Inspection on 13/09/05 for Fisher Close Nursing Home

This inspection was carried out on 13th September 2005.

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

Fisher Close Nursing Home 05/08/08

Fisher Close Nursing Home 28/09/07

Fisher Close Nursing Home 28/11/06

Fisher Close Nursing Home 03/02/06

Fisher Close Nursing Home 21/02/05

Fisher Close Nursing Home 23/09/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 Fisher Close Nursing Home Grangewood Farm Estate Walton Chesterfield Derbyshire, S40 2UN Lead Inspector Rose Veale Unannouned Inspection on 13 September 2005 at 12:15 pm 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Fisher Close Nursing Home Address Grangewood Farm Estate, Walton, Chesterfield, Derbyshire, S40 2UN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01246 200138 Derbyshire Care & Home Support Limited Mrs Kathleen Wood Care Home with nursing 15 Category(ies) of Learning Disability (15) registration, with number of places Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21/02/05 Brief Description of the Service: Fisher Close is situated in a residential area approximately 2 miles from the centre of Chesterfield. The home comprises of three bungalows, each providing nursing and personal care and support for up to five adults with learning disabilities. Although the home is registered and managed as one establishment, each bungalow has its own separate nursing and care staff group and dedicated facilities including aids and adaptations. All residents are accommodated in single bedrooms. Each bungalow has its own garden area, accessible to residents. Transport is provided for residents. There is a car park to front of the bungalows. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over a period of 5 hours on one day. There were 14 residents accommodated in the home on the day of the inspection. Staff were spoken with, a tour of the bungalows was undertaken and records were examined relating to the care of residents, staffing and management of the home. Since the last inspection, a visit had been taken place on 22/08/05 to look at the extensions and associated work carried out to bungalows 1 and 3. What the service does well: What has improved since the last inspection? What they could do better: Most of the requirements made at the last two inspections had not been met and have been carried forward in this report. Some of these requirements were to address shortfalls in the provision of equipment in the home which would ensure a safer environment for residents and staff. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 6 Staffing levels at the home were an issue, as they were at the previous inspection. The situation appeared to have worsened recently as staff had been moved and their hours had not been replaced. Although the home had an acting manager whilst the manager was on longterm leave, the acting manager did not appear to have supernumerary time to deal with necessary managerial and administration tasks. The home appeared to lack the sense of leadership and continuity provided by a permanent manager. The following issues were raised as matters of serious concern and a letter has been sent to the providers requesting a written response detailing the action they will be taking in order to address the issues and the timescale within which these will be addressed: • there are no sluicing disinfectors provided in the home • adjustable height beds have not been provided for all residents who require them • staffing levels are not always sufficient to meet the needs of residents • the acting manager does not have sufficient supernumerary time to complete managerial and administration tasks. 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. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 2 Residents / their representatives do not have all the information they need to make an informed choice about living in the home. Assessment information was generally good and was reviewed regularly to ensure residents’ current needs were being met. EVIDENCE: The Service User Guide and the terms and conditions for residents were seen. Some of the information required at the last inspection had been included in the Service User Guide and the terms and conditions included all the required information. There were still some items missing from the Service User Guide, such as details of the relevant qualifications and experience of staff, and residents’ views of the service provided. The care records of three residents were examined. All the records contained detailed information about the resident’s family / social history, personal likes and dislikes. The assessment information included moving and handling needs, risk of developing pressure sores, dependency level, and nutritional needs. The assessments had been reviewed six monthly in the last year. There was no continence assessment in any of the records seen, though all three residents had care plans regarding their continence needs. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Care plans and risk assessments were generally good with detailed information about the action required by staff to meet the needs of residents. EVIDENCE: The care plans for three residents were seen. The care plans were generally detailed and comprehensive. One resident had information from the Speech and Language therapist regarding feeding, but had no care plan to detail the action required by staff. Most of the care plans had been reviewed within the last six months, and all of them had been reviewed in the last 7 months. The care records seen all contained risk assessments appropriate to the needs of residents, such as falling out of bed, and going on holidays or trips out of the home. The risk assessments had all been written or reviewed within the last 9 months. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 Residents were offered a good range of leisure and development activities, although this was sometimes compromised by not enough staff being available. EVIDENCE: The three care records seen contained details of activities residents’ had taken part in, and details of the residents’ usual attendance at day care centres. Residents were supported to access day care services in Chesterfield and Tibshelf. Activities included use of Snoezelen equipment in the home, trips out, shopping, going to the theatre, and going out for lunch. A separate book was seen for one resident which recorded daily activities. This was detailed and informative. Staff expressed concern that planned activities sometimes could not be carried out due to a lack of staff. For example, one resident required two staff to go out and this was not always possible. This issue was raised at the last inspection and it appeared that no progress had been made. Residents records contained details of contact with family and friends. Some residents were able to visit family, others were supported to maintain contact through letters and telephone calls. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 Residents’ health care needs appeared to be well met with good liaison with other healthcare professionals. EVIDENCE: Residents’ records contained details of their likes and dislikes and preferences regarding daily routines. Staff spoken with were knowledgeable about residents’ needs and preferences. Staff felt that routines in the home were often dictated by the shortage of staff and that flexibility was not always possible. The care records seen showed that residents had access to other healthcare professionals, such as dentist, optician, learning disabilities consultant, and physiotherapist. It was clear that residents’ health was monitored and action taken to deal with any health problems. For example, asking for a referral to an ear, nose and throat consultant, or seeking advice and support from a speech and language therapist. Residents were registered with local GPs and records were kept of the input and treatment given. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The rights of residents were limited by the lack of correct information provided in the complaints procedure. EVIDENCE: The complaints procedure provided to residents was seen. This was in an appropriate format with simple text and pictures. This version of the complaints procedure had not been changed since the last inspection and a requirement made then had therefore not been met. The complaints procedure referred to National Care Standards Commission instead of Commission for Social Care Inspection, (CSCI), and did not include the information that residents / their representatives could contact CSCI at any time. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27, 29 and 30 Generally, the home provided a pleasant and comfortable environment for residents. However, there were shortfalls in the provision of equipment required to fully ensure the safety and welfare of residents and staff. EVIDENCE: Bungalows 1 and 3 had been extended since the last inspection. The extensions and associated work within the existing buildings had resulted in all residents being accommodated in single rooms, four of these with en-suite shower and toilet. Bungalow 3 had been redecorated throughout and new carpets laid. New curtains were to be provided for the lounge. New flooring had also been provided in bungalow 2. Bungalow 1 had some areas still to be completed and decorated. It appeared that no progress had been made with this since the visit on 22/08/05. Storage areas had been incorporated into the new extensions to bungalows 1 and 3. Apart from the areas awaiting redecoration, the bungalows appeared bright and attractive. New office space had been provided in bungalow 1. This was particularly welcomed by staff. Wash-basins had been provided in the bedrooms in bungalow 1. The bedrooms seen were all well decorated, well personalised and reflected the interests and character of the resident. In the garden for bungalow 2 the patio Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 14 area had recently been enlarged to provide a better area for residents using wheelchairs. At the last inspection it was a requirement that cleaning products and other chemicals must not be left out openly. None were seen during this inspection and cleaning products were seen to be stored in locked cupboards. Requirements were made at the last inspection to move the position of the rise and fall baths in bungalows 1 and 2 to allow safer access for staff assisting residents to use the baths. This work had not been carried out. The bath in bungalow 1 was reported to be not working properly and demonstrated to be leaking from the taps. Bath water temperatures were recorded as 44 or 45 degrees centigrade throughout July and August 2005. It was a requirement at the last inspection that the water temperatures should be between 41 – 43 degrees centigrade as they had been regularly recorded between 44 and 48 degrees centigrade. This requirement had therefore been met as a tolerance of or – 2 degrees centigrade was acceptable. It was reported that the bath in bungalow 1 was leaking from the taps and that the Jacuzzi function was not working properly. There was a requirement made at the last inspection that adjustable height beds must be provided in accordance with the documented needs assessments of residents. Two adjustable beds were in use in bungalow 1, and another bed was reported to be on order. Staff said that there were 2 other residents who required adjustable beds. In bungalow 2 there were no adjustable beds although staff said that 4 were needed. It was clear from observation, from discussion with staff and from assessment information seen that there were residents using low, fixed height, divan type beds who were fully dependent on staff to move them in and out of bed, and who would benefit from the provision of adjustable height beds. It was reported that the portable electrically operated hoist in bungalow 1 used for transferring residents was not working. A temporary replacement had been provided, but staff were concerned that this would be needed elsewhere. All the bungalows were clean and free from offensive odours on the day of the inspection. It was a requirement from previous inspections that sluicing disinfectors must be provided in each bungalow. None had been installed, despite verbal and written assurances from the providers that the installation would be carried out as part of the building work. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 The home did not always provide staff in sufficient numbers to ensure that residents’ needs were fully met. EVIDENCE: Since the last inspection, the home had employed a housekeeper. Staff spoken with felt that this had really helped by relieving their workload of many domestic tasks. The home had therefore met a requirement made at the last inspection. Staffing levels in the home, particularly in bungalow 1, were clearly an issue. On the day of the inspection it was reported that there should have been three staff working in bungalow 1 for the afternoon shift but it had proved impossible to cover the shift and there were only two staff. On examination of the staff rota for the previous six weeks this was shown to be a regular occurrence. It was reported that staff from bungalow 1 had been moved to another home but their hours had not been replaced. It was therefore proving very difficult for the remaining staff to cover shifts, or to get help from the other bungalows or other homes. Agency cover was never used, this was said to be because of the difficulty of getting appropriately trained and experienced staff. Staff stated that they felt that standards care were being affected by the shortage of staff, as staff did not have sufficient time to spend with residents. Staff stated that they were in discussion with their employers regarding staffing levels at the home. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 and 41 There was no clear sense of direction and leadership in the home, leading to reported low staff morale and possible negative effect on residents. EVIDENCE: The home’s manager was on long-term leave and the acting manager was not on duty on the day of the inspection. It was reported that the acting manager did not have any supernumerary time allowed to carry out managerial and administration tasks. The duty rota in bungalow 2 showed that the acting manager was included in staffing numbers on every shift worked and no other hours were recorded. Concern was expressed that although staff felt the acting manager was doing her best, sufficient time and support were not provided to allow her to manage the home effectively. It was clear that staff felt the lack of a permanent manager. Staff morale was reported to be low, particularly in bungalow 1 where staff were struggling to provide sufficient staff cover. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 17 It was a requirement at the last inspection that the staff rota should include the full names and designations of staff. The rotas were seen in all three bungalows and this requirement had been met. The certificate of registration for the home was not properly displayed. This had also been identified at the last inspection and a requirement made which had not been met. The certificate displayed in bungalow 1 was a photocopy and was of one page only of the two page certificate. It was also a requirement made at the last inspection that the most recent inspection report must be available in the home. This had not been met. The inspection report produced when asked was from September 2004. Some information and records required were not available for inspection as the inspection was unannounced and the acting manager was not on duty. Requirements made at the last inspection relating to these have therefore been carried forward in this report. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 x 2 1 Standard No 11 12 13 14 15 16 17 x 2 x 2 3 x x Standard No 31 32 33 34 35 36 Score x x 1 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fisher Close Nursing Home Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 1 x x 2 x x C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 19 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 5(1) Requirement The Service User Guide must contain all information in accordance with NMS 1.2 (v) (viii) Original timescale 30/04/05 Assessments must cover all the needs of residents, (including continence assessments). Access to activities for residents must be facilitated by adequate provision of staff The complaints procedure provided for residents in a simple picture format must detail the residents right to to contact CSCI at any time they choose. Original timescale 30/11/04 The requirements/ recommendations of the Fire Officer during their recent visit to the home must be in accordance with the Fire Officers timescales The redecoration and refurbishment of bungalow 1 must be completed The position of the rise and fall bath in bungalow 2 must be reviewed and positioned appropriately to ensure that staff and residents can access this safely. Original timescale Timescale for action 31/10/05 2. 3. 4. 2 12, 14 22 14 16(n) 22(7)(b) 31/10/05 31/10/05 31/10/05 5. 24 23(4) as per Fire Officer timescales 31/10/05 31/12/05 6. 7. 24 27 23(2)(d) 13(4)(b) 23(2)(n) Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 20 31/01/04 8. 27 13(4)(b) 23(2)(n) The position of the rise and fall bath in bungalow 1 must be reviewed and repositioned as necessary to ensure safe access and use by residents and staff assisting them The rise and fall bath in bungalow 1 must be repaired or replaced A review of beds must be undertaken and adjustable height beds must be provided for those residents who need them in accordance with their documented needs. Original timescale 31/08/05 The hoist in bungalow 1 must be repaired or a permanent replacement provided Separate and adequate sluicing facilities/sluicing disinfectors must be provided in each bungalow. Original timescale 31/04/04 At least 50 of care staff must NVQ Level 2 by 2005 The Registered Person must provide sufficient numbers of staff of duty at all times to ensure the health and welfare of residents The Registered Manager must complete Level 4 NVQ in management (or equivalent) by 2005 A copy of the most recent inspection report must be provided in the home, which is accessible to residents and their representatives. Original timescale 31/03/05 The certificate of registration issued under this part must be kept affixed in a conspicuous place in the establishment. Original timescale 31/05/05 31/12/05 9. 10. 27 29 23(2) (c) 23(2)(n) 31/12/05 31/12/05 11. 12. 29 30 23(2)(c) 13(3) 13(4) (c) 31/12/05 31/12/05 13. 14. 32 33 18(1)(a) & (c)(i) 18(1)(a) 31/12/05 31/10/05 15. 37 18(1)(a) & (c)(i) 17(2) Schedule 4 31/12/05 16. 41 31/10/05 17. 41 Section 28(1) part II, Care Standards Act 2000 31/10/05 Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 21 18. 41 18(1)(a) Schedule 4 The staff rota must show the all the hours worked by the acting manager, inlcuding the supernumerary time allowed for management responsibilities 31/10/05 19. 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 26 Good Practice Recommendations The Registered Person should consider the provision of computer equipment for residents who would benefit. Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT 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 Fisher Close Nursing Home C52 C02 S2056 Fisher Close V248730 130905 Stage 4.doc Version 1.40 Page 23 - 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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