Inspection on 06/09/06 for Hazelmere Nursing Home

This inspection was carried out on 6th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hazelmere Nursing Home 06/08/07

Hazelmere Nursing Home 08/11/05

Hazelmere Nursing Home 25/05/05

Hazelmere Nursing Home 17/01/05

Hazelmere Nursing Home 25/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Hazelmere 9 Warwick Road Bexhill On Sea East Sussex TN39 4HG Lead Inspector Melanie Freeman Key Unannounced Inspection 6th September 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hazelmere DS0000013994.V309572.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. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazelmere Address 9 Warwick Road Bexhill On Sea East Sussex TN39 4HG 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) 01424-214988 Mr Rodney Gadsden Mrs Corinne Gadsden Mrs Corinne Gadsden Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability (23) of places Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That the maximum number of service users/residents/individuals to be accommodated at any one time is twenty three (23). That the care home provides general nursing care to older people aged sixty five (65) or over on admission and can provide care to people with a physical disability. 8th November 2005 Date of last inspection Brief Description of the Service: Hazelmere Nursing Home is situated in a residential area approximately half a mile from Bexhill town centre. The main-line station, seafront and local bus services are close by. The home has a large, pleasant and well-maintained garden with an ornamental fishpond to the rear of the building. There are car parking facilities on site and unlimited parking facilities outside the Nursing Home in Warwick Road. There is a pleasant lounge overlooking the garden that is also used as a dining room. The home is registered to provide general nursing care for older people and older people with a physical disability up to a maximum of 23. Both private and socially funded service users are cared for by the home. This home is owned and managed as a family business. The home’s fees as from 01 July 2006 range between £417.15-£650.00 per person per week. Additional costs are charged for chiropody, hairdressing, newspapers, any shopping and the use of a private physiotherapist. The homes literature states that ‘We like to think that all the residents here can also feel part of that extended family. This is home where the members can live their lives in the warmth and security of the care we have to offer’. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Hazelmere Nursing Home will be referred to as ‘residents’. This was a key inspection that included an unannounced visit to the home and a further visit, which was completed via an appointment to follow up issues with the home manager/owner and to provide direct feedback. On the day of the home visit the inspector spent most of her time meeting with residents and their visitors, and observing practice in the home. A tour of the premises was undertaken and a range of documentation was reviewed including the home’s statement of purpose and service users guide, care plans, duty rotas, medication records, and recruitment files. The care documentation pertaining to three residents was reviewed in depth along with a number of policies and procedures and records relating to health and safety. The inspector was able to eat a midday meal with the residents in the communal dining room during the unannounced visit. In addition service users surveys were given to 10 residents or their representatives and 5 staff surveys were left in the home for staff to complete and return. The inspector received 9 service users/representatives surveys no staff surveys were returned, information contained in the returned surveys has been incorporated into this report. What the service does well: Hazelmere nursing home provides a good level of nursing care to residents in a home like environment, and this care is delivered in a caring manner. Resident’s visitors and visiting professionals spoke very positively of the home and the service provided by staff. The food provided was mostly well received and focuses on home cooking. Hazelmere nursing home provides a home like environment where visiting is encouraged with some visitors spending long periods of time in the home. The care needs of residents are fully assessed following admission and care is planned on an individual basis. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 6 The manager/owner is well respected and has a close relationship with residents and their relatives. Staff feel comfortable and able to discuss any issue with her at any time. What has improved since the last inspection? What they could do better: The care documentation including preadmission assessments and care plans need to be further developed to ensure residents receive appropriate care to meet all the residents needs. The manager needs to ensure that staff adhere to the homes procedures including the administration of medicines to ensure safe practice at all times. Further attention needs to be given to providing appropriate entertainment and activities to ensure individual recreational and leisure needs of residents are met. Staff need to have a clear understanding of adult protection issues and have a clear procedure to follow in the event of abuse being alleged or suspected to ensure residents safety. The call bell system needs to be improved to ensure any residents wanting to call for help can do so. The resident seating needs to be improved to ensure residents sitting at the dining table are able to do so safely. The recruitment practice of the home needs further improvement and should always include appropriate referencing and the retention of the required documentation to demonstrate a thorough and robust recruitment procedure. Quality assurance measures need to be further improved to ensure residents and their representative’s views on the home are taken into account and responded to in a formal manner. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 7 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. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents have access to full information about the home to inform their choice of home. All residents are assessed prior to admission and residents are only admitted to the home if their assessed needs can be met; however the assessment is limited. EVIDENCE: The home provides a combined statement of purpose and service user guide and a copy of this document was found to be available in the office and the communal sitting/dining area. Although this document is informative it needs to be accurate for example it referred to the registering authority as the health authority, and should also include the views of residents. A relative spoken to confirmed that the admission process was clear and well executed. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 10 The certificate of registration is displayed in an appropriate area and is correct. A review of the care documentation confirmed that pre-admission assessments are completed by the home manager/owner prior to an admission being agreed and ensures that the needs of residents admitted to the home can be met by the staff within the homes environment. The last two pre-admission assessments were reviewed to assess the quality of these assessments. They were found to be rather limited and did not reflect a multi disciplinary approach to care, some documents were also not dated or signed. These shortfalls were highlighted at the last inspection. Intermediate or rehabilitative care is not provided at Hazelmere Nursing Home. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although care documentation provides a framework for the provision of care it needs to be extended to cover all care needs and promote person centred care. Resident’s care needs are met taking into account resident’s dignity with evidence of regular input from health care professionals as necessary. The medicine administration practice in the home does not ensure best and safest medicine administration practice is followed. EVIDENCE: The care documentation pertaining to three residents were reviewed as part of the inspection process and the care plans were found to provide a framework for the residents care. However specific care needs are not always documented for example one resident who had complex communication problems did not have this covered in the plan of care. There was also not enough information on his mobility or his emotional needs. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 12 Observations confirmed that residents were clean and well looked after and that they were treated as individuals by the carers looking after them. All residents and visitors spoken to indicated that they were very happy with the way the needs of residents were being met and the way that they were treated although one relative believed further individual time for the residents would be beneficial. The comments received included ‘the staff are lovely not one that I could complain about’, I am very impressed with the home and the care provided’, ‘the care provided is very good’. During the inspection it was noted that staff do not use handling belts and this was raised with the home manager/homeowner and she confirmed further moving and handling training is to be provided to all staff in the near future it was also noted those residents at risk from falling are not fully risk assessed. During the inspection it was again noted that staff were not following the homes procedure on medicine administration so best practice was not being followed. On review, the medicine records were found to be clear and accurate and the medicines room was well organised. Staff have regular contact with the local GPs and work with them to review and ensure residents receive appropriate medical care. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected 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 good. This judgement has been made using available evidence including a visit to this service. Links with friends and relatives are encouraged and choices made are respected. Resident’s opportunities for stimulation through leisure and recreational activities are not fully developed in the home to meet individual needs. Residents receive a wholesome and appealing diet. EVIDENCE: Although activities do provide some one to one time and some musical entertainment the individual approach to activity and entertainment is not well developed and ways of improving this through person centred care was discussed with the home manager/owner. During the inspection visits residents were able to enjoy the garden area staff were careful to ensure that they were shaded from the sun and sitting next to people they could talk to. One resident said how much she relied on the fortnightly visit from the library service. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 14 Visitors spoken to again confirmed that they are very well received by the staff at Hazelmere and feel comfortable to visit as much as they want to, visiting times are not restricted. Some links with the community are maintained including links with the church if wanted. The inspector was able to see that residents were given choices through the day and that when these choices were made staff responded them to. It was also noted that the home promotes the use of advocacy through Age Concern. The meal eaten by the inspector was found to be well presented and to have a good taste with an emphasis on home cooking. The main meal was roast pork and vegetables with a crumble pudding. Residents enjoyed the meal and were given a choice if they did not like the roast pork. The inspector again noted that residents sit at individual tables and there is no feeling of a social event at mealtimes. A staff member identified that residents are not able to sit at the dining table as the chairs are not suitable and this was discussed with the home manager/owner. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be 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. The home has a suitable procedure for dealing with complaints made to it. The home’s procedures do not ensure that the correct alerting procedures are followed once an allegation or suspicion of abuse is highlighted. EVIDENCE: The home has a detailed complaints procedure, and although there had not been any formal complaints recently, residents and relatives spoken to confirmed that they would speak to the registered nurses on duty, if they had any issues and that these would be addressed by the manager/owner as necessary. Discussion with one of the registered nurses identified that she was not clear on how she would record a formal complaint as most concerns are dealt with on an informal basis quickly. The practice in the home needs to be reviewed to ensure all staff are aware of the procedure and have access to the necessary forms/complaint book and that this is stored ensuring appropriate confidentiality. The current Adult Protection procedure is not appropriate and does not reflect the local guidelines. Staff training still needs to be established for all staff. Hazelmere DS0000013994.V309572.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, 22, and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with a comfortable safe environment that has a home like feel and meets the stated purpose of the home. EVIDENCE: Hazelmere Nursing home is a converted premise that has retained a home like environment. Accommodation is provided on two floors with disabled access to the first floor via a passenger shaft lift. There is a large garden with a fishpond and this is kept well maintained and is accessible to wheelchair users and was being used by residents during the inspection visits. The residents using the garden said how much they liked the garden. