Care Home: Franklyn Lodge

What the care home does well People living in the home are given information that is easy to understand. Their care needs are well assessed and recorded and care plans are reviewed regularly. People get the help and support they need with their personal and health care. People get the medication they need and this is well managed by staff. People working in the home work well with each other and other agencies to meet residents` care needs. What has improved since the last inspection? When we last visited the home in March 2007 we made three requirements to improve staff training and recruitment. During this visit the Manager told us that some vacant staff posts had been filled and staff had completed the training they needed to work effectively with residents. What the care home could do better: Following this visit we have made one requirement and two recommendations to further improve the good standards of care provided in the home. The manager must make sure that a record of staff CRB checks is kept in the home. Staff should make sure that the language they use in written records refers to residents respectfully. The provider should consider recruiting male staff to help meet the care needs of the current residents. CARE HOME ADULTS 18-65 Franklyn Lodge 58 Kings Road London NW10 2BN Lead Inspector Tony Lawrence Unannounced Inspection 17th January 2009 10:00 Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 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 Franklyn Lodge DS0000017458.V373724.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Franklyn Lodge Address 58 Kings Road London NW10 2BN 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 8830 0142 020 8903 9860 Residential Care Services Ltd Rachel Abosede Mojisola Oshowo Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 4 6th March 2007 Date of last inspection Brief Description of the Service: 58 Kings Road is registered to provide a service for up to four younger adults with a learning disability. At the time of this inspection, there were four people living at the home. The home is operated by Residential Care Services Ltd and is one of seven care homes in the group. The home has a registered manager. The home is a terraced property located in Willesden Green, Northwest London. It is close to a range of health and social care facilities plus a variety of shops, public transportation services, leisure, social and religious amenities and services. Two staff are normally on each duty shift and one staff sleeps in as part of the night staffing cover. During the middle of the day from 10am to 3pm the home may be un-staffed. Additional support and professional input is also received from health and social care professionals who are located in the surrounding community. The current weekly fees for the service can be obtained from the provider. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We started this unannounced key inspection on Tuesday 17th January 2009 and went back to the home on Friday 6th February to meet the residents. During these visits we judged the outcomes for residents against the National Minimum Standards for care homes for adults. We did this by talking to the Manager and staff, checking care records and spending time with the residents. The Manager also returned the Annual Quality Assurance Assessment (AQAA) we sent to her a part of this inspection. In the AQAA the Manager told us how the home provided good outcomes for residents. The AQAA also gave us some numerical information about the home. We have used information from the AQAA to help us make judgements about standards in the home. What the service does well: 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. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. People experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The provider has developed clear information that helps people understand the services offered in the home. Admissions are not made to the home until a full care needs assessment has been undertaken. EVIDENCE: ‘We always get our service users involved during the assessment process. We ensure that whenever we get a referral from the placing authority we always gather as much information about the service users as possible’. Extract from the provider’s Annual Quality Assurance Assessment (AQAA). During this visit we saw that the provider had produced a Service User Guide that gave residents and other people important information about the home. The Manager must make sure that details in the Guide of staff working in the home are regularly updated. We also checked the care plan files of two people to see how they had been referred and moved into the home. One person had lived in the home since 1995 and the care plan file included a copy of a contract that detailed the main terms and conditions of residence. The contract had been produced in an easy read format, using a photograph of the resident and other pictures to make the information easier to understand. The person’s original care needs assessment was not available, but we saw good evidence that their care plan had been regularly reviewed and updated. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 8 The second person moved in during October 2008 and the care plan file included a copy of a detailed care needs assessment. The assessment had been well completed by a local authority social worker in October 2008 and included the person’s main care needs and how these should be met in the home. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service involves people in planning the care that affects their lifestyle and quality of life. Care plans include comprehensive risk assessments. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. EVIDENCE: ‘We always plan service users’ care according to their assessed needs and their care plans. We ensure that care packages for service users are individualised as well as practical and that they meet service users’ needs’. Extract from the provider’s Annual Quality Assurance Assessment (AQAA). During this visit we reviewed the care plans and risk management plans for two people living in the home. Both care plans were dated October 2008 and staff had made good use of pictures and photos trop make information easier for residents to understand. We saw that people’s care plans covered all aspects of their health and social care and there was good evidence that people had been involved in writing their own plans. Both plans included realistic and achievable goals covering a range of issues, including independent living skills, personal care and the management of challenging behaviours. We saw evidence that the plans were regularly reviewed. For