worked hard to organise different activities to entertain them, and also worked hard at fundraising to ensure there were different activities available. There is some one to one time with service users when they are able but this is restricted due to staffing problems. Social and recreational needs of service users on the upstairs unit are not being met, this is due to lack of knowledge and direction. The activities organised are reliant on fundraising, there is no allocated budget for equipment or transport. Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 12 There is a new cook in post who has developed some good menus. One inspector sat with four service users on the downstairs unit at lunchtime all gave positive comments about the food, choice and staff. Alternatives are always available for all meals to ensure service users choices are catered for. The other inspector observed lunch on the upstairs unit, it was very disorganised service users were not sat at the table but given lunch in the lounge area, face and hands were not always washed and if food was spilt clothes were not always changed, service users were not offered the toilet before or after lunch as detailed in the care plans, therefore not meeting service users needs. Flower Park Nursing Home DS0000015860.V312455.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 & 18. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Complaints are taken seriously and systems are in place to protect service users from abuse. EVIDENCE: The home has a good comprehensive complaints procedure, which is displayed, in the entrance hall. All service users spoken to were aware of this, but all stated if they had any concerns would go straight to the manager or a member of staff. The home had received a number of complaints regarding laundry back in September this is now resolved. A number of adult protection referrals are still ongoing and being dealt with through the multidisciplinary strategy meetings to ensure service users are protected. Most staff have received protection of vulnerable adults training and staff spoken to were aware of the procedure to follow, one nurse spoken to was not clear, she had not received the training. The manager had followed policies and procedures when dealing with possible abuse to protect service users. Flower Park Nursing Home DS0000015860.V312455.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, 21, 22, 24, 25 & 26 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Environmental standards were extremely poor, in a large number of bedrooms, the dining chairs and tables , the bathrooms and toilets. Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 15 EVIDENCE: On arrival at the home both inspectors noted a foul odour throughout the home. A tour of the building took place upon arrival starting with the upstairs unit. The home was found to be in a poor state of cleanliness the mattress covers on beds were dirty encrusted in debris and badly stained, many pillows were lumpy and unacceptable, the carpets were stained and smelt of urine. The bedroom curtains were poor most were detached from the curtain tracks and old and faded. The communal bathrooms were dirty the floor coverings badly stained, bases of toilets were dirty and stained, the bath hoist and bath was filthy and one toilet seat was missing. Most were ill fitting, the seat used in the walk in shower was stained and in a poor condition and needed replacing. The curtains in the lounge and dining area were also not fitted properly looking shabby and neglected. On finding so many issues the manager was asked to join the inspectors and the above issues were shown to him. Radiator covers were loose and detached from the radiators which could be dangerous to service users, the maintenance person had identified this problem however the radiators were old and fixing mechanisms were no longer available, he had been trying to rectify the problem for a while. One radiator in the shower was to be replaced as it was rusting. On the downstairs unit similar problems were identified, most items had been identified by the manager and were on a three year renewal budget for replacement however the environment is extremely poor for the service users now. The current arrangement does not provide a safe, clean, fresh smelling well maintained environment. The domestics were observed cleaning empty rooms this is a poor use of resources as some rooms were very dirty and required a deep clean, it would be helpful if there a housekeeper were employed to manage the domestics and laundry personnel. Cleaning fluids were found in one bathroom left unattended, placing service users at avoidable risk. Most beds were not made until 3pm when the laundry had been returned this shows a lack of bedding. Many service users kept asking when their beds were going to be made, as they wanted to go and lay down. The current arrangement is unsatisfactory and deprives service users of a facility, which should be readily available. The manager has carried out a bed rail audit and has identified different types of bed required to meet service users needs and meet health and safety requirements. These have been ordered and approved but are being delivered over a long period of time because of budget restrictions. Many service users are still waiting which means the old bed rails are being used that are not safe. Flower Park Nursing Home DS0000015860.V312455.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 & 30. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Recruitment is good, although more staff are required, recruitment is ongoing. Staff training needs to be updated and staff need to do NVQ qualifications. Closer supervision of staff would benefit service users by improving standards of care. EVIDENCE: There has been a large turn over of staff since the last inspection five qualified staff have left and a number of care staff. This has affected the staff team and the progress of the requirements. New staff have been recruited staff spoken to said the moral has improved. Minimum staffing is being maintained although agency is being used regularly to maintain levels. The manager has had the budget passed to increase the qualified nurse numbers on nights from one to two, which should improve things for the service users, as there will be a qualified staff member on each unit. Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 17 The home has not been able to maintain 50 of care staff trained to NVQ level 2 or above due to the staff turn over. The manager said he is committed to achieving this again to ensure service users are in safe hands at all times. The training officer has tried to continue with the training to ensure all staff have achieved the mandatory training and that it is regularly updated. This has not always been possible with the amount of qualified staff that have left. Health and safety, fire and food hygiene have still to be completed by all staff. A selection of recruitment files were looked at they were very good, well organised and contained all the required information for protecting the residents. Flower Park Nursing Home DS0000015860.V312455.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 & 38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The outcome overall is adequate although the maintenance records and financial arrangements for service users is good. EVIDENCE: The registered manager has been in post since January 2006, and has made many improvements however budgetary restraints and staffing issues have restricted progress. The manager is qualified and experienced to run the home and is registered on the registered managers award but has yet to start. Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 19 Quality assurance monitoring is in place and is carried out when possible the manager has developed an internal home audit and has requested a manager of another home to come in and carry it out. So far health and safety, kitchen and bed rails have been addressed and further audits are to be implemented. Care plan audits were ongoing at the time of the visit and the inspectors saw the records. There is no planned maintenance budget for the home the manager has to submit a quote for approval and this process could take three months, which inevitably leads to delays. Service users financial interests are now safeguarded, the systems have improved and good records maintained. The maintenance records for gas safety, electrical safety certificates, PAT testing, legionella and safe environment including equipment and machinery were available and up to date at the time of the inspection. The risk assessments on safe working practices were still not available, the manager is aware these need to be drawn up but has had other urgent issues to address. This leaves service users at an avoidable and unnecessary risk. Flower Park Nursing Home DS0000015860.V312455.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 1 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 1 X 1 1 X 1 1 1 STAFFING Standard No Score 27 2 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 1 Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Ensure all service users have a plan of care that reflects their needs. (Old timescales of 1.1.06, 1.3.06, 1.4.06, 01.09.06 & 06.11.06). Ensure that all service users have a detailed assessment in their plans of care. (Old timescale 01.09.06) Ensure all health care needs are identified and met. (Old timescale 01.09.06) Ensure all service users social and recreational needs are met. (Old timescale 01.09.06) Ensure all mandatory training is updated for all staff. (Old timescale 01.10.06) Ensure all quality-monitoring systems are carried out to ensure the home is run in the DS0000015860.V312455.R01.S.doc Timescale for action 01/01/07 2. OP3 14 01/01/07 3. OP8 12 01/01/07 4. OP12 16 01/01/07 5. OP30 18 01/01/07 6. OP33 24 01/01/07 Flower Park Nursing Home Version 5.2 Page 22 best interests of the service users. (Old timescale 01.09.06) 7. OP38 23 Ensure the risk assessments for safe working practices are drawn up. (Old timescale 01.09.06) Ensure service users are given a choice regarding all aspects of their life in Flower Park. The home must be maintained in a good state of repair internally in particular floor coverings, furniture and décor. Provide suitable furniture, bedding, curtains and floor covering to all service users rooms. Ensure the premises are kept clean, hygienic and free from offensive odours throughout. Ensure the skill mix of staff is appropriate to meet the needs of the service users. Ensure that 50 of care staff has achieved NVQ level 2. Ensure all chemicals are locked away at all times if not being used and if being used are with a member of staff, not out of sight. Provide suitable toilet, washing and bathing facilities that meet service users needs in particular making sure suitable shower chairs are provided and bath hoists are maintained in good state of repair. Ensure all old beds and bed rails are risk assessed. Reassess the cleaning schedules/routines and set priorities so service users can have clean fresh smelling beds and bedrooms. DS0000015860.V312455.R01.S.doc 01/01/07 8. 9. OP14 OP19 12 23 01/01/07 01/02/07 10. OP24 16 01/02/07 11. 12. 13. 14. OP26 OP27 OP28 OP38 23 18 18 13 01/01/07 01/02/07 01/05/07 01/12/06 15. OP21 23 01/01/07 16. 17 OP22 OP26 23 16 14/12/06 14/12/06 Flower Park Nursing Home Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Flower Park Nursing Home DS0000015860.V312455.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Flower Park Nursing Home DS0000015860.V312455.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. 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