Inspection on 13/04/06 for Glenesk Care Home

This inspection was carried out on 13th April 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

Glenesk Care Home 12/04/07

Glenesk Care Home 09/01/06

Glenesk Care Home 11/01/05

Glenesk Care Home 09/09/04

Glenesk Care Home 01/03/04

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

CARE HOMES FOR OLDER PEOPLE Glenesk Care Home The Cresent, Queen Street Retford Nottingham DN22 7BX Lead Inspector Judith Avill Unannounced Inspection 13th April 2006 09:25 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 Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 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. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Glenesk Care Home Address The Cresent, Queen Street Retford Nottingham DN22 7BX 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) 01777 702 339 01777 702 339 Mr Mohammed Akbar Mrs Barbara Khan Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2006 Brief Description of the Service: Glenesk care home provides personal care and accommodation for 22 older people. Privately run and managed by two registered managers, the home does not provide nursing care. The home is an extended, adapted house with 18 single and two double bedrooms. There is a well laid out private garden, which is accessible for all service users. Glenesk is situated near the centre of Retford, off the main road in a quiet residential area. There is car parking space at the front of the home. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection commenced at 9.25am and was over 7.5hours. One manager was on duty and the other registered manager arrived during the inspection. Both managers and staff gave valuable assistance and were helpful during the inspection process. At the time of inspection there were 16 service users accommodated at the home one resident was in hospital at the time of inspection. The method used for inspection was Case Tracking residents were spoken with about their experiences and expectations of living at the home, with analysis of the records and talking with members of staff to ensure that those living at the home have their needs met and their health and welfare maintained appropriately, together with a tour of the home. No visitors were spoken to during the inspection. Residents at the home commented on the commitment of staff at the home to provide a good standard of cleanliness, good quality food and care to meet their needs. What the service does well: What has improved since the last inspection? All the daily records inspected were up to date, and there was evidence that a maintenance record book had been commenced. The staff rota seen included records of some staff commencing working earlier in the morning and working shifts in the evening to provide adequate hours to meet the needs of the residents. Staff files viewed evidenced staff appraisals and the supervision rota provided included records of the planned supervision sessions for all staff. Evidence of structured interview questions, answers and scoring were seen on one staff file. Supervision for all staff, at least six times a year has been planned and a written staff-training programme has been Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 6 developed and training provided for 2005/2006. Evidence of training attended was seen. Records of residents taking part in planned activities were seen and Easter bonnets prepared by staff and residents were prepared for an Easter bonnet parade 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. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 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 Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 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): Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before this visit to this service. Prospective residents are assessed by one of the registered manager’s prior to admission to the home. No written confirmation that the home can meet resident’s needs is sent to prospective residents. The Statement of Purpose and service user guide are not available in leaflet form. EVIDENCE: As stated in the last inspection report Glenesk has a statement of purpose and service user guide, but this has not been made available to the Commission or available as individual leaflets for prospective service users. The registered managers reported that work on developing the documents in a leaflet form is ongoing. (This requirement is outstanding). No evidence of terms and conditions were seen on resident’s files case tracked. The last resident admitted to the home had an assessment by one of the registered managers before their admission to the home. No record of the registered person confirming in writing to the resident that the home can meet their needs in respect of his health and welfare. Health and social services assessments were evidenced on resident’s files during the case tracking process. The care plans seen, were appropriate and appeared to meet the needs of the service users. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 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 &11 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before this visit to this service. Resident’s individual care plans case tracked met their health needs. Records of risk assessment on medical conditions use of equipment for transferring residents and weight recordings were not consistently recorded. Residents commented that staff’s treat them with dignity and respect. The medication records are stored securely. The policy and procedure on death and dying needs further development. EVIDENCE: One care plan viewed did not contain details of a risk assessment and action by staff to be taken in response to changes in medical condition. Records of optical, dental and chiropody treatment were seen. Information for staff to follow for the personal care and preferences of individual residents were clear changes in residents’ conditions were followed up and daily records were maintained up to date. Staff reported that records of residents weight are recorded fortnightly but records seen were not consistent and no records of weight were maintained on care plans. No reference to the number of staff required, type of equipment i.e. hoist sling type was recorded on individual plans. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 10 Risk assessments on medical conditions were not consistent. The medication trolley is stored securely in the dining room, staff observed administering medication approached residents sensitively and followed good practice. Records and medication checked were accurate. At the time of inspection no service users self medicate. No policy for residents who wish to self medicate was evidenced. Four residents spoken with commented that staff treated them with respect at all times and offered flexible arrangements for personal care and meal times. The policy and procedure seen on death and dying was well documented on action to be action of staff in the event of a death but no reference to individual care plans was evidenced for details of preferences besides religion. No evidence of facilities for relatives, support for and practical assistance and bereavement counselling for residents and staff were seen. The procedure also needs to include notification to the Commission as per Regulation 37. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 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): 12,13& 14 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before this visit to this service. The home provides a varied diet and meals are flexible to suit the residents. Since the last inspection a range of activities have been planned but no programme of activities and events was seen. EVIDENCE: The registered managers reported that since the last inspection the home has employed an activity coordinator four hours per week. The 3 -week rotas provided on the day of inspection detailed only one week that included the four hours for activities. During the inspection several residents stated that they had bingo sessions and Easter bonnets were seen prepared for Easter Sunday. One resident commented that the library visited on a regular basis and choices of books’ were seen around the home. A file of planned activities was seen including a record of which residents attended each activity. A notice stating that a service was to be held on the day of inspection was viewed in the wipe board in the entrance hall. No written planned programme of events for residents or relatives was seen. Two residents said that they had been on outings with one of the registered mangers. Residents spoken with stated that they had visits from different church groups. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 12 One of the registered managers reported that all activities were funded by the home including meals, drinks out and petrol. One manager has access to a people carrier vehicle and the other is insured to take residents out in her car. Details of some of the residents’ interests are recorded in individual care plans. No individual interests were evidenced in the activity file nor details of how these interests are maintained. All service users spoken with confirmed that their visitors were always made welcome and felt comfortable when visiting the home. Everyone spoken with said they were happy with arrangements at the home and felt they were able to make choices and decisions. Food observed being prepared looked of good quality and well made. Residents commented that there was plenty of food and meals can be available at different times to suit their wishes. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 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): 16 &18 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before this visit to this service. Complaints procedure is in place in the home and staffs are aware of the Protection of Vulnerable Adults. The policy and procedure on allegations of abuse needs further development. EVIDENCE: Residents spoken with said they felt able to talk to the managers and staff about any concerns and complaints. Staff spoken with all said they were aware of the complaints procedure, of who would be the best person to take a complaint to. The procedure was seen displayed in the entrance to the home. No recorded complaints were seen during this inspection. The staff confirmed and training certificates seen verified that they had attended training on Protection of Vulnerable Adults training, and some said they had covered abuse within their National Vocational Qualification Level 2 training. No allegations or suspicion of abuse has been reported since the last Inspection. The policy and procedure seen on abuse did not include any reference to the need to follow adult protection procedures and reporting allegations of misconduct to the Commission. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 14 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): 19,22,24 &26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before this visit to this service. The home was clean, pleasant and hygienic and there is access to all areas for the service users. Residents own rooms are individualised, comfortable and have their own possessions around them. One bathroom on the first floor is still not suitable for use of many of the service users but equipment has been ordered. Bathing and showering facilities are available on the ground floor. The home has commenced a decorating programme and a system for repairs. EVIDENCE: The maintenance requirements within the home are being addressed by the employment of a handy man 2 days per week. A diary of repairs and planned redecoration is in place. During the inspection the inspector observed 2 commodes that were worn and needed replacing. Some of the vacant bedrooms have been redecorated and new furnishing provided. The residents rooms inspected were clean well personalised and residents spoken with said they were really happy with their rooms and the standard of Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 15 cleanliness. Redecoration of some bedrooms has taken place since the last inspection. The bathroom on the first floor which has a bath fixed to a wall on one side has no lifting aids. A requirement was issued at the last inspection to provide improvements to this bathroom. (Outstanding requirement.) The registered manager reported a chair hoist has been ordered. At the time of inspection staff reported that this bathroom is still not used and staff said that residents use the bigger bathroom and shower on the ground floor. Lack of storage space continues to be a problem within the home, but wheelchairs during this inspection, were appropriately stored. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before this visit to this service The staff files evidence recruitment practices which protect the service users. However the written recruitment procedures do not reflect practice. Most staff have attended mandatory training since the last inspection. Staffing numbers are adequate when a manager is on duty but still falls below levels appropriate to meet the needs of service users at other times. EVIDENCE: Staff files inspected showed evidence of two references and Criminal Records Bureau checks being obtained. They contained application forms and a recently recruited staff file evidenced records of interview. However the policy and procedure on recruitment and selection of staff seen does not include advertising for posts, obtaining references before appointing staff, exploring gaps in employment records obtaining satisfactory police checks before employment and staff being employed in accordance with the code of conduct set by the General Social care Council. No record of terms and conditions for staff were seen on staff files. One of the registered mangers stated that she has developed links with a training organisation to provide training for all levels of staff at the home and she is undertaking the Level 4 Management in Care at the time of the inspection. The staff training records were up to date and staff spoken with said they have completed the National Vocational Qualification at Level 2. Details of some staffs’ non-attendance on planned training were seen on Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 17 records. Certificates for training attended had not been received for some courses, however staff confirmed that they had attended the training courses. No planned programme of training for 2006/2007. Both managers raised concerns about staff being reluctant to attend training. As staff have no contract of employment no evidence of employer/employee responsibilities were evidenced. The duty rota seen identifies the role of each staff member, and which member of staff is in charge of the shift. From the 3 week rota provided for 3 days per week 3 staff including a manager work from 7 am with 2 night staff until 7. 