Inspection on 16/02/06 for Hornchurch Nursing Centre

This inspection was carried out on 16th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hornchurch Nursing Centre 03/09/07

Hornchurch Nursing Centre 21/02/07

Hornchurch Nursing Centre 04/11/05

Hornchurch Nursing Centre 11/03/05

Hornchurch Nursing Centre 01/07/04

Hornchurch Nursing Centre 03/12/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Hornchurch Nursing Centre 2a Suttons Lane Hornchurch Essex RM12 6RJ Lead Inspector Joanna Moore Unannounced Inspection 16th February 2006 01:30 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 Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hornchurch Nursing Centre Address 2a Suttons Lane Hornchurch Essex RM12 6RJ 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) 01708 454 422 01708 445 456 ANS Homes Limited Ms Carol Baldock Care Home 55 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (38), of places Physical disability (5) Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th November 2005 Brief Description of the Service: Hornchurch nursing home is a purpose built fifty-five bed home which is owned and operated by ANS Homes Ltd a company which operates similar homes throughout the country. ANS Homes Ltd has recently been bought by BUPA but remains a wholly owned subsidiary company. The home caters for three categories of service user: up to 16 people over the age of 65 with a diagnosis of dementia, up to 34 people over the age of 65 who have age related physical illnesses/ disabilities and up to 5 people between the ages of 18-65 who have physical disabilities / complex needs. The home is managed and staffed by registered nurses, care assistants and support staff. The home offers administrative, catering and laundry facilities on the ground floor and care accommodation on the further three floors. Each floor operates as a separate unit with staff allocated to each floor with bedrooms, lounge/ dining room, small kitchen area, bathrooms and toilets situated on each floor. The Home itself is situated within two minutes walk of the railway station and is easily accessed by car from the A13, A127 and M25. Hornchurch shopping centre is approximately twenty minutes walk or a short bus ride away. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the annual inspection program and took place between 1.30 and 5.30pm. The manager and hotel services manager were not on site at the time of the inspection and therefore it was not possible to access some information during the inspection which the inspector would have liked to have seen. Some staffing requirements remain outstanding as it was not possible to establish whether or not these had been met. The inspector was assisted during the inspection by the nurses on each floor visited and the handyman. The inspector spent the majority of the time touring the home talking with residents, relatives and staff. What the service does well: What has improved since the last inspection? The period since the last inspection has been one of significant change for the staff and manager and the home has focussed on maintaining the standards within the home during this period. A program of redecoration is underway. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All standards in this section were checked as part of the last inspection and assessed as met these standards were not checked again during this inspection. EVIDENCE: Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10 &11 Service users benefit from quality care however this can not be evidenced as required through the homes recording systems. EVIDENCE: Medication was checked at the last inspection and assessed as safe and was not checked as part of this inspection. Three service users files were viewed as a part of this inspection. Two of these service users had clear care plans in place, which were recorded as reviewed monthly. It is recommended that care plans incorporate the social needs of service users. One care plan for service user “A” and the waterlow risk assessments in the file stated they had been reviewed on 24.2.06 prior to the date of the inspection (the date of the inspection was 22.2.06). The inspector was concerned that staff had predated care plan reviews. The moving and handling care plan on this service users file however was not recorded as having been reviewed and updated since 26.4.05. The registered person is required to ensure that risk assessments and care plans are reviewed and updated regularly, accurate dates of these reviews must be recorded. It is recommended that care plans be reviewed monthly and risk assessments six monthly or more frequently if changes in need occur. Service user “A” was Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 10 receiving “ensure” as a nutritional build-up to supplement poor appetite. A fluid chart was also in place however was not totalled and did not appear to be fully completed. The home must ensure that such records are accurately maintained. Daily records evidenced that the service users had the support of a GP, chiropodist and other appropriate health professionals as required. Feedback from relatives was that they were very happy with the healthcare arrangements for their relatives. It was noted that a service user was being transported in a wheelchair with no footplates, the staff said this was because the service user did not like them. All service users must be transported in wheelchairs and foot plates used unless there is a risk assessment in place detailing why this is to happen and what other systems are in place to ensure the service users safety. Relatives comments included. “The staff are all very kind, they take time to talk with mum and chat to her whilst giving care. I am happy with her here. Mum is gaining weight and she enjoys the food. I am kept well informed of any changes in her and am always made to feel welcome when I visit.” Relatives interviewed said that they were confident that the home would manage the death of their loved one sensitively and provide appropriate support in line with their wishes. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 & 15 Service users benefit from comprehensive activity opportunities which are well publicised and attended. Service users benefit from a variety of wholesome home cooked food. EVIDENCE: “The activities lady keeps them lively and busy. Mum likes to join in, she has done potting plants, and lots of other things, she went with them to Southend and I met them there so I could spend the time with mum, which was really nice. They decorate the home for valentines, Christmas, Halloween, mothers day and St. Georges day.” “ They made his birthday really nice, organised a sing-along, cake and balloons.” “The staff are all very friendly and we are made welcome whenever we visit. The carers seem really good. The laundry service is very good, hardly anything goes missing and if it does they go to great lengths to find it. We can make tea and toast if we want in the little kitchens and I have even been offered dinner here as I am often about at lunchtime. There’s always something going on and he does join in.” Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 12 The food is cooked on the premises from scratch and positive comments were received as to the amount and quality of food provided. The menus were displayed in the lounges and showed a variety of nutritious food provided. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18 Systems are in place to protect service users from abuse and carers are aware of the issues. A recommendation has been made for ancillary staff to receive training in adult protection awareness. Service users and their families feel confident in the homes complaints procedures. EVIDENCE: The home has clear complaint policies (viewed at the previous inspection). Relatives said they felt able to complain and were confident in the management of the home taking their concerns seriously. The home has clear policies in place in relation to adult protection and the manager through previous discussions has shown clear awareness as to the procedures to be followed should such an allegation be made. Carers have also shown awareness of the issues. The inspector asked ancillary staff if they had received training in this area and they had not. Previous inspection reports and records provided to the Commission note that all carers and nurses have received this training. No adult protection allegations have been made in the past two years. It is recommended that basic awareness training in adult protection be provided to ancillary staff as they as with carers, need to be aware of the issues and what to do should they observe any ill treatment of service users. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 &26 Service users and their families benefit from safe and suitable accommodation which meets their needs and the national minimum standards. The home is clean and odour free. The home is generally well maintained although some maintenance issues were noted. EVIDENCE: The home is divided into three units on three floors. Each unit operates independently and has its’ own staffing team for the shift. Sufficient and appropriate toilets, bathrooms, bedrooms and communal lounges with kitchenette are provided in each unit. All service users have their own private rooms, which are furnished and decorated according to their choice. The building was maintained to a safe standard. A program of refurbishment is underway which includes decorating all and carpeting many of the communal areas. New curtains were provided last summer. Those areas visited were clean and hygienic with no noticeable odours. From discussions with relatives the day of the visit was representative of the normal standard in the building. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 15 The manager advised the inspector at the previous inspection that the home is budgeting for the remainder of service user beds to be replaced with high low beds for staff safety and service user comfort by the end of the next financial year. The manager advised the inspector that the whole home is due for refurbishment and that as part of this process over ridable locks will be fitted to all service users bedroom doors by the end of the next financial year. Some maintenance issues were noted as follows: the wardrobe door was broken off in room 30 and requires repair/ replacing. Outside room 54 and the lounge the carpet was not fixed adequately and was lifting presenting a tripping hazard. The registered person is required to have these maintenance issues addressed. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 &30 Service users benefit from caring competent staff that show a genuine interest in the welfare of the residents. The number of qualified nurses per daytime shift must be maintained at one per unit. EVIDENCE: The inspector was advised that since the last inspection a qualified nurse has now been allocated to work on each floor however on the day of the inspection this nurse was covering the middle floor as well. The home is required to have a qualified nurse on each floor between the hours of 8am and 8pm. Staffing levels were satisfactory with this exception. On the top floor there was one nurse (shared with middle floor) and three carers to provide support to 17 service users most of whom have high care needs. Most of the staff at Hornchurch nursing centre have worked at the home for a number of years. Staff turnover has been little and service users enjoy staff who are regular and who are familiar with their needs. Relatives and service users interviewed spoke very positively about the staff. Relative’s comments included: “There is good continuity of staffing both qualified and carers, they are all very kind and take time to talk and they chat to her whilst providing care.” “ The staff are all very friendly and we are made welcome whenever we visit. The carers seem really good. The laundry service is very good, hardly anything goes missing and if it does they go to great lengths to find it. We can make tea Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 17 and toast if we want in the little kitchens and I have even been offered dinner here as I am often about at lunchtime” Staffing requirements from the previous inspection related to staff supervision, induction and recruitment and could not be checked at this inspection and therefore remain outstanding in this report. The manager has however written to the inspector stating : “Supervision. This has started and documentation is in my office to support this. This is in the process of being performed by qualified staff to the care staff and once established will continue on a 2 monthly cycle. Induction. As yet we have yet to employ a member of staff since the last inspection in November 2005. We have been provided induction booklets by Bupa for new staff. …” The home has shown improvement in the frequency of staff meetings being held. The staff nurse interviewed during the inspection had worked at the home for three years. She was familiar with the needs of the service users and able to answer the inspector’s questions regarding care needs. This nurse said she had received training in fire prevention, dementia care, food handling, manual handling and adult protection. The home displays in each lounge a duty rota detailing, which staff are on duty at what time over a 24 hour period this is for the information of service users and their families. It is recommended that the home consider supplementing this with a photo of the individual staff member against their name to aid recognition. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 &38 The home monitors health and safety but at the time of the visit service users, staff and visitors were not fully safeguarded from fire, risk of tripping or food poisoning. EVIDENCE: All key standards in this section were assessed as met at the last inspection and assessed as met or are detailed in this report. Fire doors on the first floor were not automatically closing, this had been identified and the handyman was able to evidence it had been reported to the company contracted to maintain them but a part was being awaited. It was required that the home liaise with the fire authority and agree a plan of safety with the LFEPA for the interim period including whether and when it was acceptable to prop open doors for frail service users to have free mobility around the building, what checks to be carried out and when. It was noted that the fire door to the kitchen was propped open, which the kitchen staff advised Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 19 was because they were cleaning the floor. When viewing the regular safety checks carried out by the home however it was observed that this had been noted during these checks on several occasions. It therefore appeared that this was not a singular event but part of a pattern of practice. An immediate requirement notice was served in relation to the fire arrangements. At the time of writing the report the inspector had been informed that the notice had been met. The registered person is required to closely monitor fire prevention arrangements. The metal shelving units in the Kitchen have uneven slanted shelves and present a health and safety hazard and therefore require replacing. Carpets outside room 54 and the lounge area must be fully secured. Raw meat was noted to be left uncovered in the fridge. The registered person must ensure that raw meat is appropriately covered at all times to prevent cross contamination. Records of care were not kept accurately in order to evidence the care given, the issues are detailed under standard 7. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 X 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 2 2 Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The home must be able to evidence in detail the care that is required and the care that is provided and records must be updated regularly to reflect changes in need. Where assessments such as waterlow are carried out and identify high levels of risk then the care plan must evidence that this risk is translated in to guidelines for care. This is a repeated requirement. The previous timescale set was 1/12/05 The homes records must be accurate, detailed and evidence the care given. This is a repeated requirement. The previous timescale set was 1/12/05 All service users must be transported in wheelchairs and foot plates used unless there is a risk assessments in place detailing why this is to happen and other systems in place to ensure the service users safety. DS0000015596.V285769.R01.S.doc Timescale for action 11/04/06 2. OP7 17 11/04/06 3. OP7 13 04/04/06 Hornchurch Nursing Centre Version 5.1 Page 22 4. OP19 23 the wardrobe door was broken off in room 30 and requires repair/ replacing. Outside room 54 and the lounge the carpet was not fixed adequately and was lifting presenting a tripping hazard. The registered person is required to have these maintenance issues addressed. The home is required to have a qualified nurse on each floor between the hours of 8am and 8pm This is a repeated requirement. The previous timescale set was 1/12/05 04/04/06 5. OP27 18 01/05/06 6. OP29 19 7. OP36 18 8. OP36 13 It is required that the application 01/05/06 form of prospective staff are monitored to ensure that actual dates of employment are detailed rather than just a year in order to identify gaps in employment. This is a repeated requirement from the previous inspection which could not be checked at this inspection. The previous timescale set was 1/12/05 It is a requirement that 02/05/06 supervision is started and records kept of sessions for all staff. This is a repeated requirement from the last two inspection which could not be checked at this inspection. The previous timescales set were 1/6/05 and 2/2/06. It is required that a minimum 20 02/05/06 minute handover time be built into each shift handover. This is a repeated requirement from the last two inspection which could not be checked at this inspection. The previous timescales set were 1/6/05 DS0000015596.V285769.R01.S.doc Version 5.1 Page 23 Hornchurch Nursing Centre 9. OP36 18 10. 11. OP38 OP38 23 13 12. OP38 13 and 2/2/06. It is required that all staff receive a comprehensive induction and that records of this are held. This is a repeated requirement which could not be checked at this inspection. The previous timescale set was 2/2/06. The registered person is required to closely monitor fire prevention arrangements. The metal shelving units in the Kitchen have uneven slanted shelves and present a health and safety hazard and therefore require replacing. The registered person must ensure that raw meat is appropriately covered at all times to prevent cross contamination. 02/05/06 04/04/06 01/06/06 04/04/06 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. Refer to Standard OP7 OP7 OP18 OP27 Good Practice Recommendations It is recommended that care plans incorporate the social needs of service users. It is recommended that care plans be reviewed monthly and risk assessments six monthly or more frequently if changes in need occur. It is recommended that basic awareness training in adult protection be provided to ancillary staff. The home displays in each lounge a duty rota detailing, which staff are on duty at what time over a 24 hour period this is for the information of service users and their families. It is recommended that the home consider supplementing this with a photo of the individual staff member against their name to aid recognition. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 24 5. 6. OP28 OP30 7. 8. OP36 OP36 It is recommended that the home ensure that at least 50 of care staff complete NVQ 2. Whether this had been achieved was not checked at this inspection. It is recommended that in line with standard 30 staff receive a minimum of three paid training days per year. Whether this had been achieved was not checked at this inspection. It is recommended that all staff receive supervision at least six times per year. Whether this had been achieved was not checked at this inspection. It is required that all staff receive a comprehensive induction and that records of this are held. Whether this had been achieved was not checked at this inspection. Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Hornchurch Nursing Centre DS0000015596.V285769.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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