Inspection on 26/04/06 for Bank House Nursing Home

This inspection was carried out on 26th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bank House Nursing Home 15/09/08

Bank House Nursing Home 01/08/07

Bank House Nursing Home 15/11/05

Bank House Nursing Home 20/12/04

Bank House Nursing Home 26/04/04

Bank House Nursing Home 18/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Bank House Nursing Home Shard Lane Hambleton Near Blackpool Lancashire FY6 9BX Lead Inspector Mrs Christine Marshall Unannounced Inspection 26th April 2006 08:00 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 Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 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. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bank House Nursing Home Address Shard Lane Hambleton Near Blackpool Lancashire FY6 9BX 01253 701635 01253 701751 ogdenv@bupa.com www.bupa.co.uk BUPA Care Homes (Partnerships) Limited 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) Mrs Vivien Ogden Care Home 50 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (35) of places Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is registered for a maximum of 50 service users to include; up to 35 service users in the category of OP (older people over the age of 65 years) up to 15 service users in the category of DE (dementia) five named persons under the age of 65 years within the maximum number of 50 The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 15th November 2005 2. Date of last inspection Brief Description of the Service: Bank House Nursing Home is situated within its own grounds, very close to the village of Hambleton, where there are shops and local facilities such as a garage and a public house. The home provides accommodation for 50 people and offers nursing and dementia care. There is a Statement of Purpose, Service Users Guide and Information Pack that is given to all prospective residents; this is a set of written information that tells you about the care service that is offered, who the owners, manager and staff are and what the resident can expect if he or she decides to live at the home. The most recent inspection report is available in the reception area of the home. At the time of this visit, (26/5/06) the information given to the Commission showed that the fees for care at the home are from £350 to £550 per week, with added expenses for hairdressing, chiropody and newspapers. All accommodation is in single bedrooms that meet the minimum space requirements. Each room is furnished to a good standard. Nine bedrooms have en-suite facilities. There are adequate bathrooms and toilets throughout the home. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 5 The home comprises of ground and first floor accommodation and the lounge and dining areas are decorated and furnished to a good standard. There are three dining/lounge areas, two on the general nursing unit and one on the dementia unit. There is a passenger lift and wheelchair access throughout the home. The gardens are well maintained. There is adequate car parking space. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This is the first of two unannounced inspection visits, scheduled from 1st April 2006 to 30th March 2007. All of the people spoken to and who were able at the home said that they preferred to be called residents. This unannounced inspection took place over two days and was carried out by the home’s designated lead inspector Christine Marshall. A tour of the home included bedrooms, lounge and dining areas, and bathrooms. All areas were clean, hygienic and pleasantly furnished: Administration records were also examined. The first day of the inspection was spent on Garden Court dementia unit, speaking to residents, their relatives and staff. The second day was spent on the general nursing unit of the home, speaking to residents and staff and looking at administration records. The manager completed a pre-inspection questionnaire before this key inspection visit and comment cards were received from residents, relatives and visiting professionals. The manager, nurses and care staff were spoken to and their responses are to be found in the body of this report. Everyone was very friendly, welcoming and co-operative throughout the visit. What the service does well: Bank House provides a pleasant environment for the people who live there. There is a generally relaxed atmosphere throughout the home. The lounges and dining rooms on the general nursing unit are homely. The fabric and furnishings are of a good standard and the home is kept clean and hygienic. The staff are friendly in their approach to care and the residents who were able said that the staff were all kind and caring. Observation of staff practice showed that there is a very good interaction between carer and resident. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 7 Daily routines for the people living on the general nursing unit of Bank House are flexible and the residents’ personal routines and lifestyles are respected; there is a very varied social activities programme in place in this part of the home. A small number of residents on the nursing side of the home were able to make comments such as “Everything is very nice.” “I have no complaints.” What has improved since the last inspection? What they could do better: Garden Court activities and mealtime routines again must be reviewed. Although there has been a good deal of improvement in the daily routines of this unit, there were still areas for improvement that are needed to promote equality and diversity for the residents. This has been raised in previous inspection reports and must be addressed as a matter of priority. Basic staffing levels were provided on the general nursing unit of the home, however there was not enough staff on Garden Court to give the care that is needed by the residents, particularly during the morning and periods of increased activity such as meal times. This has been raised in previous inspection reports and must be addressed as a matter of priority. Training in dementia care is still not given to all staff that work on Garden Court and again, this is needed to make sure that the residents on this unit have the care and understanding that they need to promote a good quality of life for them. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 8 This has been highlighted in the previous two inspection reports and must be addressed as a matter of priority. The home still does not have the 50 National Vocation Qualification (NVQ) trained care staff. This has been highlighted in previous reports and must be addressed to make sure that the carers are competent in their knowledge, practise and understanding of caring for older and vulnerable people. 