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Inspection on 27/07/05 for Hazelwood Care Home

Also see our care home review for Hazelwood Care Home for more information

This inspection was carried out on 27th July 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users feel that they are well cared for by a friendly and supportive team of staff. There is encouragement for service users to retain as much control over their lives as possible and they are supported to maintain links with the community. There are opportunities to take part in the interesting and varied activities programme and this includes regular trips out from the home. Staff receive on-going training to provide them with the knowledge and skills to undertake their roles professionally. The home is safe and there are systems in place to promote the continued welfare of the service users. Service users are very satisfied with the catering and the menu offers a good choice. The managers are receptive to service users views on the home and they are dedicated to providing a good quality service.

What has improved since the last inspection?

From the findings of past inspections it was apparent that the physical environment in many parts of the home needed to improve. This is now being addressed and the current building alteration and refurbishment work is significantly enhancing the home for the service users. In addition to the structure of the building, there has been purchase of a substantial amount of new carpeting and new furniture, all of which improves the environment for the service users. Risk assessment processes have developed and a particular example relates to the risk assessment for the prevention of falls. The acting manager reports that the prevalence of service user falls has reduced since the introduction of a formal risk assessment process targeting this subject. Routine maintenance monitoring such as the recording of water temperatures has been formalised and there are now detailed records available at inspection. This further assures a safe environment for the service users.

What the care home could do better:

When asked at the inspection, the service users spoken with felt that there was nothing of particular note that could be improved. The environmental shortfalls are being addressed, although the requirements remain in place until the works are completed. There is evidence that the service carries out quality assurance and quality monitoring work. However, there needs to be better reporting of the statutory visits made to the home by the registered provider (or by a designated person on behalf of the registered provider) in order to demonstrate that these visits are meaningful, structured and result in action to address any issues identified from them.

