Inspection on 10/05/05 for Park View

This inspection was carried out on 10th May 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.

Other inspections for this house

Park View 24/11/08

Park View 22/11/06

Park View 01/12/05

Park View 07/02/05

Park View 20/08/04

Park View 29/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Park View 29 Cocknage Road Dresden Stoke on Trent ST3 4EG Lead Inspector Lorraine Mavengere Unannounced 10 May 2005 9:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Park View Address 29 Cocknage Road Dresden Stoke on Trent Staffordshire ST3 4EG 01782 252586 01782 333366 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) Strathmore College Limited Ian Clarke Care Home 12 Category(ies) of 21 LD registration, with number of places Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Category LD, 3 (three) of whom may be 16 to 18 years of age. Date of last inspection 07 February 2005 Brief Description of the Service: Park View is a twelve bedded residential unit, which can provide accomodation for up to twelve younger adults with learning disabilities. It is a detached property, providing ten single and one double bedroom, communal facilities are adequate. The home located in the residentyial area of Dresden, close to local amenities and a main bus route into the nearest town centre of Longton. The home is part of the Strathmore Colleg Group, operated by Craegmoor Health Services. Residence at the home is limited to three years; the package provided is jointly care and education. Service users leaving home are supported to find alternative placements through extended transitional arrangements. The home is known as a residential college and service users residing there are referred to as students. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Tuesday afternoon and early evening. Four members of staff were spoken to during the inspection and five service users. The home refers to its service users as students; similarly in parts of this inspection report references are made to the student. The home was clean and well decorated and the atmosphere was pleasant. The inspection found that most of the requirements from the last inspection had been met. There were requirements around training that had not been met but there was evidence that dates had been booked for Manual Handling, Epilepsy and VAP training. The good practice recommendations are still being explored and implemented but are currently outstanding. What the service does well: The service provides clear information for prospective and existing service users. The levels of social and educational activities are high meaning that service users are developing their social and educational skills constantly. The food is varied and service users play an active role in choosing, shopping and preparing the food. All service users have a pre admission assessment carried out prior to being offered a placement, this helps ensure that the home can meet their needs at every level. Part of the pre admission service includes risk assessing all prospective service users. It was evident that service users are offered personal support for their activities of daily living. They also have access to the required healthcare services. The home is run in an open and transparent manner with the management style enabling both staff and service users to voice their concerns as they arise. The home’s complaints procedure is comprehensive and available to all service users and significant others. The procedure also contains contact details of relevant other agencies including CSCI. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5 Service users living in the home receive clear information to enable them to choose whether or not they would like to live in the home. Their needs are adequately assessed to enable the home to establish whether the service offered can meet their needs. Prospective service users are given the opportunity for introductory visits prior to making a final decision to enable them to test drive the service. The service user contract does not include information on fees charged, what they cover, when they must be paid and by whom, and the cost of facilities not covered by fees. This therefore means that the service users are not protected in this area and there is no clarity on the part of the service users what services they are paying for. EVIDENCE: Standard One: Both the service user guide and statement of purpose were examined during the inspection. Both these documents are comprehensive and contain all the required information. There was no mention in the service user guide of residents’ right to advocacy services. It is recommended that service users are made aware of their right to advocacy. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 9 Standard Two: A discussion with the manager confirmed that service users are only admitted into the home following a comprehensive needs assessment. Four care files were sampled during the inspection. There were, however no assessments on individual care files. The registered manager explained that this is purely because all assessments are kept at head office. For this reason, this standard could not be fully assessed. The registered manager must ensure that all needs assessments are kept in individual care files and open to inspection. The statement of purpose was seen to very clearly show that pre admission assessments are part of the admission criteria. Standard Three: Staff training schedules were seen during the inspection. These demonstrated that the staff team have the collective and individual skills mix to meet the needs of the existing service user group. The statement of purpose clearly states who the service is geared towards. Care records showed that the service users admitted to the unit are as outlined in the statement of purpose. Observations made during the inspection showed staff to interact and work with service users well. Standard Four: Discussions with the registered manager confirmed that each individual is offered an assessment week. This is also outlined explicitly in the statement of purpose. During the inspection there was one such prospective service user who was on a week’s assessment visit. Staff were able to talk through what the assessment week consisted of, hence demonstrating the team’s ability to assess needs during this period of time. Neither the statement of purpose nor the service user guide, stated that service users are entitled to a three month settling in period. It is recommended that this entitlement is outlined in these documents. Standard Five: The contracts were examined during the inspection. These were in formats suitable for the service users and contained most of the relevant information as outlined in the standards. The contracts however, did not highlight fees to be charged, what they cover, when they must be paid and by whom, and the cost of services and facilities not covered by the fees. All contracts were signed and dated. