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Inspection on 23/11/05 for Park View Care Centre

Also see our care home review for Park View Care Centre for more information

This inspection was carried out on 23rd November 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.

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

What the care home does well

What has improved since the last inspection?

The manager and director acknowledge that the standard of training must be raised in respect of identification of training needs, planning, implementation and review. Following the inspection, a comprehensive training matrix for 2006 was received. The matrix covers in-house, statutory, adult protection and specialist training relating to the current knowledge of medical conditions relevant to the categories of registration of the home. NVQ training is provided alongside in-house training. Residents said that he food has improved and now contains more home cooked dishes.

What the care home could do better:

Following receipt of the training programme for 2006, which are the minimum managers and their deputies should implement, individual staff training profiles must now be devised and an implementation programme introduced. Whilst staff are introduced to the issues surrounding adult protection at the induction stage, there is no recorded evidence that staff have been given formal training in this respect since March 2005. The manager acknowledged that this was the case and explained the reasons why. It is a requirement that staff are trained to "prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse". It was noted that the training programme for 2006 incorporates Adult protection, abuse and POVA. 17 out of the 36 comment cards received stated that, at times, particularly at the weekends, they felt there were not enough staff. This issue was discussed in respect of residents` dependency, residents` and relatives` perception, unit management and staff "visibility". The manager is aware that staffing levels need to be very carefully monitored in order to match the needs of the residents with the number and competencies of the staff on duty. Whilst care plans continue to improve, deficits and inconsistencies were noted in the sample of care plans viewed on one nursing unit. Whilst it was said that care plans are audited, the tool used may not be robust enough to evidence consistency and currency. Whilst unit audits are carried out, there is currently no medication audit tool for the nursing units. It was recommended that a protocol be devised for "as required" medication.Whilst relatives said that they like the staff and appreciate their hard work, some staff were heard to be calling residents "darling" and use other terms of endearment rather than calling residents by their names. This is an inappropriate way of addressing residents and may compromise their dignity and respect. The issue was discussed with the manager who said this is being addressed.

