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Inspection on 03/01/07 for Linden House Nursing Home

Also see our care home review for Linden House Nursing Home for more information

This inspection was carried out on 3rd January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

All sources of information reviewed indicate that the home provides a high standard of care with an emphasis not just on skilled nursing but also on interpersonal skills that make the service user and their family welcome. Cards sent to the home by service users and their relatives indicate that people value the kindness of the staff. "Staff are very patient with her...." "We will never forget the kindness and consideration..."There is an emphasis on providing as much care as the service users needs whether for a short period or permanently. "I feel so much better for the two weeks with you."wrote one service user. While families wrote with thanks of the care provided to relatives on admission to the home and at the end of their lives. "Thank you for the effort and thought that which has gone into welcoming mum" "We are..grateful for the kindness and care given..." and "deep gratitude for excellent care....." The training provided for staff and the in-house training and supervision ensure that nursing and care is skilled and reflective. The home is very well cared for and maintained. The home is managed thoroughly and effectively by people who are committed to the well-being of service users. There is evidence of a creative and imaginative programme of social events.

What has improved since the last inspection?

The environment improves continuously. The new wing has made more communal space available throughout the home. A new nurses office has been provided and improved medication storage is available in the newly fitted clinical room.

What the care home could do better:

Daily records contain evidence that short term needs are identified and dealt with on a regular basis. Sometimes the full picture of a service users problems and treatment can only be determined by reading through these notes. The documentation used in the home is suitable for the identification of these events in the care plan itself and trained staff could discuss the way in which this could be used more fully.

