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Inspection on 29/04/08 for Belton Lodge Nursing Home

Also see our care home review for Belton Lodge Nursing Home for more information

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People live in a comfortable environment. People who live in the home have told us that they are happy and content and satisfied with the care and approach of the staff. There is a friendly and relaxing atmosphere in the home.

What has improved since the last inspection?

All the requirements and recommendations have been addressed from the previous key inspection visit. Staff training has improved since the last inspection to ensure that staff have more skills and are competent to care and support the residents in the home. The management of the home has been improved by reorganising the office and management systems. Quality assurance has improved through regular visits by the homeowner, reports of his findings as well as regular quality assurance surveys to learn about, and begin to take action on, residents and visitors` views about the home.The environment in the home has improved with the installation of a new roof on the conservatory and 6 new lounge chairs. The views of people have been obtained about the range of social activities provided. An activities programme has been produced as a result of this. Following an inspection by South Kesteven District Council`s Environmental Health Officer the home on the 9/4/2008 was awarded 3 stars (good) for its` catering.

What the care home could do better:

There were no requirements from this inspection visit. However, registered nurses who work at the home and the manager need to ensure that all care plans contain clear information about all the care and support needs of the people who live at the home. With this in mind the owner and manager needs to consider developing their quality assurance systems further to include internal audits on care records and care practice. Recommendations are contained in the report about care practice and that the home should obtain publications, which can assist the home with improving this.