CARE HOMES FOR OLDER PEOPLE Park View Care Centre Field View Park Farm Ashford Kent TN23 3NZ Lead Inspector Lisbeth Scoones Announced Inspection 23rd November 2005 09:00 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 View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park View Care Centre Address Field View Park Farm Ashford Kent TN23 3NZ 01233 501748 01233 501757 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) Ranc Care Homes Limited Vacant Care Home 88 Category(ies) of Dementia - over 65 years of age (43), Old age, registration, with number not falling within any other category (45) of places Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The forty three (43) beds for DE (E) residents are located on the ground floor. The forty five (45) beds for nursing clients are located on the first floor of the building. Service users under 65 years old in the nursing unit to be restricted to one (1) whose DOB is 29/12/1951. One (1) room in nursing wing to accommodate one (1) service user with a diagnosis of DE(E) whose DOB is 27/11/1914. Services users under the age of 65 years to be restricted to two (2) whose DOB are 21/01/1943 and 23/10/1941. 11th May 2005 Date of last inspection Brief Description of the Service: Park View Care Centre is an 88-bedded, purpose built two storied home located on the outskirts of Ashford. It is set in its own grounds, surrounded by gardens and has plenty of parking spaces. The Home is registered to care for 45 Service Users requiring nursing care on the first floor and 43 Service Users who are elderly mentally infirm on the ground floor. Mrs S Erasmus is the manager and became registered with the CSCI on November 1st 2005. Two unit managers and a newly appointed nursing and operations director support her. Staffing levels are stable and there are few staff vacancies. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place during the hours of 09.00 and 17.30 on Wednesday 23 November 2005 during which the inspector met with the registered manager Mrs S Erasmus, the nursing and operations director Mr R Greaves, both unit managers, other members of staff, 10 residents and a several visitors. A tour of the building was undertaken (excluding the kitchen and laundry area) and a shared lunch with the residents enjoyed. Care plans, training records and other documents were examined and discussed. Since the previous inspection, the inspector visited the home once to introduce herself to the new manager. This was the first inspection for the registered manager and the nursing and operations directors and they were both present throughout the inspection. Prior to the inspection, the manager completed a pre-inspection questionnaire and the inspector received 36 comment cards completed by relatives on behalf of the residents and 3 completed by residents. The inspector is grateful for this information, which informed the inspection process. Comments made will be incorporated and referred to in the report. What the service does well: Many relatives commented favourably on the care their relatives received. One comment read, “Overall my mother and myself are more than happy with all aspects of the care at Park View.” One relative said that her mother was pleased that her room was painted at her request in her favourite colour. Another relative said, “I have been very pleased with everything.” Another, “We always found that the manager is willing to have a chat when needed.” Another, “my aunt has always stated that she is happy.” Residents and visiting relatives spoken to during the inspection said they were happy with the care provided. Good interaction was observed between the staff and residents in both units. Staff know the residents, their preferences and wishes very well. The standard of décor throughout the home is good. The manager is a good communicator and relates well to the residents, their relatives and staff. All complaints and concerns are taken very seriously, investigated and acted upon. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 6 The manager and director were receptive to recommendations made by the inspector. It is acknowledged that much work is currently being undertaken in respect of staff training, devising training profiles, auditing of records and recruitment files and the standardisation of policies, procedures and practices. What has improved since the last inspection? What they could do better: Following receipt of the training programme for 2006, which are the minimum managers and their deputies should implement, individual staff training profiles must now be devised and an implementation programme introduced. Whilst staff are introduced to the issues surrounding adult protection at the induction stage, there is no recorded evidence that staff have been given formal training in this respect since March 2005. The manager acknowledged that this was the case and explained the reasons why. It is a requirement that staff are trained to “prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse”. It was noted that the training programme for 2006 incorporates Adult protection, abuse and POVA. 17 out of the 36 comment cards received stated that, at times, particularly at the weekends, they felt there were not enough staff. This issue was discussed in respect of residents’ dependency, residents’ and relatives’ perception, unit management and staff “visibility”. The manager is aware that staffing levels need to be very carefully monitored in order to match the needs of the residents with the number and competencies of the staff on duty. Whilst care plans continue to improve, deficits and inconsistencies were noted in the sample of care plans viewed on one nursing unit. Whilst it was said that care plans are audited, the tool used may not be robust enough to evidence consistency and currency. Whilst unit audits are carried out, there is currently no medication audit tool for the nursing units. It was recommended that a protocol be devised for “as required” medication. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 7 Whilst relatives said that they like the staff and appreciate their hard work, some staff were heard to be calling residents “darling” and use other terms of endearment rather than calling residents by their names. This is an inappropriate way of addressing residents and may compromise their dignity and respect. The issue was discussed with the manager who said this is being addressed. 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 Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 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 View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Prospective residents are provided with comprehensive information about the services the home provides. Each resident is provided with a detailed admission agreement. EVIDENCE: The home’s service user guide, welcome pack and statement of purpose have recently been reviewed and comply with the standard and regulations. A resident’s admission procedure provides the residents with clear information. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10, 11 A clear and consistent care planning system is in place in the dementia care unit that adequately provides staff with up to date information to look after the residents’ needs. Care plans in the nursing units need further scrutiny to ensure that all care needs are recorded consistently. Residents’ health care needs are met with evidence of input from multidisciplinary professionals. Residents are protected by the home’s policies and procedures for dealing with medicines but it is was recommended that a protocol for as required medication be devised. Personal care is offered in a way, which protects residents’ privacy and dignity. However, staff must refrain from using terms like “darling” which may be regarded as disrespectful. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 11 EVIDENCE: A sample of care planning and daily records seen in the dementia care units provides evidence that an appropriate system of recording is used. A recommendation was made for recording doctor’s visits. A sample of care plans in the nursing units was in general well maintained but recommendations were made for improved recording in respect of wound care, continence promotion and review ensuring that changes in condition are included. A relative said that he had signed his relative’s care plan and had contributed to the contents. It is recommended that, when possible, this good practice be extended to all care plans. Care plans contain a multi-disciplinary and doctors’ page evidencing visits from the GP and health professionals (continence advisor, CPN, chiropodist, physiotherapist and others). The possibility of delegations of certain key nursing roles was discussed in respect of “link” status for e.g. continence promotion, infection control, care planning, health and safety, risk assessments etc. See also standard 32 in respect of job descriptions, roles and responsibilities. Medication charts were viewed and had in general been well maintained. It is recommended that medication charts in the nursing unit be formally audited and a protocol devised for “as required” medication which should include the correct code for non-administration. It was further recommended, for accountability purposes, that all handwritten entries or transcriptions are signed and countersigned. From observations made and discussions with staff and residents, it is ascertained that residents are treated kindly. Residents said they liked the staff. One resident, referring to a senior member of staff said, “he is helping me to walk again”. It was however noted that some staff address the residents as “darling”, which is inappropriate and may compromise residents’ dignity and respect. Residents looked well dressed and groomed. A regular hairdressing service is offered. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, 15 Designated staff are employed who regularly offer residents a range of activities suitable to their needs. Residents’ spiritual needs are accommodated. Residents’ relatives and friends are encouraged to maintain contact. The food provided is of a standard acceptable to the residents providing a choice and variety EVIDENCE: The home employs two activities coordinators. Between them they provide activities in all units. Group and on-to-one activities are provided. On the day of the inspection, group activities were observed in both units. A weekly activities programme was noted in the dementia care unit. Every week musical entertainment is provided as well as a special monthly event. Recently a Fair held at the home proved to be a great success. Residents are provided with choices in respect of what wish to wear, what they would like to eat, when to get up and go to bed. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 13 The inspector did not meet with the chef but shared lunch with the residents, which was enjoyed. Home made dishes have recently been introduced to the menu. Whilst fresh fruit is not generally provided to all residents, this is available. Stewed fruit and fruit crumbles were seen on the menus. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 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 the following standard(s): 16, 18 The complaints procedure provides residents and relatives with an opportunity to complain feeling confident that their concerns are listened to and acted upon. Whilst staff demonstrated an awareness of what constitutes abuse, no recorded training has been provided since March 2005. This is insufficient evidence that residents are protected from abuse. EVIDENCE: There is a detailed complaints procedure on display and incorporated in the welcome pack. Residents spoken to said that they feel able to air their views and know who to complain to. The manager keeps a complaint log, which includes evidence that the complainant is satisfied with the outcome of the investigation. Whilst staff are introduced to the issues surrounding adult protection at the induction stage, there is no recorded evidence that staff have been given formal training in this respect since March 2005. The manager acknowledged that this was the case and explained then reasons why. It is a requirement that staff are trained to “prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse”. It was noted that the training programme for 2006 incorporates Adult protection, abuse and POVA. See also standard 30 in respect of training. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 23, 24, 25, 26 The standard of the environment within the home is good, well-maintained, clean, pleasant and hygienic providing residents with an attractive and homely place to live. EVIDENCE: The home provides a pleasant, clean and well cared for environment. No unpleasant odours were noted. Recently some bedrooms have been decorated. In a residents’ room, additional grab rails were noted which had been strategically placed to ensure the resident’s safety. Whilst the garden is safe and provides wheel chair access, it is currently not used to its full potential. The manager intends to make the garden more interesting and user friendly, improve the walking facilities so that may go out more and enjoy the changing seasons. A memorial feature was noted. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30 In general, staffing levels are adequate to meet the needs of the residents. The home is committed to provide staff with the training they need to deliver the care. Insufficient records are available evidencing staff training. EVIDENCE: The home now has a stable workforce and few vacancies exist. The home is advertising for weekend laundry staff. Staff work according to a duty rota. Staff spoken to on both units said that staffing levels are adequate except when people are off sick. A resident said that, at times during the day, she had to wait for a while for the call bell to be answered. As mentioned in the introduction, some relatives perceived staffing levels as not always being sufficient particularly at weekends. The issue of adequate staffing was discussed with the manager and the director. They confirmed that staffing levels are carefully monitored based on resident’s needs and staff competencies. Whilst staff files were not examined at this inspection, it is evident that robust recruitment procedures are in place, which include enhanced CRB and POVA checks. The director said that all staff files are being audited to ensure compliance with the standard and regulations relating to recruitment. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 17 The home is committed to NVQ training. 6 staff are about to complete and 15 staff to commence NVQ training. The nursing units manager oversees and facilitates staff training. Whilst there is evidence of recent training (continence care, diabetes, Parkinson’s disease, multiple sclerosis) and a training matrix for 2005 was seen, there was no evidence of adult protection training since march 2005 and there is currently no system in place to flag up any outstanding training. As already mentioned, training has now been given high priority and a training programme for 2006 has been devised. The director said that the appointment of a training coordinator for the Ranc Care Homes Ltd group is being considered. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37, 38 The manager has a good understanding of the areas in which the home still needs to improve. The manager ensures that staff are aware of their roles and responsibilities. Good systems are in place ensuring that residents are asked for their views about the way the home is run. With standardised policies, procedures and practices the home assures residents that their rights and best interests are safeguarded. Through risk assessments and staff training, the health, safety and welfare of residents and staff are promoted, reviewed and safeguarded. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 19 EVIDENCE: The manager is fairly new in post and recent registered with the CSCI. Residents and staff spoken to praised the manager’s open, positive and transparent style of leadership. She carries out spot visits and the heads of unit undertake monthly periodic service reviews. The manager has introduced this innovative client and service centred quality assurance tool which is compliant with the national minimum standards for older people. Information thus obtained is analysed and graphed. Job description review for all care staff were discussed in respect of delegation, roles and responsibilities. Regular staff meetings are held both at management and unit level to ensure that staff are involved with and consulted about plans for change. A relatives and residents’ meeting is planned for the new future. The manager informs the CSCI of every event reportable under Regulation 37. The newly appointed nursing and operations director meets with the manager weekly and provides the CSCI with a comprehensive monthly written report. All policies and procedures are currently under review as part of the home’s quality assurance programme. Risk assessments are undertaken to ensure a safe environment and working conditions for residents and staff. Statutory training is provided to all staff in respect of fire safety awareness, infection control, first aid and food hygiene. The possibility of appointing an in-house moving and handling trainer is being explored. As already referred to, the training programme for 2006 identifies a clear structure of staff training. Staff confirmed that they are formally supervised and that such sessions are recorded. It was recommended that, where training needs are identified, written evidence is provided regarding the action taken. A supervision planner was noted. Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 3 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 2 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 x 18 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 x x 2 3 3 Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NA 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 OP18 Regulation 13 (6) Requirement That registered person shall make arrangements by training staff …to prevent residents from being harmed…… Timescale for action 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard OP7 OP9 OP27 OP30 OP36 Good Practice Recommendations 1 2 3 4 5 That care plans in the nursing units contain all care needs and that daily records reflect that the care is given That medication records are audited, all handwriiten entries signed by two staff and a protocol for “as required” medication devised. That staffing levels continue to be carefully monitored and that residents views in this respect be taken into account That evidence be provided of all statutory, in-house, specialist and other training That the home evidences that training needs identified at supervision be provided Park View Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Care Centre DS0000026097.V253047.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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