Inspection on 13/11/05 for Herrington Grange Nursing Home

This inspection was carried out on 13th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Herrington Grange Nursing Home 16/10/07

Herrington Grange Nursing Home 05/10/06

Herrington Grange Nursing Home 16/03/06

Herrington Grange Nursing Home 09/03/05

Herrington Grange Nursing Home 01/10/04

Herrington Grange Nursing Home 09/03/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Herrington Grange Nursing Home Southburn Terrace New Herrington Houghton Le Spring Tyne & Wear DH4 7AW Lead Inspector Sam Doku Unannounced Inspection 14th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 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. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Herrington Grange Nursing Home Address Southburn Terrace New Herrington Houghton Le Spring Tyne & Wear DH4 7AW 0191 584 5854 0191 512 0958 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) Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care Limited) Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (10), Physical disability of places over 65 years of age (30) Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2005 Brief Description of the Service: This home provides 50 places for elderly persons. It is purpose built and the internal space is generous and there are a variety of lounge and dining areas. The bathrooms and communal WC’s have handrails and appropriate lifting equipment for disabled service users. The home is constructed in a traditional style of brick and tile. It has two floors with passenger lift access to the first floor. The access is level from the ground floor entrance. It stands in grounds that are shared with another care home belonging to the same company. The grounds are well kept and there are paved areas accessible to service users. There is an adequate amount of parking space. The home is located in a village, in a rural area. The main road passes the front of the building and there are local facilities close to the home including shops. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection and took place on the 14 November 2005. The inspection commenced at 10:00 and finished at 17:45. The process included seeking the views of service users and relatives. It also involved observation of practices and procedures, examination of documents and records, and discussions with staff and management, which contributed to the inspection findings. On arrival, the inspector was advised that the manger of the home had left her position two weeks ago. The nurse in charge was not entirely familiar with the inspection process and would not have been able to fully assist the inspector with the process as she was not aware of the details of the last inspection report and the recommendations made in that report. The inspector asked for the regional manager to be present and this was arranged. The atmosphere and environment within the Home was friendly, relaxed and comfortable throughout the day of the inspection. A number of service users and visiting relatives were keen to speak with the Inspector. All were generally very complimentary about the Home and the staff. Service users appeared cared for and comfortable with the staff. The inspector was made welcome and staff were professional in their manner and care practices. What the service does well: There are good systems in place to ensure that prospective service users are well informed about the home before they come to live there. There is also a general policy offering prospective service users the opportunity to visit the home to see for themselves the facilities that would be available to them. The care practices that were observed were generally good and staff conducted themselves in a professional manner. Staff showed regard for the service users’ rights, privacy and dignity. The service users are treated with respect and dignity, and this was confirmed by comments from the service users and relatives. Suitable arrangements are in place to ensure the safety and wellbeing of the service users. Details in the records showed that health and safety matters Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 6 are properly dealt with, including appropriate health and safety training for all staff. The service users care needs were met and service users and relatives were complimentary of the service. The role and enthusiasm of the new activities coordinator is acknowledged by a number of service users and staff. He has started to put together a programme of social and recreational activities for the service users. What has improved since the last inspection? What they could do better: A number of bedroom doors, including the laundry door were noticed to be wedged open throughout the time of the inspection. Door guards must be fitted if identified or assessed as needing one to ensure that fire safety measures are not being compromised. The menus displayed in the dining room was too small to read. A newly admitted service user was not given the opportunity to choose what he would like to eat. The gentleman was given the main meal of the day without being offered an alternative. There was lack of observation on the part of the staff in the dining room regarding the personal care need of one service user who had running nose. This lack of attention to his need compromised his dignity and self esteem and may have caused discomfort or embarrassment for those who shared table with him. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 7 Communication between staff regarding the specific care needs of some service users need to be improved to ensure that those care needs are not visibly displayed in bedrooms. It was noticed that in two cases, the instructions to staff on meeting certain needs had to be displayed on the service users wardrobe. This practice should be discouraged as it infringes on the dignity of those service users concerned. The fire risk assessment should be comprehensive to cover all the risk areas of the home. 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. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, 5, There is good and effective policy in ensuring that assessments are completed prior to admission. This establishes that the care needs of potential service users can met. Pre-admission information is available to prospective service users and their relatives to enable them to make informed choice about whether or not Herrington Grange meets their needs. EVIDENCE: The admissions policy has ensured that prospective service users have their needs assessed by their social worker/PCT Nurse Assessor and also by the home before admission is agreed. This enables the manager of the home to establish if the identified care/nursing needs can be adequately met in the home and that the staff have the necessary skills to meet them. Service users records were examined and contained copies of pre-admission assessments by social workers/nurse assessor and also assessments that had been carried by the nursing staff. This assured the prospective service users Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 10 and their families that proper steps have been taken to ensure that the needs of the person can be met in the home. Two relatives and three service users confirmed this arrangement. They all stated that they found the exercise very useful as it gave them the opportunity to ask appropriate questions to assure themselves about the operations of the home. A senior manager for the company stated that it is the home’s policy to regard the first six weeks of residency as a trial period for the benefit of the service user and the home. This is stated in the Statement of necessary Terms and Conditions and in the Service User Guide. This allows the prospective service user sufficient time to experience the living situation during that period and to decide whether they would like to live in the home on a permanent arrangement. At the time of the inspection, one service user had decided to move to a home closer to her family. The necessary arrangements were made to allow this to happen. Family members who were interviewed showed their appreciation to the home for the support they receive in enabling this to happen. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10. Individual care plans set out the nursing, social and personal care needs of each service user and plans are formulated to meet them. This has ensured that the care needs of the individuals are fully met. The service users are treated with respect and dignity by the staff. EVIDENCE: The care plans that were examined and were found to provide details of service user’s nursing and personal care needs and details of how those needs were to be met. Risk assessments have been carried out for those service users for whom it is thought necessary. These included prevention of fall, moving and handling, nutrition, pressure area care and skin condition. In assessing the arrangements for meeting the healthcare needs of the service user, three service users files were examined. These provided details of visits by GPs, consultants, chiropody treatment, opticians, dentists and other healthcare professionals. In discussions with two relatives, they all confirmed that the service users’ healthcare needs are met within the home and feel that the staff take active role in promoting this. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 12 Service users confirmed that their healthcare needs are adequately met in the home and that the arrangements for their care are good. Recording on the Medicine Administration Record charts were seen and found to be satisfactory. Drugs were safely and securely stored. There are training and written policies on safe handling of medication are in place. This ensured that the service users’ healthcare needs regarding the management of their medication is safeguarded. A number of practices were observed which indicated that on the whole staff promote privacy and dignity for the service users. Staff were observed to knock on bedroom doors and wait for a response before making entry. All the service users who were spoken with said they feel the staff respect their privacy. They also confirmed that visits from GPs and other health professionals take place in the privacy of their rooms, thus ensuring their confidentiality, dignity and privacy. The two visiting relatives of relatives also confirmed the views expressed by the service users. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15. The home provides a flexible regime that encourages the service users to exercise choice and autonomy over matters relating to daily activities and health. This promotes a healthy lifestyle for them. Service users receive nutritious and diet which promotes the health and wellbeing. EVIDENCE: Three service users’ files were examined which showed, amongst other details, the service uses’ interests. The activities organiser maintains record of activities with service users. Service users described the activities that are provided for them. Some of the care plans that were examined showed recorded evidence of social and recreational activities that they have been involved in. Service users stated that no one is made to join in any organised activities if they did not wish to, thus promoting their independence, choice and respecting their wishes. The home encourages service users to use community facilities such as the local shops, visits to the hairdresser, GP appointments and local church. This provides the opportunity for the service users to continue to access community facilities. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 14 The relatives who were spoken with indicated that they are in regular contacts with their relations and receive good support from the home and the staff in ensuring that they continue to be involved in the care of their relatives. The service users were very complimentary about the catering staff and the quality of the meals provided in the home. Nutritional assessments have been carried out for those service users who require their diet intake monitored to ensure they receive adequate diet. The four weeks rotating menus provided evidence of varied and nutritious meals, including alternatives for the service users. This provides the service users with the opportunity to make choices regarding meals. However, it was also noticed that what was provided did not reflect what was on the menu. The cook who is new in her post indicated that she is in the process of compiling a new set of menus for the home. It was also noticed that the menu on the notice was hardly noticeable as the print size was too small to be notice. Service users confirmed that they are not able to read this, and therefore it was of no use to them. The dining areas were pleasantly furnished and provide spacious and congenial settings for the service users. Lunch was served in a relaxed setting and the service users had time to enjoy their meals. A number of service users commented that if they wish to have their meals in their bedrooms, staff would make the necessary arrangements for this to happen. This provides choice for service over where and when to have their meals. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. The home has a clear and easy to understand complaints policy, which is accessible to the service users and relatives thus providing the opportunity for them to complain if they wish. Suitable training, policies and procedures are in place, which ensured that service users are protected from all forms of abuse and to protect their rights. This is an effective part of the home’s strategy, which protects the service users from abuse and promote their safety and wellbeing. EVIDENCE: There is a corporate complaints complaint procedure, which is in line with the City of Sunderland complaints procedures. Summary of this is included in the Statement of Purpose/Service User Guide, which is made available to all the service users. Staff who were spoken with confirmed that they are aware of both the complaint and whistle blowing policies. Service users and the two visitors stated that they were aware of the home’s complaint procedure, and would know how to access this if they had to. A complaints book is available in the home for recording complaints and compliments received. Details of the complaints record provide evidence of how the complaints were investigated and the outcome. Examination of staff files indicate that staff have received training in the City of Sunderland adult protection policy and also of the home’s whistle blowing policy. Staff were aware of the various forms of elder abuse and how these Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 16 could be prevented. Such training and awareness amongst staff has been effective in reducing the likelihood of abuse to service users. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 17 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. Service users benefit from well-maintained, homely, safe and clean environment. This helps promote a positive image for service users, and ensure they remain comfortable and safe. EVIDENCE: The handyman is responsible for ensuring that safety measures relating to equipment, fire and other environmental health matters are addressed. The fire-log book contained details of regular fire alarm tests and maintenance of fire detection and fire fighting equipments. Staff members who were spoken with were able to describe what to do in event of discovering fire in the home. Fire risk assessment had been carried out but on examination, this did not seem to be comprehensive enough to address all the risk areas within the home. All staff have received training in fire safety and record of fire drill has been maintained. This provides the names of staff who have been involved in the various fire drills. These arrangements have been maintained which ensured a safe environment and the safety and well-being of the service users. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 18 However, during the inspection, it was noticed that a number of bedroom doors have need wedged open, including the laundry room, thus compromising the fire safety in the home. At the time of the inspection the home was noted to be clean and free from offensive odour. It was noted that all toilets had liquid soap dispensers. The laundry machines have facilities for sluicing and washing foul linen at very high temperature to avoid the spread of infection. This also contributes to the health and safety of the service users. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. The home maintains adequate staffing levels to meet the needs of the service users. Suitable arrangements for staff training and supervision are in which, ensured that staff are equipped to provide good quality service that benefited the service users. EVIDENCE: The staffing rotas were examined and found to be sufficient in numbers to meet the care needs of the service users. Examination of past rotas showed evidence of staffing levels being consistently maintained. However, on the day of the inspection, the home was one carer short. This had a significant negative impact on the service as there were a number of service users who required assistance with feeding. There is a clear corporate policy on recruitment and the staff files that were examined confirmed that the home follows these policies rigorously. All the staff have been given terms and conditions of employment and job description. All staff who were interviewed confirmed this. Most of the staff working in the home have been there for a considerable number of years thus providing a stable care environment for the service users. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 20 The staff training log contained details of the training provided for the staff which included moving and handling, first aid, fire safety training, food hygiene, falls prevention and protection of vulnerable adults awareness training. One senior nurse confirmed that new staff are provided with induction training followed by foundation training within the first six months of employment. The emphasis on providing suitable training to the staff has positive impact for the service users. The good practice models observed on the day of the inspection was evidence of the good training provided. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 21 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, 38. The home has no manager at the moment and the day to day management is the responsibility of the trained nurses. This arrangement makes it difficult to identify who has ultimate responsibility for the home. Nonetheless, the home continues to be run in the base interest of the service users. EVIDENCE: During the inspection, the inspector was advised that the registered manager had left her position two weeks previously. The regional manager for the company indicated that arrangements would be made to appoint a suitably qualified manager shortly. In the Manager’s absence, the management of the home is being shared by the qualified nurses until a new manager is appointed. Service users who were spoken with did not indicate any significant change in the running of the home even though the manager had left her employment. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 22 Staff who were spoken with also confirmed that there is no change in the quality of care that is provided and that the care and welfare of the service users continue to be the priority of the staff. All portable appliances have been tested. A record is maintained of monthly water temperature tests in the home. There is evidence of regular servicing of fire equipment, gas and electrical appliances being carried out by the Company. All the servicing records that were examined were up to date. These included fire fighting equipments, servicing of hoists, water treatment, electrical installation and gas servicing. Up to date servicing and maintenance of these services and equipments ensure a safe environment for the service users and the staff who work there. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 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 X X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 2 Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 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 OP10 Regulation 12(4)(a) Requirement Timescale for action 14/11/05 2 OP19 13(4)(c) 3 OP35 20(1)(a) Service users who rely on staff for personal tasks must be regularly observed to ensure their right to dignity is not compromised. The practice of wedging bedroom 14/11/05 doors open must cease as this compromises the fire safety in the home. Service users monies must not 01/04/06 be pooled into a single account unless the account is in the name of the service user. 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 OP10 OP15 OP15 Good Practice Recommendations The display of care plans in service users rooms should be reviewed. Menus should be in large print so that service users can read it. The menus should be reviewed to reflect what is actually DS0000018196.V265818.R01.S.doc Version 5.0 Page 25 Herrington Grange Nursing Home 4 OP31 provided. The registered person should make necessary arrangements to appoint a manager as soon as practicable. Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 26 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 Herrington Grange Nursing Home DS0000018196.V265818.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!