Inspection on 07/07/06 for Hazelhurst Nursing Home

This inspection was carried out on 7th July 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hazelhurst Nursing Home 05/06/07

Hazelhurst Nursing Home 03/10/05

Hazelhurst Nursing Home 03/06/05

Hazelhurst Nursing Home 10/11/04

Hazelhurst Nursing Home 30/06/04

Hazelhurst Nursing Home 12/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hazelhurst Nursing Home Bishopswood Ross-on-wye Herefordshire HR9 5QX Lead Inspector Wendy Barrett Unannounced Inspection 7th July 2006 09:30 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 Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazelhurst Nursing Home Address Bishopswood Ross-on-wye Herefordshire HR9 5QX 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) 01600 890600 01600 890926 Hazelhurst Nursing Home Limited Mrs Bernice Cooper Care Home 45 Category(ies) of Dementia (45), Dementia - over 65 years of age registration, with number (45), Old age, not falling within any other of places category (45), Physical disability (45), Physical disability over 65 years of age (45), Terminally ill (45) Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd October 2005 Brief Description of the Service: This service is provided at an Edwardian country house set in extensive grounds with gardens. Hazelhurst has been modernised and extended to create a care home with nursing. It is registered to offer services for up to 45 people, and most people there are aged over 65 years. On the outskirts of the village of Bishopswood, the property is approached by a long drive and is in a peaceful rural position. The Provider confirmed fees ranged from £485 to £683 as at 22nd May 2006. Funded residents pay extra for hairdressing, chiropody and newspapers. Self funding residents pay for these services within their standard fee. All residents are charged for private telephone calls made from their bedroom. A brochure is handed to all prospective residents. This contains information about the service and advises how additional information can be obtained e.g. full version of the home’s Statement of Purpose. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to inform this report was obtained from the Commission’s records of contacts with or from the service, written and verbal feedback about the service from residents and relatives, and other information obtained at the home during two inspection visits. The first of these was unannounced. The second was announced. What the service does well: What has improved since the last inspection? There has been a major review of all health and safety aspects of the service to strengthen the overall safety of residents at the home. This has included attention to premises and updating of relevant policies and procedures. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 6 The Provider has recognised an ongoing problem recruiting local staff and has devised a plan of action to address this. This should result in less dependency on agency staff who don’t know the individual residents and the work routines as well as the permanent staff. The level of qualified nursing staff has been increased and the roles of the two Deputy Managers have been reviewed so that they can better support the Care Manager with everyday care management issues. 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. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents or their representatives have the information needed to choose a home that will meet their expectations. The prospective resident’s care needs are fully assessed by competent staff at the home so that only residents whose needs can be met are admitted. EVIDENCE: There is good written information about the service and this is made available to prospective residents and/or their relatives. Self-funding residents – or their relatives, also receive Contracts of Residence that confirm the terms and conditions of the placing agreement. When residents are funded by a local authority the contractual agreement is made with the placing authority. The Care Manager or other competent senior undertake pre-admission assessments so that they can meet prospective residents in their current home environment and decide if the home will be able to cope with their needs. Written records of these initial contacts, and information gathered, were seen Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 9 during the inspection visit. A staff member described a pre-admission visit to meet a potential resident and assess her needs. Arrangements were made for her to be at the home to welcome the resident on the day of admission. The home welcomes visitors who are looking for accommodation for an elderly relative, and also encourages introductory visits to the home to help the new resident settle in. Relatives were observed arriving for an on the spot look at the home during the inspection visit. The son of a resident described how he chose Hazelhurst as a care home for his mother. He had recently received a revised Contract of Residence. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health care and medication is well managed by competent professional staff. There should be more attention to helping junior staff work with the generally frail residents in a way that reflects the resident’s individuality and quality of everyday life. EVIDENCE: Each resident has a written plan of care and this is regularly reviewed to make sure it is kept up to date. When appropriate, relatives are consulted in care planning. e.g. when the resident’s personal activities involve some risk. An example of this consultation was seen in a care record. Relatives had signed the plan to confirm their agreement with action required to protect the resident from harm. Health care needs are well addressed and the records clearly show how the related care plans are monitored and revised when necessary. A report from the Provider refers to routine audits of accident records as one method of identifying and dealing with potential hazards to all, or particular residents. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 11 The residents are offered a programme of social activities and an activities organiser also spends time with individuals for whom one to one support is more desirable. Records are kept of her work and she is much valued – ‘she is wonderful’. Although most residents have significant physical care needs when they come into Hazelhurst, the care planning should take into account any social or emotional issues. Specific action plans should be used for dealing with these needs in the same way they are used to deal with the physical care needs. The front lounges are occupied by a group of very frail residents who need considerable support to help them through daily life. Because these residents find it difficult to initiate communication with each other the atmosphere is rather ‘flat’. This impression may be due to the size of the group and the degree of their disabilities but it would be advisable to consider whether more staff time should be devoted to these rooms. The activity organiser does spend some time with these residents but this leaves a large part of the day when there may be no regular staff presence. Perhaps there could be more thought about ways to develop more junior staff awareness of the individuality of this particularly frail group e.g. their involvement in developing life histories with the involvement of the residents’ relatives/friends. Nurses who are well aware of current legislation and good practice guidance very safely manage medication. Some residents are subject to ‘end of life’ programmes and these situations often involve complex medication regimes to address things like pain relief. Because of this type of situation there is little use for homely remedies at Hazelhurst, but it is recommended that residents should be asked to inform staff if they are using any homely remedies because sometimes this may react badly with prescribed medications being administered by the staff. Several very complimentary ‘thank you’ cards from the families of residents who have been cared for until their death at the home were seen. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents whose health care needs are paramount, or who can express their own wishes, receive a good standard of care. There should be more attention to the individuality of those residents who require support in expressing this for themselves and in maintaining their personal dignity. EVIDENCE: There have been some concerns raised at the home, and with the Commission, about the personal care of some residents. These tend to be concerns about personal presentation e.g. dentures missing, hair unkempt or lack of support with food and drink e.g. nowhere for them to place hot drinks, staff not staying to help residents enjoy their drinks. Other residents and relatives are very satisfied with the service and have good relationships with the Care Manager and staff. There are considerable demands on all staff because of the challenging health care needs of many of the residents. Many residents have complex health care needs that inevitably require robust management of care tasks. The evidence confirms these demands are well met. The care of some other residents may Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 13 need to be delivered in a more flexible way that is based on their individual lifestyle preferences and current abilities. Although a key worker system is in operation it may be helpful to consider whether some relatives, and the more junior staff, may need additional encouragement and guidance in developing constructive communications with each other. The home has a large staff team and some visitors may find it difficult to find a way to engage with the most appropriate staff in meaningful discussions about everyday care issues. The catering service at Hazelhurst has consistently received praise and this positive picture continues at the point of this inspection. Choice and dietary need are well addressed in the way this aspect of the service is managed. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are clear procedures for dealing with complaints and adult protection and the staff are trained to use these effectively. There have been some examples that suggest this guidance has not always resulted in satisfactory outcomes for all residents or their relatives. EVIDENCE: All new residents, or their representatives, receive written guidance about how to raise a concern about the service. When complaints are raised at the home they are all recorded with full details of action taken to rectify the problem. This reflects an open management approach although a few contacts with the Commission over the past year describe some difficulty in achieving changes to the everyday care of their resident in a way they feel is appropriate. The concerns tend to be issues affecting personal dignity rather than significant health risks but they are, of course, important in making the service acceptable e.g. inadequate support with personal presentation. A relative was dissatisfied with staff explanations when she asked why the resident did not have her dentures in, and was not wearing stockings. During the past year, the Provider and Care Manager have been involved with other local professionals in investigating allegations of unacceptable care practice at the home. They have demonstrated an open and co-operative attitude towards ensuring the safety of residents at the home and have Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 15 contributed their observations on the effectiveness of the local procedures for investigating these types of issues. The staff have received training in abuse awareness and adult protection and there are relevant policies and procedures to help them identify and report any concerns. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a well maintained, comfortable home and the Provider has demonstrated, through prompt action, a commitment to identify and address any shortfalls that could affect the safety of the residents. EVIDENCE: The accommodation is situated in extensive, attractively maintained grounds. It consists of an original adapted building with a more recent, purpose built extension. Bedrooms in the original part of the building offer a generous amount of space to bring in personal items of furniture. Remaining bedrooms comply with space requirements. A short stay resident said ‘ yes, I’m happy with my room. It’s nicely laid out’. A blind resident had been recently admitted. Work was underway at the time of the inspection visit to fit a mixer Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 17 tap at her washbasin, and two hooks for hanging wash flannels (resident’s request). Following a successful prosecution by the Health and Safety Executive earlier this year, the Provider is currently undertaking an extensive piece of work to review the overall safety of the accommodation. The prosecution related to injury sustained by a resident on an uncovered heated surface. A considerable amount of work has already been done e.g. boxing in heating pipes, filling in of swimming pool, installation of water treatment system. A pre-inspection questionnaire reflects good attention to maintenance of essential services and specialist equipment e.g. fire safety system, hoists, safe disposal of soiled waste and medications. All related policies and procedures are being revised and staff familiarised with current requirements. Routine decoration and refurbishment has continued e.g. decoration of 11 bedrooms. New purpose-designed armchairs were seen in the front lounges. These offer an appropriate variety of seat levels and attractive, but hygienic soft coverings. The Provider implements a system for reviewing and replacing equipment and aids at the home. The Commission has been informed of an infectious outbreak and robust measures taken by staff to comply with regulatory and good practice guidance for infection control. