Inspection on 14/02/07 for Linden Manor Care Home

This inspection was carried out on 14th February 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Linden Manor Care Home 14/01/09

Linden Manor Care Home 28/04/05

Linden Manor Care Home 11/11/04

Linden Manor Care Home 15/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Linden Manor Care Home 159 Midland Road Wellingborough Northants NN8 1NF Lead Inspector Thea Richards Key Unannounced Inspection 14th February 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Linden Manor Care Home DS0000050670.V316801.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. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Linden Manor Care Home Address 159 Midland Road Wellingborough Northants NN8 1NF 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) 01933 270266 01933 229141 manager.linden@regalcarehomes.com www.regalhomes.com Regal Care Homes Ltd Mrs Susan Dunnell Care Home 28 Category(ies) of Dementia - over 65 years of age (28) registration, with number of places Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total number of service users at Linden Manor must not exceed 28 Linden Manor must only admit service users within the category of Dementia DE(E) One existing service user within the category of Mental Disorder MD(E) may remain at Linden Manor while their needs can be met 24th August 2005 Date of last inspection Brief Description of the Service: Linden Manor is a care home providing personal care and accommodation for 28 older people who have a dementia related condition. The home is owned by Regal Care Homes who own a number of homes in the area. The home is situated close to the centre of Wellingborough and is easily accessible by private and public transport. There is parking available in the grounds of the home. The accommodation is a three-storey detached house set within its own grounds, which have been improved and are accessible for the residents. There is a mixture of single and shared bedrooms on all three floors, most of which do not have en-suite facilities. The first and second floors can be accessed by stairs or by a passenger lift. The home can be contacted by telephone, fax or email. The fees range from £348.55 to £400.00 There are extra charges for hairdressing, chiropody, some activities and personal items Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of a care home for older persons, which ended with an unannounced visit to the service. Before the visit the inspector spent four hours reviewing information received by the Commission for Social Care Inspection (CSCI) since the last inspection on 24 August 2005. The visit took place on the fourteenth February 2007 and lasted six and a half hours. During the visit the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called ‘case tracking’. Case tracking means that the inspector looked at the care provided to three of the residents. To achieve this, the residents and their families were spoken with. The inspector spoke with the staff supporting their care and looked at the records relating to their health and welfare. With their permission the client’s bedroom was looked at. The inspector also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. The inspector looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them were looked at. The inspector looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. During the visit the inspector spoke with the manager, residents and two of the residents’ families. What the service does well: Linden Manor provides a pleasant environment for the residents to live in. The care staff are well trained to meet the needs of the residents. ‘ They look after me well’ ‘ I enjoy the arts and crafts’ Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Linden Manor Care Home DS0000050670.V316801.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 Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 6 is not applicable in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are well assessed prior to moving into the home by the completion of a pre-admission assessment. This is completed by an experienced member of staff, by Social Services where appropriate and a visit to the service. This makes sure that the resident and their families know that they will receive the correct care. EVIDENCE: The inspector checked the care records of three of the residents (with their permission) who were case tracked. All of the residents had received a Statement of Purpose and a Service Users guide. The Statement of Purpose and Service Users’ Guide provide all of the required information about the services offered and the Terms and Conditions that apply. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 9 Providing a comprehensive Statement of Purpose & Service Users’ Guide results in good information for the residents, enabling them to get the most suitable care. Completed assessments were present in the files, identifying the clients’ care needs, before they were admitted to the home. Care plans showed that they contained the needs of the resident which had been identified in the original assessment. The staff spoken with said that they usually knew what the resident’s needs were before they were admitted to the home. The care plans seen had been agreed by the residents or their families. Two of the residents families spoken with told the inspector that they had a visit from the home manager before their relative was admitted. They confirmed that they were given the opportunity to visit the home before they came in. They said that when they came in they had a month’s trial to see if they liked it. This makes sure that that the staff in the home have the the right information before the resident is admitted so that the resident gets the best care. It makes sure that the home can meet the residents needs and that the resident meets someone from the home who they can recognise. This makes the move into care easier to manage for them. The current registration certificate from the Commission for Social Care Inspection (CSCI) was displayed in the entrance of the home. There was no up to date certificate of insurance displayed but this was seen in the office by the inspector. The manager confirmed that she had placed a copy in the entrance hall. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff fully meet the care needs of the residents as identified in the care plans. EVIDENCE: Care plans for three residents were ‘case tracked and were found to contain good individual evidence of care, which reflects the care being given to the residents. This includes a regular assessment of the residents’ weight and their nutritional needs. There are records of the involvement of G.P.s, chiropodist, optician and dentist present, giving evidence of thorough health care being provided for the residents. The residents and the families spoken with said that they could see a doctor whenever they needed to. They also said that they saw the other health professionals when they needed Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 11 to. The inspector spoke with a district nurse on the day of the visit. She said that she was very happy with the care given to the residents and that the staff were aware of the residents needs and would have no hesitation in calling a G.P. or a district nurse if they were needed. The Primary Care Team has recently allocated a G.P. surgery to work with the home, which means that the team can work more closely together to provide good care for the resdents. Consideration will be given to a resident or their family if they object to the choice of doctor to allow them to have a G.P. of their choice. The daily record of care was up to date, which makes sure that the residents receive the right care and the staff know what has happened to them during the day or night. The inspector observed residents being treated with dignity and respect when staff spoke with them. The staff were observed sitting with the residents, helping them with their lunch and sitting talking with them in the lounge area. Staff seen giving care, which included moving and handling the residents, did so in the right way, whilst giving the residents privacy. Staff spoken with were aware of the care needs of the residents and the residents and the visitors spoken with were happy that all care needs were being met. Medication records for the case tracked residents were in order. Medicines are only given by staff who have had training to administer medicines. Staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of medicines. The manager completes monthly audits of the medication records to make sure that they are being completed correctly. The above makes sure that the residents are protected with the correct medicine administration. There are no residents in this home who are able to administer their own medicines. Two visitors spoken with on the day of the visit were very happy with the level of care being given, they had had the opportunity of visiting the home prior to their relative being admitted and had a visit from the manager of the home. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their social, spiritual and nutritional needs met. EVIDENCE: There was evidence of some activites being provided for the residents, these were recorded in a file with a separate sheet for each resident. On the day of the visit there was no formal activity taking place but two residents were seen colouring and doing a jigsaw. The home does not employ a dedicated activities organiser, but the manager said that there were enough staff on duty to make sure that activities always happened. There were long periods when there were no staff in the lounges with the residents. This means that the residents could have an accident with nobody there to help them. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 13 There is a choice of two main meals available every day and diabetic meals are provided. The cook was not on duty on the day of the visit and a member of the care staff was working in the kitchen. She had completed a basic food hygiene course and had some knowledge of the diets needed such as diabetic and gluten free diets. Residents spoken with all said that they enjoyed the food and were happy with the choices. The inspector observed lunchtime in the dining room and all the residents said that they were enjoying their meal,which was well presented. Visitors are made welcome in the home and some regularly take their relatives out. This was confirmed by visitors spoken with who told the inspector that they were made very welcome at any time. The inspector observed the welcome given to visitors when coming into the home which was warm and friendly. They are spoken with regularly on a one to one basis by the manager. The manager sees each of the residents on a one to one basis every day. There are annual quality audits to get the views of the residents and their families. These practices ensure that the residents maintain contact with the community and their families and that views for improvements can be considered. There is a monthly church service within the home which the residents enjoy. There are no residents currently in the home who wish to take communion but this would be arranged if it was required. The local Roman Catholic church arranges visits for those residents of that faith. These practices make sure that the pastoral care needs of the residents are met and that all Faiths are provided for. A hairdresser visits every two weeks which is enjoyed by the residents. A specialist hairdresser visits to do some of the residents hair as they want it. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place to support and protect residents and most of the staff are aware of the processes. EVIDENCE: There is a complaints policy in place which gives the details of how to complain and who to complain to if they needed to. The complaints book was looked at and there are no records of any complaints having been received since the last inspection on the 24th August 2005. The residents spoken with were happy that they would speak to the manager or a member of staff, if they had a problem and that it would be dealt with. Visitors spoken with on the day of the visit said that they were aware of the procedure to complain and would have no concerns about doing so. The Commission for Social Care Inspection has received no complaints or concerns since the last inspection on 24t August 2005. The care staff spoken with were aware of ‘safeguardig adults’, the procedure to follow and would be prepared to ‘whistle blow’ if they thought there was a need to. One member of staff was not very sure about the procedure and the manager is to arrange training. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 15 This makes sure that the residents are safe from any abuse and that any concerns are handled correctly. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are protected by the policies and procedures in the home to provide a safe environment. EVIDENCE: The registration certificate from the Commission for Social Care Inspection was displayed in the reception area. The current inspection report is available in the managers’ office. Linden Manor is a converted house close to the centre of Wellingborough. There are three lounge/dining areas including the conservatory area and the residents have a choice of where to sit. The bathrooms are clean, tidy and free of any hazards. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 17 One of the bathrooms contained toiletries that were unnamed and left in the room. This is unsafe practice in infection control, as using the same products for more than one resident could cause a spread of infection. The residents should have their own items to maintain individuality and safety. The residents with confusion might drink these items if they are left available to them, which could cause a reaction or damage to them. This was brought to the attention of the manager and she had the items removed before the end of the visit. With their permission the case tracked residents bedrooms were viewed by the inspector. They provided good accommodation, which had been personalised with the resident’s belongings and a resident spoken with was ‘very happy with her room’. The bedrooms were clean and well maintained. The shared bedrooms had a curtain around each bed to maintain privacy and the residents had separate wardrobes and storage. There was an odour noted in the entrance hall and in some communal areas at the start of the visit, which had improved by the end. The call bell system is old, but still works, however, it allows the staff to turn the bell off without visiting the bedroom. This could lead to residents not getting the attention that they need or the staff forgetting to visit the resident. There was evidence of equipment such as hoists and special mattresses having been provided to help in the care and comfort of the residents. A resident was seen to remove the fireguard from around a fire in one of the lounges. The fire was on and the resident could have been burnt. This was brought to the attention of the manager, who immediately switched the fire off and put a notice on it to stop it being used. She confirmed to the inspector that the fireguard had been mended and was now fixed to the walls to stop it being moved. There were no further outstanding safety or maintenance issues noted on the tour of the premises. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ needs are met and their safety protected by the recruitment policy and by the training that is in place. EVIDENCE: There is evidence of a good skill mix of staff to make sure that the residents have the right care. The duty rota reflected the number of staff on duty. The residents, staff and visitors spoken with felt that there were usually enough numbers of staff on duty to cater for their needs. Three staff files were looked at by the inspector and the required information was complete in all the files. This included evidence of identification, adequately completed application forms, two written references and Criminal Records Bureau checks. There was evidence of staff training including induction and the staff spoken with confirmed that they received regular training in moving and handling. They said that they were encouraged to complete a variety of training. There were non mandatory training courses available, such as dementia training dementia, first aid, infection control and parkinsons disease which the staff could do. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 19 There is a record of training held by the manager with the certificates in the staff files. The number of staff in the home who have achieved the level of National Vocational Qualifications(NVQ) in care at level two or higher, is above the required level. Several more staff were about to commence the training. This is to be commended. The Manager holds an NVQ level 4 in care and in management. The National Vocational Qualification is a qualification for care staff to ensure that they receive appropriate training in the needs of the resident group whom they are caring for. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a home, which provides for their needs, with good safety systems in place. EVIDENCE: The manager was available for most of the visit to the home, she was away for part of the time to do an assessment for a prospective resident. During her absence the care manager was available. The manager has had several years experience as a care manager and has been at Linden Manor for two years. She has completed National Vocational Awards at level four in both care and management. This ensures that managers have the required skills to manage a care home. She has no administrative support in the home but Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 21 manages on her own with support from the registered person and the company’s head office. The staff receive training to equip them to care for the residents safely whilst protecting them from any abuse. This was confirmed by available records, the manager and by staff spoken with. There was evidence of staff supervision taking place. This process gives the staff and their ‘line manager’ the opportunity to have individual discussions about work and training needs. The staff spoken with confirmed that they received supervision. The manager told the inspector that the senior care staff were going to receive training in the supervision of staff. This training will allow them to supervise some of the staff which will give the manager more time to spend on other areas. The manager holds regular meetings with the residents and the staff as well as one to one discussions both to pass information on and to listen to their views and opinions. There are annual quality questionaires sent out to residents and their families to gain their views about the home. This allows the manager and the responsible person to respond to the residents and the staff’s needs. Residents finances are handled by their families, with the home holding some monies on their behalf for incidental expenses. This is handled by the manager and there are always two signatures to confirm any transactions. This records for the ‘case tracked’ residents were looked at and found to be in order. Records for the maintenance of fire equipment, and testing of water temperatures were found to be in place and up to date. There are risk assessments in place to cover risks in the home and individual risks to the residents. This makes sure that the residents and the staff are protected from any risks that have been identified without restricting their activities. The accident book was inspected and found to be complete and in order. There were copies of accident forms present in the residents careplans. These practices make sure that the residents live in a safe environment and their lives are protected. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTE3CTION Standard No Score 16 3 17 3 18 2 2 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP12 OP18 OP19 Good Practice Recommendations The manager should make sure that the residents are more frequently supervised in the lounges. The manager should make sure that all the staff working in the home receive training in safeguarding adults. The registered person should give consideration to installing a new call bell system to protect the residents from the possibility of having a call ignored. Linden Manor Care Home DS0000050670.V316801.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Linden Manor Care Home DS0000050670.V316801.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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