Inspection on 11/08/05 for Park Lane Residential Home

This inspection was carried out on 11th August 2005.

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 Lane Residential Home 04/06/08

Park Lane Residential Home 30/05/07

Park Lane Residential Home 13/07/06

Park Lane Residential Home 28/04/05

Park Lane Residential Home 17/11/04

Park Lane Residential Home 02/08/04

Park Lane Residential Home 01/03/04

Park Lane Residential Home 20/11/03

Park Lane Residential Home 09/01/03

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

CARE HOMES FOR OLDER PEOPLE Park Lane Residential Home 7 - 9 Park Lane Congleton Cheshire CW12 3DN Lead Inspector Judith Morton Announced 11 August 2005 9.30am. 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 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 Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Park Lane Residential Home Address 7 - 9 Park Lane Congleton Cheshire CW12 3DN 01260 290022 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Winnie Care (Park Lane) Ltd Wendy Gregory Care Home 42 Category(ies) of Dementia - over 65 years of age (18) registration, with number Old age, not falling within any other category of places (42) Dementia (1) Female Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 42 older people, 18 of whom may be older people with dementia, and 1 adult aged 52 years of age with dementia Date of last inspection 28/04/05 Brief Description of the Service: Park Lane is a care home owned by Winnie Care [Park Lane] Ltd. It is close to Congleton town centre and is near to all community facilities and public transport. There are a small number of car parking spaces available at the home.Park Lane has been purpose built to provide care to up to 42 older service users. The home is divided into five wings, one of which is designed to provide a more secure area for people who have dementia. The home is a three-storey building, accommodation being situated on lower ground, ground and first floors. Six service users who are more able to care for themselves have the rooms on the lower ground floor. Access between floors is via a passenger lift or the stairs.Service users accommodation consists of 38 single rooms, 36 of which have en-suite facilities and two double bedrooms both with en-suites. There are 5 day/quiet rooms available for service users. There are sufficient numbers of toilets and bathing facilities to meet the required standard. The main entrance of the home, plus a number of internal doors, are opened by a keypad system.There is a bench outside the entrance to the care home and several small patios around the home. There is an enclosed garden at the rear of the home. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours 50 minutes. It covered mainly the standards not met and those not inspected on the previous inspection. Three care files were reviewed, 5 residents and 5 staff were spoken with. Comments from 8 questionnaires were taken into account when inspecting. Additionally, the comments from cards returned to the Commission by three health/social care professionals were reflected in the report. What the service does well: What has improved since the last inspection? What they could do better: Improvements need to be made to the programme of activities for the residents and they should be consulted about activities, outings and menus they would prefer. The garden area has been very close to completion for a number of months now and priority should be given to making this a safe and usable area before the summer ends. Thorough checks should be carried out on all new staff before they start working in the home, in order to protect residents from possible harm and poor practice. Staff need to receive training about protecting adults from abuse and those staff working in the dementia unit need training about dementia to ensure that appropriate care is given to the residents. Recommendations have been made in relation to the dining arrangements, staff knowledge about medical conditions, improvements to the environment and the laundry systems, in order to improve the quality of the service available at the home. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 6 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. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 & 6. A new assessment system was being piloted at the home to ensure that relevant information about each resident is easily available for all health and social care staff that might work with them. The statements of terms and conditions of living at the home ensured that residents and their relatives were aware of what was to be provided and by whom. EVIDENCE: Three of the residents’ care files were viewed. The home had begun to pilot a new contact assessment form. This is a single assessment to be used by all health and social professionals and contains relevant and detailed information about the person. The files also contained further information about the person’s needs, how they should be met and, if there was any risk, how this should be managed. There was a contract agreement held on a separate file for each resident. This indicated what was to be provided for the resident and who was responsible for payment. All parties, including the resident, where able, had signed it. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 9 The home accepts residents for intermediate care and there is evidence to show that the staff work closely with the intermediate care team to ensure the resident returns home with an appropriate care package within 2 – 3 weeks. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 11 There were systems in the home to make sure that all residents’ health needs were well looked after and they received medical treatment when they needed it. The residents’ needs were clearly identified in the plan of care but the daily recordings were not informative enough to show whether the residents’ care needs were being met appropriately. EVIDENCE: There was a new review format and recording sheet being used at the home, which would clearly highlight any changes to the care plan on a monthly basis. Daily recordings continued to be uninformative in many cases, stating things such as “all care given”. This was identified as a problem at the last inspection, as it was not possible to track what care was being provided for residents each day. This is particularly concerning as care plan workshops have been completed by all staff. More information should be put in these records, which should reflect how the identified needs had been met that day. (See recommendation 1) Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 11 Medication storage and records were inspected. The medicines were being stored safely and the records were accurate, with the correct coding being used when required. All of the senior care staff had received training in the administration of medication. There was no evidence on the files viewed that the residents’ wishes in the