Inspection on 12/09/07 for Hill House Nursing Home

This inspection was carried out on 12th September 2007.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

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

CARE HOME ADULTS 18-65 Hill House Nursing Home Sand Lane Osgodby Market Rasen Lincolnshire LN8 3TE Lead Inspector Wendy Taylor Key Unannounced Inspection 12 September 2007 09:10 Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 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 Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill House Nursing Home Address Sand Lane Osgodby Market Rasen Lincolnshire LN8 3TE 01522 560951 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) United Health Limited Vacant post Care Home 35 Category(ies) of Learning disability (35) registration, with number of places Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following categories of service only: Care Home with nursing (N) to service users of either gender, whose primary care needs on admission to the home fall within the following category - Learning Disability LD. The maximum number of service users who can be accommodated is 35. New service 2. Date of last inspection Brief Description of the Service: Hill House provides nursing and personal care to people over the age of 18 years who have a learning disability. The home is situated in the grounds of an equestrian centre and some of the residents are actively involved in caring for the animals. Within the grounds there is the main house and two separate buildings, which accommodate residents who are able to live more independently. All care records are maintained within the main house. Accommodation is provided on the ground and first floors. The home does not have a lift and residents accessing first floor rooms must be able bodied. The current fee range is £433:00 to £629:00 per week. Additional charges are made for hairdressing, chiropody, newspapers, toiletries, holidays, public transport, and riding lessons. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during September 2007. It is the first inspection visit since new providers took over responsibility for the service in April 2007. Twenty-eight people were living at the home on the day of the visit. Some residents were going out to do activities, some were working in the equestrian centre and some were joining in with in-house activities. The care received by four residents was followed in detail, using a method called case tracking. This includes talking to the resident, and looking at their care plans, medical records and daily notes. Some general house records and staff records were also looked at. Residents, staff and the acting manager were spoken to and the care being provided was observed. Information already held by the commission was also used as part of the inspection process, such as a self assessments and notifications. Residents said that they are supported very well at the home, and staff said they enjoy working there, and they are looking forward to the planned developments. What the service does well: What has improved since the last inspection? As the current provider is newly registered with the commission, and this is their first inspection process, it is not possible to say what they have improved about their own service provision at this time. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is clear information about the services that residents can expect to receive. However, although resident’s needs are being met, there is no up to date assessment information about their needs. EVIDENCE: There have been no new admissions since the new providers took over the service. The acting manager said that there are no plans to admit new residents in the immediate future. There is a statement of purpose and service user guide in place, which contains a sample copy of the quality questionnaire that is used to gain people’s views. The acting manager said that in the near future the documents would be available in alternative communication formats such as symbols and pictures. Pre inspection information shows that the new provider has reviewed individual contracts. There were no assessments in personal files; the acting manager said that assessments carried out by the previous providers have been archived when care plans had been updated. During the visit one resident’s Local Authority Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 9 assessment was being updated and the acting manager said that this process was on going for the other residents. The acting manager said she would ensure that up to date assessment information for each resident is placed in personal files. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices and decisions in their daily lives, and they are involved in planning their own support. However records do not contain sufficient details to demonstrate this. EVIDENCE: Pre inspection information shows that there are policies in place regarding needs such as privacy, dignity, rights, choice and care planning. Care plans are in place in personal files and address needs such as spirituality, personal finances, family contact and communication. Some care plans do not contain evidence that the resident or their representatives have been involved in developing the plans. The acting manager said that since the new provider has taken over, all of the care plans have been updated and she is awaiting feedback and signatures from some people. The plans cross-reference with other information such as risk assessments (see Standards 22-23) and they Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 11 make some reference to maintaining privacy, dignity and independence for residents. However plans do not always contain enough detail about how to meet a need. For example, one care plan states that ‘symptoms of infection’ should be reported but it does not say what those symptoms are. There is evidence in the files that care plan reviews are carried out regularly, but again the records do not always contain enough detail about why changes have or have not been made to the plans. For example, one review record says ‘care plan remains valid’, but does not say how this conclusion was reached. Individual risk assessments are in place for needs such as walking unaided, general mobility, scalding/use of hot water and use of bedrails. There are also risk plans for use of hoisting equipment and wheelchair maintenance. Residents said that they could choose what they want to do with their days and how they want to live their lives. Although there is no recorded evidence of resident’s involvement in the care planning process, they said that they know about and are involved in developing their care plans, and they know who their keyworkers are. They said that the acting manager keeps them informed of what is happening around the home and asks them for their views. They said that they had chosen the symbol format that is used for making information accessible to them. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a range of in-house and community based activities. They benefit from being able to choose from a varied and balanced menu. EVIDENCE: There is an equestrian centre attached to the residential service. The provider owns some of the horses and residents own some. A number of residents help to look after the horses and the stable yards, and they have access to riding lessons and wider equestrian events held at the centre. The acting manager said that the general activity programmes are currently being reviewed with residents, and two new vehicles have been purchased so that more community-based activities can be offered. Pre inspection information shows that there are plans to increase the access to local colleges, and expand the equestrian centre to accommodate Riding for the Disabled. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 13 Staff and residents spoke about doing activities such as swimming, trips out, sewing, music and movement, news discussion groups and cookery sessions. Residents spoke about helping with household chores such as cleaning and laundry, and a rota for involvement chores was seen. Some residents were observed doing art sessions and jigsaws; others were listening to music or watching TV, and some were attending day services away from the home. Residents described plans for raised areas to be built in the garden so that they can grow plants, and they talked about house meetings were they could tell the staff what things they would like to do. Minutes of house meetings show that activities are discussed and there is evidence from talking to residents and from records that their views are responded to. Records are kept of what activities residents join in with. Care plans refer to maintaining family contact and several residents spoke about going to visit their families. Menus are available in a four weekly rotation. Residents said that they have been involved in choosing the menus and this is confirmed by minutes of house meetings. Menus are now made available in symbol format. The portions of fruit and vegetables for each meal are indicated so as to help staff offer balanced alternatives when residents choose different meals. Residents said that they enjoyed the food offered, and everyone said that the lunchtime meal was very good. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have good access to appropriate local health care services, however they are not fully protected by current medication arrangements. EVIDENCE: Care plans are in place for needs such as continence, eating and drinking, personal care and sleep (see also Standards 6-10). Equipment such as hoists, specialist chairs and walking aids are available where required. Records are kept for needs such as weight monitoring and physical observations; and they also show that residents have access to services such as chiropodists, physiotherapists and speech and language therapists. The acting manager has begun the process of implementing health action plans for all residents, and there is evidence of this in some files. Appointments with GP’s are recorded clearly. Pre inspection information shows that there are policies in place for issues such as first aid, continence and medication. It also shows that the format for recording health issues is currently under review. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 15 Residents said that they could see their doctor when they need to and the staff always help them if they are not feeling well. The acting manager said that an inspection from the local pharmacy took place the day before this inspection visit. She said that the pharmacist had raised no issues. During the morning medicine round some medication was put out into pots before residents were available to take it. This practice was not observed during the lunchtime medicine round. The issue was discussed with the acting manager, who recognised and acknowledged the risks that this could cause. Pre inspection information shows that there have been no serious medication errors since the new provider took over the service. Some medication records had not been signed by the member of staff giving the medication, and the acting manager demonstrated that she had recently addressed this with staff. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by clear policies and procedures; and staff are well trained and knowledgeable about how to keep people safe. EVIDENCE: Pre inspection information shows that there are policies in place for issues such as complaints, whistle blowing and safeguarding adults. Records in the home show that there have been no complaints or safeguarding adult referrals since the new provider took over the home. Letters complimenting the current service provision are available in the records. The acting manger said that she is in the process of putting the complaints procedure into a symbol format so that residents have more access to it. Residents said that they know how to make a complaint but they have nothing to complain about at the moment. They said that the acting manager and staff listen to what they have to say, and help them to solve any problems they might have. Records demonstrate that staff have training in how to keep residents safe from abuse, and they demonstrated their knowledge and understanding of the subject during discussions. Residents said that they feel safe living at the home and they trust the staff. Records demonstrate that income and spending for residents personal finances is recorded and monitored regularly, and the balance of money kept in the home on the day of the visit tallied with the records. Residents said that they could have access to their money when they wish. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 17 The acting manager said that some residents have advocates in place to support them with decision making, and she described plans to have an independent advocate to chair residents meetings. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable and safe home, and they are able to say how they want the environment to be developed. EVIDENCE: A partial tour of the building and grounds was undertaken during the visit. Bedrooms were very well personalised with décor, furniture and equipment. Residents said that they choose their own colour schemes and décor, and were comfortable in their rooms. Communal areas such as corridors and lounges have recently been redecorated and carpeted, and a new bath has been installed in one bathroom. Gardens were being tended during the visit and looked neat and tidy. The report from a recent Environmental Health Officer visit shows a four star (very good) rating for hygiene and practices within the home. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 19 The fittings and decoration in some areas of the home, such as a small bathroom, a toilet area and a small kitchen area show signs of wear. However there is evidence of on-going work to improve and upgrade the existing environment such as extending the dinning room, painting the exterior of the building, refurbishing a small kitchen, and providing appropriate notice boards so that information is more accessible to residents. The acting manager and residents described plans for redevelopment of the site, including the equestrian centre, during the next year. The plans include redeveloping the existing layout of the home to provide smaller units in which residents can have their need met in a more individualised way and not have to share a bedroom; developing the area in which small animals and pets are kept; expanding the use of the equestrian centre, and introducing holiday cottages with a view to providing work opportunities for some residents. Residents said that the acting manager tells them what is happening with plans and encourages them to say what they think and want in the future. On the day of the visit the home was clean and tidy and smelled fresh. Infection control information is available around the home, and staff demonstrated their understanding of infection control by, for example, the appropriate use of aprons and hand washing. Risk assessments are in place for issues such as the use of steps, uneven ground, wet floors, smoking and electrical equipment. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A safely recruited staff team, who are well trained and can demonstrate that they know how to meet resident’s needs, protects the residents. EVIDENCE: No new staff have been employed since the new provider took over. Staff records contain evidence of recruitment processes such as criminal record bureau checks, references and an application forms. Pre inspection information shows that there are policies in place for subjects such as recruitment, induction, training, grievances and disciplinary procedures. The information also shows that 50 of the permanent staff team have or are working towards nationally recognised care qualifications. The acting manager said that some staff would be undertaking courses to allow them to assess the people working towards those qualifications. Records show that staff have undertaken training such as food hygiene, first aid, infection control, moving and handling, and health and safety. Staff Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 21 confirmed this during discussion and said that they also undertake training sessions at every staff meeting such as challenging behaviour, learning disability awareness and diabetes. There are training videos available to staff covering subjects such as supervision and fire safety. There is also an induction process recorded for agency staff that work at the home when they are short of permanent staff. The induction includes the agency staff being familiar with care plans, which they sign to say they have read. Records are available to show that staff are receiving supervision sessions, however the acting manager said that she plans to increase the frequency of the sessions in the future. Staff said that they are supported by the manager and colleagues, and they said that there is good communication within the team. Staff made comments such as they ‘love working at the home’ and they are ‘looking forward to the planned developments’. Minutes of regular staff meetings show that issues such as communication, working roles, care planning and recruitment activity are discussed and staff said that they are able to voice their opinions and make suggestions about how to improve the quality of care for the residents. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally well managed, and residents have opportunities to express their views and be involved in the development of the home. EVIDENCE: The acting manager has been in post since the new providers took over responsibility for the home in April 2007. She is a qualified nurse with extensive experience of managing services for people who have a learning disability and associated needs. She said that she would be applying for registration with the commission in the near future. Staff said that she listens to what they have to say and is supportive towards them. A recent visit by a representative of a placing authority highlighted that the acting manager is making progress with improvement to the quality of care and the environment. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 23 Pre inspection information shows that there are policies in place for subjects such as confidentiality, quality assurance, equal opportunities, fire safety, management of resident’s money, record keeping, and health and safety. The information also shows that there are systems in place for managing substances that are hazardous to health, testing electrical equipment and hoists, and testing fire safety equipment. Residents said that they have regular meetings to discuss things like menus, leisure activities, shopping trips and plans for the development of the environment. Records of these meetings were seen, and they are available in symbol formats. They were able to demonstrate that they know what is happening to the building and general environment, and they said that staff listen to what they have to say. The acting manager said that an open day for relatives has recently been held, where they can be kept up to date with developments in the home, and she said that they plan to hold more regular meetings for them in the future. The acting manager said that an operational manager from the provider company visits at least once a month to carry out monitoring reviews of things such as care plans, general record keeping and environmental issues. She said that the views of residents and staff are also taken into account during these visits. Records of the visits were not available at the home, however the acting manager said that they would be forwarded to the commission in the near future. A sample quality survey is contained in the service user guide. Fire safety records show regular testing of things like call points and emergency lighting. Residents and staff were able to describe clearly how they would react if the fire alarm sounded, and they knew where the evacuation area is sited. Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 3 X X 2 X Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Requirement The pre dispensing of medications must cease because it is unsafe practice and puts residents at risk. When medication is administered to residents it must be clearly recorded, to ensure that they receive the correct levels of medication. Timescale for action 29/09/07 2. YA20 13(2) 29/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Hill House Nursing Home DS0000069470.V335055.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!