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Inspection on 19/10/05 for Marine View Rest Home

Also see our care home review for Marine View Rest Home for more information

This inspection was carried out on 19th October 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

All residents spoken with were happy residing at the home and felt that their needs are being met and were complimentary about the staff. The home has a friendly and welcoming atmosphere.

What has improved since the last inspection?

The home has worked towards meeting some of the requirements and recommendations made at the last inspection. Some individual rooms have been redecorated and a cleaning schedule has been implemented as required at the last inspection. Some areas of documentation has been improved.

What the care home could do better:

The home needs to ensure that all service users have a pre assessment undertaken to demonstrate that the home can meet the needs of any prospective service user. Staff will also be clearer on documentation if a standard format of care planning is used. Policies and procedures must be available at the home at all times. Documentation and maintaining of records need to be improved. Although there have been a number of requirements made, the reader should be aware that the overall outcome for residents is positive.

CARE HOMES FOR OLDER PEOPLE Marine View Rest Home Marine View Rest Home 277/279 Kingsway Hove East Sussex BN3 4LJ Lead Inspector Jennie Williams Unannounced Inspection 19th October 2005 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 Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 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. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Marine View Rest Home Address Marine View Rest Home 277/279 Kingsway Hove East Sussex BN3 4LJ 01273 417696 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) Mr Mohammed Shareefuddin Ali Mrs. Gloria Toll Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users must be older people aged sixty-five (65) years or over on admission. The maximum number of Service Users to be accommodated is nineteen (19). 25th May 2005 Date of last inspection Brief Description of the Service: Marine View Rest Home is registered as a care home providing services for up to 19 older people. There is no nursing care provided at the home. District nurses will visit those residents requiring nursing input. The home is located in Hove opposite the Hove Lagoon. There is no parking available at the home, but street parking is available on adjacent streets within the area. Some areas of the home provide views of the sea. There are local amenities within walking distance and access to public transport is nearby. The home is two houses that have been joined together and converted for its current use. Rooms are located over three floors and residents residing in rooms above first floor must be able to independently mobilise. One stairway leading to first floor has a stair lift available. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Marine View Rest Home will be referred to as ‘residents’. This unannounced inspection took place over approximately seven hours on the 19 October 2005. Staff files, care plans and MAR charts were inspected. Policies and procedures were not available for inspection on this occasion. Residents and staff were spoken with throughout the inspection process. The environment and some individual rooms were spot-checked. There were 12 residents at the home on the day of the inspection. What the service does well: 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. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 6 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 Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 7 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, 2, 3, 5 & 6 The home has information available for prospective residents/representatives to make an informed decision if the home can meet their needs. Terms and conditions/contracts must be provided for all residents. EVIDENCE: The home has a Statement of Purpose and Service User Guide that contains information for all prospective residents/representatives to make an informed decision if the home can meet all of their needs. The home must ensure that all residents have a contract/terms and conditions. There were two recent residents that received respite care that were not provided with these documents. Management must ensure that all residents sign a contract/terms and conditions. The home recently had respite admissions that had not been pre assessed by the home prior to moving in. There was no information available for one of these residents. The importance of a pre assessment was discussed in detail with the registered provider at the inspection. Copies of social services care plans are obtained wherever possible. It was made an immediate requirement that all prospective residents are assessed prior to being admitted. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 8 Prospective residents/representatives are encouraged to visit the home prior to moving in. The layout of the home may prevent the admission of some residents. The location of the room available is taken into account prior to admitting anyone. The home does not have any dedicated accommodation to provide intermediate care. Respite care is available. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 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 Residents’ needs are being met at the home. Medication is being signed for at the time of administration. Residents’ privacy and dignity are respected. EVIDENCE: The home is still using two different formats for care plans. It is still recommended that a standardised format be used. There was evidence that care plans were being reviewed on a monthly basis. It was confirmed that residents are involved in the reviewing process of care plans. It was discussed with the manager that evidence be provided of resident/representative input into the reviewing of care plans. There were various assessment forms used throughout the care plan. Some of these had not been dated or signed. There are clear records kept of visiting health professionals for each resident. These forms have been developed and implemented as recommended at the last inspection. Health care needs are being met at the home. There is specialist advice and pressure relieving equipment available at the home when required. Some residents that wear glasses confirmed that they receive eye tests when required. One resident confirmed that a relative arranges her dental care Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 10 when required. A nurse visited the home on the day of inspection to provide some residents with their flu vaccinations. When speaking to residents the Inspector noted that some residents had not received thorough personal care. Faces had not been cleaned. Although the Inspector is sensitive to those residents wishing to remain independent, staff should still provide support/encouragement to ensure that residents appear clean. Particular attention needs to be paid to eye care. MAR charts inspected demonstrated that medication is being signed for at the time of administration. The home now keeps a record of all controlled drugs used at the home. One controlled drug spot-checked demonstrated that there was one less tablet than recorded in the book. The home needs to ensure accurate records are maintained. The controlled drug required to be broken in half. It is recommended that the home purchase a tablet cutter to ensure that an individual receives the correct dosage. It is required that the home maintains sample signatures of staff that administer medications. There were some prescribed creams in an individuals’ room for whom they were not prescribed. It was reiterated that medication/creams are only used for whom they have been prescribed. Resident spoken with confirmed that they felt their privacy and dignity are respected. Residents were complimentary about the staff at the home. Staff were observed to knock on residents’ bedroom doors prior to entering. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 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 Residents lifestyle in the home is their own choice. Clear documentation of all activities provided to residents would evidence that all residents are provided with activities to suit their lifestyle and capabilities. Visitors are welcomed at the home. EVIDENCE: Residents spoken with during the inspection process confirmed that their lifestyle is their choice. The routine of daily living is flexible to suit the individuals. Some residents will leave the home to mix with the local community. There were mixed feelings from residents regarding the provision of activities. Some don’t get involved by choice. Some were happy with the activities provided and some residents felt that more could be more. Records inspected demonstrated that for a period of nearly three months there were no records of activities that had been provided. It was confirmed that activities had occurred within this period. It was reiterated the importance of maintaining clear documentation. It is recommended that feedback regarding activities is included in the quality assurance and quality monitoring process. Visitors are welcomed at the home. Residents may see visitors in their own rooms if they wish. There is a visitor’s book kept at the entrance of the home. This demonstrated that there had been no visitors since the Inspector’s last Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 12 inspection undertaken in 25 May 2005. It was discussed with the registered provider that for Health and Safety reasons, all people visiting the home should sign the book. It is important that in the event of a fire, all people that may be in the home can be accounted for. Residents spoken with were complimentary about the food provided at the home. Some residents informed the Inspector that they would like the provision of fresh fruit. This was discussed with the cook and manager at the inspection. They confirmed that steps will be taken to action this request. It was confirmed that the home had previously offered fresh fruit, which was not popular with residents. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 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 Procedures for the dealing of complaints and adult protection issues need to be available for staff at the home at all times. EVIDENCE: The complaints and adult protection policies were not available for inspection. It was confirmed that the registered provider had taken them home to review. The registered provider needs to ensure that policies and procedures are available at the home at all times. There has been no complaint made to the home or CSCI since the last inspection. Records are kept of all complaints. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 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, 24, 25 & 26 The location of the home provides opportunities for residents and visitors to access local amenities and transport. The admission of residents may be restricted due to the layout of the home. EVIDENCE: The home is located in a residential area of Hove and is opposite the Hove Lagoon. Rooms are located over three floors. Residents must be able to independently mobilise safely to reach the rooms on the top floor. There is a chair lift available to the first floor, and a steep stairway between first and second floor. Residents are able to bring personal possessions with them into the home. Not all individual rooms were inspected. Rooms were randomly spot-checked. Some areas of the home need to be more thoroughly cleaned and some furnishings are old and in need of repair or replacement. The Inspector was pleased to note that some individual rooms have had the carpet replaced. There is now a cleaning schedule implemented as requested at the last Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 15 inspection. The building is an old building and will require gradual maintenance improvements. There was a chair noted in an individuals’ en suite with a loose cover and nails protruding. The bases of beds need to be regularly cleaned. Some toilets were old and had a build up in the bowls and a toilet seat required to be replaced. There was a commode in use that was very old and rusty. A sink in an individual’s room had a build up of grime and the bench top had exposed chip board that was damaged from water. Quality checks on all facilities/furnishings provided to individuals should be undertaken regularly and action taken to address any shortfalls identified. There was a bath found to be delivering hot water around 65°C. It is required that temperature control valves are installed to ensure the safety of residents. Hot water was being delivered at 34°C in an individuals’ room. The registered provider confirmed that checks are undertaken every six months for hot water. It is required that more regular checks be undertaken to monitor the temperature of the hot water being dispensed. It remains an outstanding requirement that all hot water taps dispense water around the recommended 43°C. Some radiators have been guarded as required from the last inspection and furniture has been placed near others that may pose a risk. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 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 Residents would be protected and safeguarded better if the home implemented robust recruitment procedures. Staff were observed to have a good professional rapport with residents. Staff spoken with are happy working at the home. EVIDENCE: Staff are happy working at the home and residents’ were complimentary about the staff. Staff and residents spoken with felt that there were always enough staff on duty at all times. Care staff prepare the evening meal, which leaves one care staff member on the floor to care for residents. It was made a requirement at the last inspection that this procedure be reviewed. The registered provider confirmed that the same system is still in place and is working well with the residents that are currently residing at the home. Management must keep this procedure under review if the needs of residents change. The home is working towards having 50 of care staff with NVQ level 2 or equivalent qualified. It was confirmed that three carers currently have NVQ level 2 qualifications and a further three is currently undertaking this training. This has not been reflected as an outstanding recommendation as there is evidence the home is working towards the required ratio of trained staff. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 17 There remain shortfalls in the required documentation to be kept on all staff. A full employment history and explanations of gaps in employment need to be provided. A recent photo and ID must be obtained for all staff. Shortfalls were discussed with the registered provider on the day of the inspection. All staff files must comply with Schedule 2. This remains an outstanding requirement. Ensuring application forms are fully completed will assist the home in tightening up on recruitment shortfalls. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 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, 36, 37 & 38 The home is run in the best interest of residents. There is clear leadership and guidance for staff to ensure residents receive consistent quality care. EVIDENCE: The manager has been managing the home for the past 25 years. The manager has not undergone any management training and does not propose to undertake any management qualifications. It is recommended that the manager undertake relevant management training. Both manager and provider will participate in training sessions provided to staff. Financial procedures were not inspected on this occasion. The registered provider confirmed that the home is still financially viable. Management must provide staff with regular supervision and records be kept of these sessions. Staff undertaking supervision must be trained in the supervisory role. It was confirmed that staff are regularly observed whilst they Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 19 undertake their duties. It was confirmed that there are not regular staff meetings and no records kept of any discussions. The home has undertaken some quality assurance and quality monitoring checks that are reflected in an individuals’ care plan. It is still required that a formal system is implemented and an analysis of the feedback is provided and action taken in any areas identifying shortfalls. Feedback should also be sought from relatives/visiting health professionals etc. This has not been reflected as outstanding as there is evidence that the home is working towards meeting this requirement. This will be assessed again at the next inspection. Policies and procedures were unable to be sighted on this occasion as the registered provider has taken them home to review. It is required that policies and procedures are available at all times at the home for staff to refer to. It was noted that the home keeps a communication book where daily reports are written on residents. It is required that notes recorded on residents are kept within the individuals’ file to promote confidentiality. It remains an outstanding requirement that records as stated in Schedule 2 to Schedule 4 are maintained and kept up to date. It is required that fire training provided to staff be clearly recorded. There were records identifying that regular fire drills are undertaken. An accident form inspected demonstrated that clear records are not being maintained. Accident forms must be fully completed and staff to record what action was taken. Management must familiarise themselves of what is reportable under Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). It remains an outstanding requirement that the home complies with Regulation 37 reports. New carpet has been installed in an individuals’ room. This is preventing the door to shut securely. The registered provider was made aware of this and will address this problem. This has not been reflected as a requirement. Any other shortfalls in the health, safety and welfare of residents have been addressed in the relevant sections of the report. Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 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 3 2 1 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 2 X X X X 2 2 2 STAFFING Standard No Score 27 3 28 2 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 2 2 2 Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 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. 2. Standard OP2 OP3 Regulation 5.1(b) 14.1 Requirement That all service users are provided with and sign a contract/terms and conditions. That all prospective service users are assessed prior to being admitted. (Immediate requirement) That evidence be provided of service users/representatives input into the reviewing of care plans. That all assessment forms in use are dated and signed. That a sample signature of staff administering medication be obtained and kept up to date. That medication only be used for whom it is prescribed. That service users are provided with suitable activities and clear records to be maintained. That all visitors to the home sign the visitors’ book. That all hot water taps dispense water around the recommended 43°C. (Timescale 31.07.05 not met) That regular checks of the temperature of hot water be DS0000014214.V259317.R01.S.doc Timescale for action 30/11/05 19/10/05 3. OP7 15 30/11/05 4. 5. 6. 7. 8. 9. OP8 OP9 OP9 OP12 OP13 OP25 17 13.2 13.2 16.2(m,n) Schedule 4 (17) 13.4 30/11/05 30/11/05 30/11/05 30/11/05 30/11/05 15/01/06 10. OP25 13.4 30/11/05 Marine View Rest Home Version 5.0 Page 22 11. 12. 13. 14. OP29 OP36 OP37 OP37 Schedule 2 18.2 37 17 15. 16. OP38 OP38 17 Schedule 4 (14) Schedule 4 (12) undertaken. That staff files comply with Schedule 2. (Outstanding from previous two inspections) That all staff receive formal supervision and records be kept. That the home complies with Regulation 37 reports. (Timescale 25.05.05 not met) That the daily reports of service users are kept within the individuals’ file to promote confidentiality. That clear records be maintained of fire training provided to staff. That accident forms are fully completed. 15/01/06 15/01/06 31/10/05 15/01/06 30/11/05 30/11/05 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. 4. 5. 6. 7. 8. Refer to Standard OP7 OP8 OP9 OP9 OP12 OP26 OP26 OP31 Good Practice Recommendations That the care plan format is standardised. That particular attention is paid to eye care when providing personal care. That a table cutter is purchased to ensure correct medication dosage is administered. That a clear record of controlled drugs be maintained to safeguard service users and staff. (Outstanding recommendation) That the provision of activities be included in the quality assurance and quality monitoring process. That improving the cleanliness and maintenance within the home continues. (See content of report) That regular quality checks be undertaken on facilities/furnishings provided to individuals and action taken when to address any shortfalls. That the manager undertakes relevant management training. (Outstanding recommendation) Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Marine View Rest Home DS0000014214.V259317.R01.S.doc Version 5.0 Page 24 - 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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