Inspection on 04/12/06 for Holywell Bay Care Home

This inspection was carried out on 4th December 2006.

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

Holywell Bay Care Home 21/04/09

Holywell Bay Care Home 11/11/08

Holywell Bay Care Home 24/04/08

Holywell Bay Care Home 08/10/07

Holywell Bay Care Home 16/05/07

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

CARE HOMES FOR OLDER PEOPLE Holywell Bay Care Home Rhubarb Hill Holywell Bay Newquay Cornwall TR8 5PT Lead Inspector Elaine Bruce Key Unannounced Inspection 09:30 4 and 5th December 2006 th 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 Holywell Bay Care Home DS0000068129.V318452.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 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. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holywell Bay Care Home Address Rhubarb Hill Holywell Bay Newquay Cornwall TR8 5PT 01637 830801 01637 831119 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) Newport Care Limited Care Home 45 Category(ies) of Dementia - over 65 years of age (45), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (45) Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 4 adults under the age of 65 years An application must be made to the CSCI by the home manager to become the registered manager within 6 months following the registration date. Date of last inspection Brief Description of the Service: Holywell Bay is situated close to the beach and a few miles from Newquay. The home is registered to provide care with nursing and accommodation for up to 45 older people who have care needs with a dementia or mental health. The home is owned by Newport Care Limited. Accommodation is provided on the ground and first floor which are linked by a shaft lift and stairs. Large communal areas are provided in the centre of the home on the ground floor. There is a small enclosed garden area and car parking externally. Some bedrooms, notably those on the first floor overlook the sand dunes and golf course. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection at Holywell Bay took place over two days (12 hours) and was carried out as an unannounced inspection. This was the first inspection under the new ownership of Newport Care Limited. The acting manager was available during the course of the inspection. As part of this unannounced inspection the quality of information given to people about the care home was looked at. The dependency of the service users limited conversations to establish if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedures. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. Three visitors were spoken to during the course of the inspection. Two of the visitors expressed concerns about the poor standard of the premises. The range of fees at the home per week is from £467.00 to £700.00 What the service does well: The home has a number of service users who have very complicated care needs to include frailty and challenging behaviour. The staff team were observed to treat the service users in a kind and caring manner respecting their privacy and dignity. It was noted that considerable thought (and expense) has gone into ensuring that each service user has a present to open during the coming Christmas period. Some of the service users have no relatives to undertake this task. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 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 Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The statement of purpose document and service user guide require updating to ensure that service users and their representatives have correct information on the service. More information should be provided in the contract of care to ensure all details on the terms and conditions of the placement are recorded. The acting manager assesses all service users prior to admission to the home to ensure that the home will be able to meet their care needs. EVIDENCE: The main requirements of the statement of purpose and service user guide documents are in place. Important updated information has though not been included for example information on the new owners and acting manager. The Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 9 acting manager explained that this documentation is given to the representative of each service user. The service user guide clearly mentions that the home is able to cater for the diverse range of needs of the service users. Due to the high dependency levels of the service users conversations could not take place to test their understanding of the information in these documents. Each service user has been provided with a contract of care that is held in a file on their behalf. The new contracts issued by Newport Care Limited require further information on the terms and conditions of the placement. Information is missing on the bedroom number that the service user is occupying. Where funding is being provided by Adult Social Care, these contracts are in place. An admission procedure is available to guide staff at the home. Prior to admission the acting manager assesses all potential service users to ensure that the home will be able to meet their needs. A pre admission document is completed prior to admission and the records show that the home is accessing all information from the Adult Social Care Department when they are funding placements. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service user’s health, personal and social care needs are being met as evidenced by care planning but lack of equipment is compromising the delivery of basic care. Medication arrangements were found to be adequate and two good practice recommendations are made in this report to ensure medication administration is safe. Service users were noted to be treated with kindness and respect during the course of the inspection. EVIDENCE: All the service users have a comprehensive plan of care in place. The care plans include the activities of daily living, mental health needs, social care needs, mobility and moving and handling assessments. The care plans are Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 11 completed by the qualified staff and are supported by good daily day and night records. In addition documentation is in place for daily care delivery. In these records it indicates that very few baths are taking place at the home. This is related to the lack of equipment in the form of bath hoists. The upstairs bathing facility has had a hoist condemned on safety grounds and is therefore not being used. The downstairs bathing facility is a parker bath and therefore not suitable for all the service users. It is essential that a new bath hoist is purchased to allow the staff to be able to undertake their care tasks. The home has recently purchased a number of wheel chairs which unfortunately have had to be returned which is also causing problems with care delivery. Daily records indicate that aspects of care to include fluid and dietary needs, general well being and