CARE HOMES FOR OLDER PEOPLE Hazelwood Care Home Skeavingtons Lane Cotmanhay Ilkeston, Derbyshire DE7 8SW Lead Inspector Andrew Bailey Unannounced 27/07/05 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 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. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hazelwood Care Home Address Skeavingtons Lane, Cotmanhay, Ilkeston Derbyshire, DE7 8SW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01629 580000 Derbyshire County Council Beryl Ryder Care Home 37 Category(ies) of OP - Older People registration, with number of places Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None stated Date of last inspection 31 January 2005 Brief Description of the Service: Hazelwood is a care home currently registered to provide personal care and accommodation for 37 older people. The single-storey home is owned by Derbyshire County Council and is situated in the village of Cotmanhay on the outskirts of the town of Ilkeston. The Home comprises of separate wings, each with a lounge and dining area. There is also a larger communal lounge area situated near to the main entrance and the administration offices. All bedrooms are single occupancy. There is separate bath/shower and toilet provision (no bedrooms are equipped with en-suite facilities). The Home has a hairdressing salon. Support services include General Practitioner, district nurse, chiropodist, dentist and optician. Community psychiatric nurses, occupational therapists, physiotherapists and dietician are accessed as required. Staff training takes place to inform and enable staff to care for service users appropriately. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the duration of the inspection was approximately 4.5 hours. A tour of the building took place. Discussions were held with six service users and with two staff. A number of records were examined, including care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual service users). The registered provider has submitted an application to vary the registration of this care home. The home currently comprises of four wings, which lead off from centralised facilities, including the administration area, laundry and kitchens. There are currently building works taking place, with one of the wings in the process of being converted into a rehabilitation unit (to be run by a different provider). A positive outcome for the service users is that the care home facilities are being refurbished during the alterations and the physical environment is undergoing substantial improvement. What the service does well: Service users feel that they are well cared for by a friendly and supportive team of staff. There is encouragement for service users to retain as much control over their lives as possible and they are supported to maintain links with the community. There are opportunities to take part in the interesting and varied activities programme and this includes regular trips out from the home. Staff receive on-going training to provide them with the knowledge and skills to undertake their roles professionally. The home is safe and there are systems in place to promote the continued welfare of the service users. Service users are very satisfied with the catering and the menu offers a good choice. The managers are receptive to service users views on the home and they are dedicated to providing a good quality service. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 6 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. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 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 standard(s) 1 & 3 (standard 6 is not applicable to this service) There is written information available to service users to assist them in making decisions about this home as a place for them to live. Pre-admission procedures are in place to facilitate the admission of service users on the basis of a comprehensive assessment of their needs. EVIDENCE: There was a Statement of Purpose and Service User Guide available at the home to provide written information about the facility for service users and prospective service users/representatives. The written information was last updated in April 2004 and the acting manager stated that there are plans to review the documents again when the building alterations are complete (the content of the Statement of Purpose in respect of the services and facilities will be revised). Community care workers undertake the initial assessment of service users and provide a written care management assessment and associated care plan. A unit manager also assesses prospective service users before admission to the Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 9 home. There was documentation in the care plan files examined at this inspection confirming these assessment arrangements. The system provides appropriate evidence that the home seeks to provide a suitable placement for service users. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 & 10 The care plans provide detailed records about service users, and contain appropriate information to guide staff in caring for service users. Service users are protected by systems that promote safe administration and handling of medicines. EVIDENCE: As part of the service user case tracking process three care plans were examined in detail at this inspection. The care plans laid out the needs of the service users and identified how these needs were to be met by the staff. Monthly audit of the care plans by management helps to ensure that an appropriate standard of record keeping is maintained. A risk assessment with particular attention to prevention of falls had been initiated. The acting manager reported that it had been observed that the incidence of service user falls had decreased since the introduction of this risk assessment. Risk assessment documents for tissue viability and nutrition were examples of the proactive systems in use to promote the health of the service users. The tissue viability monitoring document had been produced by the health service for use in care homes and did not include a section for the person making the assessment to sign the document. Notwithstanding this, some staff had signed Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 11 against their entries and it is recommended that all staff follow this practice in order that the principles of good record keeping are upheld. There had been regular audits of the medication system by the community pharmacist (latest report examined from an inspection on 25 July 2005, with satisfactory findings). The system provides external quality monitoring of the homes medication practices and supplements the home’s internal quality monitoring. Staff who administer medication had received training from an outside agency. This provides further assurance that competent staff administer the medications. The documentation used to record the risk assessment and agreement for selfadministration of medicines should be reviewed to ensure that a comprehensive record is maintained, where this is appropriate to the individual service user. The documentation currently in use could be interpreted as covering arrangements where a service user either accepts or declines responsibility for all prescribed medication. However, there may be circumstances where only some of the prescribed medications are appropriate for self-medication e.g. inhalers, and the written assessment should reflect this. Service users spoken with confirmed that staff are respectful of privacy and dignity in their interactions with the service users e.g. staff knock on the bedroom door before entering the room. Staff observed on the day of the inspection were polite and supportive in their approach to the service users. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 & 15 The social & leisure programme is well organised, providing stimulating and interesting opportunities for the service users. Service users are encouraged to maintain links with the community. Meals are provided to a good standard with choices. EVIDENCE: The activities programme is well developed and received positive comment from the service users spoken with at this inspection. One of the deputy managers organises the activities. She has undertaken British Heart Foundation training and this enables her to deliver a specific chair-based exercise programme, and also to teach other staff to deliver this programme. The activities programme provided is designed to meet a range of interests. Trips out from the home are organised, and recent trips include Blackpool and Skegness. There is usually at least one trip out per month. Within the home there is a hairdressing service (twice per week), daily music, movement to music (weekly), beauty sessions, croquet, bingo, quizzes and special evenings such as fish & chip suppers. A mobile library visits two-weekly. There are links with another local authority home and there have been visits to this nearby home so that the service users could enjoy candlelit dinners. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 13 Open visiting is encouraged and service users reported that their visitors are made welcome when they visit. For example, one of the service users commented that their visitor is invited to dine with them. There was confirmation from service users that the home is run with flexible routines, with an emphasis on personal choice for the service users. Some of the service users spoken with maintained links with the community, either shopping locally or attending luncheon clubs for example. Service users are able to exercise as much control over their lives as possible. The food at the home received praise from service users spoken with at the inspection. The meal served at lunchtime on the day of the inspection appeared to be of good quality and was clearly well received by the service users. There is opportunity for alternatives to be served for service users who choose this, and the preferences of the service users are actively sought. The menus examined demonstrated that there is a varied and imaginative approach to the catering provided at the home. The deputy manager reported that feedback from residents’ meetings had influenced the development of the menus. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 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 standard(s) 16 & 18 A complaints procedure is in place, with confirmation from service users that any concerns are acted upon. The adult protection systems in place and the training of staff promote the safeguarding of service users from abuse and neglect. EVIDENCE: The complaints procedure is contained in the Statement of Purpose, Service User Guide and is on display in the entrance area of the home. This means that service users and visitors are aware of how to raise any concerns with the registered provider. Service user feedback indicated that management are accessible and deal with any concerns promptly. There are no current complaints or serous issues of concern being investigated by the management of the home, or by CSCI. Staff have attended training on adult protection (Derbyshire Social Service training) and the local adult protection guidance is readily available within the home. There is an internal policy and procedure to guide staff in the event of allegations of abuse. There is also a video utilised in staff training sessions entitled ‘Enough is Enough’. Staff have received guidance through related inhouse training on dealing with physical and/or verbal aggression. Appropriate measures are being taken to protect service users from abuse and neglect. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 25 & 26 The environment is maintained to a satisfactory standard for the service users, with good standards of hygiene and cleanliness maintained. The building alterations currently in progress will further enhance the facilities for the service users. EVIDENCE: A tour of the building was undertaken during the inspection. The building is maintained to a satisfactory standard, which is visually pleasing to the service users and visitors, and also provides assurance that there is regard to the safety and welfare of the service users. Requirements from previous inspections, for example the need to improve the access arrangements for persons with mobility problems, are being addressed as part of the building alterations, which are currently in progress. There is presently some disruption due to on-site construction and refurbishment work, but the impact to service users is being kept to a minimum. There will be significant benefits for the service users and staff when the works are complete. These include new windows (pvc to replace the wooden units, many of which are rotten), new pathways outdoors, new hairdressing salon, larger Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 16 office accommodation, disabled toilet and automatic entrance doors, with ramp. There has also been investment in a substantial amount of new furniture and new floor coverings to improve the decoration and comfort of the service users bedrooms. The Environmental Health Officer visited the catering facilities recently and there are some requirements to address. Action has been taken to effect this and again some of the requirements will be met as part of the building alterations. There are comprehensive records maintained relating to the measures in place to monitor the water systems (Legionella prevention and scald prevention). The systems promote the safety and welfare of the service users. There is a range of infection control guidance available for staff to refer to and to direct them in their practice. All service users spoken with identified that the home is maintained to good hygiene standards by the domestic staff, and also that the laundry service is efficient and meets their needs. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 28 Staff are employed in sufficient numbers to meet the needs of the service users residing at the care home. The recruitment processes in place promote the protection of the service users. EVIDENCE: Service users spoken with at this inspection gave praise for the staff for their efforts and the service users were very appreciative of the good standard of care that they consider that the carers provide to them. Service users feel that there are sufficient staff employed at the home to meet their needs. The staffing rotas demonstrate that the staffing levels are in accordance with the occupancy and dependency of the service users currently admitted to the care home. A thorough recruitment process is adopted in respect of the appointment of staff, with regulatory checks made to further assure the safety of service users. A recruitment file relating to a member of staff was examined at this inspection and the evidence contained within it supported that appropriate recruitment measures were in place. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 There is effective unit management of this care home and management is accessible and responsive to service users. The reporting of registered provider visits to the home is not sufficiently detailed to demonstrate effective quality assurance on behalf of the service users. The safe working practices employed at this home promote the health and safety of the service users. EVIDENCE: The registered manager is currently on sick leave. However, there is an acting manager working at the home, supported by deputy managers. The acting manager has the recognised qualifications to manage a care home (National Vocational Qualification Level 4 in social care, and Registered Manager Award). There was evidence of quality assurance monitoring at this care home, to demonstrate that there is some on-going assessment of the service by persons not directly involved in the day-to-day control of the home (in relation to Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 19 Regulation 26 of The Care Homes Regulations 2001). However, the documentary reporting of these visits is not satisfactory. The report forms are not dated and signed by the person undertaking the inspection visit, and the reports contain insufficient detail to demonstrate how the inspection has been undertaken and how issues are followed through e.g. action to address any findings that require attention. Therefore, these visits do not provide sufficient evidence of quality assurance and quality monitoring by the registered provider, on behalf of the service users. There was evidence of feedback from service user satisfaction surveys. Surveys are facilitated by Age Concern, and then analysed and reported upon in summarised form, for sharing with service users and other interested parties. The latest results (dated February 2005) were prominently displayed for service users and visitors. Staff had received training in safe working practices. Whilst it was evident that there had been training on infection control, this subject is not currently part of the formalised training programme (in the same way as manual handling, for example) i.e. planned on-going updates specifically dedicated to this important subject. It is recommended that infection control training be approached in the same way as the other safe working practices training to ensure that there is regular reinforcement of positive infection control messages for staff. There was evidence that equipment and services had been regularly serviced/inspected (sample of records examined at this visit, included gas, electric and equipment). The overall approach to safe working practices provides assurance that satisfactory efforts are being made to promote the health and safety of service users, staff and other persons visiting the premises. Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 2 x x x x 3 Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 21 no Are there any outstanding requirements from the last inspection? 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 19 Regulation 23 (2) Requirement The home and grounds must be well maintained (previous requirement - now being addressed as part of the building alterations - timescale extended to reflect this) The requirements from the latest Environmental Health Officer inspection report must be met There must be suitable access to the premises for persons using wheelchairs, or with mobility problems (previous requirement - now being addressed as part of the building alterations timescale extended to reflect this) The monthly written reports on the conduct of the care home must be comprehensive and detailed Timescale for action 31 October 2005 2. 3. 19 20 16 (2), 23 (2) 23 (2) 31 October 2005 31 October 2005 4. 33 26 30 September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 22 Hazelwood Care Home 1. 2. 8 9 3. 38 Assessments should be signed by the person completing them (recommendation from the last inspection - remains relevant to tissue viability assessments) The system of assessment and documenting the arrangements for self-administration of medicines should be reviewed to provide a more detailed outcome from the assessments Formulised training for staff on infection control measures should be scheduled at regular intervals, as per other safe working practices training Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road, Derby DE1 3QT 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 Hazelwood Care Home C02 C52 Hazlewood S35716 V240684 270705 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!