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Inspection on 12/01/06 for Hebburn Court Nursing Home

Also see our care home review for Hebburn Court Nursing Home for more information

This inspection was carried out on 12th January 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.

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

The Home provides a pleasant and homely environment for residents to live in. The Home had a very welcoming and friendly atmosphere, which residents and visiting relatives confirmed was always there. Staff are friendly, approachable and caring, and show sensitivity when carrying out care tasks with service users. Visitor`s are made to feel welcome and can visit at any time. Some comments from families included: "I have no concerns, my husband is looked after well", "I had a lot to do with choosing where my relative lives", "staff are lovely with residents" and "we have a lot to do with her care and staff keep us informed". A good level of social activity is offered to residents.

What has improved since the last inspection?

The order of serving meals has improved as recommended at the last inspection to allow all residents on one table to eat their meal together. Residents who have chosen to move into the Home now have it confirmed to them in writing that their needs can be met by the Home.

What the care home could do better:

The Home must make sure that records are available to confirm that all necessary assessments of residents needs are available before they move into the Home. Work must continue by nursing and care staff to make sure that all the necessary documentation is recorded in residents care plans. Nurses responsible for medicines must make sure that all the records concerning medicines are accurate and complete at all times in order to confirm that residents are protected from potential harm. Written confirmation of the plans for the decoration and refurbishment of the Home, and other works planned, must be sent to the Commission. As the meals are now served from the kitchen, and taken to the first floor on a tray the Deputy Manager should keep a check of the temperature of the meals sent to the first floor to make sure that they are of an acceptable temperature when they arrive . Round dining tables and chairs that `slide and glide` should be considered for purchase to replace the worn furniture currently used, as this type would be safer and easier for residents to use, and would allow socialising between residents to be easier.