one person who had Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 10 lived in the home since 1995 we saw evidence of two reviews each year. One review was carried out by staff working in the home and the other by staff with contributions from the relative’s family, day services and local authority care manager. Both of the care plans we saw considered the person’s cultural and religious needs and how these would be met in the home. We did see one example of inappropriate language used in one care plan. Staff should make sure that residents are always referred to respectfully in written records. We also saw that staff had completed clear risk assessments and risk management plans for each of the people we reviewed during this visit. The risk assessments and plans had been completed in October or November 2008 and covered appropriate areas, including vulnerability when out of the home, use of the bathroom, challenging behaviours and road safety. We saw that the plans included clear guidance for staff on how risks should be minimised for each resident. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. People experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are involved in meaningful daytime activities of their own choice and according to their diverse needs and capabilities. People who use the service have the opportunity to develop and maintain important relationships. EVIDENCE: ‘I like going to college, I’m doing a Foundation course and I want to do my ‘A’ Levels’. Comment from a resident. ‘I went to church today. They have drums, a guitar and keyboards’. Comment from a resident. ‘My mum visits me every week’. Comment from a resident. ‘We give as much support to service users to ensure that they live and enjoy meaningful lives. We ensure that staff prepare healthy and balanced diets that reflect their religious and cultural needs’. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 12 Extract from the provider’s Annual Quality Assurance Assessment (AQAA). During this visit we checked the daily care notes kept by staff to see how people were supported to take part in activities. We saw evidence that all four people living in the home went to adult college courses or day services for all or part of each week. One person whose care and support we case tracked during this visit went to a basic skills course at a local adult college for four days each week. The daily care notes showed us that staff from the home worked with this person to go shopping and have lunch locally every Friday. The second person we reviewed went to Franklyn Lodge’s own day service for five days each week. We saw good evidence from the daily care records that staff supported people to help with shopping, cooking and cleaning tasks. People were also supported to go to social clubs, shopping trips, the cinema, local pubs and cafes. One person also went to a local church every Sunday. We saw that details of both resident’s relatives were well recorded as part of their care plans, although one person did not have any contact with their family. The second person’s daily care notes showed us that staff supported them to have regular phone contact and visits with their family. Residents’ care plans showed us that each person living in the home was registered to vote in local and general elections. Staff told us that they would support people to go to the polling station if they wanted to vote. We saw that the home had a pleasant dining room where people could choose to eat their meals. The home’s menu book showed us that residents had a varied and nutritious diet, including Indian or Caribbean meals two or three times each week. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s healthcare needs are well recorded and act as an indicator of change in health requirements. Personal support is responsive to the residents’ varied and individual needs and preferences. EVIDENCE: ‘We ensure that service users get adequate support with their personal care. They have the choice of who to support them with personal hygiene. We have good medication policies and procedures in place to prevent malpractices associated with medication’. Extract from the provider’s Annual Quality Assurance Assessment (AQAA). During this visit we saw that the personal care needs and preferences of the two people whose care we reviewed were well recorded and regularly reviewed as part of their care plans. The care plans detailed what each person could do for themselves and the support that they needed from staff. Some of the goals in the care plans we saw aimed to maximise individual’s independence in meeting their personal care needs. We also saw that people’s care plans included details of their health care needs and how these would be met by staff in the home and other organisations involved in their care. One person with mental health needs had a separate care plan developed by all of the agencies responsible for their care and we Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 14 saw that this had been reviewed and updated last in November 2008. Both of the care plans we checked included good information about each person’s appointments with clinicians, including their GP, dentist, chiropodist and optician. During this visit we reviewed the home’s management of residents’ prescribed medication. We found that all medication was securely stored in a lockable cabinet in the staff sleep in room. We checked the Medication Administration Record (MAR) sheets for each resident and saw that these were well completed and up to date. Two staff signed these records each time prescribed medication was given to a resident. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure that is clearly written and easy to understand. The policies and procedures for safeguarding adults are available and give specific guidance to those using them. EVIDENCE: ‘Service users and their next of kin are aware of our complaints procedure and a copy is displayed in their rooms. Ours staff receive training in POVA every 2 years. We also have a whistle blowing policy in place to ensure that reports of any concerns or allegations are expressed’. Extract from the provider’s Annual Quality Assurance Assessment (AQAA). During this visit we saw that the provider’s complaints procedure was included as part of the Service User’s Guide that was given to each resident as part of the home’s admission procedures. The Manager told us that each resident’s key worker would explain the procedures and support people to use them, if required. We checked the home’s complaints record and saw that there had been no formal complaints since our last visit. We also saw that the home had a copy of the local authority’s safeguarding adults policy and procedures for staff to use. Information from the provider’s Annual Quality Assurance Assessment (AQAA) was evidence that there had been no safeguarding adults investigations or referrals since our last visit. The AQAA also showed us that staff working in the home had completed safeguarding adults training. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30. People experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The home is a pleasant, safe place to live. EVIDENCE: ‘I’ve got all my things in my room, my drums, my TV and DVD’s and my bed’. Comment from a resident. ‘We ensure that the home is kept clean and tidy and ensure that the physical environment is conducive to service users. We also promote privacy for service users and ensure that the place is a homely environment’. Extract from the provider’s Annual Quality Assurance Assessment (AQAA). 58 Kings Road is a terraced property located in Willesden Green, Northwest London. It is close to a range of health and social care facilities plus a variety of shops, public transportation services, leisure, social and religious amenities and services. The home has one bedroom on the ground floor plus a shared lounge / dining room, kitchen, laundry room and shower room / WC. There are three bedrooms and a bathroom on the first floor and the staff office is in the Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 17 converted loft. The home has a pleasant garden and meter parking is available on surrounding streets. During this visit we saw all communal parts of the home and the four residents’ bedrooms. The shared areas were spacious, comfortably furnished and well decorated. The four bedrooms were very individual and had been well personalised by residents supported by staff. All parts of the home that we saw during this unannounced visit were clean and hygienic. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. People experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are enough staff available to meet people’s care needs, with more staff being available at peak times of activity. The staffing structure is based around delivering outcomes for residents and is not led by staff requirements. EVIDENCE: ‘The staff are good, they help me with things’. Comment from a resident. ‘We ensure that staff are carefully vetted before they work. We have a robust recruitment process and we provide adequate training for all staff’. Extract from the provider’s Annual Quality Assurance Assessment (AQAA). When we arrived for the first day of this inspection, the home’s Manager was on duty. All four residents had already left for their day services or adult college courses and the morning staff had finished their shift. We checked the home’s rota that showed us there were usually two staff on duty from 07:00 – 10:00 and from 15:00 – 22:00. One member of staff slept in the home at night to support residents if needed. As all four residents were out of the home each day between 10:00 – 15:00 these levels of staffing were appropriate to meet their assessed care needs. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 19 We saw that the Manager had a good record of training completed by staff. This showed us that all permanent staff had completed the training they needed to work effectively, including fire safety, food hygiene, health and safety, safeguarding adults and manual handling. One member of the staff team had completed their National Vocational Qualification (NVQ) Level 2 training and another had completed their NVQ Level 3 training. The Manager told us that the provider had completed Criminal Records Bureau (CRB) checks for all permanent and bank staff that worked in the home. The provider must make sure that a record of the staff CRB checks is kept in the home. We noted that all of the permanent staff working in the home were female and all of the residents were male. When there are staff vacancies, the provider should consider recruiting male staff to help meet the care needs of the current residents. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41, 42 and 43. People experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The Manager has the required experience and qualifications and is competent to run the home. The AQAA contains clear, relevant information that is supported by s arrange of evidence. EVIDENCE: ‘We ensure that the service we provide meets the needs of service users and also there is effective day to day management of the home’. Extract from the provider’s Annual Quality Assurance Assessment (AQAA). The Manager told us that she had worked at Kings Road since 1999. She became the deputy manager on 2001 and had been the manager since 2007. She had completed her National Vocational Qualification (NVQ) Level 4 Registered Manager’s Award and we saw good evidence that she also regularly updated her own training and professional development. We have registered the manager as a fit person to manage a care home for people with a learning disability. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 21 Quality Assurance? We saw evidence from the provider’s Annual Quality Assurance Assessment (AQAA) that all of the policies and procedures required to meet the National Minimum Standards had been developed and regularly reviewed. During this visit we checked a selection of care records kept in the home, including residents’ care plans and risk assessments, staffing and health and safety records. Standards of record keeping were good. The health and safety records we saw during this visit were all up to date. We also saw copies of reports sent to the home by the provider after unannounced monthly visits to monitor the day-to-day running of the home. The reports were well completed and included action points to make sure that issues identified during the visits were resolved by the provider or other agencies. Franklyn Lodge DS0000017458.V373724.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 Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 3 3 3 3 Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA34 Regulation 19 Requirement The manager must make sure that a record of staff CRB checks is kept in the home. Timescale for action 30/04/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA35 Good Practice Recommendations Staff should make sure that the language they use in written records refers to residents respectfully. The provider should consider recruiting male staff to help meet the care needs of the current residents. Franklyn Lodge DS0000017458.V373724.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Franklyn Lodge DS0000017458.V373724.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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