CARE HOMES FOR OLDER PEOPLE Belton Lodge Nursing Home 213 Belton Lane Grantham Lincs NG31 9PW Lead Inspector Tobias Payne Unannounced Inspection 29th April 2008 08:10 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 Belton Lodge Nursing Home DS0000002587.V363410.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. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belton Lodge Nursing Home Address 213 Belton Lane Grantham Lincs NG31 9PW 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) 01476 579798 01476 579798 R S Medicare Limited Mrs Indra Nathan Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration The maximum number of service users in the home with nursing does not exceed 10 and the maximum number of service users with personal care only does not exceed 3. 10th January 2008 Date of last inspection Brief Description of the Service: Belton Lodge is a care home providing personal and nursing care for 13 older persons. On the day of the inspection visit there were 12 people living in the home. The home is a converted bungalow situated in Belton, a village located on the outskirts of Grantham. There is a lawned garden at the rear of the home and there is car parking space to the front of the property. All accommodation is situated on the ground floor. There are 7 single bedrooms one with en-suite and 3 shared bedrooms each with en-suite. The home has one lounge/dining room and an adjacent conservatory. The fees at the inspection visit on the 29/4/2008 ranged from £400 to £500 a week. Extras are for hairdressing which ranged from £9.75 to £23, chiropody £10, toiletries and personal newspapers and magazines. Information about the home including a copy of the last inspection report, the statement of purpose and service user’s guide can be obtained from the manager. Belton Lodge Nursing Home DS0000002587.V363410.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 key inspection visit was unannounced and started at 8.10 am. It was done using a review of all the information available to us about Belton Lodge Nursing Home. It took place over 5 hours. We spoke with 3 staff, the manager deputy manager and the owner who was present for part of the inspection visit. The main method of inspection used during our visit was called “case tracking”. This involved spending time to find out how the care was provided for one person through the checking of records, discussion with the care staff and looking at how the care was actually given and the outcomes for the person. We also looked at records, spoke with staff and other people who live at the home and walked around the home. We also spoke with the owner about what improvements had taken place since our last inspection visit. What the service does well: What has improved since the last inspection? All the requirements and recommendations have been addressed from the previous key inspection visit. Staff training has improved since the last inspection to ensure that staff have more skills and are competent to care and support the residents in the home. The management of the home has been improved by reorganising the office and management systems. Quality assurance has improved through regular visits by the homeowner, reports of his findings as well as regular quality assurance surveys to learn about, and begin to take action on, residents and visitors’ views about the home. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 6 The environment in the home has improved with the installation of a new roof on the conservatory and 6 new lounge chairs. The views of people have been obtained about the range of social activities provided. An activities programme has been produced as a result of this. Following an inspection by South Kesteven District Council’s Environmental Health Officer the home on the 9/4/2008 was awarded 3 stars (good) for its’ catering. 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. Belton Lodge Nursing Home DS0000002587.V363410.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 Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who choose to come into the home receive an assessment and know their needs can be met. They are also involved wherever possible in this process. There is information to enable them to make a decision about whether or not to move into the home. EVIDENCE: There was a new detailed statement of purpose and service user’s guide; a copy of was in each of the residents’ bedrooms. The documents now contained the correct information about what the home was registered for. In addition a new certificate of registration issued on the 29/2/2009 was displayed on the notice board at the entrance to the home. Since the last inspection visit the manager confirmed that no one new had moved into the home. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 9 We could see that where a person asked to move into the home the manager would assess them and written confirmation would be sent to show that the home was able to meet their needs. The home does provide intermediate care. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans, created from assessments of need help to ensure that people’s current health and welfare needs are met. Daily records need to be routinely transferred to care plans to make sure any changes in need can be clearly communicated and fully met. People are supported to take their medicines by staff who know what they are doing. EVIDENCE: Since the last inspection a new system for recording residents, care and social needs had been introduced. All residents had care plans. Records included an assessment of their needs, dependency assessment, risk assessment with the signature of the resident/relative, specific care plan outlining the care and support, daily record and evidence of monthly review. We looked in detail the care plan for one person. The way their needs were recorded was clear. We also saw that fluid charts were correctly filled in with date, amount and type of fluid. For those people who needed to be supported Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 11 in bed a turning chart was available to show when the resident’s physical position was changed by staff and was correctly recorded and dated with staff initials. The staff completed daily records so that the residents changing needs could be recorded and responded to in the right way by the care team. We saw staff using the daily records to check on updates to the residents needs. However we could see that some of the changes noted in the daily records, although acted upon were not always transferred and used to fully update the care plan. We discussed this with the deputy manager who recognised that there is a risk of information about changes in care needs being missed which could mean they may not always fully met. The deputy manager took action during our visit and updated all the care plan information during our visit. We also spoke to the manager who said that she recognised the importance of keeping care plans fully up to date and that she would continue to ensure that the care plans fully reflected the changing needs of all the residents. There were plastic aprons; gloves and antibacterial hand wash in each bedroom. Staff were seen to attend to people promptly and with little fuss. Since the last inspection, arrangements have been made for a new pharmacy provider to supply medication. This will include training for all staff responsible for the administration of medication and the home also signed a pharmacy agreement on the 21/4/2008. All the people who live at the home needed some form of support to take their medicines when they needed them. We observed this being done in a sensitive way. Medicines were given from a trolley, checked against the chart, given to the person and signed for after this. Registered nurses who work at the home administered the medication. Each nurse was assessed by the manager and considered competent to administer medication. We have recommended that the manager obtain a copy of the new Royal Pharmaceutical Society of Great Britain “The Handling of Medicines in Social Care”. This is so that the manager can continue to develop the practice of the care team as a whole. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are able to choose to take part in a range of social activities offered. This helped to ensure that their social and cultural needs are being met. People choose and enjoy a well balanced diet. EVIDENCE: Since the last inspection the manager has updated the care records to add some information about what each resident likes to do and their interests. The staff have asked each resident what they like to do. As a result of this exercise additional musical sessions called “sing along” were being introduced. There was a written activities programme showing that activities take place every day. These included pass the ball, hand massage, gentle movements to music and hairdressing every week. Staff said they provided activities in the home and we could see that staff were spending time talking to the residents. However, during our visit we saw no actual activities taking place. Some people were watching the television in the lounge or dosing in front of the television. Others were in bed. The people we spoke with did not know a lot about the activities available but told us they Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 13 could choose to do what they wanted and were happy in the home. Comments were, “I like being here” and “the staff are very nice”. We spoke to the manager about the activities programme and she said that the team would be spending more time to encourage people to make choices to take part in the activities offered. The kitchen was seen to be clean, tidy, well organised and well stocked with meat, fresh fruit and vegetables. The cook was appropriately dressed and there were clear up to date records of food, menus, food temperatures using a food probe and cleaning rotas. An Environmental Health Officer’s inspection took place on the 9/4/2008. As a result the home was awarded 3 stars (good) award. The manager was required to adjust the temperature of the refrigerator, ensure the food probe was cleaned after each use and record the cooking temperature of food. These had been acted upon. Breakfast was observed in the lounge and dining room. Residents were eating their breakfast, which consisted of porridge, cereal, toast or grapefruit as well as tea or coffee. They were attended by care staff who wore plastic aprons and served food in a discreet manner. Tables were set with tablecloths and flower decorations. People told us they like the food and it was well served and that they were not hurried. The menu was displayed on the wall in order to show the choices on offer. People told us, “I like the food, it is hot and what I like”. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to make a complaint and feel that staff will listen to their views. The care team know how to respond to a complaint and how to act in order to protect people from abuse. EVIDENCE: There was a complaints procedure displayed at the entrance to the home and each person received a copy of the complaints procedure in the service user’s guide. The home and the commission had received no complaints since the last inspection. No one had any complaints about the home during the inspection. We noted the complaints procedure gave our old address and a recommendation is made in the report to change this to our Cambridge office. Staff knew about abuse and their role and training had been provided for all staff on abuse prevention on the 23/3/2007 and 14/2/2008. The manager also had a copy of Lincolnshire’s Adult Protection Policy for the care team to refer to. None of the people who live at the home or staff team had any concerns about the home. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in comfortable, safe, clean and well-maintained accommodation. EVIDENCE: Since the last key inspection the environment in the home has continued to improve. The owner who was present for part of the inspection told us that the second bathroom with a shower, toilet and washbasin would be completed on the 15/4/2008. We saw the new shower base, curtain, and shower chair. He also explained that a new roof had been put on the conservatory and he was to remove the tumble dryer stored in the room and make it more comfortable for the residents to use. He was to build a wheelchair store (as they were stored in the conservatory) and provide more comfortable seating as well as a television and stereo system. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 16 We found the home was clean, tidy, well organised and odour free throughout our inspection visit. We found the call system for residents to use when they needed to call for help had been fully repaired since the last inspection and was now fully functioning. There were antibacterial hand washes in each bedroom and there was an infection policy which staff used to reduce the risk of cross infection. There were also gloves and aprons and alcohol rubs which we saw being used by staff. There were 2 commercial washing machines and one commercial tumble dryer being used to make sure peoples personal clothing was cleaned regularly. The laundry room was clean and tidy. Facilities were available to ensure clinical waste was well managed. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are available in the right numbers to support people with care needs in the right way. Training has been provided to ensure that staff were competent and skilled to care and support people safely. People are protected by clear recruitment practices. EVIDENCE: Records showed that staff were recruited using application forms, references obtained and an induction. We looked at records for one new member of staff. This contained a separate file showing the application form, references, Criminal Records Bureau check, interview notes, contact and induction. There were 5 registered nurses and 7 care assistants employed. Staff rotas were available and none of the residents or staff had any concerns about the levels or availability of staff. Throughout our visit we saw staff promptly attend to the residents’ needs. Since the last inspection training had been reviewed and had included fire prevention and 10/1/2008, abuse awareness 14/2/2008. The manager told us that all the staff were to attend dementia awareness training on the 30/4/2008, moving and handling 7/5/2008, infection control 15/5/2008 and food hygiene on the 12/5/2008. In addition, the deputy manager was to attend a 2½-day course on dementia. Clearer records were now being kept of Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 18 staff training provided. In addition to the training provided we discussed the number of staff with formal nationally recognised qualifications as none of the care staff had a nationally recognised qualification. The manager told us that they wanted to improve access to courses of this kind and that there were now 2 staff out of 7 care assistants who were studying for these. We also discussed the previous observation that there were some staff employed who did not have very good command of the English language and how this could affect their communication and confidence when speaking with the residents. The owner and manager explained that the staff were now attending English classes and were being observed and supported. During our inspection visit staff spoke, kindly and politely to people. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living and working in the home benefit from the positive leadership of the management team. Management record systems show that peoples’ health, safety and welfare are promoted. The management team ensures that the people have the opportunity to voice their views and opinions. The management team uses feedback from questionnaires to make improvements. EVIDENCE: The manager was an experienced registered nurse and had extensive care and management experience. She confirmed she is studying for a management qualification. She was present at our visit as was the deputy manager and owner of the home. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 20 At the previous inspection we found the management systems in the office, poorly organised with duplicated old policies and procedures. At this inspection, the office was more organised and information was now clearer to find and records accessible and up to date. The owner also explained that he was to provide additional storage on the first floor. The new policies and procedures, which were provided in March 2007, were now being implemented. For example, we could see that staff were now receiving regular formal supervision and notes were now being kept. Staff said that they felt the management were supportive. Since the last inspection, regular visits have taken place by the owner. Records of his visits were being kept and sent to us. At these visits quality audits had taken place on the 18/1/2008, 12/2/2008 and 13/3/2008. In addition, service users questionnaires were sent out to 5 residents and 4 visitors. The comments rating ranged from good to excellent. Specific comments were, “the roof of the conservatory needs replacing” (this had now taken place) and “much improved recently”. Further questionnaires were sent out to 2 visitors and 2 residents on the 12/2/2008. Specific comments were, “it would be beneficial to other residents if they sat in the conservatory at times to see other things rather than the same wall day after day and go out in the garden in the summer. We think the residents should move around more”. We discussed this observation with the owner who agreed that more could be done to encourage activity in the home, conservatory and garden. He said he will be addressing the issues raised and was intending to make the conservatory more comfortable and accessible. There were clear records of maintenance, which were up to date. There was a detailed equal opportunities policy, which referred to discrimination, disability and victimisation. Action had taken since our last inspection visit to assist staff who had poor command of the English language by encouraging and supporting staff to attend English classes. The manager had a comprehensive and detailed health and safety policy together with risk assessments covering all aspects of daily living activities. Records also showed there were regular tests of the fire system as well as regular fire drills. Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X X 3 3 3 Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP16 OP7 Good Practice Recommendations The complaints procedure should be amended on notice boards and in information given to residents to give the address and telephone number of our Cambridge office. The manager should continue to develop care plans and introduce person centred care records with the involvement of where possible each resident in identifying their needs and when care plans are reviewed. The manager/owner should obtain a copy of the Royal Pharmaceutical Society of Great Britain “The Handling of Medicines in Social Care”. The manager/owner should obtain a copy of the Mental Capacity Act 2005 Code of Practice and ensure that issues relating to this subject are contained in all care records/care plans. The manager/owner should obtain a copy of the Department of Health guidance on infection control “Essential Steps” which was sent to all care homes in October 2007. DS0000002587.V363410.R01.S.doc Version 5.2 Page 23 2 3 OP9 OP7 4 OP38 Belton Lodge Nursing Home Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Belton Lodge Nursing Home DS0000002587.V363410.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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