Inspection on 19/09/06 for Crossways Nursing Home

This inspection was carried out on 19th September 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

Crossways Nursing Home 23/09/08

Crossways Nursing Home 26/09/07

Crossways Nursing Home 24/05/07

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Crossways Nursing Home Greywell Road Up Nately Basingstoke Hampshire RG27 9PJ Lead Inspector Gina Pickering Unannounced Inspection 19th September 2006 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 Crossways Nursing Home DS0000066923.V310562.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. Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crossways Nursing Home Address Greywell Road Up Nately Basingstoke Hampshire RG27 9PJ 01256 763405 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) S.E.S Care Homes Ltd Mrs Rhonda-Lee Nancy Franklin Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: The home is owned by S.E.S. Care Homes Ltd who bought the home in May 2006. The staffing structure at the home including the registered manager has been unchanged from what it was with the previous homeowners. The home is situated in a quiet village near to Basingstoke. The home provides accommodation, personal and nursing care for up to eighteen persons aged 65 and over. The home can accommodate persons suffering from dementia type illnesses. Accommodation is arranged on two levels. The home has a pleasant lounge and dining room for the use of the residents. A large garden with an orchard is accessible to the residents. There are ten single rooms and four shared rooms; the majority of the rooms have en suite bathrooms. Fees for residency at the home range from £515 to £630 per week. Items not included by the fee include chiropody, hairdressing taxi fares and newspapers. Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process took into account information contained within the pre inspection document completed by the home and a site visit on 19th September 2006. During the visit to the home the inspector spoke with the registered manager (matron), trained nurses, care staff, the cook and cleaning staff, eight residents and two visitors as well as looking at documentation. The service users at the home prefer to be known as residents and this is respected in the writing of this report. What the service does well: A comprehensive pre assessment process assures residents that their needs can be met by the home when they move into the home. Individualised care plans that are reviewed regularly ensure that the personal, health and social needs of those living at the home are met. Robust medications procedures promote the health of the residents. A variety of activities are available for residents to participate in if they wish. Complaints are dealt with effectively and are seen as an integral way to improve the service offered. Residents are protected by a work force that is aware of adult protection issues as well as robust recruitment procedures. Creative rotas and effective staff training ensure that resident’s needs are met at the home. Residents live in a clean, safe environment with large gardens, cheerful communal rooms, personalised bedrooms and specialist equipment. Resident’s benefit from a management structure that supports an open and transparent culture. Crossways Nursing Home DS0000066923.V310562.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. Crossways Nursing Home DS0000066923.V310562.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 Crossways Nursing Home DS0000066923.V310562.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. The good practice of assessment ensures that when a person moves into the home their needs can be met. The home does not offer intermediate care. EVIDENCE: The matron carries out assessments of all prospective residents. Two preadmission assessments were viewed; both include comprehensive details of all aspects of the persons needs, including personal, health and social and emotional needs. Information in the form of a homes brochure, statement of purpose, service users guide, details about the complaints procedure is provided to all prospective residents. The statement of purpose needs revising to include all the required details as listed in schedule 1 of the care home regulations; the manager agreed that this would be done. Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 9 Conversation with two relatives visiting confirmed that their spouse/parent had had an assessment before they moved into the home and that they had received information about the home prior to their relative moving into the home. Service users, due to their mental conditions, were unable to clearly discuss their admission process. The home does not admit people for intermediate care. Crossways Nursing Home DS0000066923.V310562.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. The home ensures that each resident’s plan is reviewed regularly with the involvement of the resident and/ or his or her representative. The plan is updated to reflect any personal, health or social care changes. The home works to efficient medication procedures that protect the health and wellbeing of those living at the home. The aims and objectives of the home reinforce the importance of treating residents with respect and dignity. EVIDENCE: Care plans were sampled for two residents. Care plans are personalised, detailing the action needed to meet the health, personal, social and emotional care needs of the person living at the home. Plans are reviewed on monthly basis and revised as needed to reflect the current care needs and support required by the person. There is documentary evidence that some service users and their relatives are involved in the development and reviews of their care plans. There are risk assessments for moving and handling, nutrition and tissue viability. The results of these are incorporated into the individuals care plan. All residents are registered with a local GP service through which they access the multidisciplinary health care team. Residents spoken with said that Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 11 the staff at the home contact their GP’s promptly when they are unwell, this was also confirmed during conversations with relatives. Detailed records are kept of all contacts the resident has with health care professionals. G.P.s keep documented records of their contacts with all the residents at the home. Medication administration record (MAR) sheets were seen for two residents. Both these records are completed in a safe and accurate manner. Trained nurses administer all medications. It was observed that the process of administering medications is done in a safe manner. Medications are stored in secure cabinets in a clean and orderly fashion. The ordering and receiving of medications is documented. Polices and procedures are in place about he administration and handling of medications at the home. No residents at the home presently administer their own medications although procedures are in place to support those that are able to self medicate. Staff members were observed giving support to residents in a sensitive and friendly manner. Residents spoken with said that the staff are friendly, nice and caring and will generally go out of their way to help you. Staff knock on residents doors before entering their rooms; this was observed and confirmed during conversations with residents. Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15. Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. The home considers the views and interest of residents when planning the routines and activities at the home. The practices and attitudes of the staff team give residents the opportunity to remain as independent as they can be and make their own choices about daily life. Visitors are welcome at any time, residents can chose to entertain them in their own rooms or lounge or garden areas. Food is considered to be highly important and meal times are considered to be a social occasion. The menu is balanced and nutritious, though would benefit from offering a more varied choice of meals. EVIDENCE: The home employs an activity co coordinator who has responsibility for arranging group activities, one to one activities and individual outings for the residents. Information is displayed throughout the home about the activities available for residents. Speaking with the activity coordinator she explained that although there is a loose timetable of activities this is very flexible; she tailors the days activates to suit the needs and wishes of the residents on that Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 13 day. Activities include bingo, sing alongs, arts and crafts and armchair physical exercises as well as one to one sessions with residents chatting and spending time with them. Use is made of the local dial a ride service for residents to access the, local shopping area with the support of the activity coordinator. Some residents that the inspector spoke with said how much they enjoyed the opportunity to get out of the home and go to the local shopping area. One resident, who used to enjoy gardening, said that during the summer months she had been supported to plant up pots of flowers on the patio area of the garden. Residents said that staff at the home respect their decision whether to take part in activities or not. Residents are able to receive visitors at any time and can choose where to receive their visitors. Two visitors said that they are able to visit at whatever time they want to, and that the staff members always make them feel welcome. The menu plan provided by the service prior to the site visit indicated that a although a choice is offered at meal times, at lunch time this choice is based on using the same meat i.e. cottage pie or minced beef with onions, chicken pie or roast chicken. Conversations with residents suggested that if they do not like the menu on offer they generally get offered a sandwich, but as they have sandwiches at teatime they would prefer an alternative warm meal. Discussion with the cook and staff members suggested that residents dos get offered a wide variety of choices if they do not like the main meal. The menu was discussed with the manager who agreed that that the menus will be reviewed to include alternative meat at meal times. Generally residents spoken with were satisfied with the quality and quantity of the meals provided at the home. Both relatives spoken to say that their relative received meals that were nutritious, of a size that there relative wished for and of the right consistency if that person has eating difficulties. Residents spoken to say that they have they can choose whether to take their meals in the dining room or their bedrooms. Lunchtime was observed; assistance with meals is given to those that require it with sensitivity. Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. Residents and others associated with the home demonstrate a good understanding of how to make a complaint and are confident that their concerns will be addressed promptly. Residents are protected from the effects of abuse by a work force that has a clear understanding of the issues about the protection of vulnerable adults. EVIDENCE: A robust complaints procedure is in place. Resident’s spoken with expressed that they have no concerns about voicing concerns or complaints. A log is kept all concerns and complaints received by the home and the actions taken to resolve the complaint. The manager discussed that the home views complaints as one of many ways of ensuring the service provided is maintained at a good standard and continues to improve. Adult protection policies are in place. Staff have received training about the protection of vulnerable adults. Staff spoken to are clear and confident about the action they should take if they suspect an act of abuse has happened. The home has had to evoke the protection of vulnerable adults procedure once in the last twelve months. Discussion with the manager evidenced that the correct procedures had been followed, residents had been protected, and that the experience was being used to re enforce learning about the subject. Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 15 Crossways Nursing Home DS0000066923.V310562.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. Residents live in a home that has a well-maintained environment, which provides aids and equipment to meet their needs. The well being of those living at the home is protected by good hygiene and infection control practices. EVIDENCE: The home is situated in a quiet area in a village outside Basingstoke. The home consists of 10 single and 4 shared rooms, the majority of which have en suite facilities. An airy lounge and separate dining room is available. Sufficient toilet and assisted bathing facilities are provided. There is a large garden area that has seating. Both staff and residents spoke of how the garden is used in the warmer months; some residents had been planting up pots to make flower displays in the garden. A rolling programme of decorations and replacement of carpets is in place. The inspector was told that long-term plans include an extension to the home to provide further accommodation for residents. Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 17 Specialist equipment such as hoists, assisted baths and special mattresses are available. The home was clean and free from offensive odours on the day the inspector visited. Resident and visitors said that the home is kept clean and tidy. A hygiene coordinator is responsible for the cleanliness of the home. Resident’s bedrooms looked clean and cheerful, many of them have personal items such as pictures, ornaments and some furniture in them. Resident’s personal clothing is washed in the homes own laundry; bedding is sent to a commercial laundry for washing. The laundry area was clean and tidy on the day of the visit to the home. Suitable hand washing facilities are provided for staff and the residents, protective equipment such as gloves and aprons are readily available for staff members. Alcohol gels to enhance hand washing are situated throughout the home and visitors are encouraged to use these as well as staff members. Several staff member have attended courses about the control of infection. Crossways Nursing Home DS0000066923.V310562.