Inspection on 30/01/08 for Hamilton House Nursing Home

This inspection was carried out on 30th January 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hamilton House Nursing Home 19/06/09

Hamilton House Nursing Home 14/07/06

Hamilton House Nursing Home 10/10/05

Hamilton House Nursing Home 03/05/05

Hamilton House Nursing Home 15/11/04

Hamilton House Nursing Home 01/06/04

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

CARE HOME ADULTS 18-65 Hamilton House Nursing Home The Street Catfield Gt Yarmouth Norfolk NR29 5BE Lead Inspector Debra Allen Unannounced Inspection 30th January 2008 10:00 Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 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 Hamilton House Nursing Home DS0000015643.V358796.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 Adults 18-65. 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. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hamilton House Nursing Home Address The Street Catfield Gt Yarmouth Norfolk NR29 5BE 01692 583355 PF 01692 583355 info@prime-life.co.uk info@prime-life.co.ukwww.prime-life.co.uk Prime Life Ltd 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) Mrs Stella Evans Care Home 39 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (39) of places Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 2006 Brief Description of the Service: Hamilton House is a registered care home offering nursing care to 39 people who have a mental illness. It stands on the main road in the Norfolk village of Catfield. The large main house has been extended and provides 23 single rooms and 1 double room. The rooms in the extension are particularly good with their own shower facilities and French doors to the outside. The accommodation is bright and attractive and has extensive communal space. In addition, a new building on the grounds provides 8 self-contained flats, 6 accommodating 2 service users and 2 for 1 person making 14 in all. These service users are assisted to shop, make their own meals and to be more independent. There is also a large garden. The basic fees are currently in the region of £315 per week and increase according to the level of support each individual requires. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This inspection was carried out over a period of six and a half hours, during which time discussions were held with the manager, deputy, staff, relatives and some of the people who use the service. A tour of the premises was also carried out, guided by two of the people who live at Hamilton House. Care plans, staff files, health and safety information and other records required for regulation were also examined as part of the inspection process. Prior to the inspection a comprehensive Annual Quality Assurance Audit (AQAA) document was completed by the manager and submitted to the Commission. Completed questionnaires were returned by fourteen service users and six staff, all of which contained mostly positive and constructive comments. Three requirements and one recommendation have been made as a result of this inspection. What the service does well: Comprehensive needs assessments are carried out prior to each person moving into the home and people are provided with good information to make an informed choice about whether they want to live at Hamilton House. People are actively involved in their care planning and each person’s information is regularly reviewed and updated. Risk assessments are very empowering, person centred and clearly written. Personal ‘Behavioural’ risk assessments are also in place for some of the people living at Hamilton House, which contain excellent information explaining how to read and understand each person’s behaviour and mood at various times. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 6 Independence and empowerment is very much promoted at Hamilton House and people are supported and encouraged to live their lives as they choose. People are treated with dignity and respect during times of ill health or death. The home has robust recruitment procedures and provides very good training for the staff. The manager and deputy are very approachable and positive and supportive to the staff and people who live at Hamilton House. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good. People have the information they need to decide if the home is right for them and a full needs assessment is completed before people move in. Each person also has a copy of the home’s terms and conditions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection, four care plans were looked at and each was found to contain detailed information, confirming that a full assessment had been carried out prior to each person moving into the home. The information pack, which is given to all prospective service users, was seen to include: An Introduction to Hamilton House, Statement of Purpose, Terms & Conditions for Self Funding Clients and a copy of Hamilton House’s internal Quality Assurance Review. Two people specifically stated in their questionnaires that they came and had a look at Hamilton House before they moved in to see if they liked it. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Quality in this outcome area is Excellent. Each person living at Hamilton House is involved in decisions about their lives and has the opportunity to be actively involved in planning the care and support they receive and have their views listened to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The four care plans that were looked at in detail contained good evidence that people are actively involved in compiling their care plans and each person was noted to have a dedicated key worker to support them in all aspects of life, particularly with goal setting and achieving their ambitions. A good example of this was the information seen regarding a person’s proposed move from the main house to a more independent setting over at the Mews. The transition notes were very clearly written and included an agreed ‘step-by-step’ timetable. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 10 The contents of the care plans include comprehensive information under standard headings such as: Personal Profile, Physical Health, Mobility, Communication, Mental Health Wellbeing, Behaviour, Eating & Drinking, Sleeping, My Life, Social Inclusion, Accommodation, Dressing and Cleansing. Although Prime Life provide the basic format for the care plans, it was recognised that the staff and management team of the individual service have worked very hard to ensure that each person’s information is regularly reviewed and updated and that individuality is maintained and promoted. Risk assessments were seen to be very empowering, person centred and clearly written, covering areas such as hitch-hiking, cooking, alcohol consumption, smoking, managing cigarettes within personal budgets, travelling and shopping. Personal ‘Behavioural’ risk assessments were also seen to be in place for some of the people living at Hamilton House and these contained excellent information explaining how to read and understand each person’s behaviour and mood at various times, how to respond to it appropriately and any relevant de-escalating procedures. All of this was written in a very respectful manner, promoting each person’s individuality and this work is highly commended. All personal information and records relating to the people living at Hamilton House were seen to be stored securely; thereby ensuring confidentiality is maintained. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. People who use the service are able to make choices about their lifestyle and are supported to participate in various activities, which suit their individual needs, choices and aspirations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions and observations during the inspection confirmed that independence and empowerment is very much promoted at Hamilton House and people are supported and encouraged to live their lives as they choose, at their own pace, as much as possible. Some of the questionnaires completed by the people living at Hamilton House included positive comments such as: “I go for walks and shopping” and “I go out on my own in the local area on the bus”. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 12 One additional comment noted was: “I’d like to go out more but understand that the van is busy on appointments”. A discussion with the manager confirmed that, although this was recognised as an issue, people were still supported to go out by using alternative forms of transport such as the local buses or taxis. One person spoken to described how they enjoy going shopping in the nearby town and regularly books a taxi for themselves. Two relatives spoken to, said their family member enjoyed going out to places such as Wroxham Barns and Tesco’s. They also stated that they were always made welcome when they visited. Discussions with other people living at Hamilton House and information noted within the care plans, confirmed that additional pastimes included adult education, bingo, quizzes, listening to music, watching DVDs, walks, art, pub visits and visiting friends. Although actual mealtimes weren’t fully observed, the people spoken to during the inspection confirmed that they enjoyed the food and the relatives said it seemed good. There was a relaxed and cheerful atmosphere around the lunchtime period in the main house. Prime Life have recently completed a comprehensive study (A Passion for Food) of their fifty care centres around the country, as to how food is provided, which focuses heavily on “the enjoyment and pleasure that food can bring, as well as regarding food as essential to maintaining good health”. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 Quality in this outcome area is good. The health and personal care that people receive is based on their individual needs, and the principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans looked at showed that the people living at Hamilton House receive differing levels of personal and healthcare support, according to their individual needs and daily notes showed information relating to people’s moods, behaviour, sleep patterns and appetite. Records of visits to, or from, various healthcare professionals, such as doctors, psychiatrists, community psychiatric nurses, social workers, dentists and opticians were also seen to be maintained in people’s individual care plans. The administration of medication, by the nurse on duty, was observed as part of the inspection and the system continues to be robust. The ‘Controlled Drugs Book’ was also seen, together with medication administration records and everything was found to be in order, with no errors or omissions noted. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 14 With regard to times of ill health or death, information seen in the care plans confirmed how service users have been supported and this information also indicated that people had been treated with dignity and respect throughout. Discussions with staff also confirmed that staff and ‘client’ meetings had been held following the death of one person, which provided support and understanding to all concerned and everybody at Hamilton House was offered the opportunity of attending the funeral. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Service users feel their views are listened to and acted on and they are protected from abuse, neglect and self harm as much as is possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All fourteen questionnaires returned by the people living at Hamilton House confirmed that they knew how to make a complaint. Additional comments included: “I would like to see my social worker more” “I speak to staff I feel comfortable with” “certain staff I like to talk to, who understand me” and “When I need to speak to the staff, there is usually someone available”. However, it was noted that the concerns, comments and complaints section in Prime Life’s Policies and Procedures brochure needs updating, to state that the Commission for Social Care Inspection (CSCI) can be contacted at any time with regard to any concerns, comments or complaints. Staff spoken to on the day had a clear understanding of adult abuse and protection. Training records and discussions with the manager and staff confirmed that all staff have received training in adult protection. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 & 30 Quality in this outcome area is adequate. Hamilton House provides a homely, comfortable and safe environment for people to live in, which is mostly clean and hygienic, although the grounds would benefit from more regular clearing and tidying of litter and cigarette ends. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the main house, guided by one of the people living there, showed Hamilton House to be mostly clean, hygienic and pleasantly decorated. The guiding person included their own rooms as part of the tour, which they said they were very happy with and information seen in their care plan showed how much they had improved, with regard to keeping the bedroom and bathroom clean and tidy for themselves. However, it was noted that staff only assist or support with this task once or twice a week but a requirement has been made that they do more frequently, whilst still promoting independence, Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 17 paying particular attention to the shower, sink and toilet for health and hygiene purposes. A second person was happy to give a guided tour of the grounds and the Mews, in which they had their own flat. The flat was seen to be very homely and provide good opportunities for independent living. The grounds, although very pleasantly landscaped, were spoiled somewhat due to a considerable amount of litter and cigarette ends. A recommendation has therefore been made for staff to consider ‘leading by example’ and encourage the people living at Hamilton House to take pride in their surroundings and take responsibility for its appearance, by working together. Meanwhile, a notice was observed on the conservatory door, which made reference to people smoking and leaving the area in a mess, but it was written in a very harsh and disrespectful manner, especially with reference to ‘whom the house belongs’. A requirement has been made for this notice to be removed and, if it is deemed necessary, replaced with something more appropriate and respectful to the people living at Hamilton House. The following are some of the comments made in the questionnaires by staff and people living at the home, which should be given consideration: “The toilets are sometimes dirty” “The décor of the house lets the hard work of the staff down” “the heating is poor in some areas” and “the home would benefit from having a full time maintenance person”. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. The people who live at Hamilton House are supported by competent and qualified staff and the service has robust recruitment policies and practices, which helps to ensure people are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two staff files were looked at during the inspection and both of them were seen to contain all the relevant records such as application form, references, confirmation of identification and clear, enhanced Criminal Records Bureau (CRB) disclosures, therefore confirming that the home/organisation has robust recruitment procedures. Training records were also looked at and evidence was seen of courses attended such as first aid, fire safety, health & safety, moving & handling, food hygiene, adult protection, medication, COSHH, mental health awareness, infection control, confidentiality and NAPPI. Discussions with two staff during the inspection confirmed that they received one-to-one support and supervision on a regular basis. Both staff members Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 19 said they enjoyed working for the company and that the training and support was really good. Some of the comments noted in the questionnaires included: “Hamilton House is a happy, but busy, workplace” “the care is above standard” “everything is carried out professionally” “we are well trained and have regular updates” “we are sometimes short-staffed at weekends” “we care about the residents and really want to give them a better life” “handovers could sometimes be better” and “my induction was in-depth and satisfactory”. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. The manager is a competent and professional person who runs the home with the best interests of the people who live there at heart. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of Hamilton House is very experienced and competent and has managed the service for a number of years. The staff, that were spoken to, said that the manager and the deputy are both very supportive and approachable. The service users who were spoken with said they liked living at Hamilton House and that the manager helps them get things sorted. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 21 The internal ‘Quality Assurance Review’ was seen for September 2006 and it was confirmed that another one was carried out at the end of last year, but the collated information wasn’t available at the time of inspection. The service was seen to have a good system in place with regard to policies and procedures, which were noted to be regularly reviewed and updated as required. The regulated checks for fire, environmental health, water and electric were found to be satisfactory and cleaning materials/hazardous chemicals were seen to be stored appropriately. Hamilton House Nursing Home DS0000015643.V358796.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 2 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 4 3 LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 4 3 X 3 X X 3 X Hamilton House Nursing Home DS0000015643.V358796.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 YA22 Regulation 22 Requirement The complaints procedure, including the concerns, comments and complaints section in Prime Life’s Policies and Procedures brochure, needs to be updated and state that ‘the Commission for Social Care Inspection (CSCI) can be contacted at any time’ with regard to any concerns, comments or complaints. The notice on the conservatory door, regarding smoking, must be removed and, if necessary, replaced with something more appropriate and respectful to the people living at Hamilton House. Timescale for action 31/05/08 2. YA16 12 30/03/08 3. YA16 13 Staff must support/oversee 30/03/08 service users with the cleanliness of their rooms more often, especially the wash/toilet areas, to ensure health and hygiene is maintained. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 2. Refer to Standard YA16 Good Practice Recommendations Staff should consider ‘leading by example’ and encourage the people living at Hamilton House to take pride in their surroundings and take responsibility for its appearance, by working together. Hamilton House Nursing Home DS0000015643.V358796.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Hamilton House Nursing Home DS0000015643.V358796.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. 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