30 am and 2 carers and a manager for the rest of the morning shift. Domestic staff cover for breakfast until the cook attends for duties at 8.30 am. 2 carers are on duty 2.10 pm and one carer working 7pm to 9pm. Domestic staff provide cover at lunch -time and teatime. This leaves the service users 4 days per week with a reduced staff level from 7am. This lack of staff leaves staff little flexibility to provide residents with individual choices of rising times, choice of promotion of self care and may restrict encouraging maintaining independence for some residents. At the time of inspection there were three service users who required assistance from two care staff. The staffing levels must meet the needs of the service users and additional staff to be on duty during peak times of activity during the day in accordance with the guidance recommended by the Department of Health. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 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): 31,32,33,35&38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before this visit to this service. Both the managers, who job-share, are registered with the Commission try to run the home in the best interests of the service users, to protect their rights and safeguard their welfare. There are, however, areas in recording and development of management systems that require changes to support this ethos to ensure the home meets the National Minimum standards and legislation. EVIDENCE: Only one of the managers has experience of nursing and care and the other who stated she “deals mainly with the paperwork” is a qualified accountant. The manager with the accountancy background reported that she is undertaking training in Management, NVQ4 and both managers have attended mandatory courses provided. Some certificates of attendance on courses were seen. The managers explained their roles but no clear description of roles and Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 19 responsibilities was documented. Whilst it is appreciated that the managers have different roles some of the responsibilities need to be done by the person in charge. For example reporting example Regulation 37 notifications to the Commission. Policies and procedures seen during the inspection require further development the policy and procedure on risk assessment for individual residents and the environment include the identification of the risk, action to be taken by staff equipment to be used and the review date. No dates of the development or planned review date of the policy and procedures were recorded on documents seen. Staff and residents all stated that both the Managers work towards creating an open and positive atmosphere, hold service user meetings, which help affect the way in which the service is delivered. One of the managers reported that since the last questionnaire was distributed and answered by service users no further self-monitoring method of quality assurance involving service users, has been distributed. The registered managers confirm that the registered provider visits the home on a regular basis. Records seen stated that the registered provider talks to residents and staff and checks the complaints book. Regulation 26 states that the person carrying out the visit shall inspect the premises its record of events and records of any complaints. The insurance certificate was displayed at the time of inspection. The registered manager stated that the home does not handle any of the resident’s finances. Records of maintenance tests and checks on equipment are maintained up to date except for the monthly fire tests. Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 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 1 x 3 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X 2 X 3 X 3 STAFFING Standard No Score 27 1 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 3 3 X X 3 Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 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 OP1 Regulation 4(2) Requirement The registered person shall supply a copy of the statement of purpose to the Commission and shall make a copy of it available on request for inspection by every service user and any representative of a service user (Outstanding requirement) The registered person shall supply a copy of the service user’s guide to the Commission and each service user. (Outstanding requirement) The registered person shall ensure that prospective residents have confirmed in writing that the home is suitable for the purpose of meeting the service users needs in respect of his health and welfare The registered person must ensure that all fire records are maintained up to date The registered person must ensure that Risk assessments are completed on residents medical conditions Timescale for action 13/04/06 2. OP1 5(2) 13/04/06 3. OP4 14(1) (d) 25/05/06 4. 5. OP8 OP8 17 13 13/04/06 13/04/06 Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 22 6. OP18 17 7. OP21 23(2) 8. OP30 18(1) 9. OP29 18 (4) 10 OP37 26 (2) 11 OP37 26 (4) (b) The registered manager must ensure that the policy and procedure on abuse includes details of the adult protection guidance and action to be taken by staff Ensure appropriate numbers of baths and showers to meet the needs of the service users. There is a ratio of 1 assisted bath to 8 service users. (Outstanding requirement) Ensure that at all times suitably qualified competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of the service users The registered person shall make arrangements for providing persons employed at the home with information about any code of practice published under section 62 of the Act The registered person shall establish system for- reviewing at regular intervals and improving the quality of care at the home and supply a copy of the report to the Commission and make a copy available for residents The registered person shall inspect the record of events of the care home 25/05/06 13/04/06 13/04/06 13/04/06 25/05/06 25/05/06 Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 23 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 OP11 Good Practice Recommendations The registered persons shall develop the policy and procedure on death and dying to include reference to individual care plans was evidenced, details of facilities for relatives, support for and practical assistance and bereavement counselling for residents and staff and notification to the Commission as per Regulation 37. The activity programme be developed as a planned programme and circulated to all service users in formats suited to their capacities. Develop the medication policy and procedure to include residents who wish to self medicate Include date of when policy agreed, and a planned review date on policies and procedures 2. OP3 3. 4. OP9 OP37 Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Glenesk Care Home DS0000008681.V288642.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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