Inspection on 24/09/07 for Gedling Care Home

This inspection was carried out on 24th September 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

Gedling Care Home 03/04/09

Gedling Care Home 16/07/08

Gedling Care Home 02/08/06

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

CARE HOMES FOR OLDER PEOPLE Gedling Care Home 23 Waverley Avenue Gedling Nottingham NG4 3HH Lead Inspector Michael Williams Key Unannounced Inspection 24th September 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 Gedling Care Home DS0000067378.V351665.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. Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gedling Care Home Address 23 Waverley Avenue Gedling Nottingham NG4 3HH 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) 0115 9879792 Kalbro Care Uk Limited Pauline Margaret Park Care Home 26 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (26) of places Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the total number of beds, a maximum of 26 may be used for the category DE (E). Within the total number of beds, a maximum of 6 may be used for the category DE. 3rd January 2007 Date of last inspection Brief Description of the Service: Gedling Care Home provides high dependency residential care for 26 older people in the early stages of dementia. The home has benefited from the extensive refurbishment programme and the new owner registered the home on 28th March 2006. The home is located in an inner city area of Gedling, Nottingham, close to the local shops, general practitioners’ surgery and other amenities. The home is an extended residential house, which consists of three-storeys. The home has two lounges, a conservatory and a separate dining area. The home has 20 single rooms one of which is fitted with an en-suite facility and 3 double rooms. There is a passenger lift permitting access to the first and second floor. A small enclosed garden is to the rear of the property. The current fee is £329.50 per week; this does not include toiletries, clothing, hairdressing, holidays and outings. This information and a copy of the last inspection report is available to service users and their representatives on request. Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspection undertaken by the Commission for Social Care Inspection is upon outcomes for service users, and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that require further development. This was an unannounced key inspection undertaken by one inspector. The main method of inspection used is called ‘case tracking’ which involved selecting two residents and tracking the care they receive through checking their records and discussion with them, and observations of the care received and asking staff about their needs. Two residents and two members of staff were spoken with as part of the inspection other residents who were not part of the case tracking were observed and also spoken with. Documents and medication policy and practice were examined as part of the inspection to gain evidence and form an opinion about the residents’ health and safety. A partial tour of the premises was undertaken which included communal areas, and a sample of bedrooms to ensure that the environment was pleasant, homely and safe. A review of all the information about the home received by the Commission since the last inspection was taken into consideration in planning this inspection and helped in deciding what areas of care were looked at, this included a completed Pre-Inspection, and service user questionnaires. What the service does well: What has improved since the last inspection? All service users receive a holistic assessment of needs before being admitted into the home. Care plans are developed in consultation with service users or their representatives with information as to how service users needs in respect to health and welfare are to be met. Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 6 Appropriate medication management policy and procedures are in place to protect service users. Satisfaction questionnaires and regular resident and relatives meetings have been introduced to promote the consultation process. The garden area has been improved to provide a pleasant outdoor space for service users to enjoy. What they could do better: To enable prospective service user to make an informed choice about moving into the home, Information about the services offered by the home could be made available in formats suitable for those who may have difficulty in understanding written formats Written confirmation should be provided to ensure that service users know that the home can their meet assessed needs. To ensure that sufficient numbers of suitably experienced skilled and trained staff are available to meet the assessed needs of people living at the home of review of staffing levels should be undertaken. Staff recruitment procedures should include obtaining two written references to protect service users. Regular recorded supervision should be provided for staff to ensure that the needs of service users are being met. To safeguard the health of people living at the home, records water monitoring and legionella checks should be maintained. To protect service users, all serious injury, or event that adversely affects the well being or safety of any service user should be reported to the Commission. A risk assessment of the paved garden area will should be undertaken to assess the safety of service users with mobility difficulties and those susceptible to falls using this area. Personal information contained in the accident book should be filed securely in line with the Data Protection Act 1998. Please contact the provider for advice of actions taken in response to this Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 7 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. Gedling Care Home DS0000067378.V351665.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 Gedling Care Home DS0000067378.V351665.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Quality in this outcome area is adequate Sufficient information is available about the services offered by the home, however information is only available in written format, which may impact on prospective service users ability to make an informed choice about moving into the home. Individual needs are assessed before service users are admitted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and a service user guide provide information about the aims, objectives and values of the home. Information is also available about the manager, the staff team structure, and life living at the home. Information contained in the statement of purpose and the service user guide is only available in written format, which may impact on prospective service users ability to make an informed decision about the home being able to meet their needs. Service users and relatives spoken with felt that they had received sufficient information before deciding to move into the home. However, There were no copies of the service user guide in service users rooms or in files viewed. Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 10 Service users and their representatives can visit to assess the suitability of the home, and a six week review is offered to assess if service users satisfaction that the home is meeting individual needs. Relatives spoken with confirmed this. Files viewed contained a full assessment of needs focussed upon identifying holistic needs and promoting the physical and emotional well being of service users, However, no written confirmation that the home can meet assessed needs was available. Contracts of the terms and conditions of the placement were available. Intermediate care is not provided by the home. Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 11 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 and 10 Quality in this outcome area is good Health needs are identified, personal care is provided in a way in which service users prefer, medication management protect service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an effective care planning process in place designed to meet the assessed needs of service users, care plans are formulated from pre admission assessments and risk assessments. Care pans viewed covered a range of areas, and provide details of how staff are to support personal, health and social care needs such as dietary needs, moving and handling, communication, personal care, nutrition and falls. Risk assessments are in place in relation to dependency levels, managing falls, pressure ulcers prevention and nutrition Documentation viewed evidenced that professionals such as doctors, chiropodist, district nurses and social workers are involved in the care of service users. Some service users are not registered with a local dentist, the manager explained that this was due to difficulties in finding dentist who register National Health Service (NHS) patients, however any dental problems referred to emergency dentist. It was evident that cultural needs and Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 12 preferences are considered, for example the care plan of one service user case tracked stated that only relatives should provide personal care. Relatives spoken with confirmed this. It was evident that care plans are regularly reviewed, however, there was inconsistencies where service users or their representatives consented to care plans. Staff spoken with were able to demonstrate a good level of knowledge about the needs of people living in the home, and how to support service users. Relatives and service users spoken with felt that identified health care needs are met and said that staff always ensured that privacy and dignity is respected. “Staff treat us with respect” There is a policy for the management of medication place, the home is registered with a local pharmacist and appropriate procedures are in place for the ordering, receipt, and storage of medication. Case tracked service users medication administration records (MAR) were examined, entries were clear with no unaccounted for gaps. Medication is administered to service users, appropriately, and staff administering medication said that they had received appropriate training; this was evidenced in staff files viewed. Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate Some opportunities are provided for service users to exercise control, make decisions and lead the lifestyle that they wish, however limited opportunities are available for service users to participate in community activities. Family contact and relationships are encouraged and supported. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Preadmission assessment includes identifying needs and lifestyle choices such as social interest, preferred bedtimes, routine, dietary needs and preference. The home is currently in the process of appointing an activities coordinator; a volunteer visits the home several times a week to undertake activities and befriend service users. The volunteer said that there is no set activity programme, however activities offered include sing along, dominoes, and games. During the inspection service users were observed participating in group games, reading newspapers and watching TV. There was information placed around the home, providing details of the dates when entertainers were booked to visit the home. Service users spoken with also confirmed that a musician had recently performed at the home. Social activity records in files viewed showed little recent community activity. Staff spoken with said that due to staffing levels, limited opportunities are available for service users to Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 14 participate in community activities. Service users spoken with said that they sometimes felt bored, and would like to participate in community activities more often. Family contact is encouraged and supported relatives spoken with said `that they are always made welcome by staff, and can arrange to have meals at the home with service users if they wish. Dietary needs and preferences are recorded in files, and nutrition risk assessments and care plans are in place. There are no menus or records of meals offered to service users. On the day of inspection lunch consisted of fish, creamed potatoes, and mixed vegetables with apple pie and custard to follow. Service uses said that they enjoyed the food offered and were always offered an alternative to the main meal if requested. “There is always something we like offered to eat ”. Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18 Quality in this outcome area is good Appropriate policy and procedures protect service users from abuse. Service users are confident that complaints will be taken seriously and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service user guide contain a copy of the complaints policy and procedures with timescales for responses and action. Since the last inspection no complaints have been made to the home, The Commission has not received any complaints regarding the home. There is copy of the Nottinghamshire adult protection procedures available in the main office. Service users spoken with said that felt safe living at the home, and would speak to staff if they were unhappy. Relatives spoken with said that they were aware of the complaints procedure and felt confident that any concerns or issues would be appropriately dealt with. Staff spoken with were aware of their role when dealing with complaints, and were also clear about their responsibilities relating to adult protection and the whistle blowing policy. Gedling Care Home DS0000067378.V351665.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, 22, 24, 25 and 26 Quality in this outcome area is good Service users live in a pleasant, safe and well maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is decorated to a good standard, and provides a pleasant, clean and fresh smelling environment for people living in the home. There is suitable lifting and mobility equipment in place for supporting service users with mobility difficulties. Communal areas include two lounges, a dining area and a large conservatory, providing a choice of areas for service users to entertain relatives and friends. There are toilets located around the home within close proximity to communal areas providing ease of access for people living in the home. Bathing facilities provide a choice of bath or shower, with suitable equipment in place to support service users who require assistance with bathing. Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 17 To support one service users whose first language is not English, there is polish signage, around the home, distinguishing communal areas such as toilets, bathrooms dining room, kitchen and fire exits. Service users bedrooms viewed were spacious, clean, pleasant and personalised ,“my room is very nice”. Service users are encouraged to bring their own furniture on admission subject to health and safety compliance regulations. The kitchen was clean and hygienic with food stored safely, appropriate food safety management procedures in place. The home benefits from an enclosed garden area, which is being refurbished, paving slabs have been laid however there was no risk assessment in place to assess the safety of service users with mobility difficulties and some who are at risk of falls using this area. Gedling Care Home DS0000067378.V351665.