Inspection on 10/01/07 for Parkview House

This inspection was carried out on 10th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Parkview House 19/07/07

Parkview House 13/07/06

Parkview House 09/02/06

Parkview House 23/10/05

Parkview House 08/02/05

Parkview House 23/07/04

Parkview House 24/02/04

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

CARE HOMES FOR OLDER PEOPLE Parkview House 12 Houndsfield Road London N9 7RQ Lead Inspector Tom McKervey Unannounced Inspection 10th January 2007 10:00 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 Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkview House Address 12 Houndsfield Road London N9 7RQ 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) 020 8805 7031 020 8805 4374 2 Care ** Post Vacant *** Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2006 Brief Description of the Service: Parkview House is operated by 2 Care who operate other care homes nationally. The building is leased from Sanctuary Housing Association, which is responsible for maintenance and repairs. This home is registered to care for forty-five older people who have a diagnosis of dementia. The home is purpose built and opened in 1993. Residents live in five units, called clusters, which each house nine people. The units are self-contained to provide a more homely environment, each with its own lounge, dining room and small kitchen for preparing drinks and snacks. There is a central laundry and the central kitchen caters for the main meals, Although the living accommodation is in separate units, the residents are able to move around the whole building, and do so quite safely, as the entrance and exit to the home is protected by a coded keypad. The home is a two-storey building with a car park at the front of the premises. There are three internal garden areas with attractive water features and there is a long ramp and a passenger lift, to provide access to the first floor. In addition, there are spacious communal areas and a Snoezelen room for providing sensory stimulation and/or relaxation for the residents. The home aims to provide a high level of support to residents to maintain their independence and quality of life. The home is located in Edmonton, opposite a public park. The fees for the service are £508 per week. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of six hours. The lead inspector was assisted by Regulatory Inspector Daniel Lim. The visit was part of the Commission’s inspection programme and to check compliance with the key standards. At the time of the inspection, there were no vacancies. The new manager was present throughout the inspection and fully cooperated in the process. The inspection consisted of a tour of the premises, including speaking to residents, individual staff and two relatives. These interviews were conducted independently of the manager. As part of the inspection process, residents’ and staffs’ records and other documents relating to the efficient running of the home were examined. What the service does well: The home is purpose-built and provides spacious individual en-suite and communal facilities. The design of the building enables residents who are confused to move around safely without the need to be accompanied, and entry to the home is secure. The layout of the gardens provides opportunities for residents to relax and be involved in gardening if they wish. Relatives say they are kept informed about any incidents affecting the residents and staff are very welcoming towards them when they visit. There are good systems in place for recruiting and screening new staff, and there is a comprehensive staff training programme. The residents are treated with respect and dignity and they are happy with their meals. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? Staff are more aware of the concept of risk assessment, and more care is being taken when supporting residents to eat. There is better recording of complaints. Several maintenance issues identified at the last inspection have been addressed, and bad odours have been eliminated. Graffiti has been removed from the exterior walls of the home. The staff records have improved and they have been trained in infection control. There is a better appointments. system in place for tracking residents’ healthcare Fire doors are no longer being wedged open. What they could do better: Two requirements from the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. In the “Timescale for Action” column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about unmet requirements can be found in the relevant standard. Unmet requirements can impact upon the welfare and safety of residents. Failure to comply by the revised timescale may lead to the Commission for Social Care Inspection considering action to secure compliance. A care plan must be provided for a specific resident and care plans for all residents need to be more comprehensive to cover mental health, spiritual and cultural needs. More care must be taken regarding the recording of the administration of medicines. Staffing levels need to be increased so that when two staff are attending to a resident, the other residents are not left unsupervised. Care staff should be freed from cleaning and laundry duties to allow them to devote more time to residents’ individual needs. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 7 The range of activities for residents must be extended, particularly one-to-one, so that residents are appropriately stimulated. This could be considerably improved by raising the number of staff available, and by the appointment of an activities coordinator. The assisted bathroom in Durrant cluster must be cleared of clutter and the bath in Groveland cluster must be thoroughly cleaned of lime-scale. Several maintenance issues throughout the home must be addressed. The wheelchair in Jubilee cluster must be repaired or replaced. 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. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, & 3. Standard 6 does not apply to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Licence agreements are in place for residents whose care is funded by the local authority, and contracts are issued to residents who are self-funding when they become permanent. All residents have a comprehensive assessment of their needs prior to, and at the time of admission to the home. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 10 EVIDENCE: The records of three recently admitted residents contained licence agreements for those whose care is funded by the local authority, and contracts are issued to people who are self-funding when they become permanent residents. There was evidence in the case files to show that the residents had a comprehensive needs assessment by the referring agencies and senior staff from the home. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a good format used for care plans, but mental health, cultural and spiritual needs are not always documented, and one resident did not have a written care plan. This could lead to residents’ needs not being fully addressed by the staff. Residents receive a good range of healthcare from professional services and they say the staff treat them with respect and dignity. Medication is generally safely administered, but in some instances there is poor recording, which could lead to mistakes being made and residents’ well-being being put at risk. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 12 EVIDENCE: Five care plans were sampled. Some of the care plans were signed by residents or their relatives, demonstrating that they had been involved in drawing up the care plan. The care plans were reviewed on a monthly basis and any changes in the person’s needs were noted. The care plans addressed most aspects of daily living, but some did not address mental health, cultural or spiritual needs. In Grovelands, one resident did not have a care plan at all. Requirements are made to address these issues. There were risk assessments documented in the care plans, including risks of falling, pressure ulcers, choking, wandering and aggressive behaviour. Staff who were spoken to, understood the concept of risk assessment and were knowledgeable about the residents and their needs. There were good records of healthcare appointments, which were recorded in a “healthcare tracking form”. There were several instances of pressure relieving mattresses in use to prevent pressure ulcers. Residents who were spoken to, said they were well cared for, and the staff treated them with respect and dignity. The medication standards were examined. In general, the administration of medicines was being carried out safely. However in Pymms cluster, there was confusion with two residents’ medication. For example, it appeared that tablets were being taken from the wrong “blisters” and it was difficult to know if the medication was being given at the prescribed time. Also in Pymms, it was evident that a resident’s morning medication was frequently withheld because it was difficult to arouse this person. A requirement is made for the GP to review the medication to see if it could be safely administered at a more appropriate time. In Jubilee cluster, the staff’s signature was missing for a nighttime medication that appeared to have been given. A requirement is also made to address this issue. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 13 The majority of the residents have advanced dementia. However, those who were articulate, said that the staff were very kind and caring and treated them with respect. The relatives were also complimentary about the staff. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there are good facilities available, there is a lack of stimulating activities provided for residents. One resident should be reassessed to determine if they are appropriately placed in the home. There is an open visiting policy. The meals are varied and nutritious and residents are able to have hot and cold drinks at any time. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 15 EVIDENCE: All clusters were visited. The inspectors were informed that various activities are carried out with the residents, for example; birthdays are celebrated throughout the home, and “theme nights” are held to reflect different cultures, for example; Greek and Polish. Staff said that a volunteer comes to the home once a week and goes to each cluster to engage with the residents. Since the last inspection, new DVD players and some board games had been purchased for each cluster. There is a large communal room that can be used for group activities and a “Snoezelen” room for providing sensory stimulation or relaxation. However, there was little evidence in the records about these activities and most of the residents were sat around the lounges watching television. One resident in Montague cluster, told the inspector that they were bored as there was little to do. It appeared to the inspectors that this person was more able than the other residents and may not be appropriately placed at this home. A requirement is made for this resident’s needs to be reassessed by their doctor and care manager. Some staff said they wished they could provide more activities, but there was insufficient staff numbers and time to do this because care staff also do the cleaning in the clusters. At the last inspection, a requirement was made for more stimulating activities to be provided and a recommendation was made for an activities coordinator to be recruited, which would improve this situation. These are restated. The visitors’ book showed that relatives and friends are able to visit the home at any time. The menus were examined and they indicated that well-balanced and nutritious meals were provided. The residents said there was plenty to eat and they could choose alternatives to the planned menu. There were ample supplies of food in the kitchen stores, and hot and cold drinks were available at any time. Staff were observed while supporting some residents to eat. This was carried out in an unhurried manner and at an appropriate pace. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good procedures in place for addressing complaints and staff are knowledgeable about abuse issues and how to report any concerns relating to residents’ welfare. EVIDENCE: The complaints record showed that two complaints had been made in the past year, one of which had been addressed appropriately. There was one complaint in the log that was currently being investigated by the manager. There were records to show that staff had been trained in adult protection procedures, including “whistle blowing”. The staff who were spoken to, were able to describe their responsibilities regarding reporting suspected abuse. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 23 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is secure and the standard of cleanliness is generally good. However, several maintenance issues must be addressed to improve the comfort and well-being of the residents. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 18 EVIDENCE: The inspectors carried out a tour of the premises, including a selection of bedrooms in each cluster. All bedrooms have en-suite facilities, and there are also communal assisted bathrooms in the clusters. There is a protected entry and exit system in place. Otherwise, all interior areas of the home were accessible to the residents. It was noted that many requirements made at the last inspection regarding the environment had been complied with. However, the following issues were identified at this visit. Grovelands cluster: In bedroom 2, there was no covering in the bathroom floor. However, there was evidence that a new covering was due to be installed on 12/1/01. The assisted bath was dirty and was encrusted with lime-scale. Durant cluster: The communal bathroom was very cluttered with weighing scales, chairs etc. Jubilee cluster: The dining furniture was very worn and chipped. A requirement is made to replace the furniture. The inspector noted that a wheelchair in this cluster was broken and the brakes did not work. Several bedroom doors throughout the home were very marked and need repainting. Requirements are made to address these issues. There has been an improvement in the overall cleanliness of the home, including the absence of offensive odours. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is still a concern that staffing levels are not sufficient to meet all the needs of the residents. Residents’ are protected by thorough staff recruitment procedures, and staff receive training that is appropriate to meet residents’ needs. EVIDENCE: The new manager is commended for developing an impressive spreadsheet that clearly displays the rotas and staff training and development courses. At the last inspection, a requirement was made to review the staffing levels because the inspector was concerned that there were insufficient numbers of staff to meet residents’ needs. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 20 There was no evidence to indicate that this had been done and there are still only two care staff on duty during the day and one at night to care for the nine residents on each unit. The two staff includes a senior carer who has additional management responsibilities. The staff also have cleaning duties on the clusters. These staffing levels impact on their ability to supervise other residents when two staff are required to support an individual or to provide stimulating activities. The new manager said that she was looking at extending the handover time to provide more time for activities. In the meantime, the requirement to review the staffing levels is restated. There was evidence that staff attend training courses relevant to their duties as carers. These include health and safety subjects and dementia care. The records of four recently recruited staff were examined. The staff files contained application forms and interview notes. There were documents confirming proof of identity and records of training. Appropriate references were obtained and Criminal Records Bureau, (CRB) checks had been carried out before they started work. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although there have been several changes of manager at the home in a very short period, the staff have confidence in the new manager’s ability to run the home effectively. Residents’ and staffs’ health and safety are safeguarded by appropriate procedures and training. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 22 EVIDENCE: The previous manager had only been in post for a few months and had apparently left for personal reasons to move to another part of the country. The new manager was appointed in October 2006. She has twenty years of experience in care work with older people, including sixteen years at management level. The manager is supported by a deputy and senior carers, one of whom acts as duty manager on a rostered basis. At the time of the inspection, the administrator post was vacant. There have been three changes of manager in the last two years. While some staff expressed concern about this, the majority said they had confidence in the new manager who provided clear leadership, and they supported the initiatives she was introducing. These included introducing person-centredplanning for service users, and reviewing shift handovers. Relatives were informed by letter about the appointment of the new manager. Staff said that they had regular one-to-one supervision to support them in their work and provided an opportunity to discuss work-related and personal issues with their line managers. On the morning of the inspection the fire alarm sounded. The inspectors noted that there was a good response from the staff in following the fire procedure while waiting for the fire brigade to arrive. In the event, the cause of the alarm was identified as toast being burnt, which was dealt with properly. There were records showing that fire alarms were tested weekly and drills carried out. A fire risk assessment of the home had been completed. Staff were provided with training in health and safety subjects and infection control. No hazards to health and safety were identified during the inspection. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 23 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 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 2 3 X X 2 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 X 3 Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15(1) Timescale for action The registered person must 28/02/07 ensure that a new resident has a care plan and that all residents’ care plans address all their needs. The registered person must 28/02/07 ensure that all administered medicines are signed for accurately. This requirement is restated from the last inspection. The previous timescale was 31/08/06 The registered person must 28/02/07 ensure that more stimulating activities are provided for the residents, particularly on an individual basis. This requirement is restated from the last inspection. The previous timescale was 30/09/07 4. OP19 23(2)(d) The registered person must 31/03/07 ensure that the following issues are addressed. Durrant Cluster. Unnecessary furniture Parkview House DS0000010566.V326111.R01.S.doc Requirement 2. OP9 13(2) 3. OP12 16(2)(n) and Version 5.2 Page 25 equipment is removed from the assisted bathroom. Jubilee cluster. Old dining furniture is replaced. The wheelchair is repaired or replaced. Grovelands cluster. The assisted bath is thoroughly cleaned. A survey of all bedroom doors is carried out and where necessary, they are repainted or replaced. 5. OP27 18(1) a The dining room is redecorated and matching furniture is provided. The registered persons must 31/03/07 ensure that staffing levels are sufficient enough at all times to ensure that; Residents are not left unsupervised when other residents are receiving personal support. Residents have one-to-one activities and are able to be taken outside the home when they wish. This requirement is restated from the last inspection. The previous timescale was 31/10/06 Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP12 OP12 Good Practice Recommendations The registered person should consider employing cleaners for the clusters. The registered person should recruit an activities coordinator for the home to extend the range of group and individual activities for residents. Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Parkview House DS0000010566.V326111.R01.S.doc Version 5.2 Page 28 - 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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