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Inspection on 01/02/07 for Parklands Care Home

Also see our care home review for Parklands Care Home for more information

This inspection was carried out on 1st February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

During this inspection the people spoken to were complimentary about the care provided and the staff working in the home. One service user said `the staff are extremely caring and have an enormous amount of patience. I won`t hear a bad word against them they are tremendous`. One service user commented ` I have not lived here very long, but I feel very safe and well cared for`. Residents said they enjoyed the food and there was a choice of meals available. One service user said` we get fresh greens nearly everyday, I like that`. Another service user said `I have not eaten as much since I came to live here, the choice is great and the food is very well cooked`. People living at the home were comfortable and looked well cared for. The staff were motivated and enthusiastic, they receive regular appropriate training and support.

What has improved since the last inspection?

The home has continued to offer a very good standard of care and support for the people who live at the home. The manager and staff are continually working hard and looking to always improving the care and support they give to the residents who live at the home. Several areas of the home have been totally refurbished, including individual bedrooms and communal areas. The garden has been further improved, by providing two areas of wooden decking, making access to the garden easier for service users

What the care home could do better:

There were no requirements or recommendations made at this inspection. The home must continue to maintain and to build upon the good service it gives to the residents who live at the home.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Parklands Care Home Station Road Seaham Durham SR7 OAD Lead Inspector Bridgit Stockton Unannounced Inspection 1st February 2007 09:30 X10029.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 Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. 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. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parklands Care Home Address Station Road Seaham Durham SR7 OAD 0191 5130150 0191 5130626 Parklands1@aol.com 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) Searchplace Limited Mr James Cockburn Care Home 71 Category(ies) of Dementia (18), Dementia - over 65 years of age registration, with number (18), Old age, not falling within any other of places category (24), Physical disability (29), Terminally ill over 65 years of age (3) Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Convalescence: Persons over the age of 55 requiring convalescent care may be accommodated commensurate with the homes statement of purpose and function. Physical Disability: Up to 29 persons with a physical disability over the age of 55 may be accommodated commensurate with the homes statement of purpose and function. Day care: up to 2 day care attendees may be accommodated commensurate with the homes statement and purpose of function. Up to 29 younger physically disabled adults (18-54) may be accommodated in the YPD Unit commensurate with the homes statement of purpose and function. Up to 18 persons in the category DE and DE(E) may be accommodated in the Mental Health Unit commensurate with the homes statement of purpose and function. Terminal Illness: (Up to 3) Persons with a terminal illness (Palliative Care) (over the age of 65) may be accommodated commensurate with the homes statement of purpose and where qualified and conmpetent staff are provided. 6th December 2005 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Parklands is a 71-bedded single storey home. Accommodation is provided for people requiring nursing or residential on a permanent or respite basis. It is situated in its own grounds close to Seaham town centre. Parklands comprises of 3 self contained units, West Park Court accommodating young physically disabled service users, East Park Court accommodating elderly service users who require nursing or residential care and Penshaw Court for elderly service users who have mental health problems. The home is surrounded by wellmaintained gardens and has ample car parking space available for visitors. The range of fees charged are from £353.00 to £1100 per week. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 5 hours on the 1st February 2007. The home did not know the inspection was going to take place. The plan for the inspection was to talk with the residents about living in the home; to meet with care staff and the home’s management team; and to look at records. A pre inspection questionnaire had also been returned to the Commission along with some service users surveys. Some of this information has been included within this report. What the service does well: What has improved since the last inspection? The home has continued to offer a very good standard of care and support for the people who live at the home. The manager and staff are continually working hard and looking to always improving the care and support they give to the residents who live at the home. Several areas of the home have been totally refurbished, including individual bedrooms and communal areas. The garden has been further improved, by providing two areas of wooden decking, making access to the garden easier for service users. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3&6 Quality in this outcome area is good. All prospective service users are properly assessed to ensure that their needs can be met prior to admission to the home This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose and Service User Guide have been updated. These guides contain information that is required to enable people to make an informed choice about where to live. Evidence was seen that service users or their representatives have signed a contract with the home. The contracts Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 9 were detailed and included a breakdown of the fees and who was responsible for paying them. The manager confirmed that visits to prospective service users always take place before their admission to the home, to carry out an assessment of needs. Four care plans examined contained notes from assessments made on these visits. Also, each service users care plans contained assessments from the placing authority that were responsible for commissioning the service users care at the home. A resident who was new to the service was spoken to. They confirmed that they were given information about the home before they moved in. they explained how staff had helped them settle into the home and spoke very positively about the experience. The home does not provide intermediate care. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 6,9,16,18,19 &20 Quality in this outcome area is good. Service users can be confident that their privacy and dignity is protected and that there health care needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A service user plan has been developed for each service user that identifies needs associated with health and personal care. This ensures that staff are Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 11 clear about what is required of them in meeting service user’s needs. The care plans of four service users were inspected. They were comprehensive and well written. There was evidence of involvement of specialist healthcare people such as the community psychiatric nurse, the dietician and continence nurse. The management and administration of medication is carried out appropriately and audited by the manager on a regular basis. Staff were seen to be treating service users with respect and dignity and this was also reflected within the care plans. Service users said that the ‘girls are kind’ and ‘they (the staff) always knock on my door before they come in’. One service user said ‘we are all treated here with care and the staff are very thoughtful towards us all’ Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,&15 12,13,15 &17 Quality in this outcome area is good. The recreational and social needs of service users are well catered for which enables service users to make daily choices and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 13 The home employs two activities co-ordinators, who produce a varied and interesting activities program, appropriate to service users’ needs and interest. The home had a busy and purposeful atmosphere, some service users were enjoying chatting with each other, some were listing to music or else joining in with a group activity. Activities for the service users in the dementia unit were appropriate and promoted life long skills. At the time of the inspection the dementia unit was calm and quiet and service users looked happy and content. In the young physical disabled unit service users were listening to music and watching television, some were attending a community day centre. In the general unit service users were occupying themselves with reading or chatting with other service users or staff. The activities organiser was busy preparing for an afternoon games session. Service users said they were given the choice of participating in activity sessions. One service user said ‘I enjoy my own company as long as I have my television and books I am very content, the staff come and chat, I can do more or less as I please. That’s what I like about living here’ A relative who had returned a comment card to the commission said ‘mum really enjoys living here and visitors are always made welcome’. All of the service users said the food was good, a choice of meals were offered and the menus were well thought out, catering for most people’s tastes. Three comment cards received from relatives said that the food was poor. Every service user spoken to said that they food was nice, well presented and always tasty. Residents who required extra food supplements were given high calorie snacks during the day. One service user said ‘I eat very well and have put on weight since I came to live here.’ Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 22&23 Quality in this outcome area is good. Service users concerns and complaints are dealt with appropriately and safeguards are in place to protect them from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. The staff spoken to during the inspection were clear about any action they would take should they suspect abuse of a vulnerable adult was taking place. Staff training has taken place in the protection of vulnerable adults in abuse. Staff recruitment procedures were adequate and staff were employed and deployed following appropriate CRB and POVA checks. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 15 Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home was clean, comfortable and well-maintained providing service users with a safe and pleasant environment This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual bedrooms and communal areas were suitably furnished and decorated in a style liked by people living there. Several communal areas and Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 17 corridors have been re-carpeted or laminated. Some service users bedrooms have been redecorated and new carpet laid. During the inspection the decorators were busy repainting communal corridors. Wooden decking areas have been erected outside, making the garden area more accessible for service users to enjoy in the warmer weather. The communal areas of the home were clean and residents confirmed that their bedrooms were also cleaned to a good standard. Disposable gloves and aprons were available for staff use, and staff had been trained in infection control. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29&30 32,34, &35 Quality in this outcome area is good. Service user can be confident that staff are trained and on duty in sufficient numbers to meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Fourteen out of twenty seven care staff are trained to the National Vocation Qualification (NVQ) level two or above in care. There was evidence of on going training for staff in such things as moving and handling of service users, fire awareness and prevention of falls, and the protection of vulnerable adults. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 19 From the rota supplied with the pre inspection questionnaire there was sufficient care staff on duty to meet the assessed needs of service users. Service users said that staff were always around and answered the call bells quickly. One service user said ‘the staff are kind and helpful’ Another service user said ‘ they are really good, they are always willing. It is very reassuring to know that the girls are around if I need help’ Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35&38 37,39&42 Quality in this outcome area is good. Service users can be confident that the home is well managed. Systems and safeguards are in place to ensure the health, safety and welfare of service users and staff is protected This judgement has been made using available evidence including a visit to this service. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager of the home is experienced in managing a care service. There was an open, friendly culture between the management team and the staff at the home, and staff said they felt very well supported in their work. Service users benefit from a stable staff team with very little staff turnover. Service users said that the manager was very approachable and they would go to him or any of the staff if they had any concerns. The records regarding administration of residents’ personal allowances were inspected. All transactions are recorded correctly and receipts are kept. The homes health and safety file was examined; all equipment in the home is regularly checked with valid certificates issued. There are no outstanding issues from environmental health inspections or the fire and rescue services. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 X 5 X 6 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 3 36 X 37 X 38 3 Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Parklands Care Home DS0000000736.V329683.R01.S.doc Version 5.2 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. 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