Inspection on 15/03/06 for Franciscan Convent

This inspection was carried out on 15th March 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

Franciscan Convent 16/04/07

Franciscan Convent 08/11/05

Franciscan Convent 24/02/05

Franciscan Convent 10/08/04

Franciscan Convent 12/03/04

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

CARE HOMES FOR OLDER PEOPLE Franciscan Convent 63 Yorkshire Street Burnley Lancashire BB11 3BS Lead Inspector Mrs Pat White Announced Inspection 15th March 2006 10:00 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 Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 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. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Franciscan Convent Address 63 Yorkshire Street Burnley Lancashire BB11 3BS 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) 01282 459090 01282 439012 Franciscan Missionaries of St Joseph Mrs Janet Crawford Care Home 25 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (22) of places Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2005 Brief Description of the Service: The Franciscan Convent is registered to provide care and accommodation to 25 older people, including 3 older people with dementia. The Convent belongs to the Roman Catholic Order of the Franciscan Missionaries of St Joseph, and has been adapted to a care home. Only retired Sisters needing care from this Order live in the home at the present time. The Roman Catholic faith underpins the life of the home. Most of the routines are those of Convent life that the Sisters have been familiar with throughout their religious lives, including the daily celebration of Mass and Prayers in the Convent’s Chapel. The premises are an older Convent building, in the centre of Burnley, which has been well adapted to its dual function of Convent and care home. It comprises 3 floors, linked by a lift. There were 22 bedrooms, which at the occupancy levels at the time of the inspection, were all used as single rooms. There were 10 WCs, 4 baths, two of which were assisted baths, and two showers. None of the bedrooms were en suite. There was extensive communal space which included a large lounge / dining room, a conservatory, a library, a T.V. lounge and a visitors lounge. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an announced inspection, the purpose of which was to assess important areas of life in the home that should be inspected over a 12 month period, check the progress of previous legal requirements and good practice recommendations, and check any other matters in the home which came to the inspector’s notice. The inspection took 7 hours and comprised of, talking to the Sisters, a tour of the premises, looking at Sisters’ care records and other documents, and discussion with the manager, Mrs Janet Crawford. A pre - inspection questionnaire was completed and information from this is included in the report. Five Sisters were spoken with and three Sisters completed comment cards. Some views and comments they expressed are included in this report. What the service does well: The Convent has consistently over time, provided a high standard of care. The Sisters were well cared for by a staff group who understood their physical needs for care and also their needs as Sisters of a Religious Order. Sisters praised the staff for being kind and understanding. The written information about the Sisters’ needs and how these needs were to be met was detailed and well written. Their personal and health care needs were well monitored and addressed. The way the home was managed and run enabled the Sisters to continue their religious and Convent life. Sisters regard the Convent as “their home” rather than as a “care home”. Appropriate activities and routines were maintained and encouraged. The food served in the home has consistently over time been of a high quality and which meets the Sisters’ preferences. Sisters’ spoke positively of the meals served. There were good opportunities for staff training, which were in line with Government guidelines and which ensured that the staff had the right knowledge and skills. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 6 The home was well maintained and decorated and provided a comfortable, peaceful, spacious and safe environment for the retired Sisters. There have consistently been sufficient members of staff on duty, with sufficient skills, to meet the needs of the Sisters. The home was following thorough recruitment procedures that complied with the legal requirements. This helped to ensure that only suitable staff were employed in the home. The home has benefited from a stable long serving management team, of which the present manager has been a part, and this has helped to ensure consistent high quality care. What has improved since the last inspection? What they could do better: Medication management could be further improved by better and clearer recording of information about changes in medication and changes in instructions from the GP and the District Nurses. Whilst the care plans were comprehensive and well written more useful detailed information about the care needs of the very dependent Sisters could be recorded, such as the assistance required with feeding and the procedures needed whilst being cared for in bed. Care plans should be updated when the Sisters care needs change significantly. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 7 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. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 8 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 Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 9 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): 1 & 4. Standard 6 not applicable There was useful written information about the home’s accommodation and facilities, to assist the resident Sisters and prospective Sisters. The physical and spiritual needs of the Sisters were being met. EVIDENCE: The Statement of Purpose and the Service user Guide had been updated early in 2006 to reflect recent changes in the management of the home. These documents provide useful information to the Sisters and to any prospective resident. The Sisters had wide ranging needs; from those who were relatively independent and could go out alone, to those with high dependency care needs. The Convent could also accommodate 3 Sisters with needs relating to dementia. The inspection methods used indicated that the varied needs of the Sisters were being met. Some members of staff had completed training on dementia care. The Sisters spoken with said that the staff were patient, kind and understanding Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 The care plans were well written and contained useful information about the Sisters needs and how these needs should be met. However these could contain further details on some matters. The Sisters’ health and personal care needs were well monitored and fully met but some medication practices must be improved to ensure safe administration. EVIDENCE: All the Sisters had comprehensive care plans. Those