Inspection on 08/08/06 for Heather House Nursing Home

This inspection was carried out on 8th August 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

Heather House Nursing Home 05/07/07

Heather House Nursing Home 13/02/06

Heather House Nursing Home 02/08/05

Heather House Nursing Home 15/12/04

Heather House Nursing Home 04/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Heather House Nursing Home Bannerdown Road Batheaston Bath Bath & N E Somerset BA1 7PL Lead Inspector Jill Cornelius Unannounced Inspection 9:30 8th & 22 August 2006 nd 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 Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Heather House Nursing Home Address Bannerdown Road Batheaston Bath Bath & N E Somerset BA1 7PL 08453 455741 01225 859210 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Sally Roberts Ms Lorna Flick Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate 36 Persons aged 50 years and over Staffing Notice dated 10/10/2001 and as amended on 31/03/2003 applies. Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 13th February 2006 Brief Description of the Service: Heather House is registered as a care home with nursing for 36 older persons. The home has voluntarily capped its registered beds at present to 34.The home is situated in Batheaston, which facilitates ready access to Bath. The home itself can be accessed by car or bus. There is easy access to local shops and social venues. The home is a converted older property, providing a mix of single, companion and en-suite rooms. Care is offered over two floors, with communal space in three areas on the ground floor. There is a passenger lift providing access to all resident areas. Heather House is part of the Blanchworth Care group. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted as part of the annual inspection process. The inspection lasted eleven hours over two days. During the inspection the inspector spent time in discussions with the manager, senior Registered Nurse and examined records relating to the day–to–day running and management of the home. The inspector spent time observing the residents in the home throughout the course of the visit and spoke with four at length, two visitors and one health professional. Members of staff were observed on duty and four were consulted individually. What the service does well: What has improved since the last inspection? The activities on offer are improving generally. Activities include organised trips and in-house entertainment. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 6 The home’s general environmental improvement through a deep cleaning programme continues to be implemented. The removal of clutter in bathrooms has taken place. The rearranging of the dining room furniture has enhanced residents’ dining experience. The reintroduction of resident’s meetings has promoted greater involvement for residents in what goes on in the home. 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. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5 The quality in this outcome area is good. The home continues to be committed to providing a good level of information and opportunities to visit for prospective residents. Resident care needs are fully assessed and a decision is made about the suitability of a prospective admission is well met. Residents are given a copy of the statement of purpose and service user guide. EVIDENCE: Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 9 A Statement of purpose and the service user guide is available in one document. This was updated in May 2006 and at present is under review. This document contains detailed information for service users to make an informed choice. It is also available for anyone to obtain from the head office on request. Comprehensive pre-admission assessments are completed. Service users are only admitted following a full pre-admission assessment, which is carried out by the manager. The manager stated that visits to service users homes or the hospital are usually arranged; the inspector examined the pre-admission assessments for the last two admissions, they contain a full description of the service users needs. This information is then used to determine the suitability of placement. Emergency admissions can be arranged following a full assessment. Prospective service users are invited to visit the home prior to admission, they are invited to stay for a meal and meet other service users and staff. An enquiry was made during the inspection and the inspector observed the manager inviting the prospective service user around the home. This was undertaken during the inspection. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 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, 10 and 11 The quality in this outcome area is good. The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. Individual care plans remain satisfactorily completed. Residents are looked after well in respect of their personal care needs. Their privacy and dignity are maintained and they can be assured of sensitivity from the home at the time of their death. EVIDENCE: The inspector reviewed a random selection of six care plans, they all contained very clear information and were very concise, they showed evidence of monthly re-evaluation and, following the requirement made at the last inspection, residents reviews are now being signed by those able to do so. This confirms residents are consulted in evolving their care plans. When speaking to Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 11 one resident they were able to confirm that they were aware of care plans “it was a planned account of my care”. The inspector reviewed a very detailed wound care plan for one service user which showed a clear record of progress and prescription changes, the home also keeps photographic evidence of the improvements made with consent from the resident or if unable their family. The care plans reviewed provided the inspector with evidence that the health care needs of the service users were being met. The inspector saw evidence that residents received visits from, the chiropodist, and optician. Referrals are made to dentists and specialist health care services, a GP surgery is held weekly. Residents spoken to stated that they were always helped to obtain access to any health care services they needed. A visiting health professional commented, “staff at Heather House provide a very supportive home for high needs service users”. The home continues to make every effort to care with sensitivity and respect for residents who are approaching death. Heather House has strong links with Dorothy House Hospice and family and friends are encouraged to spend as much time as they wish at the home if a resident is dying. Correspondence was seen from three families who expressed their “personal appreciation to the carers at Heather House for the care their loved ones had received”. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 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, 15 The quality in this outcome area is good. Relevant activities are offered but further opportunities may be worth considering in consultation with residents. Visitors are actively welcome in the home and family links are supported. Resdients receive varied and nutritious meals in pleasant surroundings but could be given more advance information about available menu choices. EVIDENCE: The inspector spoke to four residents who were happy with the range of activities now provided and were happy to pick and choose those they wished to attend. However, one resident wished there was “more opportunity to have more quizzes”. With the resident’s permission this wish was passed onto the manager. Residents had enjoyed the summer fete and were looking forward to the trips. These had been planned in consultation with them during the summer months. A religious service is held fortnightly. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 13 Rising and retiring choices are indicated by the residents daily and accommodated in balance with assessed needs. The residents spoken with also confirmed this, as did documented evidence in care plans viewed. Many people have well-established links with their families. Heather House has an open policy with regard to visitors and this is clear in its statement of purpose and a notice in the home welcoming visitors with the agreement of the resident. This was also evidenced in the visitor’s book. The inspector spoke to three visitors who said they were “very satisfied with the care in the home”. They praised staff for their “commitment and support”. The residents’ the inspector spoke with stated they “enjoyed their meals” and felt they received “a balanced diet”. During the tour of the building there was evidence of plenty of drinks available. Two residents and one visitor confirmed, “these were always available”. Meal times are appropriately spaced throughout the day. A four-week menu plan based on Cora (balanced plan) is provided with additional items as required to accommodate individual preferences. The menu however was not on display for residents. There was nothing to prompt the residents of their choice in the dining room. Residents make their choice of lunch and evening meal at coffee time. This is good practice. Confirmation of this as “a normal routine” was given by a number of residents. During the inspection the inspector joined three residents for lunch. The dining room was nicely presented giving residents views outside into the gardens and views. Everyone commented on the food said how “good it was”. Staff were observed to be courteous and calm in manner in assisting with the lunchtime meal. A month’s record of meals served is kept and showed a varied and balanced diet. The catering staff are able to offer alternative choices. The kitchen was not inspected at this visit and will be a focus for the next inspection. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 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, 18 The quality in this outcome area is good. There are robust and comprehensive policies in place to manage complaints or allegations of abuse. EVIDENCE: A copy of the complaints procedure is on display in a well-frequented part of the home, which means people will know how to obtain the required information if they want to make a complaint. The complaints policy and procedure is detailed and contains all the required information. The Commission for Social Care Inspection has received no complaints about the service since the last inspection of February 2006. Any concern raised by residents and visitors is dealt with immediately; information of the outcome is cascaded down to the staff, through hand over and recorded in the resident’s notes. Where necessary written confirmation of the outcome and how issues will be resolved is also sent to the relative and families and evidence of this was seen during the inspection. All concerns are logged on a register. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 15 The home has clear policies and procedures for Adult Protection and Whistle Blowing, staff receive training on Adult Protection during their induction and qualified staff are aware of the procedures to follow, however the inspector noted that the manager could not locate a copy of the B&NES Adult Protection Procedure on the first visit. This had been obtained by the second visit. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 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): 20, 21, 24, 26 The quality in this outcome area is adequate. Residents continue to have access to comfortable indoor and outdoor communal facilities and to be able to personalise their rooms but they currently lack choice in their bathing experience. The standard of cleanliness in the home has improved. Ongoing attention is required to the monitoring of the clutter that builds up in areas around the home. EVIDENCE: There are two lounge areas, the smaller one with level access being a designated smoking / quiet area. The larger lounge is accessible via stairs for mobile service users or along the corridor, down the ramp into the dining area Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 17 and then into the lounge area for wheelchair users. There is limited level access to the garden area. It is accessible to wheelchair users only with assistance via the dining room and down a ramp. Guardrails have been fitted at the end of this ramp to reduce the risk to wheelchair users. The flagstones had been addressed following a previous requirement. There are sufficient toilets and bathrooms on all floors and facilities for the disabled, which include ramps, rails, hoists and slings to assist with bathing. However, residents currently only use one bathroom for bathing. When three residents were asked “why that particular bathroom”, they answered “that’s the one offered”. This was shared with the manager who agreed that an independent review of all the bathrooms needs to be undertaken, with the outcome to be shared with the residents and an action plan of the findings to be drawn up and implemented. This would promote residents choice in their bathing experience. A Recommendation is made in relation to this. The inspector viewed most of the bedrooms, they all showed evidence of personalisation and reflected individual taste, some service users had bought in their own furniture and rooms contained care equipment such as hoists and recliner chairs where it was needed. It was noted that reference work to source these were being actioned whilst this inspection was taking place. The premises were clean and free from offensive odours; staffs have written guidance for infection control, the inspector observed staff following prescribed procedures. Since the last inspection a programme is in place for regular deep cleaning. The manager informed the inspector that additional staff would assist with this. This will promote the home’s environment for all residents. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 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, 29, 30 The quality in this outcome area is adequate. Adequate staffing levels help to ensure that resident’s needs are met. The inspector was unable to inspect standard 29 fully, as the records required were not available within the home in breach of legislative requirements. Although an ongoing programme of staff training is in place, the records of the training that is occurring do not clearly evidence this at present. EVIDENCE: By undertaking an early morning inspection it was evident that enough staff are deployed to meet the current needs of the residents. Care staffs have a range of length of experience working at Heather House and a range of levels of previous relevant care experience. The inspector reviewed the current and some past duty rotas, which showed evidence that the home complies with the Staffing Notice. Residents said that “at times there is a delay in carers attending to their needs” and staff spoken to confirmed that at times this was evident. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 19 The manager is not supernumerary and during the inspection had the resident’s best interests at the centre of her attention. The files of employees were not examined as Blanchworth Care has these documents at head office. The inspector saw evidence of Criminal Records Bureau checks and POVA 1st checks on a spreadsheet from the database. Also available on the data base spreadsheet were the RN’S pin numbers with validation dates. The recruitment procedure includes a week’s induction programme. During the inspection a new qualified member of staff started her first shift and was under going the induction process and ongoing training programme incorporates national training targets. The training records were only available on a data - base spread sheet and although these showed planned training there was no hard evidence regarding attendance with signatures and certificates. The inspector noted that there were training sessions advertised on the office notice board and Registered Nurses spoken with informed the inspector that they had attended clinical update training on Palliative Care, Tissue Viability, Wound Management, Parkinson’s disease, Pressure Area Care, Infection control, Baric Urology and Catheter Management. Carers spoken with informed the inspector of attendance in First Aid, Abuse and Challenging Behaviour, Dementia Care. Staff training records were not documented in the home’s filing system. The evidence of these was gained by viewing entries in diaries, certificates/photo copies, advertisements of training events. There was no evidence of individual signatures of attendance in records of training. These should be provided. There was no availability for the inspector to observe via the IT system, as the manager was not able to undertake this. A requirement is made in relation to this. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 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, 32, 33, 34, 36, 37, 38 The quality in this outcome area is adequate. Residents’ needs and best interests are central to the management approach in the home. Residents are safeguarded by appropriate insurances. The home is managed efficiently but attention needs to be given to the completion of environmental improvements to better promote and protect the safety of residents and staff. Feedback is sought from residents about the service provided through anonymous user satisfaction questionnaires. There was evidence of regular staff supervision within the home. Records are kept confidentially but some are not available for inspection as is required. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 21 EVIDENCE: The registered manager Lorna Flick has a 1st level RN qualification and significant experience and has managed this home in excess of 4 years, in addition to maintaining her clinical update training. She has recently completed her Registered Managers award level 4. During the inspection the inspector spoke to residents, stake holders and staff they all stated that they were well supported and that Ms. Flick was accessible to them. Residents said they were “very happy at Heather House, and the staff were patient and respectful”. Residents meetings are held and the minutes were viewed. The manager has undertaken staff meetings since the last inspection; the inspector viewed minutes of these which evidenced consultation in the running of the home and the seeking of other views re decisions to be made. An annual quality assurance satisfaction survey was carried out in 2006; the comments received were largely complimentary, the home needs to put together a document that identifies the comments made and shows how they were acted on. The manager carries out the supervision of qualified staff. Senior RN’s then undertake this for the carers; all have attended training on carrying out staff supervision. One carer’s booklet was observed and this showed that staff receive a completed induction and have access to ongoing training. All records available for inspection were well maintained. The maintenance and health and safety records showed evidence of regular checks and action taken when maintenance needs are identified, the home was undergoing maintenance during the inspection. However, it was evident that in the clearing out of a storage building there was no safety equipment being used. When the inspector tried to track documents relating to risk assessments for this work, these were not evident. A request was made to the manager to undertake this immediately and take appropriate action. This was undertaken before the end of the inspection period. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 22 The COSHH record was up to date and reflected chemicals in use in the home, no products were visible around the home during the inspection. Current maintenance certificates were available for hoists lifts and all equipment used in the home, and the landlord’s gas certificate was dated within the last twelve months. A full service record was seen for appliances used in the home and the fire alarms and fighting equipment had been serviced within the last 12 months. The fire logbook evidenced compliance with the weekly, monthly and annual checks alongside staff training and drills. The certificate of registration and a current insurance certificate were displayed. The home is insured and this included consequential loss. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 23 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 X 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X 3 3 2 Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 24 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 OP29 Regulation 19 (Sch 4.6) 18 (1) (c) Requirement Timescale for action 16/12/06 2. OP30 Employment records required by legislation must be available at all times for inspection within the home. Training records required by 16/12/06 legislation must be available at all times for inspection within the home. 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. Refer to Standard OP15 OP21 Good Practice Recommendations Provide residents with menus in a suitable format. Assess and action plan bathing facilities to meet the needs of the current residents needs. Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Heather House Nursing Home DS0000020361.V293159.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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