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. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 9 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 Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 & 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Anyone who is considering entering Bank House is supplied with enough information to help them make that decision. The home also gathers enough information about that person to ensure that their needs can be met. This means that people can make good choices and receive the care they require. EVIDENCE: The home’s Statement of Purpose and Service Users Guide is a set of written information that tells you about the care service that is offered, who the manager and staff are, and what the resident can expect if he or she decides to live at the home. This has been reviewed and updated and copies put in every residents bedroom. This information is also available in the reception of the home. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 11 Some residents and relatives said that they knew about this information. Although the staff said that knew about the Service Users Guide and Statement of Purpose, some were unable to describe what was actually in this information. This means that they were not clear about the provision of care that they were giving to the residents. Pre-amission assessments were looked at and were completed satisfactorily. Two visiting relatives said that they had been invloved in a pre-admission assessment with their parents/spouses and the home. Contracts of care were also in place and signed by either the resident or their advocates. This means that residents know what to expect from the home and what is expected of them. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents health and social care needs are mostly met and people are treated with dignity and respect at this home. Residents are mostly supported and protected in their daily lives. EVIDENCE: Care plans on the general nursing side were reviewed and were satisfactory, reflecting the care that was being given. Care staff said that they knew about the care plans and that these generally reflected that care that was being given to each person. Two residents were able to say that they knew about their care plans and that they had signed them. Care plans on Garden Court were in place and mostly satisfactory, but some were in need of monthly reviews and did not fully reflect the actual care that was being given. Health care opportunities are offered to all residents and there are records of GP, chiropody and physiotherapy visits. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 13 The medication system at the home has been changed and is now a monitored dosage system (MDS). Records were satisfactory with the exception of Garden Court where one signature was crossed out. General advice was given about storing creams and medications in the fridge and also the recording of redundant flu vaccines from the GP. It is recommended that the medication room temperature is recorded daily, to make sure that creams and lotions are stored at the right temperature; otherwise the system is operated satisfactorily. The residents were generally treated with respect, privacy and dignity, but on Garden Court there were still areas of personal choice that needed to be addressed; for example residents getting up late in the morning due to staff levels being poor. All of the residents spoken to on the general nursing unit of the home said that they were satisfied with their environment and care. The residents on Garden Court were unable to fully speak for themselves and relatives spoke on their behalf. There were three visiting relatives available on Garden Court, who said that they were happy with the carer’s approach, however they did express concerns at the levels of staffing, particularly during meal times at the weekend. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The residents throughout the home are not full supported so as to promote the quality of their daily lives. EVIDENCE: The quality outcome for this area of care is assessed as poor due to the lack of social activities and poor mealtime routines on Garden Court. There were good activities programmes for the residents on the general nursing side of the home, but there remained a major shortfall of activities for those on Garden Court dementia unit. Only two residents from the unit were taken to the coffee morning that had been arranged on the day of inspection. Nothing was in place for the other 11 residents living on the unit. Staff said that there was no suitable activities programme for the residents and relatives also said that this was lacking. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 15 All residents seem to be supported in their contact with the community, although this is limited for those suffering with dementia. The general nursing side of the home provides very good meal choices, dining area and mealtime routines. However, there is an inequality of care for the residents on Garden Court, who were not fully supported, supervised and helped with their meals; they were not offered condiments, soft drinks or water until this was requested. One resident was given an inappropriate diet (not the soft food that her care plan indicated) and another was not fully supervised or helped with her meal even though the care plan indicated a dramatic weight loss: there was no evidence of a supplementary drink being offered and the member of staff who was helping her was busy with two other residents and not able to give the attention and help that the resident needed to promote and encourage good nourishment. The meals were served hurriedly and three relatives were helping to give food and said that they visited at lunchtime to help with their loved ones’ meal. Staffing levels during this time were inadequate to support the needs of the residents during the mealtime and the routine of giving meals to the residents on this unit must be reviewed. This has been required on previous inspection reports and must be addressed as a matter of priority. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s policies, procedures and practice make sure that residents are supported and protected. EVIDENCE: There are policies and procedures in place for complaints, whistle-blowing and adult abuse issues, and staff said that they were aware of these. Residents and relatives also confirmed that they knew about the complaints policy and had no complaints to offer. Training files showed that all staff have had abuse awareness training. There has been one allegation made at the home since the last inspection visit and this has been dealt with through the Social Services Adult Protection Protocol; the allegation was found to be unsubstantiated. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are provided with a comfortable, clean and hygienic environment and bedrooms were personalised. This means that residents will feel at home with their belongings around them. EVIDENCE: A tour of the home showed that the general environment was good; furnishings were very comfortable and aids and adaptations are in place to help with the residents’ mobility and personal toilet and bathing needs. Bedrooms are personalised and comfortable and three residents were able to say that they were happy with their room. Visitng relatives said that they were happy with the standards of cleanliness at the home and comments cards that were received agreed with this. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 18 The laundry area was clean and hygienic. A refurbishment programme is in place to maintain the environment, furnishings and fittings. The post of maintenance person is currently vacant and interviews are being held within the next week or so. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents are protected through good recruitment procedures but staffing levels do not meet the residents needs. EVIDENCE: The quality outcome for this area of care is poor because although the general nursing unit of the home was adequately staffed, Garden Court staff provision was low and the staff were not able to give the care that the residents needed. Staff on duty on the dementia unit said that they did not have enough time to attend to the needs of their residents and that there were concerns about the lounge area being left unsupervised. It was observed that there were frequent periods of non-supervision of the residents in the lounge on this unit. Two residents were not able to get up because of staff breaks and morning drinks round. One resident was disruptive and exhibiting exreme behaviour towards other residents and was unsupervised for over ten minutes until staff came into the lounge area: this happened throughout the morning. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 20 There was no time for staff to promote social activities or personal activity of any kind. The lunch mealtime was disorganised with the staff struggling to assist the residents, some of whom needed one-to-one help. Three relatives were assisting their loved ones which lessed the pressure on the staff. One resident was served with an inappropriate meal and when a member of staff was informed of this, she merely tried to mash the meat rather than get a soft diet as was specified in the care plan. It seemed that she was too busy to go to the kitchen to change the meal. All of the staff that were spoken to throughout the home said that they did not feel that there was enough staff on Garden Court to enable them to supervise the lounge, do their duties and give the care that is needed by the residents. There is an inequality of care within Garden Court in that staff levels are low and training programmes do not fully equip the carers and nurses with the knowledge that us needed to attend to the dementia residents’ needs. There are still shortfalls in National Vocational Qualifications (NVQ) at the home. The percentage remains below 50 . The manager said that this was an ongoing problem and that she was currently enrolling staff on the training programmes. All records that were examined in the staff recruitment files were satisfactory and staff siad that they had undergone all of the employment checks before starting work at the home. All staff training records that were examined showed that induction and training and the mandatory health and safety training programmes were in in place. However not all of the staff who work on Garden Court had had dementia training. This shortfall has been raised in previous inspection reports and must be addressed as a matter of priority. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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 residents are supported by an experienced manager and there are quality systems in place to make sure that they are protected. EVIDENCE: The manager is qualified and experienced and the residents said that she was approachable and often seen around the home. The Investors in People (IIP) quality monitoring systems in place and the manager undertakes monthly audit reviews that include - care plans, accidents, training, environment, medications and kitchen/menus. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 22 There are regular staff meetings and resident surveys. Staff confirmed that they had meetings and minures of these were seen. Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP7 OP15 Regulation 15 16 Timescale for action Care plans must be reviewed and 10/06/06 reflect the care that is being given to the resident. Residents on Garden Court must be provided with mealtime routines that are suitable for their assessed needs. 21/12/05 This is a requirement from the previous inspection report that has not been fully complied with. Amended timescale 10/06/06 Staffing levels must be reviewed to make sure that the residents are being given the care that they have been assessed as needing. 21/12/05 This is a requirement from the previous two inspection reports that has not been fully complied with. Amended timescale 10/06/06 A written plan must be developed for 50 of care staff to achieve NVQ level 2. 21/12/05 This is a requirement from the two previous inspection reports that has not been DS0000006023.V286158.R01.S.doc Version 5.1 Page 25 Requirement 3 OP27 18 4 OP28 18 Bank House Nursing Home 5 OP30 18 fully complied with. Amended timescale All staff who work on Garden Court must have dementia training. This has been raised in previous inspection reports and must be addressed as a matter of priority. 10/06/06 10/06/06 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 OP9 OP12 Good Practice Recommendations The medication room should have the temperature recorded daily to ensure the safe storage of medications. Training for the personal and social activities needs of the dementia resident should be provided for all carers on Garden Court. This is an outstanding recommendation from the previous inspection and a plan for this should be developed. Staff should be made fully aware of the contents of the home’s Statement of Purpose. A plan for this should be developed. 3 OP1 Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 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 Bank House Nursing Home DS0000006023.V286158.R01.S.doc Version 5.1 Page 27 - 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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