CARE HOMES FOR OLDER PEOPLE Hebburn Court Nursing Home The Old Vicarage Witty Avenue Hebburn Tyne And Wear NE31 2SE Lead Inspector Mrs P A Worley Unannounced Inspection 12th January 2006 10:45 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 Hebburn Court Nursing Home DS0000039411.V265717.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. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hebburn Court Nursing Home Address The Old Vicarage Witty Avenue Hebburn Tyne And Wear NE31 2SE 0191 428 1577 0191 483 5555 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) Southern Cross Home Properties Limited Mrs Carole Ann Craig-Gilby Care Home 68 Category(ies) of Old age, not falling within any other category registration, with number (68), Physical disability over 65 years of age of places (15) Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 2005 Brief Description of the Service: Hebburn Court Nursing Home is a purpose built home situated in a quiet and discreet residential area of Hebburn, at the site of an old vicarage. The rear of the building provides a pleasant garden view and ample privacy. The Home is registered to accommodate up to 68 older people who require personal and/or nursing care, including up to 15 people with physical disabilities. There are 44 single bedrooms, and 12 double bedrooms that are used for single occupancy. En-suite facilities are not provided but there are adequate toilets and bathroom facilities throughout the building. The Home has two floors that are accessible by a passenger lift and stairs. A large central reception area on the ground floor provides seating, in addition to the large lounge/dining areas, and is available to service users and visitors. A separate smoking lounge is provided. A large patio with seating facilities is provided to the rear of the ground floor lounge. Access for wheelchair users is available throughout the Home. The Home is within easy reach of public transport facilities, and the local shops and amenities. The Home is about one mile from Hebburn town centre and approximately two miles from the nearby town of Jarrow. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was carried out by one Inspector over one day. Twelve residents, the Deputy Manager, a number of nursing and care staff, the maintenance person and three visiting relatives were spoken to. A sample of records were inspected that included, care plans and resident’s finance records of personal allowances, and staff training records, complaints records and medication records. The building was checked to see the facilities and equipment available for residents, and the general maintenance and safety of the property. What the service does well: What has improved since the last inspection? The order of serving meals has improved as recommended at the last inspection to allow all residents on one table to eat their meal together. Residents who have chosen to move into the Home now have it confirmed to them in writing that their needs can be met by the Home. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 6 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. Hebburn Court Nursing Home DS0000039411.V265717.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 Hebburn Court Nursing Home DS0000039411.V265717.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): 3. Insufficient evidence was available to confirm that all service users have their needs fully assessed before moving into the Home. Where evidence was found, these service users are given written confirmation that their needs can be met. EVIDENCE: Examination of a sample of service users care plan files failed to provide evidence for one service user that appropriate assessments had been carried out prior to that person being admitted into the Home. In another file a Care Managers assessment was available but the Home’s pre-admission assessment provided personal details but was inadequate in the information it provided about the service users’ care needs. Following a requirement at the last inspection, people moving into the Home are now given written confirmation that their needs can be met. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Service users appeared well and spoke of staff meeting their health and personal needs. Residents’ care plans are in place, but still do not fully reflect all of their observed needs. This can limit the guidance available to staff regarding care practice and consistency. The systems in place for dealing with medicines are satisfactory and the arrangements ensure that resident’s medication needs are met, but records to record all stages of medicine handling were not all complete and consistent. Staff at the home support service users with their social, health and personal care needs in a way that treats them with respect and generally promotes their rights and dignity. EVIDENCE: In conversation with the Deputy Manager and other staff, they displayed a good knowledge of individual residents and their needs. They were able to say how those needs would be met and how identified risks were managed. A sample of care plans was examined and contained good basic information but more and specific detail, about the care delivered, and addressing changing Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 10 needs should be recorded. Health related risk assessments were carried out and care plans as to how they were to be acted upon with reference to falls, nutrition and pressure damage assessment were available, but the information in these needed to be expanded upon. The care plans contain information and records of the input by GP’s and other relevant professionals. Evaluations were not all up to date and tended to give information that indicated that the plans of care were being monitored rather than stating how effective the care given is and demonstrating where care plans are changed to reflect changing needs of residents. The Home is still in the process of changing the care plan format to the new Provider Company’s style. The value of monthly care plan audits was discussed with the Deputy Manager, as the quality of documentation did not reflect adequate information about care delivery. Residents who were spoken with described how their health care needs were met. One resident said, “I’m well looked after ”, and another said, “they look after all my health care”. A policy is available for guidance about the control and administration of medicines. The arrangements in place are satisfactory but a number of medicines received had not been signed and dated as received therefore balances and audits could not be easily accounted. The Medicine Administration Records (MAR) were generally satisfactory in accounting for medicines administered, although there were some inconsistencies in the way staff recorded whether/when ‘as required’ medicines were given. An audit trail of some Controlled Drugs (CD) was carried out and was correct. There is an appropriate contract in place for the disposal of medicines including CD’s and a record is maintained in the Home of medicines disposed of. A number of oxygen cylinders were stored in the medicines room. All were free standing on the floor but some were not secured and could pose an accident to staff if they fell or were knocked over. Staff were observed to treat residents with respect in their approach to them, and upheld their privacy and dignity when dealing with personal care issues such as using the toilet and at mealtimes. All residents appeared well cared for and appropriately dressed. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 11 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): 13, 14 & 15. Service users are encouraged and supported to lead active lifestyles and to control how they spend their daily lives, based on their preferences, choices and abilities. Links with families, friends and the community are maintained and service users are supported by staff in doing this. Residents are offered and receive varied, wholesome, nutritious and wellpresented meals. EVIDENCE: The home encourages and supports residents’ friends and families to visit and maintain links with them in the home and community according to their wishes. Evidence was seen of this during the day as visitors came at different times and spent time with residents as and where they chose to, and some residents went out with relatives. Conversations with residents and visiting relatives confirmed that this is normal practice. Some residents spoke of the events that are arranged but said that this has been less in the cold winter months. They spoke of the entertainments that take place in the Home and how they choose to spend their time how and with whom they wished. All residents spoken with were consistent in their view that staff were helpful and supportive in this. Evidence was seen from Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 12 observations, of staff asking residents what they wished to do, where they wished to go, and of generally offering choices to them on various matters throughout the day. Residents were also observed coming and going as they chose and were able, and generally doing things to suit their individual preferences. A number of residents confirmed that the meals are always good and that they receive plenty and have choices and alternatives to the menu if they wish. Revised arrangements for serving meals have very recently been introduced whereby meals are served directly, covered and on trays, from the kitchen instead of from the hot trolley brought to the dining room. Residents who were asked said that this was proving satisfactory so far and the meals were still hot enough when they received them. This was confirmed by joining some residents for lunch on the ground floor, as the meal served was hot and well presented. The meals are taken up in the lift by staff, on trays, in the same manner as the meals on the ground floor. The additional distance and time lapse could reduce the serving temperatures of food and the Deputy Manager was therefore advised to have the temperature of the meals delivered to residents on the first floor, monitored. As recommended at the last inspection, all residents at one table were served their meal together so they could all eat their meals at the same time. Cold and hot drinks were offered and served at the mealtime, with the tea being served from large flasks with milk already added. However, staff demonstrated awareness of individuals’ preferences and some individual residents who either did not take milk or drink tea, were given individual pots. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 13 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. A suitable complaints procedure is in place and is made known to residents and relatives. Residents and relatives feel confident that complaints would be listened to and acted upon appropriately. EVIDENCE: The Home uses the company’s corporate complaints procedure for staff guidance and a more user-friendly version is provided in the Home for service users and relatives. Information about complaints is available in the foyer of the Home. Complaints are recorded appropriately but a suggestion was made to keep an index or register of complaints for easy referral and auditing. Complaints that have been made to or known to CSCI in the past year have been dealt with promptly and appropriately. Some service users and a relative who were spoken to indicated that they are aware of who to make complaints to should they wish to do so and felt confident to raise any concerns to staff and the Manager. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 14 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 & 26. The environment of the Home is clean, safe and well maintained but would benefit from being decorated in some places, and having some refurbishments to the Home’s furniture, to provide more comfort and a brighter appearance for residents. EVIDENCE: A tour of the premises was carried out and showed the Home to be clean, odour free, generally well maintained and homely in appearance. However a number of communal areas and items of furniture were showing marked signs of wear and tear and looked rather shabby. This was particularly evident of some toilets, the woodwork and the dining room tables and chairs. The Deputy Manager advised that plans were in place for the Company to carry out some works within the Home to provide en-suite facilities in some bedrooms and to decorate and refurbish the Home. The provision of round tables and ‘slide/glide’ type chairs should be considered for the dining rooms as the tables will enable better interactions between residents, and the chairs would be safer and easier for residents to use and move. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 15 During the inspection Estates staff from the Company arrived to carry out some measuring and planning work regarding the en-suite facilities proposed for the first floor. A programme of the planned works and decoration and refurbishment of the Home should be forwarded to the Commission when available. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 28. The numbers, experience and skill mix of staff provided ensures that service users needs are met and that they are supported at all times. Residents are supported and are in safe hands as all staff are appropriately trained and qualified to provide the care. EVIDENCE: Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 17 Discussion with the Deputy Manger and inspection of staffing rotas indicated that minimum staffing levels and skill mix are maintained to meet the needs of service users. However, it is Company policy that only nurse is to be provided per shift, between both floors, for up to twenty-eight nursing residents, when a second nurse can then be provided. When the Manager, who is a nurse, is absent from the Home she is not replaced, therefore only one nurse is available to carry out all nursing care and management of the Home during that period. Adequate and competent care staff are provided, and although an ‘on call’ person is always available; it is potentially and professionally unsafe for only one nurse to take responsibility for all residents and the running of the Home. Good levels of ancillary/support staff are in post and include an administrator, maintenance person, an activity organiser, and housekeeping staff to include a ‘bed-maker’ and kitchen staff. A staff training and development programme is in place to cover induction training, statutory training and other training relevant to the care offered in the Home. A good level of care staff are qualified at NVQ Levels 2 and NVQ Level 3. The lead Senior Carer has also completed the training and gained the NVQ Level 4 qualification, which is good. Evidence was seen in the training programme of the opportunities for staff training and staff records and conversations with staff confirmed that good levels of training opportunities are offered. Training includes specific conditions and care needs. The required statutory training is provided to include moving and handling, fire safety, food hygiene, infection control and Control of Substances Hazardous to Health (COSSH). The records indicated however, that control of Infection training updates should be provided. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 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 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 & 38. The Manager is appropriately qualified and has lengthy experience in care and related management, to competently run the home and service. Systems are in place to determine the quality of the service provided by the Home, and ensure that it is run in the best interests of the residents. Appropriate systems are in place and function well, to safeguard service user’s personal allowances. Records are clear and well documented. Staff follow appropriate safe working practices to promote and protect service users’ health, welfare and safety. EVIDENCE: Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 19 The Registered Manager has the appropriate nurse qualifications and experience to manage the home and has completed the Registered Manager’s Award qualification. The Deputy Manager is also a Registered General Nurse (RGN) who has undertaken the Registered Managers Award training and supports the management functions of the Home. The Company’s quality assurance systems are in place in the form of a comprehensive document entitled ‘Guidance for the Annual Register’. This includes the monitoring of complaints, maintenance, catering and domestic services in the Home. Monthly audits of the medicines arrangements are carried out, plus periodic checks by the Company’s pharmacist. Internal audits of care plan documentation are also carried out 1-2 monthly. Service user questionnaires are issued six monthly and residents and staff meetings are held with notes kept. Monthly reports of the conduct of the Home are available in the Home as required by Regulation 26 of the Care Homes Regulations 2001. The Local Authority Environmental Health Officer carried out a visit and inspection at the Home’s kitchen on 7th January 2006. Some recommendations were made, and submitted in writing in an Informal Advice Letter, which the Manager has taken actions to deal with. The majority of residents have their personal allowances held by the Home in minimal amounts, and are dealt with by the Administrator. Each service user has an individual record of all accounts and transactions, held on computer. Numbered receipts and two signatures support transactions where necessary. Inspection of the storage arrangements and transactions records for service users monies held in the home, were appropriate and accurate. Money belonging to service users is deposited in an interest free bank account held specifically for the residents. Monthly reconciliation reports are sent to head office. The Administrator advised the Inspector that she was to attend a training course the following day to be introduced to the new Company financial procedures and systems. No one in the Home is an appointee for residents’ monies’, the majority of appointees are families. The records of residents personal allowance transactions showed that they were well kept and clear, and individual records of accounts were maintained. A random check of records held showed them to be satisfactory. In conversation staff confirmed that they receive training in all areas of health and safety. Throughout the day staff demonstrated awareness of good health and safety practices. Moving and handling procedures by staff with the residents, were observed to be good with appropriate practices carried out and equipment used. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 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 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 21 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(1) Requirement The Home must ensure that evidence is available to confirm that appropriate assessments have been carried out prior to service users moving into the Home to ensure their needs can be met. Service users care plans must reflect all known and changing needs and how they are effectively met. The accurate and consistent recording of medicines must be ensured at all stages of procedure. Timescale for action 12/01/06 2. OP7 15(1) 31/03/06 3. OP9 13(2) 12/01/06 Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 22 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 OP15 OP1919 OP19 Good Practice Recommendations The temperature of meals provided to the first floor should be monitored to ensure they are appropriate when served. A programme of the decoration, refurbishment and works to be carried out in the Home should be forwarded to the Commission The provision of round dining tables and slide/glide chairs to assist residents should be considered. Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Hebburn Court Nursing Home DS0000039411.V265717.R01.S.doc Version 5.1 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. 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