Care Home: Ferndene Care Home

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What the care home does well What has improved since the last inspection? The manager stated that `the paper work has improved since the last inspection and all training is now up to date and any issues regarding safeguarding of residents is ongoing and I now take advice if I need to`. Those requirements made at the last inspection have been addressed. What the care home could do better: There were no requirements or recommendations made at this inspection visit. CARE HOMES FOR OLDER PEOPLE Fern Dene Care Home Park Springs Road Gainsborough Lincolnshire DN21 1NR Lead Inspector Doug Tunmore Unannounced Inspection 7th April 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fern Dene Care Home DS0000061520.V361889.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. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fern Dene Care Home Address Park Springs Road Gainsborough Lincolnshire DN21 1NR 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) 01427 810 700 01427 810 600 www.executivecaregroup.co.uk Executive Care Management Mrs Joyce Rose MacLennan Care Home 48 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (48), Old age, not falling within any other of places category (48) Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories; Older people, not falling within any other category OP (48). Dementia, over sixty five years of age DE(E) (48). Dementia, over 50 years of age DE(5). Maximum number of service users to be accommodated in the home is 48. 19th November 2007 2. Date of last inspection Brief Description of the Service: Fern Dene Care Home is situated in Gainsborough some twenty miles north west of Lincoln, 20 miles south of Scunthorpe and 15 miles south east of Doncaster. It is a purpose built two-storey care home in its own landscaped grounds. There are shops, a public house, a primary school and other local community amenities near by. The home is on a local bus route and is within easy 5 minutes travel of the centre of Gainsborough. Fern Dene Care Home is newly built, completed in March 2005. The home caters for both male and female residents; there are 19 ground floor and 29 first floor bedrooms, which are accessed by an eight- passenger lift, which is code lock protected on the first floor. All bedrooms are en-suite and exceed the Care Standards size requirements. All bedrooms have TV and telephone points fitted and are fully equipped and decorated. There is a large Entrance Hall and Reception Foyer, which includes a coffee shop for the residents and a fully equipped hairdressing salon. The ground floor accommodates a large fully equipped modern kitchen. The first floor, which is accessed by code locks accommodates a dining area, and two lounges. The home has a loop system for the hearing impaired, grab rails fitted, a call system fitted and ramps for wheelchair users. The fees at the inspection visit on the 07/04/2008 ranged from £378:00 to £500:00 each week. Extras are for hairdressing which range from £4:50 upwards, chiropody £8:00, personal newspapers and magazines. The provider also makes a charge of £5:52 per hour for escorting residents to hospital. Information about the home can be obtained from the manager of the home. The service user’s guide is available from the manager and is kept in the office. Fern Dene Care Home DS0000061520.V361889.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 two stars. This means that people who use this service experience good quality outcomes. One inspector undertook this visit to the home. However, information gained during a previous visit with an expert by experience on the 19/11/07 will be used throughout this report. This formed part of an unannounced key inspection. This visit took into account any previous information held by The Commission for Social Care Inspection (commission) including the homes previous inspection reports and the homes Annual Quality Assurance Assessment form hereafter in this report referred to as AQAA. ‘Have Your Say’ surveys were sent to the home by the commission and four were returned by residents and two from carers. The site inspection consisted of case tracking a sample of two residents records and assessing their care. The inspector joined one resident for lunch and spoke to other residents during the meal. Contact was also made with the Local Authorities Social Services Department and the homes pharmacist was also contacted. The inspector spent time with a resident the registered manager, the activities worker and a carer. A partial tour of the home and a review of a sample of the records were also included. What the service does well: The manager stated that staff work well together as a team and relate well to residents. Previous visits found that a relative who was being supported by the manager had a very good relationship with staff. The expert by experience who accompanied the inspector on a previous inspection found that residents were very complimentary about the care they receive at this home: ‘One resident who is a vegetarian had a pie made for him. He did not eat much of it as he did not like it, but he said that he was given plenty of vegetables, which he likes’. She also found that, ‘Staff were very helpful and thoughtful when helping residents, especially in the upper dining room, where residents needed more assistance’. Another resident stated that they are ‘ looked after well.’ ‘Food is good and sometimes there is a choice.’ Another resident commented that ‘it is good here” and she enjoyed seeing children visiting. (There was a young girl playing in the lounge at the time.) A resident stated at this inspection that ‘its lovely here, the staff are so kind and helpful and the manager is also lovely. I have a choice of meals and staff tell me what is on offer’. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 6 This home provides a pleasant, spacious and clean environment for residents who live here. The décor is of a good standard and a continual re-decoration programme is in place. What has improved since the last inspection? 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. Fern Dene Care Home DS0000061520.V361889.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 Fern Dene Care Home DS0000061520.V361889.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): Standards 1, 2, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive good information about the home, which helps them to make an informed decision about where to live. The clear assessment process assures residents that their needs can be met within the home. EVIDENCE: A review of all information available prior to this inspection and evidence seen at this inspection in residents files and care plans showed that the home does not admit residents without a care assessment being undertaken. Prospective residents are also written to by the home confirming that they can meet the residents care needs or not. The AQAA states that ‘we always complete a full assessment of the needs of all service users and a written confirmation is sent to the prospective service user or their families’. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 9 The commission has received four residents ‘have your say’ surveys. They showed that they had received a contract and had enough information about the home prior to their admission to this home. Written comments were received stating that ‘we received a contract within the first two weeks and I received all the information about the home plus meeting the manager and looking around the home’. The manager stated that there have been no changes in the admission procedures since the last inspection. The home does not provide intermediate care. Fern Dene Care Home DS0000061520.V361889.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): Standards 7, 8, 9, 10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from comprehensive care plans, which accurately reflect their assessed needs. Their personal and healthcare needs are met in a manner that promotes and maintains their privacy and dignity. An accurate record is made of medication given to people so as to ensure their safety. EVIDENCE: We found that those peoples files who were being case tracked contained detailed care plans, which described their health and welfare needs. Care records included admission details, assessments of daily living activities, personal history and moving and handling assessments, risk assessments and daily reports. We also found that annual reviews are held in which they or their representatives are involved. Care plans were seen to have been updated monthly and had been signed by residents or their families acting on their behalf. GPs, community nurses and chiropodists visit the home on a regular basis to attend to the health care needs of residents. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 11 The AQAA states that ‘all service users care plans have a daily living skills care plan, this gives staff guidance on the tasks that service users can achieve within their capabilities’. During a previous visited on the 19/11/07 the manager confirmed that she and two senior carers and two carers undertook training in all care planning, which includes: do’s and don’ts of care planning, accountability, risk assessment tools, risk assessing, writing a care plan and evaluating. During the last visited dated the 19/11/07 the expert by experience met a local G.P. who said that he visits regularly and commented, ‘The staff do not just take care of them, but have friendly banter with them.’ He has 6 patients there. Communication was good between his surgery and the home, with callouts being made appropriately. He felt ‘Fern Dene is well above average’ and he visits a lot of other homes in Lincolnshire. The pharmacist was contacted on the 08/04/08 regarding her visit to the home on the 05/02/08 and its outcomes. The pharmacist felt that there had been a large improvement since her last visit and advice was given to the manager regarding obtaining a new medication book called Handling Medication in Social Care. The inspector found that on this visit the medication sheets were signed for medication given to people on the day of the visit. Surveys received from residents confirmed that three felt that they received the care and support they needed and one stated that care and support is usually provided. They also unanimously felt that staff listen and act on what they say. One written comment from a relative was that ‘mother receives all the care and support she needs’. One resident commented ‘the care and medical support is very good’. The home has a written a policy on giving personal care to residents. Care plans seen reflected that a resident’s dignity and privacy must be maintained at all times. The expert by experience who had previously spoken to a visitor who felt that ‘the care and attention is always excellent.’ Fern Dene Care Home DS0000061520.V361889.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): Standards 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 enjoy a varied and appropriate activity programme, which enables them to maintain an active social life. They are able to choose from a range of foods within a balanced diet. EVIDENCE: The home appointed a new activities organiser in August 2007 who works twenty hours a week and also attends weekend functions. The activities organiser confirmed that she is continuing to provide a programme of activities for residents based on their requests and needs. The AQAA showed that ‘all residents files have a daily living skills care plan, which show the tasks that they can achieve within their capability’. We will try to arrange different activities for residents and respect their wishes if they refuse not to join in’. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 13 The expert by experience noted that there was a large lounge leading off the entrance, where there were armchairs and tables and chairs. Many residents liked to sit in this area as they could see people coming and going. I saw several residents playing dominoes at a table in this area. The area was large enough to accommodate small groups of chairs, so it was more like a hotel lounge, rather than residents sitting in a large circle, as in many residential homes. The expert by experience also recorded that, ‘staff and residents told me that there were regular activities, especially dominoes. There had been a Halloween party and a day when small animals had been brought in for the residents to see and stroke. There were occasional outings. There was always a party for residents’ big birthdays, when they have a cake and a buffet. Family and friends are invited’. On the day of this visited the activities organiser had arranged for bingo, dominos and snap with large cards to be played during the afternoon. The expert by experience noted on the 19/11/07 that ‘the food looked very good and virtually all residents were very complimentary about it’. She visited both dining rooms during lunch. Both were pleasant and well decorated. On the ground floor, the menu on the board was totally inaccurate. It appears that they have a wide choice at breakfast. Tea/ coffee and biscuits are served mid morning and mid afternoon. At teatime, there is a hot meal or sandwiches. Supper is served in the evening. At lunchtime, there was a choice of 2 main courses, but I saw at least 3 people have an omelette, which was additional to the menu. During this visit the inspector joined residents for lunch and positive comments were received about the quality of the food and that there was always a choice. Fern Dene Care Home DS0000061520.V361889.