event of terminal illness or death had been discussed and recorded. (See recommendation 2) Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Although the home provides some activities for residents, the variety and frequency needs to be reviewed to make sure that the residents stay active and stimulated. Residents are able to make choices and have control over some aspects of their lives in home but there are areas where this could be improved. EVIDENCE: The residents spoken with during the inspection said that they were able to spend time in their room or in the lounge or dining areas. Some residents occasionally went out with relatives and others were seen to receive visitors in their room. The home no longer has an activities co-ordinator and this has led to a decrease in the number and type of planned activities. The notice of activities displayed for the residents shows that they are now only planned for a Monday and Wednesday. The manager said that they have advertised for an activities co-ordinator and in the meantime the person who covers this role for the two other homes owned by the company is working two days at Park Lane. She also said that the staff would arrange activities when they have the time. Some of the residents spoken with said they would really enjoy short trips out and indicated that the television was their main source of entertainment. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 13 Occasional short trips out and more stimulating activities and entertainment should be provided and the residents should be consulted over what these could be. (See requirement 2 and recommendation 3). The meal provided to the residents on the day of inspection was hot, well cooked and well presented. All the seats in the dining room were taken at lunchtime and a number of residents remained in the lounge for their meal. Only one did this through choice. The manager, therefore, should consider ways in which all residents can eat their meals at a table and make use of the various lounge/dining areas within the home. (See recommendation 4) The possibility of providing a menu with pictures of the meals on offer, to promote choice, was discussed at the last inspection but so far had not been put into place. (See recommendation 3 as above) Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Although there were no complaints recorded in the complaints book there were a number of concerns raised via the questionnaires, which needed to be acted upon so residents and relatives could be confident that their concerns were being taken seriously. Staff of the home, including the manager, need to undertake training on protecting adults from abuse so that they are able to protect residents from possible harm and poor practice. EVIDENCE: There were no complaints recorded in the complaints book. However, the manager had left a questionnaire on a table near to the entrance to the home, for relatives to complete either independently or with the support of their relative. Eight had been returned and contained some positive feedback, mainly regarding the friendliness and helpfulness of the staff and the general satisfaction with the food. However, additional concerns had been raised about the staff’s knowledge of, and ability to explain, medical conditions. The manager needs to take action to address these concerns. (See recommendation 5) The manager had received training on awareness of adult abuse when she completed NVQ level 3, as had those staff who have completed their NVQs levels 2 and 3. As it is important that all staff can recognise abuse in all its forms, training should be undertaken by those staff who have not yet completed it as soon as possible. The manager also needs to be aware of her role should abuse be reported to her. (See requirement 2) Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20, 22, 23,24,25 and 26. The home is generally well maintained and safe so provides a comfortable, homely environment for the residents. They have used their own possessions, including ornaments and photographs, to decorate their rooms to help them feel more at home. EVIDENCE: On the whole the home was well maintained. However, there were a few areas that still required attention from the last inspection. These were mainly in Chatsworth unit. The carpet in the lounge has worn very thin in parts and looks dirty, even though it has been cleaned a number of times in the past. Likewise the carpet in the hallway, immediately outside of the lounge was also very dirty in parts and there was an offensive odour noticeable when first entering the unit. A number of the home’s questionnaires also referred to there sometimes being an offensive odour in the home. The manager had devised an action plan to include the treatment of the floor and replacement of the flooring in the toilet where the odour comes from. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 16 The replacement of these carpets, and the whole of the ground floor corridor, has been agreed, measurements have been made and the colour/type has been chosen. (See recommendation 6) The lack of a garden was mentioned in the responses to the questionnaires devised by the home and some of the residents spoke about this during the inspection. The patio area is almost complete apart from the fencing and it is the only thing stopping the residents from being able to use the garden. This should be done as soon as possible so that the residents can make use of the garden while the summer months are here. (See recommendation 7) There is a range of equipment and adaptations designed to maintain the independence of service users throughout the home. These include grab rails along corridors and in toilets/bathrooms, baths that have been adapted for the use by disabled people, freestanding hoists and raised toilet seats. A set of sit on scales should be provided for those residents who are unable to stand but need their weight to be monitored regularly. (See recommendation 8) It was suggested at the last inspection that, to promote the longer-term independence of the residents who have dementia, steps are taken to help them find their way around the home and to recognise their own rooms, toilets and bathrooms. The manager said that there had been attempts made to use photographs but without success as one or two residents would remove them from the doors. It is recommended again at this inspection, as methods should be found to ensure the signs/photographs cannot be removed. (See recommendation 8 as above.) The questionnaires also showed that there is some dissatisfaction with the upkeep of residents clothing. Some items of clothing had gone missing whilst others said there were buttons missing and small repair work was not carried out. (See recommendation 9) The bedrooms viewed by the inspector were adequately sized and furnished. The residents had decorated their room with photographs, pictures and ornaments from their own home. All of the bedrooms in the home had ensuite facilities. Some of the residents described their rooms as “lovely” and “comfortable”. One resident said, “I love my bedroom, you will put that in the report, won’t you?” The residents were seen to move about freely and had a number of lounges available to them in which they could spend their time. They were also able to spend time in their own room if they wished. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 There were sufficient staff available to meet the needs of the residents. Staff had received appropriate training but those working in the dementia unit needed training on caring for people with dementia so they could meet these residents care needs. Thorough checks need to be undertaken before new staff start work at the home in order to protect residents from possible harm and poor practice. EVIDENCE: The staff rotas showed that there was sufficient staffing available to meet the needs of the residents and, on occasion when there was no sickness or annual leave, the manager was supernumerary. The staffing consists of administrator, care staff, senior care staff, principal senior care, deputy manager and manager. Three new members of staff had been employed at the home since the last inspection. One member of staff started working at the home before the results of her criminal record bureau check (CRB) or protection of vulnerable adult check (POVA first) had been obtained. The manager was aware of this and said that she was being fully supervised while on duty. However, this practice is only acceptable once the POVA first check has been received and there are exceptional circumstances. Additionally, it was recorded that two references had been received but only the character reference could be found. (See requirement 3) Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 18 All of the care staff have completed, or are currently doing, induction training. Staff training included health and safety, fire training, safe moving and handling, food hygiene and first aid. A further four staff had completed their NVQ level 2 and two staff had completed NVQ level 3 since the previous inspection. Most of the ancillary staff had obtained NVQ level 1. Not all of the staff working in the dementia care unit had received training about this condition to enable them to provide appropriate care to the residents in the unit. (See requirement 4) The manager had had to put the NVQ level 4 on hold due to personal difficulties but intended resuming this as soon as she is able. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34 35, 36, 37 & 38 The manager gives guidance and leadership to the staff and has improved the access to training for many of the staff so that the residents’ best interests are safeguarded. EVIDENCE: The manager has worked in care related services for a number of years and is committed to completing her NVQ level 4. Many of the staff spoke highly of her, particularly in relation to the increase in training she has obtained for them. She often works alongside the staff team and observes their practice and offers guidance. Staff meetings are held every three months and staff handover occurs at each shift change. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 20 Staff at the home do not deal with any of the residents’ money. There is petty cash for the purchasing of small items for the home and if a resident requested some money they would be given it from this. An invoice would then be made to request this money back from head office. The petty cash and the records are well maintained by the manager and administrative assistant. The manager had commenced 1:1 supervision of the staff although not all staff had received this. The staff team had been divided into three groups and the deputy manager and principal senior care worker were also going to conduct supervision. (See recommendation 10) There are records in the home to show that regular checks are made of fire safety equipment and emergency lighting. Fire drills are also held, with the names of the staff who took part recorded. Equipment used by the residents, for example, hoists and passenger lift are also serviced and maintained. There are records held in relation to checks on gas and electrical appliances, water temperatures and food temperatures. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 3 3 3 3 3 3 Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? 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 12 Regulation 16 Requirement Suitable entertainment, activities and outings must be provided and residents participation recorded. All staff, including the manager, must undertake training about protecting adults from abuse The required checks, including POVA First and references, must be obtained for all new staff before they start working in the home Staff working in the dementia unit must receive training on dementia to enable them to provide appropriate care for the residents Timescale for action 01/01/06 2. 3. 18 29 13 19 01/09/06 01/09/05 4. 30 18 01/01/06 5. 6. 7. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 23 1. 2. 3. 7 11 14 4. 5. 6. 7. 8. 15 16 19 20 22 9. 24 10. 11. 12. 36 Greater detail is needed in the daily records to reflect how residents needs are being met. The wishes of the residents in the event of terminal illness or death should be discussed with them and their relatives and recorded on their file. Residents views and suggestions about activities, outings and menus should be sought and implemented. Consideration should be given to using photographs as visual prompts for those unable to state their choice verbally. The use of alternative dining areas throughout the home should be considered to ensure all residents can sit at the table for their meal if they choose. Staff knowledge and understanding of the residents medical conditions should be increased so that they can provide appropriate care at all times The plan for replacing the ground floor carpets and linoleum in the ground floor toilet should be implemented The final stage of the garden make-over should be completed before the end of the summer months. Consideration should be given to providing sit-on scales for those residents who are unable to stand but need their weight to be monitored. Further consideration also be given to an effective system to help residents with dementia identify toilets, bathrooms and their own bedrooms more easily. Minor repairs should be made to residents clothing before their laundry is returned to them and the laundry systems should be improved so that residents clothing does not go missing. Care staff should receive formal, recorded supervision at least six times a year. Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit D Off Rudheath Way Gadbrook Way Northwich CW9 7LT 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 Park Lane Residential Home F51 F01 S40963 Park Lane V235392 110805 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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