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory although this is only being maintained by regular use of agency staff. Some residents may benefit from more attention to get the best out of their daily life. New staff are carefully selected to be sure they are suitable to work with vulnerable adults. All staff receive training appropriate to their role. EVIDENCE: There has been a recent increase in the number of registered nurses employed at the home, and the Provider has responded to a difficulty in employing more junior staff from the local community. Proposals to recruit from Poland have been described in correspondence with the Commission. Copy duty rotas supplied with a pre-inspection questionnaire reflect a satisfactory level of care, catering, domestic and maintenance staff although there is use of agency nurses and nursing assistants to maintain this level. This should reduce if the current proposals for recruiting from abroad are effective. The level of permanent staff turnover is reasonable given the size of the staff group. Most comments from residents and relatives support the above assessment – ‘Night care assistant – she’s a wonderful person – very, very kind’, ‘the staff are very good to him’, ‘she’s better back in Hazelhurst rather than in hospital’. The Commission has received one anonymous letter that expressed dissatisfaction with night care attention. The Provider was alerted to this Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 19 contact but there was too little information to investigate further. Once again, the amount of time spent interacting with residents in the front lounges was questioned – ‘no staff visit them to have a word with them’. A period of observation in one of the lounges tended to support this view. Staff only seemed to come into the room to perform practical tasks e.g. serving drinks, helping residents to the toilet. Two recruitment files were inspected during the inspection visit. They indicated a satisfactory process of recruitment that complies with regulatory requirements for ensuring the suitability of the individual to work with vulnerable adults. A completed record of a health and safety training package was seen. This confirms that the new staff member has been familiarised with the most essential procedures before starting work e.g. fire procedure, food hygiene. The home has implemented an induction/foundation training programme that complies with national specifications. The Care Manager explained how junior staff receive guidance on specific professional practice areas e.g. visual impairment, tissue viability, from trained nurses during handover and supervision periods. 53.57 of care staff hold an NVQ level 2 award or above. This slightly exceeds the National Minimum Standard. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Provider has the skills and commitment to deliver good business planning and staff at the home are supported through policies and procedures that are kept up to date. There are systems in place to monitor and review the quality of the service. EVIDENCE: The Provider has undertaken a thorough review of health and safety aspects in recent months. This has included consultation with external consultants and has involved all staff employed at the home. Policies and procedures are being reviewed and staff familiarised with them. The ‘Environment’ section of this report describes premises work that has been completed. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 21 The Provider has kept the Commission informed of developments at the home in between inspections. Correspondence refers to regular audits of falls and accidents occurring at the home and proposals to address the ongoing problem recruiting local staff. There is also reference to a proposal to introduce a computerised records system. The situation of the current nurses station does not offer adequate security and confidentiality and a recommendation is made to consider an alternative site. Recent involvement with vulnerable adults investigations has shown the Provider and Care Manager to be prepared to work constructively with other professionals and agencies. Some relatives feel very satisfied with their involvement in care planning – ‘we always feel totally involved in all aspects of care planning’. Others have expressed difficulty in getting a satisfactory response when they have raised concerns about a resident’s care. Staff are provided with statutory health and safety training, and 11 staff are qualified manual handling instructors. There is a programme of one to one supervision and support for junior staff, and guidance is cascaded through the care team during handover periods and team meetings. The cook had recently been supplied with a very useful folder of guidance – ‘Menu solutions for Care Homes’. This would help her to ensure a varied, well balanced diet for all residents, including those with special dietary needs. The home does not involve itself in the financial affairs of any residents. Any additional expenses are recouped through routine fee accounts. One of the residents who were interviewed during the inspection visits spoke about contact with her solicitor. Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x 3 Hazelhurst Nursing Home DS0000027679.V303895.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 OP7 Regulation 12(3) and 4(a) Requirement Written plans of care must be revised through consultation with the resident or representative so that personal preferences and dignity can be maintained in the way staff deliver the individual’s care. This is particularly important for those residents who have difficulty in maintaining their preferred daily lifestyle without staff support. Timescale for action 30/09/06 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 Refer to Standard OP9 Good Practice Recommendations The medication policy/procedures should be revised to ensure action to clarify details of any homely remedies being used by residents, and confirmation that these will not react adversely with any prescribed medications. It would be advisable to consider re-siting the nurse station so that security of confidential information can be improved. 2 OP37 Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worcester Office The Coach House, John Comyn Drive Perdiswell Park Droitwich Road Worcester WR3 7NW 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 Hazelhurst Nursing Home DS0000027679.V303895.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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