Inspection on 06/02/07 for Craven Nursing Home

This inspection was carried out on 6th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Craven Nursing Home 29/12/05

Craven Nursing Home 22/06/05

Craven Nursing Home 30/11/04

Similar services:

Abbey The

Snydale Care Home

Whiteley House

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Craven Nursing Home Keighley Road Skipton North Yorkshire BD23 2TA Lead Inspector John McGarva Key Unannounced Inspection 6th February 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 Craven Nursing Home DS0000061132.V330455.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. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Craven Nursing Home Address Keighley Road Skipton North Yorkshire BD23 2TA 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) 01756 700994 01756 790925 Craven Nursing Home Ltd Mrs Felicity Coleman Care Home 68 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (28), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (1), Old age, not falling within any other category (38), Physical disability (2) Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users in the category (DE) to be aged 60 years and over. Service users in the category (PD) must be aged 55 years and over and require nursing care. To provide personal care and accommodation for up to 6 service users from the age of 60 years and over. 29th December 2005 Date of last inspection Brief Description of the Service: The Craven Nursing Home is situated in semi rural settings on the outskirts of the market town of Skipton. The home is registered to provide nursing care for up to 68 residents who are elderly, mentally ill, or suffer from dementia. A major building programme has just been completed and has resulted in an increase of beds from 48 to 68. This has permitted the separation of the categories of resident and provides en-suite toilet facilities for all rooms. It has extensive views at the front overlooking the Skipton to Keighley road and at the rear, the Leeds / Liverpool Canal flows close by. There are two vertical lifts providing level access to the first floor. The fees charged at 27/09/06 are between £500 - £600 per week. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to the unannounced inspection, which took place on Tuesday 6th February 2007and the manager Mrs Felicity Colman and Mrs Carolyn Homes, deputy manager, were available to assist with the process. The inspection commenced at 10.00hrs until 15.30 hrs, 5.5hrs in total. There were 40 residents present of which 19 were suffering from dementia and 21 who were elderly and all required nursing care. Substantial development has taken place and is now complete and provides 68 beds for people suffering from the diseases of old age including dementia. The inspections focused on the key standards as well as addressing issues raised at the previous inspection. An inspection of some of the resident’s rooms, lounges, bathrooms and kitchen also took place. Discussions took place with the manager, nurses, carers, and several residents. The residents appeared content and were well dressed with clean and wellpressed clothing. What the service does well: The home continues to provide a good quality of care in a homely and professional manner. There are good and improved systems of documentation in relation to care planning, policies and procedures. The home exceeds the minimum standards in relation to the number of care staff with NVQ Level qualifications and further training of other staff will increase this further. The care staff spoken to were very impressive, expressing not just their wish to provide good care but how uplifting and fulfilling it was to care for people suffering from dementia. One carer staff said ’ I love it when they protest and say they don’t like something as this shows their spirit is not dead, or that we know best what is best for them’. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 6 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Craven Nursing Home DS0000061132.V330455.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 Craven Nursing Home DS0000061132.V330455.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): 3,2 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s needs are sufficiently assessed thereby providing the foundation on which the care plans can be developed. EVIDENCE: Evidence from the case tracked residents records confirmed that pre-admission assessment sheets are completed prior to admission. The manager or deputy undertakes these either in hospital or the resident’s place of residence prior to admission. The thematic inspection of 4th January 2007 recommended that registered person should make it clear on the contract which room the resident will be occupying. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 9 This referred to the contracts issued by North Yorkshire Social Services (NYCC) for publicly funded placements and which have now been altered so that the home can include this information. Craven Nursing Home DS0000061132.V330455.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): 7,8,9, & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good standard of care is being provided by staff that is well-motivated. EVIDENCE: Individual ring folders are available for each of the home’s residents into which all information relating to their care plan and needs are kept. The records inspected included admission details, medical history, medications, general assessment, nutrition & risk assessments, moving & handling, weight charts, cares plans and daily statements. The care plans are specific to the individual resident and identify all pertinent issues, which helps ensure that all health and social needs are met. They are well designed, with easy to follow indexing and thoughtful indications of the interventions required. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 11 The timings of the daily statements are recorded utilising the 24hr clock in accordance with good practice. Only the trained nurses are involved in the documentation of the residents care on a daily basis. The manager will review this practice with a view to giving the care staff ownership of the documentation of the care that they provide. It will also assist with the training both of the NVQ Level 2 & 3 carers and the conversion course nurses in the home of whom there are three. The dependency of many of the residents is high with twenty suffering from dementia, twenty-nine doubly incontinent, thirty two requiring wheelchairs to move about and forty-four needing assistance with dressing, toileting and general hygiene. Four are registered blind and nine had hearing deficits. There are seven residents who are in receipt of Health Authority funding under the continuing care arrangements. Pressure-relieving mattresses are provided for the residents at risk from pressure sores and pressure-relieving cushions are also available for those at particular risk when sitting out of bed. The type or make of the pressure relieving mattresses or cushions should be identified in the care plan and the manager agreed to ensure this was done. The residents spoken to made positive comments about their care in the home with particular reference to the kindness and thoughtfulness of all the care staff. Their privacy and dignity are respected, with the staff referring to them in appropriate terms and also observed to knock on room doors prior to entering on invitation. One resident said that he could get ‘all he wants, with the food being good and varied’. He could have muesli, bacon & egg for breakfast, which is his preference. ‘ Whatever you want, you can have’. ‘ I can have a beer or whiskey, if I like’. He had a bath or shower once per week but thought he could have more if requested. ‘All is quiet now that the building work is complete’. The and was that relatives of one resident spoke to the inspector and `were very content pleased with the way the staff looked after their relative. They said she more comfortable than where she was before she came to this home and the staff were ‘kindly’. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 12 There is a ‘thank you’ file available to see where all the letters and cards from relatives and friends are located. Comments from them were very supportive, expressing gratitude for the home’s help and care for loved one’s present and departed. Management of the dying resident is an area where the home have wellstructured and thoughtful procedures in place. Comments seen from relatives and friends relating to the support they and the residents received during these episodes testifies to this. The care staff spoken to were very positive both about providing care, especially for those residents with dementia. They believed that they were doing it well and with total commitment. One of the care staff said ’ I love it when they protest and say they don’t like something as this shows their spirit is not dead, or that we know best what is best for them’. Another said she was undertaking the NVQ Level 3 training, which would be the precursor for her going into nurse training. She liked the fact that there was time to spend with the residents, listen to them and that they can have ‘everything they wish’. There are three care staff from Romania who are undertaking the overseas nurse adaptation programme to be registered as nurses in England. Manchester University audits the home so they can be confident that the home can undertake this supervised practice satisfactorily. One of these nurses discussed the difference between nurse training in England, which she thought to be more technical and theoretical rather than skills based, as in Romania. Her thoughts in this regard were very well considered and pertinent to the ongoing discussion and debate about nurse training in England. The storage, administration and recording of medications administered are managed in accordance with good practice. The traditional pharmacist supply rather than ‘blister pack’ system is provided and is working satisfactorily. Feedback from three GP surgeries were complimentary and supportive of the management of the home. Craven Nursing Home DS0000061132.V330455.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily routines enable the residents to have control over their own lives. The quality of the meals provided is good with all the residents and staff spoken to confirming this in conversation. EVIDENCE: The residents spoken to say that they decide their own daily routines. The home has an activities programme and an organiser who works 15 hrs per week to help stimulate and occupy the residents within their capabilities. There is little that can be done to assist many of the residents due to their general mental and physical debility but contact and conversation can add to the quality of their lives. Due to the increase in the numbers in the home additional activities person hours will be required. Visiting arrangements are flexible so that the residents are able to see relatives and friends whenever they wish. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 14 The residents made favourable comment on the quality of the meals provided and the staff thought the chef was ‘brilliant’. For the residents who require their food to be liquidised, the elements of the meals are attended to separately and this helps maintain attractive meals with the colours and smells of the costituent parts maintained. There is plenty of choice of meals and alternatives are also available. The chef showed the inspector the ample supplies of fresh vegetables and meat and fresh cakes and pastries are made on a daily basis. Full cream milk and butter were also provided routinely. There was no doubting the chef and his staff’s commitment to providing the residents with what they wished in terms of diet and drinks. Craven Nursing Home DS0000061132.V330455.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a relevant complaints procedure and the staff have received abuse awareness training. EVIDENCE: The complaints procedure of the home meets the required standard. Staff are aware of how to respond to any complaints made by either the residents or their representatives. There have been no complaints made about the service either to the home or the CSCI in recent times. There are records to show that there has been recent training of the care staff in abuse issues and their responsibilities in this regard. Staff confirmed that they had received training in abuse issues in recent times. The residents are made aware of how to access advocacy groups and other avenues for their rights to be exercised and protected. Craven Nursing Home DS0000061132.V330455.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): 19,20,21,22,23,24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Following substantial development the environmental standards of the home are good. EVIDENCE: The home has just completed a major building programme, which has resulted in an increase of beds from 48 to 68. The redevelopment has permitted the separation of the categories of resident and provides en-suite toilet facilities for all rooms. There are now 56 single and 6-shared rooms Refurbishment of some of the older rooms is yet to be completed. Each of the residents rooms are provided with lockable space so that they may store their valuables or medication in safety should they so wish. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 17 Residents can bring in their own furniture and this is evidenced when looking round the rooms. The requisite numbers of bathrooms, sluice rooms, lounge and dining areas have been provided and the décor has been done to a good standard. All the new bedroom doors have automatic door closers which operate when the fire alarm is activated or by a switch outside the room. There are eleven power-assisted adjustable profiling beds provided and the numbers of these will be increased over time. There are adequate numbers of hoists and ‘stand-aids’ provided to help ensure safe practice. Good quality heating and low surface temperature radiators are provided throughout to provide a safe environment. All the hot water outlets deliver water at temperature no greater than 43°C and these are tested on a monthly basis and records kept. Emergency lighting is provided throughout the home. There are appropriate policies and procedures in place to reduce the risk of cross infection. Liquid soap and disposable towels in dispensers are provided in all the residents rooms, bathrooms, toilets, medication room, laundry, kitchen and sluice rooms, thereby helping reduce the incidence of cross infection. The premises are clean and hygienic and were free from any offensive odours on the day of inspection. There are two sluice rooms with a commode pan disinfector on each of the two floors, which help in this. There is no ‘loop’ systems for the hard of hearing and as there are several residents with this disability, this would be of benefit, especially in the communal lounges. The kitchen facilities are in need of expansion and refurbishment,particularly with the 30 increase in residents. The cooker, ventilation, lighting and wall surfaces need to be improved. The reostat which should alter the speed and therefore noise of the extractor fan was not working thereby making working in the kitchen uncomfortable. There are plans to do all of this in the near future. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 18 Tea making facilities are to be provided in a room adjacent to the kitchen thereby obviating the need for the care staff to go into the main kitchen when preparing drinks. A heated ‘bain marie’ may be provided for the transport of the meals upstairs. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is sufficient staff to provide personal care to the residents and satisfactory recruitment practices are followed. EVIDENCE: Last year the home accessed ‘New deal, Skills for life initiative’ funding for the over 25 year old staff who previously had to pay for this training. Thirteen of the care staff has achieved NVQ Level 2 training standard and two are working towards NVQ Level 3 level. One level NVQ Level 2 is about to complete NVQ Level 3. Another carer has embarked upon NVQ Level 4. The percentage of the care staff trained to NVQ Level 2 or above standard is 52 , thereby exceeding the recommended standard. The recruitment procedures at the home meet the required standard and Criminal Record Bureau (CRB) checks are done for all staff. There is a training programme in place for the care staff, which meets the National Training Organisation (NTO) standards. Craven Nursing Home DS0000061132.V330455.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): 31,33,35,37 & 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 by a manager who enjoys the support and confidence of the staff. Improvements have been made in the area of policies & procedures, which will help, keep the residents safe. EVIDENCE: The Manager is a first level nurse with many years of experience in caring for the elderly and has worked in the home for six years. She acquired the NVQ Level 4 management award in 2005 and is soon to complete the Certificate of Education. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 21 She enjoys the respect and support of the staff and regular meetings are held with staff to keep them involved and consulted about the running of the home. Questionnaires are routinely distributed to elicit the views of the residents and relatives and were available to see. The latest one for 2006 included invitation to comment on areas of interest such as ‘First impressions, Care, Facilities & Equipment, Staff, Activities, Services and Catering. The results seen indicated a high level of satisfaction ranging from 85 to 100 positive. The residents or their relatives on their behalf arrange the management and control of the resident’s personal monies and in consequence there is no need for the home to be involved in these transactions. There are systems in place for the staff to receive training in the areas of Health & Safety, First Aid, Fire Safety and Moving and Handling. A member of staff is approved as a trainer in Moving & Handling. One member of the care staff stated that she ‘would not even think about moving a resident without deploying an appropriate hoist’. Regular servicing of the gas boilers, lift, hoists and other equipment takes place and records of this are maintained. The care policies and procedures of the home have been reviewed and are now numbered, indexed and dated, making them more easily accessible. There are policies to cover risks and good practice, including equal opportunities and staff spoken to were aware of these. Signatures of the staff to evidence that they have seen and understood the policies are now in place. There is now a bathing policy, which makes reference to checking the water temperature, using hoisting equipment with two people and never leaving residents in the bathroom alone. A copy of this is also on display in welded plastic in each of the bathrooms. The residents’ care records are kept in secure conditions and the manager undertook to ensure that all the care staff record their interventions and observations in the future and not just the nurses. Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP8 Good Practice Recommendations All the care staff should make a record of their interventions and observations, not just the nurses. The type of pressure relieving mattress or cushion should be recorded in the care plan. 2 3 OP12 OP19 More activities person hours should be provided to help ensure that the resident’s needs in this regard are met. The expansion of the kitchen facilities should be undertaken soon and include replacement of the cooker, and improvement to the lighting and ventilation. The provider should consider installing a ‘loop’ system in the communal lounges to aid those with hearing deficits who use hearing aids. 4 OP22 Craven Nursing Home DS0000061132.V330455.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Craven Nursing Home DS0000061132.V330455.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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