Inspection on 29/07/08 for Bedale Grange Nursing Home

This inspection was carried out on 29th July 2008.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bedale Grange Nursing Home 09/08/07

Bedale Grange Nursing Home 29/08/06

Bedale Grange Nursing Home 15/12/05

Bedale Grange Nursing Home 13/09/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Bedale Grange Nursing Home 28 Firby Road Bedale North Yorkshire DL8 1AS Lead Inspector Jane Bassett Key Unannounced Inspection 29th July 2008 09:30 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 Bedale Grange Nursing Home DS0000064737.V368872.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. Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bedale Grange Nursing Home Address 28 Firby Road Bedale North Yorkshire DL8 1AS 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) 01677 422980 01677 427535 bedalegrange@fisherpartnership.com Bedale Grange (TFP) Ltd Mrs Julie Atkins Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2007 Brief Description of the Service: Bedale Grange is a care home registered to provide Nursing and Social care for up to 21 residents. It is located just west of the small market town of Bedale and was first registered as a Nursing home in September 1985. The home is a large detached pebble-dashed building with three floors including ground and single storey extensions have been added. There is an electric chair lift from the ground to the first floor and people are accommodated on the ground and first floors only. The front elevation facing south overlooks a large garden area that has a pergola with lawn, mature trees and shrubbery extending beyond. The fees per week range from £400-£630. This information was correct at the time of the visit. Bedale Grange Nursing Home DS0000064737.V368872.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 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was a key inspection. As a key inspection, all of the key standards were looked at or discussed. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. During the inspection the inspector carried out an unannounced visit to the home. The inspector was accompanied by an ‘expert by experience’ who spent time talking to the majority of service users and two visitors. The inspection visit lasted six hours. During this time the inspector looked at a range of documentation including, service user and staff files. The inspector spoke to two staff members and the manager. Seven service users, and six staff returned questionnaires to CSCI. The agency completed an Annual Quality Assurance Assessment (AQAA). At the time of the inspection the home was providing services to 14 service users. What the service does well: What has improved since the last inspection? Work has been carried out to comply with the requirements made at the previous inspection. Service user files were seen to contain risk assessments regarding the use of bed rails. The manger has developed a good system to record the required dosage and administration of medication that may vary in dosage i.e. warfarin. The quality assurance system has been developed to include audits of areas of care provided and surveys. A privacy curtain has been provided in the shower room, and a number of bedroom doors have been fitted with door guards. Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 6 Staff have received training in moving and handling, fire safety, infection control, health and safety, medication awareness and dementia care. 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. Bedale Grange Nursing Home DS0000064737.V368872.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 Bedale Grange Nursing Home DS0000064737.V368872.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): Outcomes for standards 3 & 6 were looked at. People who use the service experience good quality outcomes in this area. Prospective service users needs are assessed prior to admission to the home. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Information recorded in the AQAA indicated pre-admission assessments are carried out. During discussion with the manager she described the process that is followed to obtain information about a prospective service users needs including, an assessment from the care manager if that person is funded by a local authority. During the inspection visit the files of three service users were examined. All were found to contain information gathered prior to that person’s admission to the home. Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 9 The home has ‘rapid response’ beds, which are used for emergencies, when this is needed an assessment is obtained prior to the person entering the home. No intermediate care is offered. Bedale Grange Nursing Home DS0000064737.V368872.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): Outcomes for standards 7, 8, 9, & 10 were looked at. People who use the service experience adequate quality outcomes in this area. People have access to health care services both within the home and the local community. Health needs are monitored and appropriate action and intervention taken. The home has a policy and procedure regarding the safe handling of medication, however this may not be always followed. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the Inspection the files of three service users were examined. Each were seen to contain assessments, including activities of daily living, moving and handling, pressure damage risk (waterlow), and nutrition. Files also contained risk assessments including the use of bedrails required at the previous inspection. All files were found to contain plans of care for identified needs, however these were found to be confusing. Two of the files contained plans that included details of more than one identified need. Reviews had taken place, however these were joint and not for Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 11 each specific need. Plans would benefit from further development to include details of how the need is to met, the service users’ abilities and preferences. The third file contained more specific plans and reviews. Assessment documentation and plans were not always dated and signed. It was therefore difficult to ascertain if the information was relevant to current need. One file seen contained records of wound care given. These were seen to contain good information on the wounds progress and current regime. Staff were seen to document in a separate record the daily care given. All files seen contained information that indicated service users have access to GP’s and other health professionals as needed. Staff who spoke to the inspector were able to demonstrate a good knowledge of individuals needs and how these are met. Staff spoke of promoting individual’s privacy, dignity and independence. Service users who spent time with the ‘expert by experience’ told her they were satisfied with the care they receive, staff were ‘friendly and caring’. Relatives who spent time with the expert confirmed they were happy with how the care is given. They said they were notified of any changes. The inspector was told medication is only administered by qualified nurses. The inspector carried out a sample audit of the medication systems. There were no major concerns identified with the ordering, recording, storage and disposal of medication. MAR (medication administration records) seen contained no ‘gaps’ in recording. However hand written entries of details of medication and method of administration did not always contain the signature of the person making the entry or the signature of a second person confirming the accuracy of detail. MAR charts would benefit from development to allow the recording of ‘one off’ and homely remedies separate from the regular medication. The home has developed a good system for recording medication that may vary in dosage i.e. Warfarin. Records seen included details and confirmation of the blood levels, dosage of medication and date of next test. Eye drops were seen to be dated as required at the previous inspection. During the inspection the medication storage cupboards and trolley were seen to be locked, however the treatment room door was open and unlocked. The manager told the inspector a number of staff required access to the room. She also said a ‘key pad’ lock was to be fitted to the door to promote security. Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 12 The inspector observed staff preparing to administer the lunchtime medication. It was seen that only three service users required regular medication at this time, staff commenced the medication round without the medication records. The home has a policy and procedure in relation to the safe handling of medication. The manager must ensure that staff follow this policy and procedure. Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 13 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): Outcomes for standards 12, 13, 14, & 15 were looked at. People who use the service experience adequate quality outcomes in this area. The food at the home is of a good quality, well presented and meets the dietary needs of the people who use the service. Activities are limited and depend on the availability of staff. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Service users who spent time with the ‘expert by experience’ told her they were satisfied with the care that they receive and their lifestyles. One person told her ‘staff spend time talking and joking with us’. Responses in survey returned to CSCI by service users and those who spoke to the ‘expert by experience’ all said activities take place, however these depend on staff having the time to carry them out. There are monthly outings/ entertainment, regular contact with a local church and communion for those who wish to participate. Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 14 Two visitors who spoke to the ‘expert by experience’ told her they could visit at any time and were always made welcome. The manager told the inspector she hopes to employ an activities coordinator in the near future. The home has also recently purchased some activity programmes including memory tests and connection games. Staff told the inspector that they try to spend as much time with service users as possible, activities include impromptu ‘sing songs’ and games. Service users spoke of the ‘home made’ meals and cakes. All said they enjoyed the food and were given choice. The home has one lounge/ dining room. There are two dining tables for anyone wishing to use them. All the current service users prefer to eat in the lounge part of the room on individual tables. The ‘expert by experience’ observed the lunchtime meal. It was seen to be well presented on individual trays. Service users were offered choice and staff were available. One person was seen to need assistance with eating. It was observed that this was done in a relaxed and unhurried manner, allowing the service user to eat at the own pace. Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 15 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): Outcomes for standards 16 & 18 were looked at. People who use the service experience good quality outcomes in this area. People who use the service are able to express their concerns and have access to a complaints procedure, are protected from abuse and have their rights protected. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home has a policy and procedure in relation to the handling of complaints. Response in surveys returned by service users to CSCI and those who spoke to the ‘expert by experience’ indicate that people are aware of how to raise any concerns should they have any. All people who responded said they were satisfied with the care they receive. The AQAA returned to CSCI indicated the home has not received any complaints since the previous inspection. Staff who spoke to the inspector were able to demonstrate through response to questions the action they would take if they became aware of a concern. All demonstrated a commitment to protecting service users from abuse. The manager was able to demonstrate the action she would take to report any concerns to the relevant authority. The home has a policy in relation to prevention of abuse, this should be developed further to reflect the ‘no secrets’‘ guidance. Bedale Grange Nursing Home DS0000064737.V368872.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): Outcomes for standards 19 & 26 were looked at. People who use the service experience good quality outcomes in this area. The home provides a homely, clean and comfortable environment that meets the current needs of service users who live there. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the visit the inspector walked around the building. It was seen that the home provides a comfortable, clean, odour free & homely environment that is generally well maintained. Service users bedrooms were seen to be personalised with items of furniture, pictures and ornaments. Service users who spoke to the ‘expert by experience’ and responses in surveys returned to CSCI indicated people were happy with the environment and facilities provided. Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 17 A privacy curtain has been provided in the shower room as required at the previous inspection. Redecoration should be carried out in one bedroom to repair the damage to the walls and ceiling from a water leak. Information contained in the AQAA indicated the home and equipment are maintained as required. During the inspection it was found that windows to a number of first floor bedrooms and bathroom were not fitted with a system of restriction, allowing them to be fully opened. Placing service users at risk of injury. An immediate requirement notice was issued. Following the inspection the provider has notified CSCI in writing that action has been taken and window restrictors have been fitted. Bedale Grange Nursing Home DS0000064737.V368872.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): Outcomes for standards 27, 28, 29, & 30 were looked at. People who use the service experience adequate quality outcomes in this area. People are generally satisfied with the care they receive. The recruitment procedure must be made more robust to promote the safety of the people who use the service. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: On the day of the inspection the home was accommodating fourteen service users. A staffing rota was examined, this indicated there was one qualified nurse and three care staff on duty during the day, one qualified nurse and two care staff on the evening and one qualified nurse and one care staff overnight. Service users who spoke to the ‘expert by experience’ and responses in surveys returned to CSCI indicated there were sufficient staff on duty to meet the current physical care needs of the residents. Service users and visitors who spoke to the ‘expert’ told her they were satisfied with the care they receive. One person stated, ‘The staff are all good, I am looked after well.’ Staff who spoke to the inspector told her there were usually sufficient staff to meet service users’ needs. The inspector examined the files of three staff members. Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 19 Two of whom had recently been recruited. Both files contained application forms. One file contained a CRB (criminal record bureau) check and one reference, both obtained after the person commenced employment. There was no evidence of a PoVA first (protection of vulnerable adults) check. The second file was for a member of staff who was employed to work as and when required. This was found to contain two references and a CRB obtained by another employer. The manager was advised that this person should not be used until the home had obtained a satisfactory CRB/ PoVA carried out by themselves. The file of a qualified member of staff seen contained no evidence of PIN (professional identification number) check being carried out either at the time of employment or since. Therefore it was not possible to check this person’s eligibility to practice. Information contained in the AQAA and discussion with the manager indicated the home has recently used staff supplied by an agency. The home had not obtained evidence for each individual confirming that satisfactory employment checks had been carried out. Training record seen indicated staff had received mandatory training as required at the previous inspection. This was confirmed by staff who spoke to the inspector. Staff also spoke of training in medication awareness and dementia care. The manager told the inspector eleven of the care staff had completed NVQ at level 2 or above and a further two staff were undertaking the training. Bedale Grange Nursing Home DS0000064737.V368872.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): Outcomes for standards 31, 33, 35, 36, & 38 were looked at. People who use the service experience good quality outcomes in this area. The manager is qualified and has the necessary experience to run the home. She is improving and developing systems that monitor practice and compliance with plans, policies and procedures of the home. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home is managed by a first level nurse who has a number of years experience. Since the previous inspection her supernumerary hours have been increased allowing her to develop further the quality assurance systems used by the home. The manager has commenced regular audits including care planning, pressure damage, accidents and medications. Views of people who use the service, professionals who visit and student nurse placements have been sort. Those seen by the inspector contained positive comments regarding Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 21 the care provided. The quality assurance system would benefit from further development to include an analysis of responses. Regulation 26 visits have been carried out, however the last report available on the day of inspection was dated May 2008. The manager has developed and is introducing a system of formal staff supervision. Care staff who spoke to the inspector told her they receive good informal support from both the manager and qualified staff. There is an ‘open door’ policy where concerns and issues can be raised and are acted upon. Staff also said communication was good, information is passed on at the start of each shift. The inspector was told the home does not hold any personal monies of service users, any expenditure is invoiced directly. Information in the AQAA received by CSCI indicated the home has a range of policies and procedures to promote the safety and welfare of service users. Other information indicated the home and equipment are maintained as required. Records seen on the day of inspection indicated fire alarms are tested weekly and recorded, and service users bedroom doors have been fitted with door guards as required at the previous inspection. Other records seen indicated hot water temperatures are checked and recorded on a monthly basis. The safety of service users would be further promoted if bath and shower temperatures were checked and recorded on a more regular basis. Bedale Grange Nursing Home DS0000064737.V368872.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Records of assessment of care need, care plans and reviews should be developed further to include clear and relevant information. All records should be dated and signed. The registered manager must take action to ensure all staff comply with the policy and procedure in relation to the safe handling of medication. Staff must not commence employment until the home has obtained a satisfactory CRB / PoVA first check and two written references. Qualified nursing staff must not commence employment until the home has carried out a satisfactory check on that persons PIN to confirm eligibility to practice. Evidence must be obtained that all agency staff employed by the home have had satisfactory recruitment checks carried out, to promote the safety of service users. Timescale for action 01/11/08 2 OP9 13 01/09/08 3 OP29 19 01/09/08 4 OP29 19 01/09/08 5 OP29 19 01/09/08 Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 24 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 3 Refer to Standard OP7 OP7 OP9 Good Practice Recommendations Plans of care would benefit from further development to include details of how care is to be given, the person’s abilities and preferences. Reviews of plans of care would benefit from development to be specific to each care need identified. Hand written entries on MAR charts should include the signature of the person making the entry and the signature of a second person confirming the accuracy of details to promote the safety and wellbeing of service users. Mar charts would benefit from further development to allow the recording of ‘one off’ and homely remedies separate from the regular medication. Consideration should be given to the fitting of a keypad lock to the treatment room door. Service users would benefit if the frequency and choice of activities were increased. The policy and procedure in relation to protection of vulnerable adults from abuse should be developed further to reflect the ‘no secrets’ guidance. The bedroom with water damage to the walls and ceiling should be redecorated. Work should continue to develop further the quality assurance systems. Work should continue to develop formal staff supervision to be carried out and recorded on a regular basis. The hot water temperatures at baths and showers should be checked and recorded on a more regular basis to promote the safety and wellbeing of service users. 4 5 6 7 8 9 10 11 OP9 OP9 OP12 OP18 OP26 OP33 OP36 OP38 Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Bedale Grange Nursing Home DS0000064737.V368872.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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