Inspection on 03/02/06 for Gillibrand Hall Nursing Home

This inspection was carried out on 3rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Gillibrand Hall Nursing Home 11/03/10

Gillibrand Hall Nursing Home 18/01/10

Gillibrand Hall Nursing Home 02/06/09

Gillibrand Hall Nursing Home 02/07/07

Gillibrand Hall Nursing Home 03/05/06

Gillibrand Hall Nursing Home 04/08/05

Gillibrand Hall Nursing Home 31/01/05

Gillibrand Hall Nursing Home 19/08/04

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

CARE HOMES FOR OLDER PEOPLE Gillibrand Hall Nursing Home Grosvenor Road Chorley Lancashire PR7 2PL Lead Inspector Anne Taylor Unannounced Inspection 09:00 3 February 2006 rd 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 Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 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. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gillibrand Hall Nursing Home Address Grosvenor Road Chorley Lancashire PR7 2PL 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) 01257 270586 Century Healthcare Limited Ms Joan Lilian Calf Care Home 50 Category(ies) of Dementia (31), Old age, not falling within any registration, with number other category (31), Physical disability (6) of places Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 50 service users to include: Up to 31 service users in the category OP (Old age, not falling into any other category) Up to 31 service users in the category DE (Dementia) Up to 5 service users in the category PD (Physical Disability) aged 55 years and above. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. One named service user in the category PD (Physical Disability), aged 50 years and above, may be accommodated within the overall number of registered places. 4th August 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Gillibrand Hall is a listed building, set in its own grounds, within a residential area close to Chorley town centre. Public Transport does serve the area nearby, but a public right of way and a driveway leading to the home reach Gillibrand Hall. The home provides care for up to fifty residents of either sex with a variety of needs. At the time of inspection thirty-nine people were living at the home. Accommodation is set on two floors. Currently, the ground floor offers accommodation for residents who require nursing or personal care and the first floor for residents who have a cognitive impairment i.e. dementia. The first floor is served by a passenger lift or can be accessed by a sweeping stairway, an original feature of the old house. A number of rooms are equipped with en-suite facilities and both floors are well served with communal areas, including dining rooms. Residents have use of an enclosed courtyard, which is furnished with appropriate garden furniture. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at 9am and lasted seven hours. Several key standards were inspected and progress on requirements and recommendations made at the last inspection was assessed. The inspection involved discussion with the people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. What the service does well: What has improved since the last inspection? What they could do better: The standard of record keeping, particularly in relation to care plans is extremely poor and an immediate requirement notice was issued at the time of inspection about this. Care planning needs to be much better to help the care process and promote the welfare of residents. Prospective and current residents need to be involved in the care planning and assessment processes so that they can be sure their needs and wants have been made clear. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 6 Some attention is needed to the environment to make sure residents continue to live in a well maintained and odour free home. A more structured approach to training is needed and training for new staff improved so they learn the skills and develop knowledge they need to help them carry out their duties effectively and make sure residents’ right to privacy and dignity are upheld. The manager needs to run the home in a more planned way and make sure the home is being run in the best interests of the people living there. Systems to check that good care is being provided, that good record keeping is taking place and that staff’s training needs are being met for the benefit of people living at the home need to be properly and consistently implemented. 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. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 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 Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 A more consistent approach to the assessment process is needed to make sure that prospective residents are involved. EVIDENCE: Standard 3 was partially assessed to monitor progress in meeting a requirement made at the last inspection. There had been some improvement in the quality and amount of information obtained as part of the assessment process so that assessment of individual need was clearer and properly recorded. However, the use of different assessment tools meant that there was no consistency in the way information was recorded and sometimes made information difficult to find. Assessment forms used by the home had been developed to show that residents or a representative had been involved in the assessment but in some cases the form was blank and it was not clear whether they had been given the opportunity to be involved or not. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9,10 The care planning system was inadequate and does not make sure that needs and risks are identified, recorded and managed properly. The arrangements in place for handling medication were thorough enough to protect residents. The delivery of care was not always done in a way that upheld residents’ rights to privacy and dignity. EVIDENCE: Standards 7 and 8 were partially assessed to monitor progress in meeting requirements made at the last inspection. Serious concerns were raised about the deterioration in the standard of care planning since the last inspection. Two new residents did not have a plan of care despite being in the home for two weeks. This means that important information about health, personal and social care needs is not available to staff and they have no instructions to follow to make sure needs are being met and risks managed properly. An immediate requirement notice was issued in relation to care planning. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 10 The risk assessment process was also poor and inconsistent. One resident had a body map assessment chart that showed a fractured limb sustained from a fall. There was no risk assessment, no plan as to how the risk of falling would be managed or what help this person needed in order for her to manage whilst in plaster. Some risk assessments had been completed but not dated or signed so the information might not have been current and therefore not relevant. The use of bed rails was not properly recorded and a risk assessment to make sure they were used safely was not in place. Polices and procedures describing the handling of medication were available within the home so staff had clear guidance to follow. Only trained nurses were authorised to administer medication and a sample list of signatures was kept at the front of the medication file so that checks for compliance could be made. The director of nursing carried out a monthly audit in relation to medication to make sure the home’s polices and procedures were being implemented properly. An action plan was drawn up if any shortfalls were identified so that action could be taken promptly to put them right. New arrangements had been made for the disposal of medicines to reflect recent changes in legislation. A revised procedure was in place and a copy attached to the front of the medication file so that staff were all aware of the new procedures. Two new members of staff did not have any induction records to show that they had had received instruction on how to promote and maintain residents’ privacy dignity and respect. The home had policies and procedures that covered the rights of residents including the right to privacy and dignity. These were not being put into dayto-day practice. Three care staff were seen entering a residents room without knocking, removing the bed covers whilst the door was open and making an inappropriate comment about what care this person needed. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,14,15 The arrangements in place at the home supported residents to maintain contact with family and friends. Residents were helped to exercise choice so that they had some control over their lives. The importance of providing a well balanced diet was recognised by staff and action taken to make sure residents ate healthily. EVIDENCE: The statement of purpose outlined the home’s visiting policy and included a statement about residents being able to exercise choice in relation to visitors. This meant that residents and relatives knew what the home’s approach to visiting was and could comply with any policies operated by the home. Residents spoken to confirmed that they were able to see visitors in their own room or in one of the communal areas of the home so the meetings could be private if they wished. One visitor present at the inspection said, “I visit most days and I can come at any time really I’m made to feel welcome”. Residents spoken to confirmed that they were able to see visitors in their own room or in one of the communal areas of the home so the meetings could be Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 12 private if they wished. Discussions with the person in charge and care staff showed that they understood the importance of residents maintaining contact with their family and friends, as they are still an important part of their life. During conversations with residents and staff it was evident that residents who were able could make choices about the way they lived within the home and in particular within the privacy of their own room. Rooms had been personalised by residents bringing in some of their own possessions so that they had familiar and treasured items around them. A record of all items brought into the home by residents had not been made so there was no way of confirming which items belonged to each resident. Residents not able to exercise full control over their financial affairs were mainly helped by a family member. Senior staff knew how and when to access an advocate to act on behalf of a resident without a representative to ensure that any decisions made were in the best interests of that resident. Information about advocacy services and how to access them was available to residents so they could do this independently of the home if they wished. Standard 15 was partly assessed to check progress in meeting a requirement made at the last inspection. There had been an improvement in the catering records kept by staff so that they were up to date and showed what residents had actually eaten every day. Staff were able to discuss the importance of monitoring the dietary intake of residents and what action they took if anyone was not eating properly. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Management processes in relation to abuse were not thorough enough to ensure the continued protection of any vulnerable residents. EVIDENCE: An adult abuse policy was in place and included a whistle bowing policy to protect staff if they reported any suspicion of abuse. The director of nursing said that the home’s procedures were being reviewed to make sure that they clearly show the correct procedure to be followed if an allegation of abuse is made. The current procedure indicates that the registered manager should carry out a thorough internal investigation. This is not best practice as an internal investigation may adversely affect any other investigation that may be needed. Training courses had been provided for staff in September and November last year but a training matrix showed that not all staff had attended. The management approach to training was muddled and some record keeping had been delegated so it was not clear who was responsible for making sure that all staff received up to date training. Some staff still need specific training in relation to the protection of vulnerable adults so they know how to recognise it and what to do about it. Some staff spoken to say that they would know what to do if they suspected abuse was happening as this subject had been covered when they completed a recognised qualification in care. Others had received training and instruction Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 14 about abuse since they came to work at Gillibrand so they knew how to recognise the signs of abuse and were clear about their responsibilities. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The home was generally clean, comfortable and homely however some improvements are needed to make sure residents continue to live in an environment that is suitable for its stated purpose. EVIDENCE: The home was accessible to all residents. Ramps allowed easy access to the outside and accommodation was over two floors accessed by a passenger lift. Outside the grounds were tidy and well maintained, providing a pleasant area for residents to enjoy if they wished. One resident said, “It is home from home here, I have a nice big room and have some of my own things here”. The handyman attended to minor repairs. Staff recorded faults or repairs needed in the home and when the work was done the book was signed and dated. Since the last inspection a corridor carpet and missing ceiling tile had been replaced. However, a planned formal refurbishment programme was not Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 16 available so it could not be determined how or when the home planned to upgrade and refurbish any parts of the home that were starting to look tired and worn. The maintenance person had started to cover exposed pipe work in bathrooms and toilets but had not finished so the health and safety risk had not been completely removed. Policies and procedures were in place that identified infection control measures in place at the home. The policies need reviewing and updating to reflect best practice. Staff were able to discuss infection control procedures and how implementing them correctly helped to minimise the risk of cross infection. The home was generally clean and tidy however, there was a strong smell of urine on the first floor where residents’ with dementia are accommodated. The home still needs to provide written confirmation that all the facilities and services provided comply with the Water Supply (Water Fittings) Regulations 1999. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 30 The management approach to training was inconsistent and muddled so that staff did not always receive the training they needed to help them do their job. EVIDENCE: There were no induction records for two new members of staff. The director of nursing said that a new training booklet had been produced but it had not been implemented by the home. Some staff spoken to say that they had received induction training others said they were supernumerary for one day and then “just expected to get on with it”. A training matrix was in place that showed when training had been completed. It was not up to date and an accurate picture of what training had been done, and what training had been planned could not be determined. Some of the recording of information about training had been delegated and it was not clear who was responsible for making sure all staff received the training they needed. National vocational training (NVQ) was available to care staff and a number of care staff had already achieved level two or three. The service provider and manager know that fifty per cent of care staff need to have a care qualification before the national minimum standard can be considered fully met. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33,35,38 The home was not well managed which affected its ability to meet its stated purpose aims and objectives and make sure the service is run in the best interests of residents. The arrangements for handling money on behalf of residents were thorough enough to ensure their financial interests were safeguarded. EVIDENCE: Records showed that the registered manager is a first level registered nurse who has experience of running and managing a care home for this client group. She was in the process of completing a relevant management qualification and has maintained the professional registration requirements of the organisation that registers trained nurses. Discussion with staff showed that there is little or no leadership and direction provided for them and they Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 19 feel there is a lack of structure and organisation that affects the quality of service they provide. The home had been accredited with an external quality award that was completed in October 2005. Feedback about the home was obtained from residents. It showed a general satisfaction with the service provided. However, the internal quality assurance systems were not being implemented properly so the home could not identify its strengths, weaknesses and whether residents were consistently satisfied with the service they received or not. Action had not been progressed within agreed timescales to address requirements identified at previous inspections, despite the timescales being extended. The home handled few personal allowances for residents. Any personal allowances and money brought in by relatives for residents was stored in a safe that only two members of staff had access to. This meant that residents’ money was appropriately safe guarded. Records were kept of any money handed in for safekeeping and receipts kept for any purchases made on behalf of residents so a clear audit trail of income and expenditure was available if needed. When asked about access to their money residents said, “my daughter looks after my money” and “I have some money in the safe here at the home, my family look after everything else”. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 x X X X X X 2 STAFFING Standard No Score 27 X 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X x Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1) Requirement Residents or a representative must be given the opportunity to be involved in the pre admission assessement. (Timescale of 30th September 2005 not met). A written plan of care as to how a residents needs are to be met by the home must be drawn up with the involvement of the resident or a representative. (Timescale of 30th September 2005 met). Immediate requirement notice issued Risk assessments in relation to the management of healthcare needs must be carried out consistently and reviewed regularly. (Timescale of 30th September 2005 not met). Arrangements must be made to ensure that the home is conducted in a manner that respects the privacy and dignity of residents. Staff must receieve training appropriate to the work they perform and arrangements must be in place to prevent residents being placed at risk from or DS0000025560.V257961.R01.S.doc Timescale for action 31/03/06 2. OP7 15(1) 10/02/06 3. OP7OP8 13(4)(c) 31/03/06 4. OP10 12(4)(a) 31/03/06 5. OP18 18(1)(c) 13(6) 30/04/06 Gillibrand Hall Nursing Home Version 5.0 Page 22 6 7. OP26 OP19 16(2)(k) 13(4)(a) 8. OP30 18(1)(c) 9. OP33 24(1) suffering abuse. Arrangements must be made to ensure that all staff are familiar with abuse and how to protect vulnerable adults. Training must be provided and kept up to date. Arrangements must be made to keep all parts of the home free from offensive odours. Arrangements must be made to ensure that all exposed pipe work in bathrooms and toilets is appropriately covered. All staff must receive induction and ongoing training that will equip them with the skills and knowledge they need and keep them up to date with best practice. A detailed training programme must be developed that shows how the home is going to do this. The registered person must ensure that the home’s system for reviewing at appropriate intervals and improving the quality of care provided at the home is properly maintained. 31/03/06 31/03/06 30/04/06 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP3 OP14 OP18 Good Practice Recommendations It is recommended that the home use one assessment tool for pre admission assessments. A record should be kept of all items brought into the home by residents. Polices and procedures in relation to abuse and the protection of vulnerable adults that are currently under review should be amended, updated and implemented as soon as possible. DS0000025560.V257961.R01.S.doc Version 5.0 Page 23 Gillibrand Hall Nursing Home 4. 5. 6. 7. OP26 OP26 OP28 OP31 Policies and procedures in relation to the control of infection should be updated to reflect changes in legislation and best practice. The home should make sure that the facilities and services provided comply with Water Supply (Water Fittings) Regulations 1999. The home should make sure that fifty per cent of care staff obtains a relevant care qualification. The registered manager should complete a recognised management course. Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Gillibrand Hall Nursing Home DS0000025560.V257961.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!