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 and 30 Quality in this outcome area is adequate Experienced, trained and competent staff ensure that service users are in safe hands. However, staffing levels are not sufficient to meet the assessed needs of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection, a review of staffing levels have been undertaken, the staff rota showed that that there are three staff on duty during the day and two night care staff. The manager provides additional support during the busy periods of the day. The manager said that a high level of agency staff have been used recently due to staff sickness and annual leave which has placed some pressure on the staff team in providing consistency of staff for service users. Staff spoken with said that staffing levels had improved however, the number of service users living at the home has also increased which has lead to increased daily tasks which sometimes impacted on the amount of time that staff could spend with service users. Relatives spoken with felt that basic care needs are being met, however, staffing levels are not sufficient to provide opportunities for service users to participate in community activities. Staff spoken with demonstrated a good knowledge of the needs of people living in the home and how they are to be supported. Staff reported that they receive relevant training to meet the needs of service users, including moving Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 19 and handling, medication administration, food hygiene and infection control. This was confirmed in staff files viewed. Staff recruitment documentation viewed showed that that staff had undergone appropriate recruitment procedures, however both files viewed contained only one satisfactory written reference. Gedling Care Home DS0000067378.V351665.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, 36, 37 and 38 Quality in this outcome area is adequate The home is run in the interest of service users, however some management procedures are not being routinely followed to ensure that service users are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager operates an open door style of management which she feels is suited to the needs of people living at the home, service users and relatives spoken with said that he manager is approachable and will always attempt to deal with any issues within the home appropriately. The manager takes on takes on domestic and care duties within the home, which impeaches on her ability to fulfil her managerial role effectively. Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 21 Documentation examined evidenced that that fire safety, servicing and maintenances procedures are being effectively maintained. Health and safety maintenance documentation viewed; showed that health and safety within the home is generally maintained, however, there were no records of weekly and monthly water monitoring and legionella checks. There was no evidence that staff receive regular supervision. Staff recruitment documentation viewed showed that that staff had undergone appropriate interview and Criminal Record Bureau (CRB) checks process, however files viewed contained only one satisfactory written reference. The manager informed inspector of a recent incident where a service user became violent towards staff, police assistance was required, the situation was satisfactorily resolved and an appropriate management plan implemented. There was no record of this incident being reported to the Commission. Examination of the accident book showed that one service user had recently had an accident in the home; there was no record of this incident being reported to the Commission. Regular visits to the home are undertaken by the provider to assess the quality of the service interviews are undertaken with service users and staff. Satisfaction Questionnaires are also provided to relatives for comments about the quality of service provided. The findings of the audits and surveys are fed back to service users in residents and relative meetings. The home does not act as appointee for any service users, relatives or social services manage service users finances. The home will manage any money provided for service users personal allowance. Examination of financial records evidenced that robust system in place to protect service users from financial abuse. A risk assessment of the paved garden area will be required to assess the safety of service users with mobility difficulties and those susceptible to falls using this area. Personal information contained in the accident book should be filed securely in line with the Data Protection Act 1998. Gedling Care Home DS0000067378.V351665.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 2 3 3 2 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 2 X 3 X 3 3 3 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 2 2 Gedling Care Home DS0000067378.V351665.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 OP3 Regulation 14:1 (d) Requirement Written confirmation must be provided to ensure that service users know that the home can their meet assessed needs. To promote service users rights and choice, written menus offering choice of meals should be made available. Menus should be available in a suitable format of service users to understand. To ensure that sufficient numbers of suitably experienced skilled and trained staff are available to meet the assessed needs of people living at the home, a review of staffing levels must be undertaken. Staff recruitment procedures must include obtaining two written references to ensure that service users are protected. Regular recorded supervision must be provided for staff to ensure that the needs of service users are being met. To safeguard the health of service users records of weekly DS0000067378.V351665.R01.S.doc Timescale for action 12/11/07 2. OP15 16:2 12/11/07 3. OP27 18:1 (a) 12/11/07 4. OP29 19:1 (c) 12/11/07 5. OP36 18:2 12/11/07 6. OP38 13:4 (C) 12/11/07 Gedling Care Home Version 5.2 Page 24 7. OP38 13:4(a) 8. OP38 37 9. OP38 17:1 (b) and monthly water monitoring and legionella checks must be maintained. A risk assessment of the paved garden area must be undertaken to assess the safety of service users with mobility difficulties and those susceptible to falls using this area. To protect service users, all serious injury, or event that adversely affects the well being or safety of any service user must be reported to the Commission. Personal information contained in the accident book must be filed securely in line with the Data Protection Act 1998. 12/11/07 12/11/07 12/11/07 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 OP1 Good Practice Recommendations To enable prospective service user to make an informed choice about moving into the home, Information about the services offered by the home could be made available in formats suitable for those who may have difficulty in understanding written formats Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Gedling Care Home DS0000067378.V351665.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!