Inspection on 11/09/07 for Birdscroft Nursing Home

This inspection was carried out on 11th September 2007.

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 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

Birdscroft Nursing Home 23/09/08

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

CARE HOMES FOR OLDER PEOPLE Birdscroft Nursing Home 16 Highfields Ashtead Surrey KT21 2NL Lead Inspector Mary Williamson Unannounced Inspection 11th September 2007 10:00 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 Birdscroft Nursing Home DS0000069495.V344698.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. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birdscroft Nursing Home Address 16 Highfields Ashtead Surrey KT21 2NL 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) 01372 274499 01372 276006 murielsandy@asterhealthcare.co.uk St Dominic’s Ltd Muriel Sandy Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Birdscroft Nursing Home is a registered home, providing nursing care for up to twenty-eight elderly residents. The home is situated in a residential avenue located within the village of Ashtead. Accommodation is provided in both single and double rooms, some of which have en-suite facilities. The rooms are arranged over two floors and there is a shaft lift in place to access the first floor. There is a small garden to the rear of the property, which is accessible by a ramp. A limited amount of parking space is available at the front of the home. The fees charged in this home range from £650 to £671 per month. Information provided on 11/09/ 2007. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first site visit of a key inspection and was unannounced. Mary Williamson who is a Regulation Inspector undertook the inspection. The inspection took place over 5.75 hours. The Registered Manager Muriel Sandy represented the establishment for the duration of the inspection. This is a newly registered home having changed ownership in March 2007. A tour of the premises was undertaken and a number of records relating to the care of the residents and the management of the home were examined. Records sampled included needs assessments, care plans, medication records, menus, activity arrangements, staff training and recruitment files, and health and safety documentation. It was possible to meet all the residents in the home and gain feedback on some of their experiences about living there. It was also possible to meet with relatives who were visiting. Equality and diversity needs are recorded on resident’s files. Discussions were held with staff on duty. They were knowledgeable about the residents care plans and the care they were providing. They also confirmed the training they had undertaken. The manager completed an AQAA (Annual Quality Assurance Assessment) prior the inspection. There have been no complaints since registration. The Commission for Social Care Inspection would like to thank the residents, relatives, and the staff team for their help and hospitality during this inspection. What the service does well: The home provided a good standard of care for residents living there. All the residents looked well groomed and the residents who were being nursed in bed appeared comfortable. Residents have access to a service user guide providing them with the necessary information about the home. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 6 Care plans are well written and include risk assessments. These are reviewed and updated regularly. There are satisfactory arrangements in place to meet the health care needs of the residents. The catering arrangements are good and residents are offered a wholesome and nutritious diet. Staff training and recruitment procedures are good. Staff training files outline all the training undertaken and the schedule planned for 2007/2008. Staff employment files sampled appeared to be in order. The registered manager is undertaking her Registered Managers Award (RMA) and had completed six modules. She manages the home well and states that she has the support of the provider and a company administrator. The home is run in the best interest of the residents. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 8 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 Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their relatives have access to sufficient information in order that they make a choice about the home. Contracts of occupancy and needs assessments are in place. EVIDENCE: The home has a statement of purpose and service user guide in place. All prospective residents or their designated representative have access to a copy of this prior to being admitted to the home. One relative stated that she was able to read this before admission. Another relative commented that she chose the home for its convenient location. One resident said that his daughter chose the home for him, and he is very happy. A copy of the service user guide is kept in individual bedrooms. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 10 Contracts of occupancy are in place. Four of these were sampled. Two were new contracts for residents recently admitted to the home. They outlined the accommodation to be occupied, the care provided, the amount of fees paid and the method and frequency of payment. Two contracts needed to be updated as they were between the previous provider and the resident. Pre admission needs assessments were seen for four residents. These were informative and had been undertaken by a trained member of staff. Intermediate care is not provided in this home. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9, and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and personal care needs are outlined in individual care plans. Appropriate arrangements are in place to meet the health care needs of residents. Privacy and dignity is observed. EVIDENCE: Individual care plans are in place, four of which were examined in detail during the inspection. These have been well written based on information gathered from the needs assessment, input from the residents whenever possible, information from relatives and any relevant medical reports. Care plans also include risk assessments for moving and handling, risk of falls and analysis, nutritional assessment, Waterlow skin care assessments, body map, and a general risk assessment. A multi-disciplinary record is kept of all GP and other visits and the treatments undertaken. Care plans are reviewed and audited every month and updated as required. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 12 The residents are registered with local GP’s at three different surgeries. Residents have the opportunity to retain their own GP if possible. There were two GP visits during the inspection. Arrangements are in place for chiropody, and dental treatment. The optician also visits annually or on request. Specialist treatment can be provided on referral from the GP. Currently there are two residents with a pressure sore and management of these are outlined in their care plan. The home has a good supply of pressure relieving mattresses, and cushions. There is also input from the tissue viability nurse. There is a medication policy in place. Boots the chemist supplies all the medication in the home mainly in blister pack format. Medication is stored appropriately in the locked clinical room. Arrangements for the administration and storage of controlled drugs are satisfactory. The controlled drugs register is well maintained. There is a fridge provided for the storage of specific medication. The medication recording charts (MAR) were examined. Each resident has an audit sheet in the front of their medication chart for recording purposes. The deputy manager had undertaken the monthly medication audit the previous day and recorded the discrepancies observed. She had noted occasional gaps in signatures, and that a bottle of liquid medicine had not been dated on opening. These shortfalls were discussed with the manager who stated that this was on the agenda for review at the qualified staff meeting to be held two days after the inspection. The inspector noted three photographs missing from the MAR charts and a recommendation has been made accordingly. Privacy and dignity is observed and staff were observed to knock on bedroom doors prior to entering. Screens are provided in shared rooms when personal care is being undertaken. Birdscroft Nursing Home DS0000069495.V344698.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): 12, 13, 14, and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an activities programme in place, and family links are maintained. Residents are encouraged to exercise choice whenever possible. The nutritional needs of residents are being met. EVIDENCE: The activities programme was discussed with the senior carer who is responsible for implementing this. She stated that whenever possible she tries to get a profile of individual interests and hobbies. The inspector was informed that time is allocated three days a week for activities. These include picture lotto, ball games, coffee mornings, quiz, and films. Outside entertainers are arranged for parties and special occasions. One to one sessions are also arranged for reading letters, or newspapers. One resident has a daily newspaper and one resident stated that he stopped his newspaper, as he prefers to listen to the news on his television. Spiritual needs are supported and the home has monthly visits from the local Vicar. Visits are arranged from various clergy on arrangement. Some residents watch Sunday service on television. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 14 Family links are maintained and visitors are welcome in the home at any reasonable time. Relatives stated that they are kept informed about residents care and always get a cup of tea when they visit. A relative also said that arrangements could be made for her to see the doctor when he visits her relative. The catering arrangements were discussed with the cook on duty who works in the home three days a week. She is responsible for planning the menus and ordering the weekly supplies. Menus are planned with input of the residents and an understanding of their dietary needs, likes, and dislikes. A second cook works part time for the other four days. Some residents were observed during lunch sitting in the dining area, while others were sitting in both lounge areas being assisted to eat by staff. Lunch consisted of fried fish, chips and vegetables, followed by fruit and artic roll. One resident was having an omelette as a fish replacement. Residents stated that the food was good, and another said that she liked the homemade cakes. The kitchen was clean and orderly and all the required documentation for food hygiene was in place. Birdscroft Nursing Home DS0000069495.V344698.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): 16, and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure and the abuse awareness procedure in the home protect the residents living there. EVIDENCE: The home has a complaints procedure in place and this forms part of the service user guide. All residents and their relatives have access to a copy of this procedure, which is kept in resident’s bedrooms. There is also a complaints log in place and two complaints were noted since registration. These in fact were issues raised during case reviews and were dealt with under the Safeguarding of Vulnerable Adults procedures. Residents and relatives were asked about the complaints procedure in place and said that if they had to complain than they would talk to the manager. One concern made to social services was case tracked and discussed with the manager, and has been managed in a satisfactory manner. There is an abuse awareness policy in place and all staff have undertaken training in this policy. The home also has a copy of Surrey’s Multi Agency Policies and Procedures on Safeguarding Vulnerable Adults in place. The concerns mentioned above were discussed with regard to implementing VAP procedures, but were successfully resolved at the planning stage. Birdscroft Nursing Home DS0000069495.V344698.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): 19, 20, 21, 24, and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment fails to meet the required National Minimum Standards. The standard of cleanliness is good. EVIDENCE: A tour of the premises was undertaken. The standard of accommodation and decoration varies throughout the home. There are two lounge areas provided for residents. One is a small quiet room with chairs arranged around the wall with a large television as the focal point of the room. The second lounge is also the conservatory. This is long and fairly narrow with chairs arranged along two walls facing each other. A television is provided in this room but most of the residents are unable to watch this due to the shape and layout of the room. Consideration must be given to the communal arrangements in the home to gain maximum use of the space available. There is a small dining room located at the end of the conservatory. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 17 This was furnished with dining tables and accommodated six residents for lunch. There are currently fourteen residents in the home, which is registered for twenty-eight residents. Provision must be made to provide adequate dining facilities to enable all residents to eat in the dining room if necessary. The home has two assisted bathrooms, one on each floor. A new bathroom was fitted on the first floor prior to the home being re-registered. Currently residents are unable to use this bath due to mobility needs. Provision must be made within the refurbishment programme for residents to have access to appropriate bathing facilities in sufficient numbers to meets their mobility needs. Residents bedroom were visited. The standard of this accommodation varied. Some rooms had been redecorated and personalised with photographs and ornaments. Two residents said they enjoyed sitting in their rooms in the evening watching television. Other rooms appeared bear and would benefit from redecoration and new furniture. The manager identified four rooms which had new carpets fitted. The hallway and rooms from room 1 to room 4 need to be decorated prior to residents being admitted. The kitchen area where the washing up is undertaken needs a new floor immediately. The flooring is lifting at the doorway and is a potential trip hazard, and there is a hole in the same floor by the staff wash hand basin. The carpet in room 11 needs to be cleaned. The laundry is located in a separate building to the rear of the home. It is adequately equipped to meet the current needs of the home. There is an infection control policy in place and arrangements are in place for the collection of clinical waste. Birdscroft Nursing Home DS0000069495.V344698.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): 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. Resident’s needs are met by the number and skill mix of staff employed in the home. The recruitment procedure in place protects the residents living there. EVIDENCE: The staff duty rota was seen. The number and skill mix of the staff employed in the home was sufficient to meet the needs of the current residents. On the day of the inspection there was a member of staff off sick. The manager stated that due to the short period of notice given that an agency replacement was not possible. The rota was examined further to establish if this was a regular occurrence, and the inspector was confident that this was a one off situation. The manager demonstrated the staff training arrangements in the home. All the staff have a Skills for Care passport in place. This has been followed up with an action plan identifying training needs. All staff undertake induction training. This is in the form of a workbook, which is signed by an independent trainer when staff are assessed to be competent. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 19 NVQ is also in place. Five staff have NVQ level 4, three staff have NVQ level 3, and two staff have NVQ level 2. There are currently two staff undertaking NVQ level 2 training. The home operates a recruitment policy whereby no staff member is employed prior to having a CRB (Criminal Records Bureau) enhanced check in place. Three staff employment files were sampled. These are well maintained and included all the required documents for employment legislation. Formal staff supervision is also in place. Birdscroft Nursing Home DS0000069495.V344698.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): 31, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed in the best interest of the residents. EVIDENCE: The registered manager has been in post since the home was registered in March 2007. She had worked in the home for two years as deputy manager prior to re-registration. She manages the home well. She is currently undertaking her Registered Managers Award (RMA) and has completed six modules, she is also a registered nurse. She has the support of a deputy manager who works in the home two days a week. The responsible individual Mr Jeebun and the company administrator both visit the home at least once a week. The manager stated that she was getting the support she needs, which was required at the registration interview. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 21 Systems are in place to monitor quality assurance. Regulation 26 monitoring are undertaken each month and these reports are retained in the home for information. Monthly audits of medication, care plans, and catering arrangements take place and are reported upon. Residents survey forms have been sent to gain feedback on the homes performance and the results have been analysed and report produced. This is very encouraging as it was highlighted in the registration report that the manager was to be supported with quality assurance systems in the home. The manager stated that the home does not handle personal finances for residents. Relatives or designated representatives manage resident’s finances on their behalf. Health and safety is promoted and risk assessments are in place for all identified risks and safe working practice. However a potential trip hazard was identified in the kitchen, which was referred to in standard 19. A monthly health and safety audit is undertaken. Staff undertake health and safety training, which includes manual handling, food hygiene, first aid, risk assessment and COSHH. Fire safety is observed. The manager stated that the fire officer had undertaken a fire risk assessment the previous week and the home was awaiting the report. There is a contract in place for the maintenance of fire fighting equipment and emergency lighting. The manager informed the inspector that she recently had a meeting with the manager of a nearby home The Red House and arrangements were made that in an emergency where residents had to be evacuated, they would be accommodated in the safety and warmth of that home and vice versa. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 5(1)(b) Requirement Timescale for action 14/10/07 2 OP19 23(2)(a) 3 OP19 23(2)(d) The registered person must ensure that all residents have a current contract of occupancy in place outlining the accommodation offered, care provided, the fees payable, and the method and frequency of payment. The registered person, and the resident or a designated representative must sign these. The physical design and layout of 14/10/07 the home to be used as the care home must meet the needs of the residents. This must include appropriate communal areas including a dining room to reflect the number of residents living in the home and a lounge where residents can sit and watch television. 14/10/07 The registered person must ensure that all parts of the care home are kept clean and reasonably decorated. This must include the replacement of the kitchen floor, which in a state of disrepair and a potential trip hazard to staff and residents who use the kitchen. This includes decorating the hallway DS0000069495.V344698.R01.S.doc Version 5.2 Birdscroft Nursing Home Page 24 4 OP21 23(2)(j) between rooms 1 to 4 and cleaning the carpet in room 11. The registered person must ensure that the provision of bathrooms in the home is suitable to meet the resident’s needs. 14/10/07 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 Refer to Standard OP9 Good Practice Recommendations It is recommended that photographs be provided for three resident’s medication recording charts for identification purposes and to promote safety. Birdscroft Nursing Home DS0000069495.V344698.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Birdscroft Nursing Home DS0000069495.V344698.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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