Care Home: Alexandra Park Home

Similar services:

• Ashlong House
• Henry Nihill House
• Birchwood
• The Infirmary
• Townley Road, 2-3
• Orchard House Nursing Home
• St Josephs Rest Home
• Foxley Lane (121a)

What the care home does well What has improved since the last inspection? What the care home could do better: Three new good practice recommendations have been issued as a result of this inspection. The manager should check training records for all staff and book staff on refresher training where needed. This should ensure that all staff are up to date with current best practice. When the manager writes to referees requesting a reference for new staff, he should ask for a company stamp or letter headed paper to be enclosed to further authenticate the reference. The manager should look into providing more training for staff about mental health issues that are experienced by residents living at the home. Key inspection report CARE HOMES FOR OLDER PEOPLE Alexandra Park Home 2 Methuen Park Muswell Hill London N10 2JS Lead Inspector Mr David Hastings Unannounced Inspection 2nd June 2009 09:00 DS0000010757.V375467.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra Park Home Address 2 Methuen Park Muswell Hill London N10 2JS 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 8883 5212 020 8883 5212 FP Mr David Weston Mr David Weston Care Home 15 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (15), Old age, of places not falling within any other category (15), Physical disability over 65 years of age (8) Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Limited to 15 people of either gender who fall into the category of old age (OP) and of whom no more than 8 people may be accommodated on the ground floor may also have a physical disability (PD(E)) One specified service user who has dementia may remain accommodated in the home. The home must advise the regulating authority at such times as the specified service user vacates the home. 10th June 2008 Date of last inspection Brief Description of the Service: Alexandra Park Home is a care home for fifteen older people some of whom may have mental health problems, up to eight people may be accommodated on the ground floor may also have a physical disability and one specified service user who has dementia. There are nine single bedrooms and three shared rooms. No bedrooms have en suite facilities, although there are a number of toilets plus two bathrooms. Alexandra Park Home is not purpose built and comprises of a large converted house with an extension on the ground floor. The home is situated in a quiet residential area of Muswell Hill and is not far from local shops, other amenities and Alexandra Park. Transport links are very good. The home’s stated aim includes “That resident rights are at the top of our care philosophy. We will advance these rights in all aspects of the home and encourage our residents to take part fully in decision-making’. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. The current scales of charges are from £400 to £600 per week. Other additional charges include hairdressing, chiropody, newspapers and magazines. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This Key Unannounced inspection took place on Tuesday 2nd June 2009 and was completed on the same day. The inspection lasted six hours. We spoke with five staff on duty during the inspection. We spoke with eight residents of the home and we observed the interactions between staff and residents. We inspected the building and examined various care records as well as a number of policies and procedures. Prior to this inspection we sent out surveys to both staff and residents. We received nine surveys back from staff and seven surveys from residents. Comments were generally very positive about the care provided at the home. The home also prepared a self–assessment (AQAA) and this was submitted to the Commission for Social Care Inspection in April 2009. This information was used as part of the inspection. What the service does well: The home had a relaxed and friendly atmosphere. There is a good rapport between residents and staff. People who use the service are treated with respect and their dignity and privacy is valued and upheld. Staff demonstrated a good knowledge of residents needs and consequently an individualised service is promoted. Residents have good access to health care professionals. The home makes sure that people’s needs are assessed before they move in so that people know the home will be able to meet their needs. Residents of the home feel that the staff are kind and polite and support them properly. Residents told us; • • • • • “I’m doing fine”. “On average the home does everything well”. “The home is honest. I like the company here”. “So far it is nice. People are nice and the food is nice”. “They do all the things well”. What has improved since the last inspection? Eight requirements and four good practice recommendations were issued at the last inspection. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 6 The registered manager has now complied with all of these. The manager and staff have worked very hard to improve the service and as a result: • • • • • • • Residents are able to express their views about the quality of care they receive and make suggestions about improvements to the service. Recruitment practices are more robust so residents are protected from unsuitable staff working at the home Procedures in relation to residents’ finances have been reviewed and improved. Fire safety at the home has improved. Infection control measures have been improved so the risk of cross infection has been reduced. The manager keeps the Commission informed about how residents are doing at the home. Information given to prospective residents has been reviewed and is clearer and easier to read. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Alexandra Park Home DS0000010757.V375467.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 Alexandra Park Home DS0000010757.V375467.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have accurate information about the home in order to make an informed choice about where to live. The home carries out an assessment of individual’s needs so that they know that the home is able to meet their needs before they decide to move in on a trial basis. EVIDENCE: We examined the home’s “Service User Guide”. This document describes the aims and objectives of the home and the facilities available to people coming into the home. This document also informs social workers looking for placements for people. Following a recommendation we made at the last inspection, the guide has been updated and is now written in large print so it is easier to read. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 9 This document clearly describes how the needs of people from different backgrounds and cultures will be met. Since the last inspection one new resident has been admitted to the home. This assessment was detailed and clearly outlined the person’s individual needs and preferences. There was also information from the placing authority. The deputy manager told us that the resident had visited the home on several occasions and that the placement had been closely coordinated by the home and the placing authority to make sure that the home was right for the resident. We also saw evidence that people have a review of their placement after 4-6 weeks to see if they would like to stay at the home on a permanent basis. Alexandra Park Home DS0000010757.V375467.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans clearly set out residents’ health, personal and social care needs so that staff know how best to support everyone at the home. Residents have good access to health care professionals and they are treated with respect. Residents get the medication they require, at the right times and by appropriately trained staff. EVIDENCE: Five care plans were examined. Each plan had a detailed description of the person’s care needs including their physical, emotional and social needs. Each plan gave clear instructions to staff about how best to care for each person. Risk assessments were being carried out in relation to fire safety, pressure care and other risks associated with the individual’s mental health. These plans were very person centred and concentrated on the person’s remaining strengths and abilities as well as their care needs. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 11 Work has been undertaken to gain a social history of residents so that staff can have an insight into what the person was like before they moved into the home. Visits by health care professionals such as doctors, district nurses, community psychiatric nurses, chiropodists, dentists and opticians were being recorded on plans we examined. These showed that people had good access to these professionals. This was also confirmed by residents we spoke with. Care plans were being reviewed and there was evidence that residents are now involved in these monthly reviews. On the day of the inspection residents appeared relaxed, appropriately dressed and well cared for. The deputy manager told us that the home has recently changed their pharmacist and satisfactory records and procedures were examined in relation to the receipt, storage, administration and disposal of medication. Staff told us that the new monitored dosage system was much clearer and easier to use. Records indicated that staff have undertaken medication training and only qualified staff administer medication at the home. We saw a number of examples of supportive staff interactions with people and staff were able to describe to us how they ensure the privacy of people they support. We saw staff knocking on resident’s bedroom doors before entering. People we spoke with told us that the staff were respectful and kind towards them. Alexandra Park Home DS0000010757.V375467.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides varied activities for people who use the service in order to keep them suitably occupied and engaged. Visitors to the home are encouraged and welcomed. Residents are able to exercise choice and control over their lives. The home provides people with a wholesome appealing balanced diet. EVIDENCE: The hairdresser was visiting in the morning and a number of residents were having their hair done. The manager told us that the activities coordinator had left the home and that he would be employing a new activities worker in the near future. There is a visiting occupational therapist who comes to the home every week. Staff were seen engaging with residents when they had time and residents seemed to be occupied with reading papers, playing cards and chatting. The manager and staff told us that they take residents out to the local shops or for a walk. More mobile residents are able to go out of the home and have appropriate risk assessments in place. People told us that they did go out of Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 13 the home and records we examined confirmed this. The manager said that he organises trips out to Alexandra Palace, which is near by. Residents are able to access places of worship of their choosing. Residents told us that they could have visitors at any reasonable time and the manager confirmed that the home has an open visiting policy. He also said that most residents at the home have visitors. We saw the visitors’ book, which confirmed that people could visit at any reasonable time. Residents said that visitors were encouraged. Following a recommendation we made at the last inspection residents now have regular meetings to discuss general issues about the home and to suggest improvements to the service. There was evidence that people are involved in deciding the menus for the home. Residents told us they could have a say in how the home is run and could choose what to do with their day. The kitchen was inspected. Fridge and freezer temperatures were being recorded and there were sufficient amounts of fresh fruit and vegetables available. The cook was interviewed and had an excellent knowledge of individual resident’s dietary needs and preferences. The meals we saw on the day of the inspection looked and smelt appetising. People who use the service confirmed that the food was good at the home and that they always get enough to eat. Alexandra Park Home DS0000010757.V375467.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are taken seriously and responded to in a professional manner. People at the home are protected from abuse by clear policies and procedures and by an appropriately trained staff team. EVIDENCE: The home has a satisfactory complaints procedure and people we spoke with said they had no complaints but would speak to the manager if they did. One person told us, “I’m not one to suffer in silence. I have nothing to complain about”. Staff were able to describe how vulnerable people could be at risk of abuse in a residential care setting. All staff interviewed were clear of their responsibility to report any suspicions of abuse to the appropriate authorities. Residents that we spoke to said they felt safe and well supported at the home. The home has a satisfactory policy and procedure in relation to safeguarding vulnerable people. Records indicated that staff have undertaken training in the protection of vulnerable people. Alexandra Park Home DS0000010757.V375467.