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 9 All service users have a care plan. The care plans cover all areas of need in a comprehensive and detailed manner. Service users spoken to are aware of, and fully involved in the formulation and reviewing of their care plans. This enables them to know and make decisions about their changing needs and personal goals. The home takes care to measure and record all areas of service user risk. This enables service users to take responsible risks, ensuring that they have good information on which to base decisions, within the context of the service user’s individual plan and of the home’s risk assessment and risk management strategies. EVIDENCE: Standard Six – Service User Plan: Records examined showed that all service users have a care plan and that these care plans cover all areas of need. Service users spoken to were aware of their care plans and stated that they were involved in formulating and reviewing of care plans. In response to a question raised about reviews, one service user said “Everyone gets together to talk about if I’m doing well and other things that I will be doing.” The registered manager confirmed that all care plans are formulated from the multi disciplinary assessments. These multi disciplinary assessments were not on care files for inspection on this occasion. Staff spoken to confirmed that there Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 11 is a key worker system in place for all service users. Staff were observed communicating with service users via means that were suitable. The registered manager confirmed that some of the service users communicate using some makaton; makaton training, he said, was therefore ongoing. Standard Nine – Risk Taking: Care records evidenced that risk is assessed prior to and during the period of admission. The risk assessments that were in place showed adequate risk management strategies by outlining the area of risk, the likelihood of this being realised and the action to be taken in order to minimise the risk. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 17 The home is a residential college owned by Strathmore College Limited. All service users admitted to the facilities are therefore admitted as students to fulfil educational and developmental needs. The students have an extensive educational/ occupational plan, part of which requires them to attend specific sessions at the educational centre. The students are provided with a basic menu that shows nutritional balance. This menu, however, is just for guidance. This is so that the students are able to exercise some autonomy and choice in the area of food and nutrition. Students play an active role in the preparation of food. All this is part of their independent living skills. EVIDENCE: Standard Twelve – Education/ Occupation: The care plans that were seen highlighted a comprehensive plan of education/ occupation to suit individual needs. Various students were spoken to. They were able to describe in detail what educational activities they take part in and enjoy. These included catering, social and life skills. The statement of purpose also outlines that where appropriate, service users develop vocation and employment skills at the college shop with support from staff. The statement of purpose also Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 13 outlines that work placements through Supported Employment agencies are made to further employment prospects on leaving college. The home actively participates in the Duke of Edingburgh Award, millennium volunteers, and business group, work experience opportunities. Standard Seventeen – Food: Meal preparation time was observed during the inspection. The service users were actively participating in this activity. There was a time table on the notice board in the kitchen to ensure that all students had the opportunity to develop their skills in the kitchen. Menu plans were examined during the inspection, these were varied and nutritionally balanced. Records show that all staff have a certificate in basic food hygiene. Students spoken to confirmed that they could exercise choice where food was concerned. Staff stated that the menu was purely for guidance. One service user said “I can go shopping for food sometimes with staff because we need fresh food you see.” All fridge and freezer temperature records were inspected. These were adequately maintained. Food cupboards were examined and found to contain varied up to date food stock. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Service users receive ongoing personal support in accordance to their assessed needs. This guarantees that service user needs are being met. The registered manager ensures that the healthcare needs of service users are assessed and recognised and that the procedures are in place to address them. The standard pertaining to medication was not satisfactorily met as there were short falls in areas around homely remedies and self administration of medication. Other areas that were non compliant with the standards were to do with creams not being dated on the day of opening and medication being signed for in advance. All other aspects of the receipt, storage, administration and disposal of medicines were satisfactory. EVIDENCE: Standard Eighteen – Personal Support: Four service user files were sampled during this inspection. All files seen showed a comprehensive service user plan that detailed all support needs and a prescribed method of meeting these. The reviews that take place at regular intervals were also good evidence that the support offered to students was ongoing. The students themselves were able to verify the on going support received with comments such as: “I get help with the things that I need help with.” And, “I talk to my keyworker or Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 15 the staff at college if I need more help.” The registered manger confirmed that where needed, guidance and support regarding personal hygiene is provided. Standard Nineteen – Healthcare: At the time of inspection records showed that no service users had been admitted into A&E since the last inspection and neither were there any service users with pressure sores. Records show that a number of GP practices are used by service users. Health records indicated that service users are assisted in accessing regular healthcare facilities as needed. These include dental and eye check ups. Standard Twenty – Medication: The medication policy was examined during the inspection. The registered manager must ensure that the policy is developed to include the home’s policy on homely remedies and the self administration of medicines. The MAR sheets showed that some medicines had been signed for in advance. The registered manager must ensure that this does not happen again. The home’s policy and practice of the receipt, storage, administration and disposal of medicines is comprehensive and up to date. The medication cabinet was examined. There were some creams that were opened. These creams, however, did not state the date of opening. The registered manager must ensure that all creams are dated on the day of opening and disposed of within 28 days of that date. Discussions with the registered manager confirmed that all staff that administer medication have received accredited medication training. Although there were no medicines requiring refrigeration on this occasion, it is recommended that storage for medicines requiring refrigeration be put in place to cater for that eventuality. A maximum/ minimum thermometer must also be made available for this facility. The care plans seen did not contain service users’ consent to medication. It is recommended that service users’ consent to medication is obtained and recorded in the individual care plan. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home has in place a comprehensive protocol for dealing with both verbal and written complaints. This enables service users to know that they have a right to be heard and for their grievances to be resolved without prejudice. EVIDENCE: During the inspection, the complaints procedure was examined. The procedure is comprehensive and reassures the complainant that their grievance will be dealt with as quickly and as efficiently as possible. Both the complaints procedure and the statement of purpose highlight that the home aims to remedy the situation within a time frame of 28 days. CSCI details and details of other relevant agencies such as social services are made available within the complaints procedure to enable service users to contact these agencies if they so wished. All service users spoken to stated that they knew what steps to take if they were not happy about something. They all expressed confidence that their matters would be resolved effectively. The registered manager stated that since the last inspection there has been one formal complaint from a neighbour. Records showed that this complaint had been solved according to the policy and the complainant was satisfied with the outcome. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion. EVIDENCE: Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 Service users benefit from the clarity of staff roles and responsibilities therefore they themselves are clear on what to expect from staff in their care packages. The home has an effective staff team, with complementary skills to support service users’ assessed needs at all times. The numbers, however, are not sufficient enough as two vacancies need to be filled. EVIDENCE: Standard Thirty One – Roles: Discussions with the registered manager evidenced that all staff have a clearly defined job description. The staff spoken to were also able to verify this. Staff spoken to demonstrated that their job descriptions support the main aims and values of the home and are linked to achieving service users’ individual goals as set out in the service user plans. Staff were observed to relate to the students in a respectful and friendly manner. The registered manager stated that issues of staff limitation were addressed through supervision and appropriate training put in place where this was relevant. The registered manager and the staff spoken to stated that all staff are supplied with the General Social Care Council code of conduct. Standard Thirty Three – Staff Team: On the day of inspection there were three members of staff on duty as well as the registered manager. Rotas Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 19 showed that there are three members of staff during peak times when most or all service users are on site. This enables service users adequate supported time to carry out all desired activities. The home is currently running on two vacancies which the registered manager stated that the home is recruiting for. Rotas show that the home has been able to cover these with existing staff. It is recognised that this cannot be a permanent set up hence that recruiting of more staff. There is one waking night staff and one sleep in staff for the night shifts. Records show low rate of staff turn over and sickness. Records show that staff meetings take place at regular intervals. The staff spoken to also verify this. Staff on duty are able to communicate with service users using their desired means of communication, i.e. English, makaton etc. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38 Service users benefit from a well run home. This creates peace of mind and a sense of safety for the service users. Service users also benefit from the ethos, leadership and management approach of the home from which both staff and service users are able to get clear direction and leadership that they understand and are able to relate to the aims and purpose of the home. EVIDENCE: Extensive discussions with staff and service users evidenced that the leadership style of the registered manager was one the promoted transparent and open management that enables people to freely voice their concerns and expect to be heard. One member of staff stated “I couldn’t ask for more in a manager, he is so supportive and ensures that the home is run as it should be.” The manager is currently in the process of completing his NVQ4. CSCI will be notified upon completion of this. Park View E51-E09 S8323 Park View V226344 100505 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 Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 x x x x x Standard No 31 32 33 34 35 36 Score 3 x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Park View Score 3 x 1 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 22 YES 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 YP5 Regulation 5(1)(b) Requirement All contracts must highlight fees to be charged, what they cover, when they must be paid and by whom, and the cost of services and facilities not covered by the fees. All creams must be dated on the day of opening to ensure that their shelf life does not expire. No medicines must be signed for prior to being administered. A facility must be put in place for all medicines requiring refrigeration. The registered manager must ensure that a policy is formulated for homely remedies and self administering of medicines The registered manager must ensure that all assessnments are available on service user files and open for inspection Timescale for action 31/07/05 2. 3. 4. 5. YP20 YP20 YP20 YP20 13(2) 13(2) 13(2) 12(4)(c ) Immediatel y Immediatel y Immediatel y 30/06/05 6. YP 2 14(1)(a)( b) 30/06/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 23 No. 1. 2. Refer to Standard YP4 YP1 Good Practice Recommendations It is recommended that service users entitlemet to a three month settling in period is outlined in the relevant document. It is recommended that service users are made aware of their right to advocacy. Park View E51-E09 S8323 Park View V226344 100505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Stafford Office - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 View E51-E09 S8323 Park View V226344 100505 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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