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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures for addressing and monitoring complaints and concerns are in place to protect residents who are vulnerable. Adult protection issues are taken seriously and the manager would seek advice if she had concerns. EVIDENCE: Previous inspections found that there is a complaints procedure and log for recording any complaints. Since the last visit in November 07 there have been no complaints. The providers complaint form also has a space for a complainant to sign or make a comment regarding the way the complaint had been dealt with or not. The Local Authority Social Service Department was contacted by the inspector in relation to a previous investigation relating to an allegation of neglect. It was confirmed by this agency that this issue has been resolved and there are no outstanding concerns but monitoring would continue. Previous inspections have found that the provider has Lincolnshire’s Adult protection procedures, as well as the homes whistle blowing policy. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 15 The training file evidenced that the manager and other staff at this home have undertaken training in the protection of vulnerable adults. The manager commented that staff are now aware that no records are to be changed after any event affecting a residents welfare. Resident’s surveys showed that three of the four knew who to speak to if they were unhappy and one usually did. All four know how to make a complaint. One residents written comment was ‘it was my decision to come into a care home. To me this is my home and I am happy living here’. The providers AQAA confirms that ‘all complaints are dealt with within fortyeight hours. All residents are safeguarded from any sort of abuse all staff have received challenging behaviour training. One resident who was being case tracked confirmed that, ‘I feel so safe, can have the lights on if I want it. I have en-suite bathroom and I have the bathroom light on. The call buzzer is by my bed at night and I only have to press it and staff are here within a minute’. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 16 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): Standard 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy living in the clean, well-decorated, homely and safe accommodation. EVIDENCE: Previous visits have found that the home has a maintenance programme, which is kept by the handyman and relates to those fixtures and fittings, which needs replacing. A tour of the environment by the inspector found that the home was decorated to a good standard. The AQAA states that, ‘we keep the residents in a well maintained environment. We have three cleaners that will continue to keep the home free from odours, as well as tidy’. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 17 Three of the four residents surveys show that the home is fresh and clean, one felt that it usually was. The expert by experience overall observations were that ‘Fern Dene is a very pleasant, spacious and comfortable home’. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a knowledgeable staff team, and residents are protected by robust recruitment and training processes. EVIDENCE: The AQAA evidences that all new staff have Criminal Record Bureau checks before they can start with us. Induction is given with a six-week time scale for completion. All training is recorded in staff training files. Staff levels are reexamined new service users that come into the home and to ensure we are in line with guidelines’. The manager confirmed at this inspection that she is waiting to employ two more carers, which would then enable her to rota on a weekly basis an extra carer from 08:00 am to 11:00 am and from 08:00 pm to 10:00 pm. Previous visits have found that robust recruitment practices are in place, with carer’s personnel files containing those checks required by law and to ensure that resident’s safety is maintained. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 19 Three of the four residents surveys show that staff are available when you need them and one felt that they usually were. Previous inspections have found that all workers in the home have been given the General Social Care councils pack relating to the registration of care workers and the philosophy of the Care Council for all social care homes. The inspector talked to a carer who stated that, She has undertaken induction training plus moving and handling, basic food hygiene, first aid and protecting vulnerable adults training. She said that she is currently undertaking NVQ (National Vocational Qualifications) training at level 2. The AQAA evidences that, all staff are undertaking NVQ (National Vocational training Qualification in working with older people) level 2 or 3. At the time of this visited adequate staffing levels were available to offer support to people when they required it. The staff rota further evidenced that there were enough staff on duty to meet the current needs of residents. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 20 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): Standards 31,33, 35 & 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 generally well managed, and there are good systems in place, which protect the health, safety and welfare of residents. Training for staff is well organised by the manager. EVIDENCE: The manager attended a ‘fit person’ interview with a commission inspector on the 01/02/07 and is now the registered manager of this establishment. She has undertaken the registered managers award and has NVQ level 2 & 3. She Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 21 stated that there is a new NVQ training provider, which is promising. At a previous visit a relative said the home had improved since Joyce (the manager) had arrived. A care assistant who had worked at the home for a year said ‘Joyce is lovely, like a friend to everyone, very supportive’. A carer at this visit confirmed that the manager is very nice and listens to what you have got to say and she is fair. Previous inspections found that there are regular staff meetings where staff can discuss issues openly. The provider undertakes annual relatives surveys with forms to be sent out in the near future. The minutes of the last residents meeting and family meeting were held in February 2008 and showed that residents are encouraged to voice their views and are actively involved in issues relating to the running of the home. The home will assist residents with managing their personal allowances and a record is made of all transactions, which is signed by two members of staff. The manager confirmed that there has been no change in this system since the last inspection. One resident uses a wheelchair belt strap to ensure her safety. A risk assessment and written agreement was available and a visitor confirmed that he had agreed to this practice on behalf of his wife. The providers AQAA showed that; gas safety inspections have been carried out, electrical wiring checks, fire precautions checks, and portable electrical equipment checks. The manager stated that risk assessments are available relating to the home environment. Staff had been trained in Health & Safety, Fire procedures, etc. Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x x 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 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Fern Dene Care Home DS0000061520.V361889.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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