viewed were well written, and contained useful information on the Sisters’ health, personal and social care needs. However the care plan viewed of one Sister did not contain details of the all the assistance staff needed to provide. Moving and handling assessments had been undertaken. Relevant risk assessments had been undertaken, including vulnerability to pressure areas. The intervention and preventative measures for pressure areas, was recorded on the care plans, and appropriate assistance and equipment was given from the District Nurses. Relevant details about dementia and mental health issues were also recorded on the care plans. Nutritional screening was carried out as part of the care plan. The care plans were being reviewed, at least monthly, and those Sisters Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 11 who wished to be, were involved in this. However the care plan of one Sister whose care needs had considerably changed did not reflect these changes and required updating. The records viewed, and discussion with the manager and Sisters, showed that the Sisters’ physical and psychological health was well monitored and maintained. The more independent Sisters made their own arrangements for health care. The staff and the Congregation supported the Sisters who needed assistance. Visits made by GPs, nurses and other professionals were recorded. With respect to medication management and administration only the previous requirements and one recommendation were monitored. Some of the previous requirements had been met but some had not. The criteria for the administration of “When Required” medication were not defined and recorded on or with the MAR sheets. Also on the MAR sheet of one Sister there was insufficient information and instructions about recent changes in her medication. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 & 15 The lifestyle, activities and choices in the Convent matched the Sisters’ expectations, including those associated with Religious Life. The food served was varied, appetising and healthy according to the Sisters’ preferences. EVIDENCE: Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 13 The home is a Convent and meets the expectations of the Sisters for Religious and Convent life. The routines of daily living were in accordance with the Sister’s expectations, preferences and capabilities. Sisters continued with the familiar routines and practices associated with their Religious Life, including the daily celebration of Mass, “Offices” and Prayers. The Sisters’ particular interests and hobbies were recorded on the care plans. One Sister spoke of her pleasure at being able to plan and work in the garden. Some Sisters were enjoying having computer lessons. One Sister had been encouraged to take up “greetings card making”. Visitors were welcome in the home at any reasonable time. Sisters from the Congregation, both from the UK and overseas, were frequent visitors to the Convent. Relatives were also welcome in the home. All visitors could stay for periods in the Convent. Sisters enjoyed the local facilities, such as Towneley Park and the town centre shops. Standard 14 was not fully assessed but some choices were available to the Sisters, such as the food served, hobbies and activities. However 3 Sisters who completed comment cards stated that they “sometimes” wished they could be more involved in the running of the home. One of the Sisters residing in the home was the Community leader of the Convent, and she helped to ensure the Sisters’ best interests are promoted. Records viewed and the menus supplied showed that the meals served were healthy and appetising and that there was sufficient choice based on the Sisters’ preferences and Feast days. Records also showed that 3 full meals were served each day, with the main, 3- course meal, being served at mid day. A lighter meal was served in the evening, but also provided a cooked option. Sisters had the option of eating together in the dining room, or in the privacy of their own rooms. Appropriate assistance was given to those who needed it. One Sister was taking food supplements and a record of the food and fluids taken was being kept. Sisters spoken with, and those who completed the comment cards, stated that they enjoyed the food. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The Sisters and visitors had appropriate channels, including a complaints procedure, through which to air any concerns or complaints. The Sisters were protected from abuse and felt safe living in the home. EVIDENCE: The home had a complaints procedure, which complied with legal requirements. The Statement of Purpose and the Service User Guide included a summary of this. Sisters would voice their concerns to the manager and various members of the Congregation, including the Convent Community Leader or the Congregational Leader. Since the previous inspection no complaints had been made, and the Sisters spoken with, and those who completed comment cards, stated that they had no complaints or concerns. One Sister said she was “quite satisfied with everything”. At previous inspections it was established that the Franciscan Convent had an “Adult Protection” policy that included a “Whistle Blowing” policy. The home also had procedures which had been developed in accordance with the local “No Secrets” (Department of Health) guidance, and which stated when the local “Public Protection” Unit should be contacted. There was also a policy on dealing with “challenging behaviour”. There had never been a reported suspicion or allegation of abuse and the Sisters who completed comment cards said that they felt safe living in the home and felt well looked after. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 15 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, 20, 22 & 26 The Convent was clean, well - maintained and decorated, and provided a spacious environment well suited to the needs of Sisters from a Religious Order who need care and support. The laundry procedures and facilities ensured a good standard of hygiene. EVIDENCE: Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 16 The Convent is an older building in the centre of Burnley, which has been adapted for its current purpose as a care home. As such it is entirely suitable for the accommodation of Sisters of a Religious Order who need varying degrees of care and assistance. There was a programme of maintenance and renewal, and the premises were well maintained and decorated. The manager stated that the premises were due to be redecorated and refurbished and some windows replaced as necessary. The home was clean, warm and comfortable with a peaceful ambience. There were small gardens to the rear and side, which were enclosed and safe, and accessible to Sisters using wheelchairs. The gardens were well kept in the growing seasons and the Sisters took pleasure from these areas. Some Sisters enjoyed working in them. A recent fire safety inspection had taken place and some recommendations had been made. The registered person was in the process of organising the work involved. Communal space