Inspection on 15/11/07 for Freshfields Nursing Home

This inspection was carried out on 15th November 2007.

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

Freshfields Nursing Home 27/10/08

Freshfields Nursing Home 24/01/07

Freshfields Nursing Home 13/07/06

Freshfields Nursing Home 02/03/06

Freshfields Nursing Home 14/09/05

Freshfields Nursing Home 01/02/05

Freshfields Nursing Home 28/09/04

Freshfields Nursing Home 11/02/04

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

CARE HOMES FOR OLDER PEOPLE Freshfields Nursing Home Agaton Road St Budeaux Plymouth Devon PL5 2EW Lead Inspector Mandy Norton Unannounced Inspection 15th November 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Freshfields Nursing Home DS0000003586.V352476.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. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Freshfields Nursing Home Address Agaton Road St Budeaux Plymouth Devon PL5 2EW 01752 360000 01752 361584 freshfields@talktalkbusiness.net 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) Freshfields Management Company Limited Mrs Hyang Ja Teasdale Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Physically disabled (over 50 years) maximum of 12 service users. Date of last inspection 24th January 2007 Brief Description of the Service: Freshfields is a purpose built facility in the St Budeaux area of Plymouth. It provides nursing and care to a maximum of 39 Service Users, male or female, over the age of 65. The home is on two floors with lift access. The majority of rooms have en-suite bathrooms. There is a lounge and a separate dining room. There is a patio to the rear leading to a garden area accessible via ramps. The home is owned by Freshfields Management Company Ltd and is currently being managed by one of the directors of the company Mrs Angela Teasdale. Information about the home was found in the entrance hall and in people’s bedrooms, it was advised that a copy of the last inspection report should be displayed in the entrance foyer. Information given to the Commission by the provider indicates the current range of fees is from £450 - £520 per week. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place from 10.00 am until 3 pm on the 15th November 2007. It was carried out by two inspectors with the assistance of the acting manager and administrator. A tour of the home was carried out and some of the people living in the home were spoken to during the visit. (Not all people living in the home were able to express a view about their care). This report also contains information from seven completed staff surveys and discussion with a number of staff on duty on the day of the inspection. There were 34 people living in the home at the time of the inspection. What the service does well: Freshfields is homely and comfortable with a welcoming entrance area. People spoken to said that the staff are ‘helpful’, ‘friendly’, ‘wonderful’ and ‘kind’. People who are thinking of living at the home are assessed by a trained nurse in their current setting to see if the home can meet their needs. In addition care plans are obtained from social and other health care professionals. The care plans are detailed and reviewed regularly enabling staff to care effectively for people living in the home. People are able to maintain contact with family and friends and exercise some choice and control over their lives. They can eat their meals where they like and spend time with others in communal areas or in their own rooms. The home presented as clean and hygienic. This makes it a pleasant environment in which to live. People take part in the range of activities that are made available in the home. People spoken to liked the donkey the home have adopted, enjoy the PAT (pets as therapy) dogs that visit and like the talks from Plymouth Museum that happen on occasions. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Freshfields Nursing Home DS0000003586.V352476.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 Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. The home does not provide intermediate care. EVIDENCE: The manager visits all prospective service users at home (with another nurse or the administrator) and undertakes a thorough initial assessment of their care needs and completes the pre admission form. A completed assessment examined showed that she had visited the person in hospital and had been Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 9 able to get sufficient information from the person and the staff about their current needs and was able to say that the home could meet those needs. A requirement was set following the random inspection (July 2007) to ensure the completion of care plans so that people have enough information to meet the assessed care needs of people living in the home. Written admission documentation was adequate and included a copy of the care management assessment. Good information was available to staff to ensure they could meet the social, emotional and care needs of new people moving into the home. Four of the five completed staff surveys indicated that they have enough information about the needs of the people they are caring for and one said that they usually do. A Service Users Guide is available to everybody moving into the home as one is kept in each room. The acting manager was advised that a copy of the last inspection report is displayed in the entrance foyer. The written contract and terms and conditions of residence are on each persons file. The current fees are included and clearly laid out. This means that the relevant people have the information they need about the service they will receive and how much it will cost them. The administrator ensures the contracts are issued and have the relevant information included in them, however only private people have a Freshfields contract. The administrator was ensuring that all people are issued with a Freshfields contract before the inspection concluded. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practice regarding the planning and delivery of care means that people living at the home can be sure that their health and personal care needs will be generally fully met. EVIDENCE: All of the care plans examined (6) had relevant information in them including; manual handling, skin, and nutritional assessments and daily evaluations. They had all been reviewed regularly. They are currently kept in people’s rooms so that care staff can update them at the time the care is provided. Information about visits from other health professionals, such as the ‘tissue viability nurse’ and GP’s, was included in the care plans. The acting manager said the staff have a daily handover about the people and their needs. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 11 In the office there is a list of each persons care manager, when reviews were last carried out by the review team, the key worker and the next review date. These practices ensure people get the nursing and personal care they need. People and staff observed during the visit were interacting well. Personal care was being carried out in private. A number of people were sitting in the lounge and some preferred to stay in their rooms. Staff had an overall understanding of the needs of number of people with dementia/ confusion and were seen to be patient and kind when interacting with them. A number of the nurses are registered mental health nurses. People spoken to said that the care is very good, they feel well looked after despite recent staff shortages and the staff are wonderful. During a tour of the home it was noted that people looked well cared for and well groomed, with cared for nails, eyes and teeth and appropriate clothing. The administration and recording of medication was satisfactory. The medication is locked in the treatment room and dispensed from blister packs. One medication administration record seen had no signature or reason for omission next to one medication for one time of the day. The acting manager said she had also noticed this and would remind the nurses of the importance of accurate recording. The unwanted medicines are removed by a licensed contractor. The drugs fridge has its temperature monitored and recorded on a daily basis. This means that people can be generally confident that the nurses are competent in the management of medicines. Freshfields Nursing Home DS0000003586.V352476.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities within the home and community mean the service users have a range of opportunities to participate in stimulating and motivating activities. Meals and mealtimes are not rushed making them an enjoyable, social occasion for the people living in the home. EVIDENCE: An activity programme is ongoing in the home giving people the opportunity to take part in a variety of activities both within the home and community. Some information about upcoming events was displayed in the entrance foyer. There is a ‘house’ rabbit in the foyer, who is popular with the staff and people living in and visiting the home. There is also information about the donkey that the home have adopted (paid for from the residents fund, with the consent of the residents able to do so). He has visited the home on occasions and people spoken to said that the donkey visits and ‘the lady with the dog’ were enjoyed. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 13 Three care staff also have activity co-ordinator responsibilities and arrange singers, talks from the local museum and are arranging the Christmas party for ‘residents and relatives’ advertised on the notice board in the foyer. The home can also sometimes use the minibus belonging to the providers other home to go out on trips. The administrator keeps good records of fundraising events for the residents fund, takes photographs of events within the home and keeps a log of all activities that have taken place. This is recognised as good practice for quality assurance purposes. People were seen coming and going throughout the inspection and one person spoken to said that staff had offered to take her out for a walk recently. Menus were varied and nutritionally balanced. The dining area is large and well laid out. The meals are served to people in the dining room from the kitchen (which is adjacent to the dining room) so it is hot. Meals are delivered to those people who choose to eat in their rooms straight from the kitchen and is covered to ensure it reaches the person at the right temperature. People spoken to said that the meals were very good with plenty of choice, food is excellent and plenty of it. Specialist diets are catered and there were sufficient staff on duty on the day of the inspection to offer help to those people requiring assistance. Freshfields Nursing Home DS0000003586.V352476.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People generally feel safe and listened to. Formal complaints and reporting of abuse policies and procedures are in place. These are available to staff at all times. The manager/ provider and acting manager need to be consistent in their approach to reporting of adult protection/safeguarding concerns to ensure that people are safe living in the home. EVIDENCE: A complaints procedure is displayed in the entrance foyer and is included in the Service User Guide (kept in each persons room). The complaints log seen had complaints recorded and details of any actions required to be taken are also documented. Four of the seven completed staff surveys indicated that they knew what to do if Service User or relative has a concern about the home, two indicated they did not know what to do and one did not answer the question. The commission has received a number of complaints since the last key inspection. One of these is still being investigated. The provider and manager Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 15 have responded appropriately to complaints raised and have followed their laid down procedures. However the provider did not follow the laid down procedures for reporting of abuse or suspicion of abuse when an incident occurred involving a person with challenging behaviour. She has fully co-operated with the authorities involved with the matter and says she has learnt valuable lessons about the correct procedures to be followed. She states she is quite new to the area of Plymouth and did not know of the procedures to follow and the people she could contact to receive information and support. She is now fully aware of the support and help available and the correct procedures to follow should any concerns(involving challenging behaviour) be raised in the future. A recommendation was made following a random unannounced inspection in July 2007 that ‘Staff at the home should improve their knowledge of Adult Protection issues by attending the specialist Local Authority training on the subject’. Training records seen and training sessions advertised on the notice board in the office show that the provider is achieving this. The policies and procedures covering procedures to be used in the event of a complaint or suspicion of abuse are available to staff at all times. Staff also have information about safeguarding during their induction period and as part of National Vocational Qualification training. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The consistent maintenance and renewal of equipment and facilities means that people have access to suitable and safe equipment. The condition of the décor and fixtures and fittings means that service users live in a satisfactory environment. EVIDENCE: Access to the home is via a security system and the main entrance is welcoming with a variety of information about the home displayed and a hot drinks machine for the use of visitors. The home was clean, tidy and odour free. Individual’s bedrooms (situated on ground and first floors) were personalised. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 17 The lounge (on the ground floor) had a variety of seating for people to use. One side has a large wall mounted TV and the other side is for people who do not wish to watch the TV. Activities arranged for the people living in the home usually take place in the lounge. There is a small quiet sitting room that can be used by people wishing to see their visitors privately away from their room or the large lounge. The dining room is large and easily accessible by service users. Outside is a large decked area with seating that is used often in the good weather. The acting manager said that rooms are decorated as required. The maintenance man works full time and carries out day to day routine maintenance that is due and anything else the staff bring to his attention. Aids and equipment provided were in good condition and had been regularly serviced. There is access to the first floor via a passenger lift. Most of the rooms have en-suite bathrooms. However most people living at the home cannot use the facilities independently and prefer to use the communal bathrooms. The laundry and kitchen have all the necessary equipment to cater for the number of people living in the home. Freshfields Nursing Home DS0000003586.V352476.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management team shows a responsible attitude and implements changes and improvements in order to improve quality and outcomes for people living in the home. The staffing levels need to be reviewed regularly to ensure peoples needs are being met at all times. EVIDENCE: The duty rota showed that for 34 people there are usually enough staff on duty. They are supported by the acting manager, administrator, domestic, catering and laundry staff. There have been occasions recently when the home has been reported as being understaffed, especially at weekends. A random unannounced inspection took place on Sunday 28th October at 9am to assess the level of staffing. It was found to be sufficient for the number and dependency of the people living in the home. During this inspection staff spoken to said that they are well supported and that there have been recent staff shortages that they have been covering with by working overtime. It was advised that the acting manager be aware of how many hours staff have been working and to consider using agency staff Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 19 sometimes to ensure that their own staff do not become overworked. Two of the five completed staff surveys indicated that more staff are needed. People spoken to had high praise for the home and the staff. One person said that they had to wait a little longer to be attended to when they are short of staff but this is not a problem. The acting manager said that there is a formal induction system in place using a system supplied by an outside provider. New staff work with a senior carer and/ or trained nurse who have t o sign to say that a person has reached a specific level of competency. Of the seven completed staff surveys two indicated that their induction covered everything they needed to know, three indicated that it mostly did and two that it partly did. The home is also used by Plymouth University for placement of student nurses. There is one currently placed at the home. Staff files seen were well ordered and there was a systematic approach to recruitment. The files are stored securely. The files examined had 2 written references, CRB checks and information about gaps in employment history. Records showed that training has taken place that includes fire safety, dementia care, moving and handling and adult protection/safeguarding. The acting manager said that there is ongoing support for those wishing to undergo National Vocational Qualification training. She said she is going to implement some in house training sessions for care staff, focussing on basic care issues. The acting manager should ensure that trained nurses who administer ‘flu jabs’ have an annual anaphylaxis update. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management arrangements are meeting the needs of the service, and the quality of the service is continually improving. EVIDENCE: The people living at the home have regular contact with the manager/provider and the acting manager. The home has undergone a lot of changes since the current provider took over and the recent spate of complaints and adult protection /safeguarding concerns have been a challenge for the provider. She appointed an acting manager to support her through this time. This has proved Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 21 to be successful and the majority of staff have responded well to the acting manager. She has an open door policy and a number of staff approached her during the inspection with a variety of queries which she managed effectively. The home is well organised, records were up to date, clear and in good order. Staff knew what they were doing and there were clear systems for delegating care tasks between staff. Supervision sessions and staff meetings are ongoing according to the manager. One of the seven completed staff surveys indicated that meetings with the acting manager happen regularly, one said often and three said sometimes and two said never. One completed survey commented that the acting manager is not supportive to staff. The accident book and fire log – book were completed as required. The maintenance man showed the inspector details of recent servicing dates of equipment and PAT (portable appliance testing) records. The administrator distributes satisfaction surveys to people living at the home and /or their representatives on a regular basis. A sample of completed ones was examined during the inspection. Results are collated and actions needed to be taken are documented. The results are also represented in a pie chart form to assess ongoing improvement or areas of concern. These results will be forwarded to the commission in future. The administrator demonstrated the system in place for dealing with peoples personal allowances. It is well organized with all receipts kept for auditing purposes. There are secure facilities for storage of money and valuables. Freshfields Nursing Home DS0000003586.V352476.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 3 3 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP18 Regulation 13 (6) Requirement All staff at the home should improve their knowledge of Adult Protection issues by attending the specialist Local Authority training on the subject. Timescale for action 01/03/08 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 OP27 OP30 Good Practice Recommendations The registered person should ensure that appropriate numbers of staff are on duty at all times to meet the assessed needs of people living in the home. The registered person should ensure that staff have appropriate training on a consistent basis to ensure they have the skills to meet the assessed needs of people living in the home. Freshfields Nursing Home DS0000003586.V352476.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Freshfields Nursing Home DS0000003586.V352476.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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