Inspection on 26/10/07 for Park Farm House

This inspection was carried out on 26th October 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

Park Farm House 15/05/07

Park Farm House 17/05/06

Park Farm House 12/12/05

Park Farm House 27/05/05

Park Farm House 10/02/05

Park Farm House 27/07/04

Park Farm House 01/12/03

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

CARE HOMES FOR OLDER PEOPLE Park Farm House Parkfield Pucklechurch South Glos BS16 9NS Lead Inspector Carole White Unannounced Inspection 09:30 26 October 2007 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Park Farm House DS0000003369.V348346.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. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Farm House Address Parkfield Pucklechurch South Glos BS16 9NS 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) 0117 9372388 0117 9372388 jhanney04@aol.com Mrs. Margaret Joan Hanney Mr. Jeffrey Hanney Mrs Margaret Joan Hanney Mr. Jeffrey Hanney Care Home 7 Category(ies) of Dementia - over 65 years of age (7) registration, with number of places Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th May 2007 Brief Description of the Service: Park Farm House is an old farmhouse set in a peaceful location away from public amenities. It has been renovated and extended over the years. Access is from an unadopted lane to which the owners of the house have full rights of way at all times. The village of Pucklechurch is the nearest shopping area about a mile away. An infrequent bus service ends a little short of the lane to the home. The home is comfortably furnished and residents’ rooms are attractively decorated. Communal areas are spacious and well set out. The accessible garden is enclosed and residents are able to use this independently. Parking is available to the front of the home. Fees range from £430-£500 per week. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit that took place over one day totalling eight and a half hours as part of the key inspection. Approximately 3 hours of the day was spent looking at care and recruitment records in order to check the working practices of the home and to follow up the requirements made at the last inspection. A further 2 hours were spent conducting a tour of the premises and talking to staff, residents and relatives that visited that day. Another hour and a half was spent in the lounge area observing the care given to a small group of residents. The care of four people was looked at in depth when comparisons with the observations were made with the homes records and the knowledge of the care staff. Prior to the site visit surveys went sent to the home for residents, their relatives and health professionals to complete. 7 residents/relatives forms were returned and one general practitioner completed a comment card. At the end of the inspection feedback was given to Mr & Mrs Hanney the owners/managers of the home. What the service does well: The home offers a relaxed, friendly and homely environment and all residents and their relatives spoken with and surveyed confirmed that they are happy living there. The home benefits from being small and therefore is able to offer a family approach to care and contact with friends and relatives is encouraged. Daily routines are flexible and staff accommodate individual lifestyle choices, whilst enabling residents to remain as independent as possible. Care planning records clearly evidence the home’s person-centred approach to the care of its residents. The home offers a varied menu, which allows for individual choice and preferences, and residents enjoy their meals in a relaxed and pleasant environment. Staff observed during the visit were seen to interact well with residents and attended to their needs in a patient and understanding manner. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 6 Comments made by residents and their relatives include: “It is a very caring home with only a small number of residents which enable the staff to give much more individual attention than in larger establishments”, “This small home offers very personal and friendly support”, “Attending to personal hygiene and keeping residents smartly dressed and well groomed” and “The staff are aware of my mother’s daily condition and are very good at helping her and keeping us informed”. What has improved since the last inspection? What they could do better: It is required that the home ensures that all residents or their representatives are supplied with a copy of the Statement of Purpose/Service User’s Guide. The Statement of Purpose must be amended in line with the regulations and a copy sent to the commission. Although the requirement made at the last inspection about references being obtained for workers prior to commencing employment has been met, further requirements and recommendations have still been made to further improve these practices. The home must ensure that records are kept for all employees of their personal details, qualifications, full employment history, and the date of commencement of employment. It is also required that the manager ensures that new care workers are physically and mentally fit for the purposes of the work. It is recommended that if an application form is used then this will enable the relevant information about new applicants to be recorded. Interview notes giving a summary of the interview should also be kept for each applicant. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 7 If verbal references are obtained it is recommended that a clear record is kept of the conversation. A job description and job specification should be developed and given to new applicants and existing staff. It is also recommended that the manager record one-to-one supervision with staff. 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. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 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 Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Current and prospective residents are given verbal information about the services that the home can offer, although the Statement of Purpose/Service User’s Guide must be amended and given to all residents or their representatives. Residents have had their needs assessed and they know that the home has the ability to meet their personal care needs. EVIDENCE: On the day of the site visit the manager was unable to locate the home’s Statement of Purpose/Service User’s Guide. This document was subsequently supplied to the commission as arranged, although it was clear that this is not a working document and is not given to new and prospective service users. It is therefore required that the home ensures that all residents or their representatives are supplied with a copy of the Statement of Purpose/Service User’s Guide. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 10 The Statement of Purpose/Service User’s Guide must also be amended in line with the regulations and a revised copy sent to the commission. The amendments required are as follows: • • • • • State that Mrs Hanney is the registered manager and give details of her relevant experience and qualifications. Give details of the numbers of staff employed and their qualifications and experience. The range of needs that the home can provide for. The complaints procedure. The number of rooms in the home. On the day of the site visit a new resident moved into the home, arriving with her family to help her settle in. From conversations with the resident’s relatives it was clear that the manager had visited the lady to carry out an assessment prior to her moving into the home. The resident had also visited the home with her family for a day prior to deciding whether or not to move in. Although the family had not been given a copy if the Statement of Purpose/Service User’s Guide they confirmed that they had been given full details about the home and the services on offer during their conversations with the manager. It was clear from observing the interaction between staff and residents that staff have the skills and experience to meet resident’s needs. Surveys received also confirmed that residents and their relatives feel that the home can meet their needs. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 11 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, 8,10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs are recorded in a care plan that is developed with the residents. Resident’s health care needs are fully met. Residents feel that they are treated with respect and their privacy is upheld. EVIDENCE: Four care files were examined at this visit and these four residents were also observed closely during part of the day. At the last inspection a newly admitted resident did not a care plan in place and another resident did not have appropriate risk assessment documentation in place to protect staff, the individual and other residents. Of these two residents one has since left the home but the other resident’s care was looked at as part of the site visit. All files examined had care plans in place giving details for staff to follow to meet the assessed needs of the individual. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 12 Appropriate risk assessments were also viewed in files. For one resident an incident of aggressive behaviour had been documented and a further risk assessment had been written with a clear link to the home’s aggression policy, giving clear actions for staff to follow to defuse any further incidents of potential aggressive behaviour. All care plans and risk assessments showed evidence of regular review. Daily records and the visitors book show that district nurses are called and attend residents when necessary. A comment card received from a local General Practitioner confirmed that the home provides good care to the people who live there. Evidence from observing residents and from the returned surveys shows that staff respect people’s right to privacy and support individuals in a way that maintains their dignity. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 13 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 -15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered a range of activities within the home that enables them to have choice and flexibility in their lifestyle and residents are able to receive visitors at their convenience. The home offers a balanced choice of meals in a relaxed and pleasant environment. EVIDENCE: The visitors book confirmed that residents receive regular visits from relatives. On the day of the inspection three residents received visitors as well as the new resident who arrived with her family who stayed for the whole afternoon. One relative was picked up by the manager at the end of the lane at the bus stop. It was clear that this is a regular occurrence because this particular visitor comes to the home several times a week. On the day of the visit staff were observed playing table skittles with those residents that wished to take part. It was clear that staff know the residents well and understand their likes and dislikes. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 14 The time spent observing residents daily life and staff care practices found that staff were very patient, always took time to ask residents questions rather than deciding for them and people were encouraged to be active, but could also sit quietly if that was their wish. Residents spoken with and surveyed all confirmed that they like the food and clearly enjoy meal times and see it as a social occasion. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. 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. The home has a simple, clear complaints procedure and residents know how to access it. The home promotes the protection of residents from abuse through the training and awareness of staff. EVIDENCE: Appropriate procedures are in place for the management of any complaints. The home has not received any complaints since the last inspection and neither has the commission. All staff are given training in the Protection of Vulnerable Adults from Abuse as part of their initial induction. The home also books courses through South Gloucestershire Social Services in Adult Protection for staff to attend. Staff spoken with demonstrated that they had a good understanding of how to identify potential abuse and report it. . Park Farm House DS0000003369.V348346.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, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, clean and well-maintained environment with comfortable bedrooms, that they are able to personalise with their own furniture and possessions. EVIDENCE: A tour of the building was conducted and the home was found to be well maintained, clean and free of any unpleasant odours. The owners are in the process and converting what was previously a walkway connecting the main building to the owners’ office into another living area. They are also considering submitting plans to convert the office area and other out buildings into two new bedrooms, which will be connected by the covered in walkway once completed. At the last inspection it was noted that the floor in the conservatory needed to be replaced. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 17 The owners are still deciding what changes to make with this room, although the conservatory is used less during the winter months because it is not as warm as the rest of the home. There are table and chairs in the conservatory but at this inspection residents were eating in the main living area. On the day of the inspection one resident used the conservatory to spend private time with his wife when she visited. Residents observed looked happy sitting in the communal areas although all are free to go to their rooms at anytime. Residents’ rooms looked homely and had been personalised with their own possessions. Park Farm House DS0000003369.V348346.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 – 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s recruitment practices and numbers of staff working protect residents. However, keeping more formal recruitment records will further enhance this. The home ensures that staff are trained and competent to carry out their work in order to meet residents’ personal care needs. EVIDENCE: On the day of the inspection adequate numbers of staff were on duty to meet the needs of the residents. All residents and relatives spoken with and surveys confirmed that the staff are competent to do their jobs. All staff files were viewed and the files of 2 new members of staff were examined in more detail. One reference for one of the employees was addressed to “to whom it may concern”, although the manager had recently been made aware that this is not acceptable practice and was in the process of obtaining a reference written directly to the home. The home had not received a reply from the other applicant’s previous employer despite repeated requests. The manager had spoken to the person verbally but not recorded this conversation. It is therefore recommended that if verbal references are obtained a clear record is kept of the conversation. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 19 Both files had evidence that the workers had received full induction training before working with residents unsupervised. Although the requirement made at the last inspection about references being obtained for workers prior to commencing employment has been met, subject to the points discussed above, further requirements and recommendations have still been made to further improve these practices. The home does not keep clear records of interviews by using an application form, interviews notes or any form of checklist to monitor the recruitment process. Records held for all members of staff are inconsistent and in most cases lacking in any comprehensive detail about the training and development of individuals. The home must ensure that records are kept for all employees of their personal details, qualifications, full employment history, and the date of commencement of employment. It is also required that the manager ensures that new care workers are physically and mentally fit for the purposes of the work. It was discussed at the inspection that the owners should consider developing an application form to record the required details for staff. It is recommended that if an application form is used then this will enable the relevant information about new applicants to be recorded. Interview notes giving a summary of the interview should also be kept for each applicant. The application form should also ask applicants to declare if they have a criminal record and any discussions that the manager may have about this should be clearly recorded. It would further enhance the recruitment process if the home develops a job description and job specification that can be given to new applicants and existing staff. Park Farm House DS0000003369.V348346.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, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents and residents’ financial interests are safeguarded. The health, safety & welfare of the residents and staff are promoted and protected. However, record keeping in relation to staff recruitment and supervision means that service users best interests are not fully safeguarded. EVIDENCE: The home is clearly run in the best interests of the residents. The home offers a relaxed, friendly and homely environment and all residents and their relatives spoken with and surveyed confirmed that they are happy living there. The home benefits from being small and therefore is able to offer a family approach to care and contact with friends and relatives is encouraged. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 21 Staff observed during the inspection displayed a good knowledge and understanding of the residents’ needs and the residents observed looked happy and well cared for. Whilst the friendly and informal way that this home is run is clearly of benefit to the people living there, this approach does leave residents at potential risk from record keeping that is lacking in relation to staff recruitment. It is clear from speaking with the manager that she uses her experience and knowledge of running a care home to make judgements about staff recruitment. However, there is little evidence to substantiate this process. As previously mentioned in the Staffing section of the report the home must ensure that records are kept for all employees of their personal details, qualifications, full employment history, and the date of commencement of employment. It is also recommended that the manager record one-to-one supervision with staff as personnel files did not all contain records of supervision, although staff spoken with did confirm that it takes place. At the last inspection Mrs Hanney stated that a senior care worker was about to start a NVQ level 4 in care management and the registered managers award. This was a long-term plan to enable this person to take over the management of the home when Mrs Hanney retires. However, although the worker did start the course she has put it on hold at the moment. Since the last inspection risk assessments have been put in place for any residents with challenging behaviour and clear records are kept of any incidents that occur when individuals display aggressive behaviour to staff or other residents. Clear instructions are given to staff to guide them in the actions to take to protect themselves, the individual and other residents. Documentation in relation to health and safety procedures were up to date, the last fire drill took place on 18th October 2007. The policies and procedures were viewed on the day of the inspection, except for the Statement of Purpose/Service User’s Guide that was faxed to the commission on the day after the inspection. The manager keeps small amounts of money for residents to pay for personal items and services such as hairdressing. Records detailing transactions were examined and found to be in order. A random check of the cash held was carried out and also found to be correct. Park Farm House DS0000003369.V348346.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 2 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 2 3 Park Farm House DS0000003369.V348346.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. 1 Standard OP1 Regulation 5(2) Requirement Timescale for action 31/01/08 2 OP1 4(1) & (2) sch 1 3 OP37 17(2) sch 4 (6) 4 OP29 19 (1) (b) Sch 2 paragraph 6 Ensure that all residents or their representatives are supplied with a copy of the Statement of Purpose and Service User’s Guide (aims & objectives). Amend the Statement of Purpose 31/12/07 to include information stated in schedule 1 and supply a copy of the amended document to the commission. Records must be kept for all 31/01/08 employees of their personal details, qualifications, full employment history, and the date of commencement of employment. Ensure that new care workers 31/01/08 are physically and mentally fit for the purposes of the work. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 24 No. 1 2 3 4 5 Refer to Standard OP29 Good Practice Recommendations The use of an application form for new applicants would enable the home to keep clear staff records in accordance with the regulations. Interview notes giving a summary of the interview should be kept for each applicant. If verbal references are obtained keep a clear record of the conversation. Develop a job description and job specification. Keep clear records of staff one-to-one supervision. OP29 OP29 OP29 OP36 Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Park Farm House DS0000003369.V348346.R01.S.doc Version 5.2 Page 26 - 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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