Inspection on 27/07/06 for Fieldhead Court Nursing Home

This inspection was carried out on 27th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fieldhead Court Nursing Home 02/03/09

Fieldhead Court Nursing Home 04/03/08

Fieldhead Court Nursing Home 28/02/07

Fieldhead Court Nursing Home 10/01/06

Fieldhead Court Nursing Home 10/11/04

Fieldhead Court Nursing Home 27/07/04

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Hawkhills

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Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Fieldhead Court Nursing Home Rectory Park Church Lane Thornhill Dewsbury West Yorkshire WF12 0JZ Lead Inspector Helen Battle Key Unannounced Inspection 27th July 2006 09:20 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 Fieldhead Court Nursing Home DS0000001082.V296199.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. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fieldhead Court Nursing Home Address Rectory Park Church Lane Thornhill Dewsbury West Yorkshire WF12 0JZ 01924 459000 01924 459000 fhcourt@rochehealthcare.com 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) Roche Healthcare Limited Mrs Kathryn Tanner Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: Fieldhead Court is a care home providing accommodation, personal and nursing care for up to forty older persons. It is owned by Roche Health Care Ltd, a private limited company with other registered care services in the district. The accommodation is a converted former rectory operating over two floors which are accessed by a passenger lift and stair lifts. There are thirty-two single rooms, of which twenty-eight have en-suite facilities. There are four double rooms, three lounges and a small dining room. The accommodation is set within large grounds in a conservation area and has car parking facilities. The provider informed the Commission for Social Care Inspection on the 27.07.06 that the fees range from £311 to £525 per week. There are additional charges for hairdressing, newspapers and magazines. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit carried out by one inspector. The inspector arrived at the home at 9.20am and left at 4.10pm. During this visit the inspector spoke to some of the service users, some of the staff and the home’s management. The inspector read care records, audited a sample of medications, reviewed staff recruitment and training records, and carried out a tour of the building. Prior to the inspection, ten service user questionnaires were sent to service users at Fieldhead Court to obtain the views of service users living at the home. Seven completed questionnaires were returned. There were thirty seven service users living at the home on the day of this inspection. Surveys were sent to ten relatives and friends of service users, a number of GPs and social workers. At the time of writing, five responses had been received from relatives and three from GPs. There were no responses from social workers, however one other health professional responded. Other information used as part of the inspection process included notifications from the home to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, and a pre-inspection questionnaire completed by the manager. The inspector would like to thank everyone for their assistance during the inspection process. What the service does well: The staff at the home evidently work hard to meet the needs of the service users. Comments received from the questionnaires included “I feel very happy and settled here and the staff are all very nice”, “dignity shown by all the members of staff.” Positive feedback was also given by relatives who said that they are made to feel welcome, can visit in private, are consulted about their relative’s care and that they were all satisfied with the overall care. It was evident that the manager of the home has worked hard to build good relationships with the service users and relatives during the 15 months she has worked at Fieldhead Court. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 6 There are currently 64 of the care staff who have achieved at least the NVQ 2 award in care. The meals provided at the home are of a good standard. Feedback from service users was positive regarding the meals provision. Activities are provided to meet the needs of the service users living at the home. What has improved since the last inspection? What they could do better: Care plans are not of a satisfactory standard. Not all the assessed areas of need were included in the care plan, they were not updated correctly and they did not include information about pressure area care where service users had been identified as being at risk. Daily records of service users did not reflect the actual care given or the needs identified in the care plans. Medication procedures are not being followed and there are discrepancies in the recording of medication. Liquidised meals are not served in an appetising manner. Staffing levels are not meeting the needs of the service users. There are gaps in recruitment practices. Not all staff have completed mandatory training updates. Monthly management visits are not carried out as required. Tests of the fire alarm and emergency lighting systems must be carried out weekly. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 7 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. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users have their needs assessed prior to admission to the care home. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The pre-admission information held for one service user was examined. This included a detailed assessment and a copy of a Community Care Assessment. All seven service users who responded to the questionnaire stated that they had received enough information about the home prior to moving there. This was confirmed by a service user spoken to at the time of the inspection. One response to the questionnaire confirmed that they had had the opportunity to visit the home prior to making a decision to move there. Fieldhead Court Nursing Home DS0000001082.V296199.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 Not all service users’ health, personal and social care needs are set out in the individual plan of care. Risk assessments are carried out but greater care is required in their monitoring. The service users are not protected by the home’s medication policy and procedure. Service users are treated with dignity, respect and privacy. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The care records of three service users were examined during this visit. All were found to have gaps in the information recorded. One care plan was of a good standard and reflected the assessed care needs of the service user. However, the other two were not acceptable in that not all the assessed areas of need were included in the care plan, they were not updated correctly and they did not include information about pressure area care where service users had been identified as being at risk. Daily records of all three service users did not reflect the actual care given or the needs identified in the care plans. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 11 It was evident that, although the care records were inadequate, the staff do know the needs of the service users and actually provide the care to meet those needs. This was observed on the day of the visit and confirmed by speaking to staff and service users. There was evidence in records that the health care needs of service users are met. Pressure relieving equipment is in place, and service users have access to GPs, specialist nurses and to chiropody, optical and dental services. The medication of four service users was checked. The medication of two of the service users tallied with the records held. One person’s medication had been left in the pack when it had been signed as being administered, one amount of medication had been signed for before the dose was due. A small number of missing signatures were noted on medication administration record sheets. Medication prescribed on an “as required” basis could not be accounted for as records were not kept up to date. Generally, eye drops were dated when opened, however, one was not. Controlled drugs are kept as required and records were clear and accurate. Service users were seen to be treated with dignity and their privacy maintained on the day of the inspection. One issue which was brought to the attention of the inspector was passed on to the manager of the home to monitor. Service users spoken to said that they are usually treated well by the staff. One service user who responded to the questionnaire stated, “Dignity is shown by all members of staff”. Fieldhead Court Nursing Home DS0000001082.V296199.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. Generally, the service users’ cultural, religious, social and recreational needs are being met, and they are supported to maintain contact with their family and friends. The service users are able to exercise choice and control over their lives. The home provides the service users with a varied and nutritious diet. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The activities provision at the home is good. A summer fayre was held in June 2006 and was said to be very successful; service users enjoyed a barbeque on this day. On the notice board near the entrance to the home, dates were displayed when the hairdresser visits and when the local Baptist church services are held in the home. Other activities include quizzes, bingo, animal therapy, word searches, entertainers, darts, skittles, local children singing and trips out. Service users were pleased to tell the inspector about trips to York, Ponderosa and pub lunches. Service users are able to maintain contact with family and friends. Visitors were seen to come and go to the home during the day and one service user Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 13 was assisted to post a letter to family/friends at the time of the inspection. The service user confirmed this was a regular occurrence. It was clear from speaking to service users that they are able to make choices about their everyday life, choosing what time they get up, go to bed and how and where they spend their day. The service users spoke about the meals at the home favourably. The main meal served at lunchtime on the day of this visit was roast chicken and seasoning or Cornish pasty, potatoes, vegetables and gravy, followed by home made rice pudding. Service users were offered drinks throughout the meal, such as juice, tea and sherry. Tables were set nicely and the meal appeared to be unhurried and relaxed. Service users who required assistance were helped in an appropriate manner by staff. Those service users who needed a soft diet were given a dish of liquidised food. This was all liquidised together and presented as a dish of brown thick “soup”. Portions of food must be presented separately in order to maintain the taste and be presented in a more appetising manner. Fieldhead Court Nursing Home DS0000001082.V296199.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 Service users, their relatives and friends are confident in raising any concerns and complaints. The service users are protected from abuse. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The complaints procedure is displayed in the entrance of the home. There have been four complaints to the home during the last twelve months. Records were seen of these complaints and they had been dealt with in an appropriate manner and according to the complaints procedure. Of the five relatives responses to the questionnaire, four said they knew how to make a complaint but had never had to. All seven service user responses to the questionnaire said that they would also know how to complain. The majority of staff working at the home have had adult protection training in the last twelve months. However, there were some gaps noted where there was no record of this particular training for a small number of staff and others who have not had an update since 2004. This must be addressed. Staff spoken to on the day of the inspection had a good understanding of adult protection issues. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The service users live in a safe and overall well maintained environment that is generally clean and hygienic. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Since the last inspection there has been a lot of redecoration carried out to the communal areas at the home. The entrance area and reception has been fully refurbished to a good standard. The “blue” lounge has been redecorated, however the carpet is also in need of replacement as it is heavily stained and is worn in the one of the doorways. The conservatory and the “green” lounge have also been redecorated to a good standard. A sample of service users’ rooms were seen. They were generally of an adequate standard, however it was noted that some of the furniture is Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 16 beginning to look worn and damaged. An audit of the bedroom furniture should be carried out and a programme of replacement implemented. Plans to renew the extension of the home to improve facilities for the service users,; ie reducing the number of double rooms, increasing the number of ensuite rooms and putting in a shaft lift, are still being considered. However, the extension in place at present is now in need of redecorating and, should the plans to renew the extension not be commenced in the next six months, work to redecorate this area should be started. Two commode chairs seen were worn and frayed; these should be replaced to ensure adequate cleaning and promote infection control. The grounds of the home are extensive and beautifully maintained. There is an easily accessible patio area which was being used by a number of service users on the day of this visit. The driveway leading down to the home is very uneven and has a number of potholes in it. This was discussed with the manager who stated that this is an unadopted road. It was reported that the provider is currently in discussion with the local authority regarding this matter. The home was clean and free from unpleasant odours. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Staff are not employed in sufficient numbers. Staff receive induction and ongoing training. The recruitment process needs to be improved to ensure the service users are sufficiently protected by the home’s recruitment policy. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Significant feedback was received from service users, relative questionnaires and from staff on the day of this visit regarding staffing levels. Four of the five relative responses to the questionnaire stated that there were not enough staff on duty in the home. Service user responses to questionnaires stated that staff are always very busy and that they have to wait. This was confirmed by service users spoken to on the day of the inspection and by observing the dependency levels of the service users and the layout of the building. Rotas indicate that staffing levels are currently: AM 1 nurse and 6 care assistants PM 1 nurse and 5 care assistants Nights 1 nurse and 3 care assistants Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 18 The residential staffing formula, used for calculating the number of care staff hours, has been used. This indicated that 968.79 hours of care staff should be provided each week. Currently there are only 718 hours provided. Nursing hours should be in addition to this. Further staff must be deployed to meet the needs of the service users, ie staffing levels must be: AM 1 nurse and 8 care assistants PM 1 nurse and 7 care assistants Nights 1 nurse and 3 care assistants Staff observed on the day of this visit appeared to be competent in meeting the needs of the service users. Evidence of induction training was seen and records of training were provided. Although the majority of staff have received training in areas including health and safety, movement and handling, adult protection, fire safety, there are a small number of staff who have not had recent updates. This must be addressed. Currently 64 of care staff hold the NVQ 2 qualification. The recruitment records for four members of staff were examined. Only two of the four had the required references in place and there were discrepancies where the start date of employment was prior to the receipt of a satisfactory CRB check. Recruitment procedures must be improved to protect service users. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33, 35, 38 The home is run and managed by a manager who is fit to be in charge. Generally, the home is run in the best interests of the service users. The financial interests of the service users are safeguarded. The health and welfare of service users and the staff is promoted and protected. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The registered manager has been manager at the home for the last 15 months. Feedback from all the questionnaires was positive about her role and how approachable she is. It was evident from observation on the day of the visit that the manager has built good relationships with the service users and their families. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 20 The manager has carried out some quality assurance monitoring and has received feedback from relatives and service users. These results have been collated and published in a letter which has been sent out to all relatives and service users. It is concerning that monthly management visits have not been carried out. This is a requirement and these visits, if carried out properly, would have highlighted some of the issues in this report. The personal monies for two service users were checked as part of this inspection. Both were found to tally with the records held. The general health and safety of service users is promoted at the home, however bars of soap were found in various bathrooms during this visit. This could be a source of cross infection. Tests of the fire alarm system have not been carried out weekly. There were also gaps in the weekly testing of the emergency lighting system. These issues must be addressed. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 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 1 X X X X X X 3 STAFFING Standard No Score 27 1 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X 1 Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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(1)(2) Requirement Timescale for action 31/08/06 2. OP9 13 (2) 3. OP19 13 (3) The Registered person shall prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met. The registered person shall make 11/08/06 arrangements for the recording, handling, safe keeping, safe administration and disposal of medications into the care home. Previous timescale of 10/01/06 not met. The registered person shall make 11/08/06 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. Bars of soap must not be used in the communal areas of the home. Previous timescale of 10/02/06 not met. Bedroom furniture must be audited and replaced if damaged or worn. The carpet in the “blue” lounge must be replaced. 30/11/06 4. OP19 16(2)(c) Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 23 5. OP27 18(1)(a) 6. OP29 19(1) (b)(c) 18(1)(C) 7. OP30 8. OP33 26 9. OP38 23(4)(c) (v) Staff must be deployed in such numbers as appropriate for the health and welfare of service users. Satisfactory checks (appropriate CRB) and references must be in place for staff prior to commencing work at the home. All staff must have training appropriate to the work they are to perform. Gaps in training must be addressed. Monthly management visits must be carried out and a report regarding this visit produced. A copy of this report must be forwarded to the Commission every month. The registered provider shall make suitable arrangements for reviewing fire precautions, and testing fire equipment at suitable intervals. Weekly tests of the fire alarm and emergency lighting system must be maintained. 31/08/06 15/08/06 30/09/06 31/08/06 31/07/06 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. 4. Refer to Standard OP7 OP15 OP19 OP19 Good Practice Recommendations Daily records should reflect the care and support provided on each shift. The food in liquidised meals should be presented in individual portions. Should the plans for work on the new extension not be commenced by 31.12.06 then the existing extension should be refurbished. The driveway should be repaired and made safe. Fieldhead Court Nursing Home DS0000001082.V296199.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Fieldhead Court Nursing Home DS0000001082.V296199.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. 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. 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