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. Residents have confidence in the staff team that care for them. Rotas show well though out and creative ways of making sure the home is staffed efficiently, with particular attentions to busy times of the day ensuring that there are enough staff to meet the needs of those living at the home. Robust recruitment procedures are followed ensuring that resident’s wellbeing is protected. The service ensures that all staff receive training focussed on improving the outcomes for those living at the home, using external agencies to provide the training if the service has not the skills to deliver the training. EVIDENCE: The staff rota evidenced that on a morning shift 1 nurse and 4 care staff are on duty, in the afternoon 1 nurse, 3 care staff. At night there is 1 nurse and 1 member of care staff. The home employs a team of bank nurses that are used at period of high activity at the home. There are separate cleaning and cooking and gardening staff. Staff said that the numbers of staff on duty allow the people living at the home to receive personal and health care and allows staff the time to pay attention to the social and emotional welfare of the residents by allowing them time to sit and chat with the residents. Conversations with visitors and residents suggested that they believed there are sufficient Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 19 numbers of staff on duty at any time to care for them. Call bells were observed to be being answered promptly during the course of the visit to the home. At present 76 of the care work force have an NVQ level 2 or above in care with another 5 members of staff due to commence NVQ training. Robust recruitment procedures are in place. Sampling three staff member’s files evidenced that recruitment procedures are followed. This includes ensuring two satisfactory references and a satisfactory CRB clearance are received before a person commences employment at the home. One of the files looked at was of a volunteer; the home completes CRB and references prior to a volunteer working at the home. Staff files contain details of the training they have received, two monthly formal supervision sessions and an assessment of the individuals training needs. Staff spoken with said that they receive the training they need to fulfil their role. For topics that the home does not have the expertise to deliver training, they make use of specialists to deliver this training for example the Alzheimer’s Society delivering training about dementia. Discussion with residents and relatives did not reveal any concerns that staff might not have the skills to care for the residents. Crossways Nursing Home DS0000066923.V310562.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality outcome in this area is good. This judgment has been made using available evidence including a visit to the service. The change of registered provider of the home has not had any impact on the day-to-day management of the home and therefore the well being of those living at the home. There is strong ethos of being open and transparent in all areas of the running of the home. The service responds to suggestions by service users, their representatives and staff members that they utilise as part of the quality auditing of the service. Clear procedures protect resident’s finances. The home has a good record of meeting relevant health and safety requirements and legislation. EVIDENCE: The home is a newly registered home, the providers being S.E.S Care Homes Ltd. The manager and staff that were employed by the previous owners of the home continue to be employed by the new owners of the home; this has Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 21 ensured stability for the residents and the workforce. Staff expressed satisfaction with the management of the home and the support given to them by the manager. Staff said that they are able to put forward ideas about the running of the home that are considered and acted upon if possible. Staff meetings are held. Minutes from these indicate that comments from staff members are acted on. Auditing of the service provided by the home is done with the use of residents/relatives meetings, resident surveys, staff meetings and the use of the providers monthly visits to the home to assess the service provide by the home. The results of resident’s surveys are displayed on the notice board and indicate changes that have been made at the home in response to their comments. Discussion with residents and their relatives indicated that they feel comfortable to voice suggestions about the running of the home and these suggestions will be considered. The home does not look after any residents users monies. Procedures are in place to handle costs incurred by the residents, the home employs an administrative manager who handles financial issues. Facilities are available in bedrooms for residents to keep money and valuables in a secure place if they wish to. Polices and procedures are in place about health and safety issues. The fire logbook indicates that all staff receives fire safety training at least twice a year. Fire risk assessments are in place. Fire safety checks are performed at the fire and rescue services recommended intervals. During the visits to the home the kitchen was a clean and tidy, foodstuff stored in an appropriate manner, a record was available of hot food temperatures, fridge and freezer temperatures and staff entering the kitchen were wearing appropriate clothing. But it was noticed that there were a number of flies in the kitchen despite the home having the equipment to deter flies. Staff commented that flies were a common problem in the kitchen. The manager said that she would contact the local environmental food safety department to seek advice about how to further deter the flies. A sample of records was seen evidencing that services and equipment are serviced at the manufacturers recommended intervals. Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 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 Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP15 OP38 Good Practice Recommendations The menu choice should include a choice of meat dishes. Advice should be sought from the environmental food hygiene department about the control of flies in the kitchen Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Crossways Nursing Home DS0000066923.V310562.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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