consisted of a large dining room / lounge, TV lounge, library, a small lounge to receive visitors, a conservatory, a sitting area between the kitchen area and the conservatory and the chapel which was always open. There was also a small lounge and kitchen on the first floor. Therefore the amount of shared space allocated for individuals was in excess of this standard, and the nature of the different rooms allowed the Sisters varied activities and privacy in addition to their bedrooms. The lighting in the communal areas was domestic in character and was sufficiently bright for reading and other activities. Furnishings in these areas were of good quality and the decorating was of a high standard. All areas were due to be redecorated. Though standard 22 was not fully inspected it was demonstrated that individual Sisters’ needs for equipment were kept under review. Based on this a “walk in” bath was to be installed in the first floor bathroom. All areas of the home were clean and fresh and the laundry facilities were of a high standard. There were appropriate laundry procedures and procedures for the control of infection. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 17 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 There were enough staff on duty, with the right kind of skills and training to meet the needs of the Sisters. The staffing compliment was supported by thorough recruitment procedures that helped to ensure only suitable staff were employed. EVIDENCE: The inspection methods used, including the number of staff on duty at the time of the inspection, the rotas supplied and discussion with the Sisters, confirmed that the Convent had enough staff on duty to meet the needs of the Sisters and to provide a high standard of care. It was clear that the staff had time to spend talking to the Sisters. Staff had a range of skills and qualifications and some staff had undertaken courses on looking after people with dementia. There were also enough cook and domestic hours worked to ensure high standards of food and hygiene were maintained. Seventy eight percent of care staff was trained to at least NVQ level two. Therefore standard 28 is exceeded. The Convent was following thorough recruitment procedures that complied with the legal requirements. This helped to ensure that only suitable staff were employed in the home. Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 18 Staff training records and discussions showed that staff were trained and competent to do their job effectively. The staff induction programme followed the Skills For Care specifications. Most of the staff had completed NVQ level 2 or 3 courses and had therefore completed topics and units, which were in accordance with Government guidelines. Staff had attended a variety of courses ranging from dementia care, bereavement, first aid, health and safety, fire safety, elder abuse, challenging behaviour and food hygiene. Staff were booked to undertake a course on “Infection Control” Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 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 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 & 38 There was a new manager who was competent and qualified to run the home in the best interests of the Sisters, whose views were listened to and taken into account. The health and safety of the Sisters and staff was promoted. EVIDENCE: Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 20 There was a new registered manager, Mrs Janet Crawford, who was appointed in December 2005. She had worked as the senior assistant manager in the home for a number of years and was qualified, competent and experienced to run the home. Mrs Crawford had completed all the necessary NVQ level 4 courses, and had management experience in the home. She had also completed other relevant courses. There was a senior assistant manager and 3 assistant managers. Some of the these members of staff had been in post for a number of years which helped to ensure continuity and stability. There were clear lines of responsibility and accountability within the home, and within the Congregation. The Congregational Leader, and Responsible Individual, Sister Joan O’Gorman, and the Burser of the Congregation visited the home regularly and supported the new manager and the Sisters. This system ensured that the care home ran as the Convent home of the Sisters, in keeping with their expectations and wishes. The home had a service quality monitoring policy, which stated that an annual quality review should be carried out. The Sisters and the staff had completed service quality questionnaires in February 2006. These will be fully analysed and the results and outcome will be sent to the Commission. Sisters’ meetings were regularly held, when such matters as arrangements for Festivals, meals and activities were discussed. The health and safety of staff and the Sisters was promoted. A fire safety inspection had recently been undertaken (see standard 19). The fire safety precautions were satisfactory, and the fire equipment appropriately tested and maintained. The gas and electrical installations and portable appliances had current certificates of testing. There was a person competent in first aid on every shift. The staff - training programme included health and safety training according to Skills for Care specifications. There was a rolling programme of moving and handling training. The home’s health and safety adviser was currently considering what the home needed to do to ensure the water system did not pose a threat of Legionella. However the Commission had not been notified of several “Notifiable Incidents” Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 X 3 X X X 4 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 22 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 The care plans must contain all aspects of the personal, health and social care required by the Sisters, and should be updated when the care needs change significantly. The criteria for the administration of all when required and variable dose medication must be clearly defined and recorded on or near the MAR sheets. (Previous timescale of 3/12/05 not met) All handwritten changes and additions to the instructions on the MAR sheets should be signed by two people (witnessed) and dated. When medication, doses and administration methods are altered there must be clear instructions, criteria and information on the MAR sheets. (Previous timescale of 8/11/06 not met) The manager must notify the DS0000009534.V282311.R01.S.doc Timescale for action 31/03/06 2. OP9 13 (2) 31/03/06 3. OP9 13 (2) 15/03/06 4. OP9 13 (2) 31/03/06 5. OP38 36 15/03/06 Page 23 Franciscan Convent Version 5.1 Commission of all incidents that affect the health an welfare of the Sisters including falls which result in admission to A & E. 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 Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Franciscan Convent DS0000009534.V282311.R01.S.doc Version 5.1 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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