Inspection on 12/01/06 for Charnwood Hall Nursing Home

This inspection was carried out on 12th January 2006.

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

The inspector 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

Charnwood Hall Nursing Home 20/07/06

Charnwood Hall Nursing Home 13/09/05

Charnwood Hall Nursing Home 10/03/05

Charnwood Hall Nursing Home 22/09/04

Charnwood Hall Nursing Home 08/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Charnwood Hall Nursing Home 38 Charnwood Road Shepshed Leicestershire LE12 9QF Lead Inspector Mrs Gillian Adkin Unannounced Inspection Thursday, 12th January 2006 09:00 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 Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Charnwood Hall Nursing Home Address 38 Charnwood Road Shepshed Leicestershire LE12 9QF 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) 01509 650717 01509 506300 Quality Care Midlands Ltd Mrs Lynne Stinchcombe Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability over 65 years of age of places (25) Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration. Date of last inspection 13th September 2005 Brief Description of the Service: Charnwood Hall Nursing Home is a Care home situated centrally in Shepshed Leicestershire. The home is owned by a Limited Company called Quality Care Midlands Limited. It is registered to accommodate twenty-five service users with physical disability and old age. It is situated on a main road within a fiveminute walk of the town centre. It is also on a public transport route. Facilities close by include several churches, and a number of social amenities including restaurants, a bowling green, local market and a number of public houses. The local community centre is within walking distance of the home. The registered provider employs Registered General Nurses, care and ancillary staff (a number of whom have been employed for many years). The town has two main GP practises which service users are registered with. Charnwood Hall was originally a Manor House, which was developed and modernised by the present owners. It is traditional in design and is furnished and fitted to a reasonable standard and offers service users comfortable, homely surroundings. It has a main lounge, which includes a dining room. A separate dining room is located next to the lounge. The home has two floors with a passenger lift between each floor. The home has fifteen single bedrooms and three double of which seven are en-suite. The home has off street parking. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6.5 hours on the 12th of January 2006. The main method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. The inspector spoke with three residents, six visitors and five staff members. No additional comment cards had been received by the Commission for Social Care Inspection since the last inspection however general comments received from relatives were very positive about the home and its staff. Typical comments included: “The Care is Brilliant” “Staff usually have time to meet the residents needs” “My mother is given a choice” “We have not discussed my relatives last wishes and they haven’t been recorded but I don’t think it’s important till the time comes anyway” “I consider that my views are valued” “I am not consulted with over my relatives care plan and have never seen it” “The meals are excellent and times are flexible, staff get really concerned if my relative doesn’t eat her food” “I visit regularly and have observed staff working they are very good at preserving dignity” What the service does well: Residents and visitors spoken with spoke highly of the staff employed at the home. Visitors also said they felt welcome at the home and could visit at anytime. The inspector observed interactions between staff and residents and found these to be positive and respectful. Staff spoken with demonstrated a good understanding of their roles; they possessed very caring attitudes and were obviously working towards serving the best interests of the residents. The registered manager had a ‘hands on’ role in the day-to-day running of the home and as a result of this had a very good awareness and understanding of Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 6 the residents and staff needs. The management approach appeared very open and helped to create a homely environment in which residents could make full use of the facilities and services and staff felt supported to carry out their work. The registered manager and senior nurse supports and encourage staff to develop and fervently sources new training two care assistants have been supported to commence their nurse training. The programme of decoration has been almost completed. The home provides excellent food and residents /relatives commented about how well fed they were. A cooked breakfast is served every day. The staff group in the home is very stable. Most staff at the home have achieved at least NVQ level 2 or higher qualification. What has improved since the last inspection? What they could do better: The random auditing of care plans by a senior person may identify where information is not accurately recorded. The inclusion of an oral care plan would improve the outcomes for those residents unable to meet this need. The detailing of personal choices and preferences in care plans may improve outcomes for residents. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 7 Two forms of identity must be included in all staff files to ensure that the home is satisfied to the authenticity of the person to be employed. Money held on behalf of residents should be randomly audited by senior representatives to ensure it is accurately maintained. Residents and their relatives should be routinely involved in the care planning process this would ensure that all interested parties are fully aware of the care to be provided and its outcomes. 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. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2.3 Written contracts fully detail Terms and Conditions of residency thereby ensuring that residents are fully informed. Appropriate assessment and risk management of service users ensures that needs are met and risks managed appropriately. EVIDENCE: Discussion with the registered nurse in charge demonstrated that all residents are issued with a contract on admission this details the terms and conditions of occupancy. One care plan tracked contained a service user agreement and a relative spoken with discussed how their relative’s fees were agreed and paid and what agreement had been issued. One of the care plans tracked had evidence of an initial assessment in place and all care plans had evidence of ongoing reviews by the funding authority. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 10 The nurse in charge indicated that was no longer in use and that a place. All three residents tracked method of assessment. None of involvement in their assessment. original documentation used for assessment new type of assessment document was in had been living in the home prior to this the residents tracked could confirm their Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9.10.11 Resident’s medical needs are met by the provision of a care plan and staff awareness. Consideration of residents’ holistic needs and more frequent auditing of plans for accuracy would improve outcomes for individuals further. Staff who are skilled appropriately administers Resident’s medication and competent this reduces the risk of errors occurring. EVIDENCE: Three care plans were tracked Assessments were in place for the risk of developing pressure sores, continence and nutrition. Records were seen of GP and community nurse visits. Care plans tracked were of a reasonable quality however in two instances contained inaccurate or out of date information, the nurse in charge rectified this immediately. Staff spoken with were fully aware of the needs of individuals tracked and any individual needs. Following discussion with some residents’ it was however Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 12 noted that important personal information relating to well being had not been recorded, this included social needs. Discussion with residents regarding their involvement proved difficult however discussion with two relatives indicated that although verbally consulted with about their relatives care had never been actively involved in the development or evaluation process. One relative stated, “ I thought care plans were private” The care plan of a resident tracked did not detail their oral hygiene needs. The resident was unable to maintain this need independently and therefore it was considered relevant to include this in the care plan. Administration records for the three case tracked residents were seen and appeared to be in good order, no residents were self-administering. Discussion with the registered nurse in charge indicated that although nurses are responsible for administration of medicines some care staff have undertaken training as part of personal development and where required were considered competent to undertake a medicine round for residential clients. A new drug trolley had recently been ordered and was awaiting delivery. The registered nurse stated that they have an excellent working relationship with the contracting pharmacist. Good evidence was seen to demonstrate that residents’ medical needs such as diabetes /high blood pressure was managed appropriately by the home and in relation to medication. Discussion with residents, relatives and staff demonstrated that privacy and dignity was maintained and considered important. Observation of staff at work demonstrated a personal approach to individuals needs. Some evidence was found in care plans tracked describing resident’s personal wishes regarding the end of their life. Discussion with two relatives indicated that one “ did not consider it necessary to have this documented” whereas a second thought it was” very important”. Three registered nurses including the registered manager have attended recent palliative care training. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): .12.13.14.15 The activities provided within the home meet service users’ expectations, interests and needs. Work undertaken by staff to achieve this outcome must be recognised as a strength in the home’s performance. Service users are enabled to make choices about visitors and daily living routines. A varied and nutritious choice of foods is offered by the home in consultation with service users. EVIDENCE: The home employs an activities organiser three times per week for six hours. Records were seen of activities undertaken and persons who attended. Activities are decided by residents and include 1-1 sessions such as hand massage and also larger group activities. It was confirmed in records and through discussion that activities were well received and enjoyable. External entertainers are regularly booked and funds raised to ensure that the comfort fund provide for extra activities such as meals out. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 14 Discussion with residents and relatives confirmed that the staff worked hard to provide fun activities, which they were involved in. Photographs were shown to the inspector of a recent party held in the home on Halloween where staff entertained residents in fancy costume. A great deal of effort was made by all staff to ensure residents had fun. This is to be commended as a strength. Relatives and other visitors spoken with described how they were welcomed at the home at any time without restriction. Discussions with staff indicated how they routinely sought residents’ views and observation of staff demonstrated that choices were offered. One relative stated that her relative had experienced difficulties with eating meals provided and how the cook had offered at least three different types of food in an attempt to get her to eat. This is to be commended. One of the three residents tracked had experienced problems with maintaining an acceptable weight. This was fully described in care plans and each resident was appropriately nutritionally assessed. Good evidence was found to demonstrate the active involvement of other professionals where concerns were raised regarding nutrition. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17. Residents’ civic rights are maintained by enabling them to take part in political processes and providing access to advocacy services. EVIDENCE: Case tracking of one resident demonstrated that she had been accepted on to the register of voters by post. A senior member of staff had instigated this for all residents wishing to be involved. None of the residents tracked were able to confirm any involvement in the civic process. One relative took his father to vote in local elections. Although none of the residents tracked were using the services of an advocate, leaflets and information was on display for visitors to take away. Staff were not fully aware of the role of an advocate and the registered nurse in charge stated that this would make a good topic to discuss at supervision. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22.25 A programme of routine maintenance and redecoration was underway at the time of this inspection. All areas of the home inspected appeared comfortable and homely and provided a safe and environment for residents. EVIDENCE: A programme of routine maintenance and redecoration was underway at the time of this inspection. The upstairs corridor had being redecorated and plans were in place to replace the lounge carpet and to redecorate and refurbish the dining room and small sitting room. Decoration of downstairs corridors was almost completed. Rooms inspected belonging to those residents tracked appeared to provide equipment and facilities which met their needs including hoists, specialist chairs, nursing mattresses etc. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 17 Discussion was held with three residents with hearing difficulties and all were noted to have hearing aids, which were working, in place. Residents were observed moving around the home whilst using equipment in a safe manner, although damaged carpeting had not been replaced it was covered and had an item of furniture placed over it. This carpet is due to be replaced when development takes place later this year. No falls in the lounge had been reported due to damaged carpeting. The home has sufficiently wide corridors to ensure freedom of movement. Discussion with two residents indicated that as the lounge was large and had a high ceiling it was not always possible to hear the television and this should be considered when seating residents in the lounge. Most residents appeared to be seated in the same seats each day according to them. One visitor spoken with indicated that she found it hard to hear her relative due to the acoustics of the room and her hearing difficulties; this was exacerbated by the large numbers of visitors in the lounge and talking at the same time. Discussion with the registered provider indicated that a quieter room was available but that some visitors may not be aware of this room. It was agreed that this information would be made readily available to new visitors. The home employs a maintenance person to carry out routine maintenance and health and safety checks. A vacant bedroom was being re-decorated during this inspection. The home was found to be sufficiently well heated and decorated and records seen indicated that water temperatures are monitored monthly. A new boiler has recently been fitted and al rooms are fitted with thermostatically controlled valves. This ensures the safety of those resident’s who are able to use facilities independently. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27.29 Provision of suitable numbers appropriately skilled staff ensures that service users needs are met. Outcomes for service users might be further improved by ensuring that the recruitment documentation as required is included in staff files. EVIDENCE: Discussion took place with staff, relatives and some residents in relation to current staffing levels. Further discussion took place with the registered provider in relation to provision of registered nurses. At the time of this inspection twenty-two residents were living in the home. At least one qualified nurse was on duty at all times, there were five care staff on duty every morning, four care staff in the afternoon/evening and one care assistant at night. Residents spoken with felt that staff responded to their needs in a prompt and efficient manner. Rosters inspected indicated that the staff team was stable and that the home rarely used agency staff stating that internal staff usually are able to cover shifts that are short. This was considered a strength in maintaining continuity of care. The registered owner is on site every day and supports the nursing team. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 19 Two staff files were inspected and although most documentation required was contained no photographic evidence was seen in either file to confirm identity. Staff files must contain two authenticated pieces of identification such as a driving licence. Birth certificate and passport (authenticated copy) evidence of address etc. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33.35. EVIDENCE: The home ensures that quality is monitored by was of a number of internal audit systems including medication and housekeeping. An annual satisfaction survey was undertaken in May 2005, which indicated that almost 50 of people responding (62.5 ) were satisfied with the service provided. Views are sought from relatives on a daily basis and a relative spoken with stated, “Our views are considered and valued” A number of compliments and thank you cards were seen on display in the home from relatives praising the home and staff. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 21 Resident’s finances were discussed with relatives (where residents lacked the ability to discuss). Most relatives stated that they either managed finances on their relatives behalf or that the home held small amounts of money for them. Policies and procedures are in place regarding personal money however they do not fully describe an upper limit for which the home will be held responsible and therefore posing a risk to residents who have no alternative. It was recommended that the policy is reviewed and fully details the upper limits and that residents are made aware of this on admission by inclusion in the service user guide. Suitable arrangements must be made for those persons entering the home with larger sums of money in their possession. Records inspected relating to those case tracked were confirmed as accurate and well managed however it was recommended to the provider that random audits by her would ensure appropriate management and accuracy of the system. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X X X X 3 X X 3 X STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 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 OP7 Regulation 15(2) Requirement The registered provider must ensure that residents and their relatives are included in the care planning and evaluation process. The registered provider must obtain and have in place in staff files documents as specified in schedule 2 of the Care Homes Regulations. Timescale for action 28/02/06 2 OP29 19(4) b Sch 2 12/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP7 OP7 OP35 Good Practice Recommendations It is recommended that random care plan audits be undertaken to ensure information contained in them is accurate and still relevant. It is recommended that oral care and hygiene is recorded in care plans where residents are unable to meet this need independently. It is recommended that a random audit of residents. DS0000054117.V275609.R01.S.doc Version 5.1 Page 24 Charnwood Hall Nursing Home 4 5 OP14 OP11 personal money is undertaken periodically by a senior representative of the home to ensure accounts are satisfactorily maintained. It is recommended that resident’s social needs are assessed and detailed in a plan of care. It is recommended that the subject of end of life arrangements be discussed wherever practicable and recorded where considered appropriate on an individual basis. Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Charnwood Hall Nursing Home DS0000054117.V275609.R01.S.doc Version 5.1 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!