Inspection on 15/02/07 for The Franklyn (Fezdene Ltd)

This inspection was carried out on 15th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Franklyn (Fezdene Ltd) 03/02/06

The Franklyn (Fezdene Ltd) 02/09/05

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Snydale Care Home

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Carentan House

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

CARE HOMES FOR OLDER PEOPLE The Franklyn (Fezdene Ltd) 25 Easby Drive Ilkley LS29 9AZ Lead Inspector Nadia Jejna Unannounced Inspection 10:45a 15 February 2007 th 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 The Franklyn (Fezdene Ltd) DS0000064293.V314336.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. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Franklyn (Fezdene Ltd) Address 25 Easby Drive Ilkley LS29 9AZ 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) 01943 816161 Fezdene Limited Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability (1) of places The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2006 Brief Description of the Service: The Franklyn is a converted, extended property situated in the residential area of Ilkley. The home is within walking distance of the town centre and shops. It is close to local bus routes and is within easy reach of a railway station and the main roads to Leeds, Bradford and Skipton. The home provides personal care with nursing for up to twenty-four elderly service users of both sexes. Accommodation is provided in a combination of twenty single and two double bedrooms, none of these rooms having en-suite facilities. The registered provider has said that one of the double rooms will be used as a single room. Service users have a choice of three lounges. There is a dining room on the lower ground floor. There is an attractive and easily accessible garden area. This has been equipped with garden furniture. Views of the surrounding areas can be enjoyed from the gardens as well as some of the lounges and bedrooms. Information about the home and the services provided is available in the Statement of Purpose and Service User Guide. Copies are kept in the managers office along with a copy of the most recent inspection. Copies will be given to enquirers on request and when they visit the home. Fees charged by the home range from £ to £ per week. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two visits were made on 15th and 21st 2007. The home did not know that this was going to happen. Feedback was given to the manager during and at the end of the visits. The purpose of the visit was to make sure the home was being managed for the benefit and well being of the residents and to see what progress had been made meeting requirements in place from the last inspection. Before visiting the home the inspector asked for information from the manager which included asking about what policies and procedures in place and when they were last reviewed, when maintenance and safety checks were carried out and by who, menus used, staff details and training provided. This information was received 14th February 2007. Comment cards were sent to the home to be given to residents, their relatives and other visitors to find out what their views of the home were. At the time of writing this report none had been returned. In order to find out how well staff knew residents care plans were looked at during the visit and residents, visitors and staff were spoken to. Other records in the home were looked at such as staff files, complaints and accidents records. What the service does well: What has improved since the last inspection? The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 6 A new manager has been in post for just over two months. In that time it is clear that a lot of work has been done on updating residents records and care plans, looking at what training staff have done and arranging for them to attend and receive training needed to help them do their work. Residents, relatives and staff said that they had seen changes for the better during this time. They said that the manager is approachable and supportive and they would be happy to talk to her about her concerns they might have. The manager has made links with the community matron who comes to the home each week to hold a clinic, carry out health checks and deal with minor ailments. She has also contacted the tissue viability nurse and the continence advisors to make sure that residents receive the specialist care, support and products needed. Two of the lounges have been redecorated and the third was being redecorated at the time of the visit. The dining room has also been redecorated and a laminate floor put down. 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. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are given enough information to make an informed choice about the home and the services provided. EVIDENCE: The manager said that the Statement of Purpose and Service User Guide is going to be revised to show the changes in the management of the home. She said she would look at guidance available on the CSCI web site when doing this. The relative of a resident who had been admitted three months ago said they had chosen the home after looking at a lot of other homes. When they visited The Franklyn they found it to be clean, homely, welcoming and friendly. Staff gave them all the information they needed to make the decision on their relative’s behalf. One of the nurses visited their relative to carry out a pre admission assessment and make sure the home would be able to give them The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 9 the care and support needed. The relative said they were very happy with the choice they had made and the care that their relative was receiving. Two pre admission assessments were looked at. They showed that the individuals’ care and support needs were identified along with any specialist equipment that might be needed, such as pressure relieving mattresses, before any agreements were made to come and live at the home. Relatives said that contracts were in place. One relative said that the manager had helped them when changes had been made to fees charged and paid by the local authority. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met, they are treated with dignity and their privacy is maintained. But the care plans need to be more detailed and individualised to make sure that staff have all information needed to meet individuals needs. EVIDENCE: The manager has only been at the home for two months and has identified that the way the care plan records have been kept needs to be improved upon. Where there have been problems with individual plans not providing enough information and guidance about how to meet individual’s needs she has spoken to the nurses responsible so that they will be rectified. She said that the company is introducing new documents to use in the near future. When this happens she will make sure that staff are trained in using them properly and make sure that the care plans are detailed and individual to each resident. She is also hoping to involve the care assistants more with the care planning process. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 11 Three care plans were looked at. They confirmed what the manager said. One plan was for a resident admitted a month ago and some of the documents had not been completed. The manager said she would deal with this immediately. Two showed that the resident or their relatives had been asked to review the completed plans and sign them. Relatives and visitors said that: * They were satisfied with the services provided by the home * The staff were hard working, caring and friendly. * Staff respected privacy and they could see visitors in their own rooms if they wanted to. The manager said that she has made links with the tissue viability nurse and the continence advisors to make sure that residents receive the specialist care, support and products needed. Links with other healthcare specialists that will be made include the falls prevention team and the palliative care team. The manager has made links with the community matron who comes to the home each week to hold a clinic, carry out health checks and deal with minor ailments. They work closely with a local GP practice. This has been running for three weeks now. The community matron was in the home on the second day of the visit and said that: * The system was working well. * Staff listened to and followed instructions and advice given. * They saw residents in the privacy of their own rooms. The manager said that from May 2007 the pharmacy services will be provided by local pharmacist and that the registered nurses and one senior care assistant are part way through a certificated course about medication. Medication records looked at showed the stock received sections were not always completed and that there was no clear record of the stock levels of individuals ‘as required’ medications. The manager dealt with these straight away. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ choices are respected and contact with family and friends is encouraged. EVIDENCE: Residents said that they could receive visitors at any time, and that they could go out with their friends if they wanted to. One resident said that they went out most days, either for a walk locally, or by taxi to a friend’s house. Visitors said that they were made to feel welcome whenever they came to the home. They said that the staff greeted them nicely and kept them up to date with any changes. They said that the home was very friendly and had a lovely atmosphere. Residents said that they can choose how and where to spend their time, either in their own room or one of the communal lounges. They said that they choose when to get up, go to bed, if they join in with any activities and where to eat their meals. The manager said that she does encourage residents to use the dining room for meals to make it more of a social occasion and she has seen that residents are talking to each other and eating a little more. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 13 The homes does not have an activities organiser but steps have been taken to provide residents with some social stimulation. Once a fortnight a guitarist visits to play and sing and every week there is an exercise session and a craft session. Staff spend time with residents when they can which is usually in the afternoons. One resident enjoys listening to talking books and the manager has arranged for audio newspapers to be delivered to the home. The cook said that planned menus are used but she talks to residents to find out what their likes and dislikes are and will alter the meal choices accordingly. A hot trolley is used to keep meals warm for residents who prefer to stay upstairs in the lounges or their own rooms. This will also be used to keep the porridge warm at breakfast time. Residents said that the food was good and they enjoyed their meals. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are confident that their concerns will be listened to, taken seriously and acted upon. EVIDENCE: A complaints procedure is in place. Since the last inspection the home has received two complaints, which have been dealt with to the satisfaction of the complainant. One of these was about a resident who needed support for their legs and the home has provided them with a recliner armchair. Residents and visitors said that they would speak to the manager if they had any concerns and were confident that they would be dealt with. Adult protection policies and procedures are in place along with copies of the local authority adult protection procedures. Not all staff have received training about adult protection or abuse. The manager has completed a ‘train the trainer’ course in this subject and will provide this to the staff who need it. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, tidy, safe and well-maintained home, which is suitable for their needs. EVIDENCE: The home was clean and tidy. Residents said that their rooms were clean. Some of the residents had brought their own furnishings and pictures in order to make the room ‘theirs’. Accommodation is provided in mainly single rooms, none of which are en suite. There are enough communal toilets and assisted bathrooms. There are three communal lounge areas. Two of the lounges have been redecorated and the third was being redecorated at the time of the visit. The dining room has also been redecorated and a laminate floor put down. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 16 Two of the lounges have lovely views of the gardens and areas beyond. The grounds are attractively planted, equipped with garden furniture and are easily accessible to service users. The last fire safety officer’s visit was in August 2006. A copy of the report was sent to the CSCI, which said that the provider had agreed that recommended works would be completed by August 2007. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents could be placed at risk because the recruitment procedures are not thorough or robust. EVIDENCE: Staff rotas showed that there were five on duty in the mornings, four in the afternoons/evenings and two at night. The manager said that she is always on call for advice and support as needed. Residents and visitors said that there were usually enough staff on duty and they did not have to wait too long for calls for help to be answered. On the days of the visit the numbers of staff on duty were enough to meet the needs the twenty residents in the home. The manager said that she would monitor resident’s needs and increase staffing levels if needed. Information provided with the pre inspection questionnaire showed that three of the fourteen care staff employed had achieved an NVQ (National Vocational Qualification) level 2 in care. Individual staff training records are kept. The manager said that she has identified that not all staff have received appropriate training to help them maintain the health, safety and well being of themselves and residents. She has asked staff to identify training sessions they would like to attend and arranged dates for these wherever possible. She is also going to carry out a The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 18 thorough training needs audit to find out who needs what training courses and put plans in place to make sure they are provided. This will include training on meeting residents specialist healthcare needs. she has already made enquiries about training courses on dementia, Parkinson’s disease, diabetes, tissue viability and falls prevention. The manager said that new staff receive an in house induction to the home and its policies and procedures as well completing an induction work book that is to Skills for Care common induction standards. The files for two recently employed staff were looked at, one nurse and one care assistant. These showed that POVA (Protection of Vulnerable Adults) were not in place and enhanced CRB (Criminal Records Bureau) checks had not yet been requested. In one case no references had been received and for the other only one had been returned. The manager was made aware that all appropriate pre employment checks must be in place before staff start to work at the home. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being run and managed in the best interests of residents. EVIDENCE: The manager has been at the home for just over two months. She is an experienced nurse who has worked at another home in the group as the deputy manager and she has already achieved the registered managers award. She will be making an application to become registered with CSCI. Residents, staff and relatives said that the manager was available to them when she was on duty and that she was approachable and supportive. She has met with staff to discuss changes in the management of the home and plans for future training. She said that she is looking at holding a residents and relatives meeting in the near future. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 20 Relatives spoken to during the inspection said that they had noticed changes for the better in the home since the manager started. They said that things seemed more organised and that the staff were paying attention to small details like making sure residents hair looked nice and that they looked smart. The pre inspection questionnaire said that nobody working at the home acts as agent or appointee for any of the residents. The manager said that money is held in safekeeping for some of the residents so that they can get it when they need it. Appropriate records of monies received and returned to residents were seen. The results of the quality assurance survey carried out last year could not be found. The manager said that a fresh survey of residents and their relatives would be carried out in the near future. The pre inspection questionnaire said that all maintenance and safety checks were up to date. The handy man checks the fire alarms weekly and records seen were up to date. Staff training in fire safety will be provided by the manager who has received accredited training in order to do so. The manager said that the handyman would take on the responsibility of checking bedrails and that records would be kept. Accident records are kept but they would benefit from additional information, including the time the accident victim was last seen and by whom, details of the accident, any treatment given and the outcomes of the accident. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 X X 3 The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 22 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 Requirement The manager must make sure that the care plans provide clear detailed information on how to meet individual residents needs. The timescale of 30/07/06 has not been met it was agreed to extend it. 2. OP18 13 The manager must make sure that all staff receive training around abuse and adult protection. The manager must make sure that at least 50 of care staff are qualified to NVQ level 2. The manager must make sure that the recruitment procedures are robust and include making sure that: * Two satisfactory written references are obtained. * Satisfactory POVA checks are in place before offering employment to staff. In these instances employment must be subject to DS0000064293.V314336.R01.S.doc Timescale for action 30/07/07 30/08/07 3. OP28 18 31/12/07 4. OP29 19 21/02/07 The Franklyn (Fezdene Ltd) Version 5.2 Page 23 receiving satisfactory enhanced CRB disclosures. 5. OP30 18 Steps must be taken to make 30/08/07 sure that all staff receive training in order to maintain the health, safety and well being of themselves and residents and to meet the needs of residents living in the home, including specialist healthcare needs such as dementia and Parkinson’s disease. The timescale of 30/08/06 was not met. It was agreed to extend the timescale. 6. OP31 9 The manager must make application to become registered With the CSCI. Steps must be taken to carry out a quality assurance survey to find out the views of residents and their relatives. The results must be made available to interested parties when ready. 30/04/07 7. OP33 24 30/09/07 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. Refer to Standard OP7 Good Practice Recommendations Staff should receive training in writing care plans and appropriate systems put in place to ensure this. (This recommendation was first made in the inspection report dated 29.7.04.) The following details should be documented in either the DS0000064293.V314336.R01.S.doc Version 5.2 Page 24 2. OP38 The Franklyn (Fezdene Ltd) accident record or in individual service users care plan following an accident: a)The time the accident victim was last seen before the accident and by whom. b)Clear and concise details of the circumstances surrounding the accident. c)Details of any treatment given and observations made. If head injury is suspected neurological observations should be carried out. d)Details of any outcomes of the accident. The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 The Franklyn (Fezdene Ltd) DS0000064293.V314336.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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