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well maintained and furnished and decorated to a good standard. EVIDENCE: The deputy manager showed us around the home and we met with some residents in their rooms. The home was clean and fresh. People we spoke to said the home was always clean. The home employs domestic staff. The water temperatures of wash hand basins in peoples’ rooms were checked and found to be within safe limits. Bathrooms and toilets were clean and all contained anti bacterial soap and paper towels to limit the risk of cross infection. The deputy manager told us that some rooms were being refurbished and new windows have been fitted in a number of rooms. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff at the home work hard to meet the needs of the residents and are provided with good training opportunities to further enhance their knowledge and skills. Recruitment practices are sufficiently detailed in order to protect residents at the home. EVIDENCE: Two care staff are on duty throughout the day and two waking night staff are on duty throughout the night. Residents we spoke with were positive about the staff. One person told us, “The staff are very nice”. Staff turnover at the home is low and staff said that staff morale is high. Staff were very positive about the training offered to them by the home. Most staff have completed their NVQ level 2 or equivalent and appropriate training certificates were seen on staff files we examined. We did notice that some training certificates were out of date and some staff need refresher training. A good practice recommendation has been issued that the manager carry out a training audit for all staff. Any gaps in training needs should then be addressed and further training booked. Staff informed us they found the training about mental health issues particularly useful and relevant to their job. Some staff Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 17 told us that would like more of this training to further improve their knowledge and skills. A good practice recommendation has been issued relating to this. Five staff files were examined from staff employed by the home. We checked these files to see if the home’s recruitment procedures were being followed so that residents are protected from unsuitable staff working at the home. The files examined contained all the information needed to protect residents including two written references, proof of identity and criminal record checks. This was a requirement from the previous inspection that has now been complied with. There has been considerable improvement in the systems for recruitment at the home. Some references had a company stamp or letter headed paper attached to further confirm its authenticity. We suggested that when the manager writes off for references he includes a request for a letter headed paper or a company stamp. A good practice recommendation has been issued relating to this. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager of the home knows the residents very well and understands their needs. Residents have opportunities to have a say in how the home is run. Residents’ financial interests are being safeguarded. The health and safety of residents and staff are promoted and protected. EVIDENCE: Both residents and staff were very positive about the registered manager, Mr David Weston. Staff told us that the manager was very approachable and that he had a good rapport with staff and residents. One staff member told us, “He helps us, he is interested”. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 19 It was clear from discussion and from observation that the manager understands the needs of people with mental health problems. The manager is a qualified Mental Health Nurse. Since the last inspection the manager has made sure that all the requirements and recommendations we have made have all been complied with. A requirement was restated at the last inspection regarding quality monitoring systems at the home. The service has now implemented a clear quality monitoring process. Surveys are sent to residents and other stakeholders twice a year. Information is then collated and published with a clear action plan of improvements needed. Residents now take part in regular meetings so they can express their views about the service. Since the last inspection policies and procedures in relation to residents’ finances have been reviewed. The manager now only holds money for one resident who requires help and assistance with their finances. Receipts were being maintained and accurate records were being kept with clear audit trails. The manager told us that he would buy residents items and invoice their relatives or representatives on a regular basis. Records in relation to fire safety were examined. The home has a satisfactory fire alarm certificate and the fire alarm is being checked weekly. Both day and night staff are undertaking regular fire drills. Residents have an individual fire evacuation plan so that staff are aware of what help people need to evacuate the home in the event of a fire. The manager is regularly checking the fire escape to make sure it is safe. Staff are attending various health and safety training but as mentioned elsewhere in this report some refresher training will need to take place. The certificates were in place to confirm the gas system and portable electrical appliances had been serviced. A satisfactory electrical installation certificate was also seen. The current insurance certificate was displayed and was satisfactory. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. 1. Refer to Standard OP30 Good Practice Recommendations The manager should check training records for all staff and book staff on refresher training where needed. This should ensure that all staff are up to date with current best practice. 2. OP30 The manager should look into providing more training for staff about mental health issues that are experienced by residents living at the home. 3. OP29 When the manager writes to referees requesting a reference for new staff, he should ask for a company stamp or letter headed paper to be enclosed to further authenticate the reference. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 22 Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 23 Care Quality Commission London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Alexandra Park Home DS0000010757.V375467.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!