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 17 The communal space is found on the ground floor and is used as a lounge and dining area, this room is well used although it was again noted that residents eat their meals at individual tables rather than at the communal dining table. It was also noted that a resident was unable to call for help when wanting to move as a call bell was not accessible to him. As the inspector was in the lounge area with him she was able to request assistance. Although on the whole the home was clean and hygienic the home needed deep cleaning in some areas including the inside of furniture and bed frames. Visitors were seen to be visiting residents while they were in the lounge and while they were in their bedrooms the manager said that all visitors are offered to see their relatives in their own room, as a separate private room is not available. Where residents like to receive their visitors should be recorded in their plan of care to ensure a person centred approach to care. Hazelmere DS0000013994.V309572.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is sufficient staff who are suitably trained on duty to ensure that residents receive the level of care they need. Residents are not fully protected by the home’s recruitment policy and practices. EVIDENCE: At the time of this inspection visit there was 19 residents living in the home and the staffing arrangements were found to be appropriate to meet their care needs. However feedback from staff and a relative indicated that more individual time would be appreciated. A staff rota was available for inspection and confirmed that a Registered Nurse is working in the home over the 24 hours with 4 carers in the morning and 3 carers in the afternoon and 1 at night. There are in addition sufficient catering and cleaning staff. All feedback received from residents and visitors confirmed that the staff are ‘very kind’ ‘thoughtful and kind’ and ‘do their very best’. Three staff recruitment files were examined. These files confirmed that the appropriate Protection of Vulnerable Adults and Criminal Records Bureau checks were being completed however the inspector was concerned to note that references obtained were not always appropriate. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 19 In two cases the most recent employer was not approached for a reference and one file did not include proof of the individuals identity. These concerns were discussed with the home manager/owner for her to address. Staff training continues to be developed and induction training is documented within records examined in the home. Individual training files need to be established with evidence that staff training is complying with the new induction training standards. Hazelmere DS0000013994.V309572.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, 33, 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 home was found to be managed in an open and friendly manner, systems to monitor and demonstrate the quality of care provided need to be fully established. Resident’s financial interests are safeguarded. The health, safety and welfare of residents and staff are generally promoted and protected. EVIDENCE: The home manager is also the registered provider and has owned and managed Hazelmere for approximately six years. She is a registered general nurse and has managed homes previously and has also completed relevant management training. She is very involved in all aspects of the homes management and has a close working relationship with all staff. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 21 It was clear following discussion with staff residents and visitors that she is well respected and makes time for anyone wishing to speak to her. Questionnaires are used to gain residents and their representatives views and although these are not reported on they are responded to on an individual basis. The use of auditing and providing a Quality Assurance report was discussed with the manager along with the need to develop the questionnaires to provide more information. The home manager confirmed that the home has no dealings with resident’s monies and that any extras costs incurred are paid by the home and then individually invoiced on a monthly basis. All records relating to health and safety matters were found to be full and thorough. Hazelmere DS0000013994.V309572.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 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X 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 2 3 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 Requirement Timescale for action 01/10/06 2. OP7 3. OP9 4. OP12 5. OP18 That the needs assessment completed on all prospective residents is comprehensive and takes into account their and representatives views along with other relevant professionals. 15(2) That the individual plans of care are comprehensive and reflect each individuals care needs and include the use of relevant risk assessments for example the risk of falling. 13(2) That all staff follow the homes medicine policies and procedures to ensure best and safest practice is followed at all times. 16(2)m)n) That the current provision and time available for activities and entertainment is improved, to ensure all residents have their social, cultural, religious and recreational interest and needs assessed and met. 13(6) That the adult protection procedure is updated and further staff training is provided. 01/10/06 01/10/06 01/10/06 01/10/06 Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 24 6. OP22 23(1) 7. OP29 19(1) 8. OP30 19(5) 8. OP33 24(1) That all residents have access to a call system to summon help when needed. That appropriate chairs are provided to ensure residents can sit at the dining table safely if they so wish. That a thorough recruitment procedure is operated that includes securing two authentic/appropriate references and the retention of documentation as identified in schedule 2.(outstanding from previous 3 inspections) That staff training is fully recorded and demonstrates that the skills for care induction are fully addressed within this training. That a full quality assurance system is established and used to maintain and improve the provision of care and services in the home. That all the homes policies are reviewed and updated to underpin best practice. 01/04/07 01/10/06 01/04/07 01/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP1 OP16 OP22 Good Practice Recommendations That the homes statement of purpose and service users guide is kept up to date and reflects resident’s views. That the complaints procedure displayed is up dated to reflect the current registering authority. That an assessment of the premises and facilities should be undertaken by a suitably qualified person, or qualified Occupational Therapist, to advise on the suitability of disability equipment and environmental adaptations. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 25 4. 5. OP26 OP30 That the standard of cleanliness throughout the home is reviewed to ensure high standards are maintained throughout the home. That a training Matrix is used to record and plan all training within the home. Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Hazelmere DS0000013994.V309572.R01.S.doc Version 5.2 Page 27 - 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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