mood of the individual are commented on well in the daily records. Regular reviews of the care plans are taking place. All the service users are registered with a general practitioner. The local general practitioner visits the home on a weekly basis (or at any other time if required). On day one of the inspection a consultant psychiatrist was attending the home along with a social worker and community psychiatric nurse. The home appears to have good working relationships with these professionals. Chiropody and dental services are available in the home as required. Good dietary information is included in care planning. The home refers directly to the tissue viability nursing staff and continence nurses as required. The service users are weighed regularly. During the course of the inspection the service users were noted to be treated by the staff with kindness and respect. Medication arrangements were found to be only adequate. On day one of the inspection medication was administered very late due to staff sickness. The home must have a back up plan for sickness to ensure that the care needs of the service users are not compromised. The medication administration policy and procedure is satisfactory and medication administration records were also found to be satisfactory on the day of the inspection. All the nurses employed by the home have medication administration duties. It is recommended that this staff list of signatures and initials is brought up to date and a photo provided to help the staff with identification of the service user for medication administration. This is essential for any agency staff employed. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care planning and daily recording evidences that the social care needs of the service users are identified. Arrangements are being made to increase the number of organised activities at the home. The home is very welcoming to all family/friends and visitors to Holywell Bay and encourages them to stay in touch with their relative. There are concerns about the standard of kitchen equipment in the home at this time. EVIDENCE: Care planning documentation identifies the social and spiritual care needs of the service users. The daily records evidence how these needs are being met and include reference to all visitors that the service user receives. The acting manager is looking to arrange more activities for the service users to include the Christmas period. She is also busy buying presents for each Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 13 service user as some do not have any family/representative who will undertake this task. The hairdresser regularly attends the home and is able to provide this service in a specially adapted room. Visitors are welcomed to the home and the home actively encourages all family/friends to stay in touch. If required there is accommodation at the home where a family can stay if they need to. On the days of the inspection breakfast took place over a number of hours as did the waking and rising time of the service users. It is apparent that the service users are helped to exercise choice and control over their lives which is a credit to the staff considering the majority of the service users cannot express their choices. The main cook at the home is a long standing employee. She is fully aware of the likes and dislikes of the service users and is able to provide a menu choice to meet the service users needs. She is though at this time compromised by a lack of suitable cooking equipment. According to the acting manager the cooker has been condemned as not safe with a new cooker on order which the new owners have agreed to. There were concerns on the second day of the inspection around the safety of the kitchen. A statutory requirement was left with the manager to deal with this as a priority and feedback to the CSCI. It is also noted that other equipment in the kitchen is not working. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a complaints policy and procedure that requires updating with information. Adult protection policies and procedures are in place to guide staff on good practice. The lack of training for protecting service users places them at possible risk. EVIDENCE: The home has a complaints policy and procedure in place which requires updating with important information. This documentation is available in the service user guide. This document is provided to the family/representative of the service users. The home has a policy and procedure in place with regard to the protection of vulnerable adults and a copy of Cornwall County Council adult protection policy and procedure is available. There is limited evidence in the files that staff have received training in this important area. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The overall quality of furnishings and fittings is poor with little evidence of improvement through maintenance or future planning. Essential equipment in the home is lacking or of a very poor quality posing a potentially dangerous situation to service users and staff. EVIDENCE: Externally Holywell Bay is in need of essential decoration. Internally furniture in communal areas is shabby and of poor quality. Seats used for eating meals on have broken springs and tables are old and wobbly. Settees are tired and dirty, paintwork is shabby. Curtains are old and ripped. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 16 It is apparent that during the change of ownership a severe neglect of the environment has taken place. Two cleaning staff are employed but their task is almost impossible due to the poor quality of what they are cleaning. For example the settees in the lounges were very dirty on the days of the inspection but they are so worn that they are difficult to improve the appearance. On both days of the inspection the industrial drying machines in the laundry were out of action casing a severe back log with the washing. Engineers had been called out to sort this problem but it would appear to be ongoing at this time. There are problems with the boiler at the home which has resulted in a lack of hot water for baths. Equipment for assisted bathing has been condemned as not safe and there are problems with the cooker. A statutory requirement sheet left on the day of the inspection has requested immediate action in regard to the safety of the home. It was also noted that pressure pads in bedrooms are very old and worn and sheets and towels are of a very poor quality. On change of ownership an inspection of the home took place by the County Council Fire Officer. There is important work still to be undertaken to meet their safety requirements. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staffing levels on day one of the inspection were poor resulting in service users not receiving consistent care. Service users are also placed in a position of possible risk due to lack of mandatory training and poor recruitment procedures. EVIDENCE: On day one of the inspection the acting manager and a carer were off sick. It is recognised that sickness does occur but there must be plans in place for staff to cover when this does occur and the nurse in charge should have authority to arrange the cover through agency. The sickness (although covered by mid morning) resulted in the medication round taking place late with an interruption for a health and social care meeting. It was noted that the nurse in charge of care on day one and day two of the inspection although new to the home presented as very capable and competent. The staffing levels on day two of the inspection were satisfactory. In addition to the care staff there is a part time administrator to support the acting manager in her duties and responsibilities. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 18 There have been a number of staff changes at the home during the change of ownership period. This has resulted in a number of care staff being employed without care experience and training. They were noted to be kind and caring to the service users but must have an induction training when they commence as well as statutory fire and moving and handling training. A basic talk (from a trained staff member) and policy and procedure is in place for the moving and handling training but the equipment is of too poor a quality for the training to take place. Staff files evidence that staff are being recruited with criminal records bureau checks and written references. Although in one staff file there was no evidence of an application form or references and no check on the pin number of the nurse employed. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The change of ownership at Holywell Bay has resulted in a home that is operating with difficulties in a number of areas at this time. Any change in registered provider has the potential for de-stabilising a care provision. This has been realised at Holywell Bay. EVIDENCE: The acting manager had been employed at the home under the old ownership. Her acting manager role is new to her and considering the concerns raised by the inspection she presented well. The CSCI is anticipating documentation to register her as manager and this needs attention to avoid enforcement action as it is a condition on the certificate of registration that this takes place within six months of the new ownership. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 20 The new owners of Holywell Bay live out of county and were in contact on the phone with the acting manager during the inspection. A regulation 26 report was available in the home to the inspector. It is formally requested that these be sent to the CSCI St Austell office monthly. It is also anticipated that this report will generate support to the home from the Registered Provider. The acting manager is a qualified nurse (RMN). She is supported by the other nurses at the home in her duties. Two team co-ordinators report to the nurses in charge of the shift. It is expected that the new owners will undertake the responsibilities for meeting standard 33 in relation to the quality monitoring and assurance of the home. The acting manager has been very busy sorting out the finances of the service users as there were changes to be made following the change of ownership in regard to accessing a bank account. This has been done but there are still improvements required, in particular to the amount of money being held on the premises. The standard re health and safety is not met. On day one of the inspection the drying machines were not working and this had been the case since the weekend. This resulted in a large build up of washing. It is a credit to the laundry staff member that he worked to get the back log cleared, but again on day two the machines were not working. There is a problem with the hot water at the home. An immediate requirement form was left for a plumber to be contacted as a priority. On change of ownership an inspection of the premises was carried out by the fire officer with essential improvements required. These are still to take place. Immediate statutory requirements were left on the day of the inspection to ensure the safety of equipment and to ensure that hot water is available at the home. In addition essential fire prevention work has to be undertaken as identified at change of ownership. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 21 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 2 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 1 x x x x x x 1 STAFFING Standard No Score 27 2 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 2 x x 1 Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 12(1)(b) Requirement The registered person shall ensure that the care home is conducted so as to make proper provision for the care of service users. The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. The registered person shall ensure that the premises to be used as the care home are of sound construction and kept in good state of repair externally and internally. The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. The registered person shall ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform. The registered person shall make suitable arrangements to provide DS0000068129.V318452.R01.S.doc Timescale for action 31/12/06 2. OP15 13(4)(c) 31/12/06 3. OP19 23(2)(b) 30/05/07 4. OP26 13(4)(c) 31/12/06 5. OP30 18(1)(c) 31/12/06 6. OP38 13(5) 31/12/06 Holywell Bay Care Home Version 5.2 Page 23 7. OP38 23(4) a safe system for moving and handling service users. The registered person shall take 31/12/06 adequate precautions against the risk of fire. 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. 4. 5. 6. 7. 8. 9. 10. Refer to Standard OP1 OP2 OP9 OP16 OP18 OP27 OP29 OP31 OP33 OP35 Good Practice Recommendations To update the service user guide and statement of purpose with important information on the change of ownership of the home. To update the contract of care with important information on the terms and conditions of the placement. To update the list of staff initials and signatures for all staff who administer medication. To provide a photo on medication records for each service user. To update the complaints policy and procedure. To provide all the staff with adult protection training. To have back up staff and a plan in place when there is sickness. To ensure that recruitment procedures include checks on nurse pin numbers and written references are at all times taken up. For the Regulation 26 reports to be sent to the CSCI St Austell office. For the registration of a manager to take place as soon as is possible. For the home to undertake a quality assurance/monitoring of the running of the home. A review of the finances being held on the premises should be undertaken as soon as possible. Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Holywell Bay Care Home DS0000068129.V318452.R01.S.doc Version 5.2 Page 25 - 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. 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