CARE HOMES FOR OLDER PEOPLE Linden House Nursing Home Lower Westford Wellington Somerset TA21 0DW Lead Inspector Shelagh Laver 3 rd Unannounced Inspection January 2007 09:30 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 Linden House Nursing Home DS0000029568.V321173.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. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Linden House Nursing Home Address Lower Westford Wellington Somerset TA21 0DW 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) 01823 667711 NA Mrs S C Joyce Mrs Linda Marie Bennett Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 3 places for Personal Care To provide Nursing care for up to 4 service users aged 45 years and over. 17th January 2006 Date of last inspection Brief Description of the Service: Linden House is situated on the outskirts of Wellington. The house was converted to a Nursing Home in 1984 and sits in large landscaped grounds and has two private access roads. Following the opening of a new nursing wing this year the home is now registered with the CSCI to provide general nursing care for up to 34 elderly persons. The home can provide specialised nursing care for up to four adults aged over 45. The home is equipped to accommodate the current service user group. The new wing provides in addition to the 12 additional en-siute bedrooms, bathrooms, a dining room and quiet room and a large well equipped laundry. The homes proprietor is Mrs S Joyce (RGN); the homes manager is Mrs L. Bennett who has been in post since September 2004. There is a Registered Nurse on duty at all times and there is a stable staff team. There is commitment to staff training. The home is well appointed and bedrooms are a good size and all different. There is regular up-dating and a thorough maintenance programme in the home. Access to the first floor is via a platform lift that has recently been replaced. Residents can have a private telephone installed if they wish. All communal rooms are well furnished and homely. The completion of the new wing has provided service users with a pleasing choice of communal areas including a spacious conservatory that overlooks the garden. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on one day by one inspector (5.5hrs). In preparation for the inspection comment cards were received from service users and their relatives. Feedback cards were received from five service users. All said that they received the support they needed and that staff listened to them and acted on what was said. All said they knew who to talk to if they were unhappy. Service users spoken to on the day who were very positive about the care received in the home. “A standard of comfort is maintained and all requests are attended to promptly. Some service users were too frail to talk to the inspector but appeared comfortable and well presented. A tour of the premises took place where all the of bedrooms and communal areas were seen. Ten service users and four staff were spoken with. The proprietor Mrs Joyce and the registered manager Ms Bennet were available throughout the inspection. Records relating to care, staff and health and safety were examined. This inspection offered the first opportunity to inspect the new wing of the home. The building has been completed to a very high standard and the alterations have resulted in improvements throughout the home. What the service does well: All sources of information reviewed indicate that the home provides a high standard of care with an emphasis not just on skilled nursing but also on interpersonal skills that make the service user and their family welcome. Cards sent to the home by service users and their relatives indicate that people value the kindness of the staff. “Staff are very patient with her….” “We will never forget the kindness and consideration…” Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 6 There is an emphasis on providing as much care as the service users needs whether for a short period or permanently. “I feel so much better for the two weeks with you.”wrote one service user. While families wrote with thanks of the care provided to relatives on admission to the home and at the end of their lives. “Thank you for the effort and thought that which has gone into welcoming mum” “We are..grateful for the kindness and care given…” and “deep gratitude for excellent care…..” The training provided for staff and the in-house training and supervision ensure that nursing and care is skilled and reflective. The home is very well cared for and maintained. The home is managed thoroughly and effectively by people who are committed to the well-being of service users. There is evidence of a creative and imaginative programme of social events. 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. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 7 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. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12345 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager spends significant time and effort to ensures that the home can fully meet the assessed needs of prospective service users prior to making a decision about admission. The pre-admission process is detailed and well managed. Staff visit prospective service users. Time is taken to ensure the move to the home is the right one. The manager ensures that prospective service users provided with appropriate information which will assist them in making a decision about admission. There is a flexible approach to home admissions that give people time to recover or consider whether the home is appropriate before a final decision is made. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 10 EVIDENCE: The home has produced a Statement of Purpose and Service User Guide which is made available to service users, prospective service users and their representatives. This has been up-dated recently to reflect the changes to the home. Information is clear and alternative methods such as a web-site are used to provide information to all. The home’s current fee range is dependant upon the room to be occupied and the assessed needs of the service user. The fee range for new service users is £540 - £720 per week. The manager ensures that prospective service users are fully assessed prior to admission. It is home policy that a service user is visited and information from other health professionals and for example hospital care notes are taken into account. Service users are invited to visit the home whenever this is possible. There is evidence that when it is needed time is allowed to enable the service user to make a decision. Alternatively when needed the home acts quickly to support families and service users. There was evidence of a flexible approach to admission to the home designed to meet the needs of the individual. One service user admitted during a time of acute illness had “decided to stay.” Another service user said after much thought she had come to the conclusion that “the time was right.” It was clear from discussions that people are given ample time to come to a decision. Two contracts for service users were examined and found to be very detailed, clear and comprehensive. Some service users are funded under Continuing Care arrangements and do not have individual contracts. There is evidence that families and representative are regularly involved and consulted with regard to the service users needs in the home. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home takes appropriate action to ensure the health care needs of service users are met. The home’s procedure for the management and administration of medication is satisfactory. The home provides sensitive care and support to all service users. Service users are treated with respect. Care practices support privacy and dignity. EVIDENCE: Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 12 Care plans are detailed and contained evidence of review. Service users receive regular visits of general practitioners, district nurses, opticians and chiropodists. These are recorded. Medication management is safe. There is a new clinical room providing improved storage. Medication records are audited by the manager to ensure records are accurate and complete. Unused medicines are disposed of appropriately. The home is pro-active in meeting service users health needs and liaises with relevant health professionals to ensure the appropriate advice and treatment is provided. There are links with the hospice, general practitioners and nurses that ensure service users at the end of their lives are well cared for. The inspector observed that for a service user with profound care needs there is continued excellent care. It is heartening that the home continues to consider ways in which the experience of this person can be improved. Staff were observed speaking to service users with respect. There was evidence that privacy and dignity is a key principle of the homes aims and objectives. Doors are closed when care is provided. Service users are smartly dressed and appeared well cared for. Comments from families indicate that service users are cared for with kindness and skill at the end of their lives. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to chose a variety lifestyle patterns in the home. Service users are well nourished and enjoy a wholesome and varied menu which takes into account the needs and preferences of service users. Service users are able to maintain contact with family and friends in a welcoming atmosphere. Service users have the opportunity to take part in a range of activities and to enjoy entertainments. EVIDENCE: The manager and chef have devised a menu which is wholesome, varied and takes in to account the needs and preferences of service users. The kitchen Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 14 has been updated. Service users confirm that whilst one main dish is listed on the menu “We can have pretty much what we like.” One service user continues to enjoy daily salads. Main dishes are coked using fresh seasonal food when possible. The contribution of food to special occasions is clear. Service users had enjoyed Christmas food. Menus are regularly reviewed and the home seeks the views of a dietician when needed. Visitors are made welcome at any reasonable time in accordance with the wishes of the service user. Visitors are welcome to spend as much time with their relatives as they wish and are supported to participate in care activities if they choose to. The inspector observed the house news sheet “Linden Latest”. This gives details of forthcoming social events and news of service users and staff. As in previous inspections some interesting and innovative events had been provided. There are a variety of outings and special events across the year. Amongst the more usual regular Flexercise classes and Sing-along entertainment there was the Linden Beach. An event that had resulted in turning the home into a seaside resort. Visits to the home by Majorettes, donkeys and babies were recorded and clearly enjoyed. There are individual records of activities that show that there is attention to those service users who need 1:1 attention in their rooms as well as those who enjoy socialising. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure in this home is good with evidence that the views of service users/visitors are listened to and acted upon. Procedures and policies aim to protect service users from abuse. EVIDENCE: Service users spoken to knew who they were able to speak to if they wished to complain. Complaints are recorded and investigated. Staff recruitment procedures, training, supervision contribute to the protection of service users from abuse. There was evidence this year that the home management is pro-active in protecting service users. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 16 Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management has provided a well maintained comfortable safe and attractive home. Service users are encouraged to think of the place as home. Bedrooms are personalised. The home’s environment is able to meet the assessed needs of service users. The home provides specialist equipment to ensure the needs of service users are met. EVIDENCE: There has been substantial continued effort and investment in the home resulting in an excellent environment. . All communal areas and most bedrooms were seen at this inspection. The home has a lounge and a dining Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 18 room/conservatory. Service users have a choice of where to spend the day. Some prefer to spend most of their time in their bedroom. The rooms are well planned and attractive with many with pleasant views. Bathrooms are comfortable and easy to use. Those in the new wing are equipped to the very highest standard and reflect current technology. Service users confirm that the home is always clean and tidy and smells fresh. Domestic staff on duty were satisfied with the time provided to care for the home and the equipment provided. There is ownership and pride in the appearance of the home. There is a pro-active infection control policy. Clinical waste is managed effectively. Bedrooms were pleasant and comfortable and it was evident that service users were encouraged to bring personal possessions into their rooms. Specialist beds and pressure relieving equipment were seen to be in place where there was an assessed need. Assessment of service users needs ensures equipment is available before they move in to the home. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home ensures that there are sufficient staff on duty to meet the service users needs. The home’s recruitment practices are robust and designed to protect the service users. Staff are well trained and have access to a range of mandatory and developmental training opportunities. The home exceeds the requirement for staff trained to NVQ level 2. EVIDENCE: On the day of inspection there was a registered nurse on duty in addition to the manager who now works one day a week as the registered nurse in charge. There were five care staff on duty. Also on duty were the cook and kitchen assistant, two domestic staff and the maintenance man. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 20 Management facilitate staff members to undertake external qualifications beyond basic requirements. There was evidence of a wide range of training accessed by staff. 65 staff have attained NVQ qualifications. The list of training completed in 2006/2007 demonstrated a wide range of appropriate training is available for all staff. Nurses had received up-dates in Infection Control, Parkinsons disease, Diabetes and Wound care. There is evidence that staff are able to follow their own interests as well as maintaining standards in the home. All carers had received Manual Handling up-dates, fire training and many had received protection from abuse training. Seminars and conferences are attended. Future training events are planned in the coming year. Staff confirmed that there was in-house observation and training carried out by a member of the nursing staff. The manager maintains an organised training file. Staff are also encouraged to share new knowledge at staff meetings. Training needs are identified at staff appraisals and any training need identified within the home is noted for action. Three recruitment files were observed. All contained evidence of a thorough recruitment process. A check list ensures that references are sent for and received and that all documents required are photocopied and included in the file. There are detailed interview records. A thorough induction is provided for new staff. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is effectively managed by the registered manager and proprietor who promotes a clear and inclusive style of management. The well-being of service users takes priority. Staff are appropriately supported and supervised. The home’s systems for ensuring the health, safety and welfare of service users and staff are comprehensive. EVIDENCE: Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 22 The registered manager, Linda Bennet is a registered nurse with many years of management. Staff benefit from regular meetings and supervision sessions. Trained staff have regular monthly meetings with the manager and proprietor. Records were seen to support this. The proprietor Mrs Joyce manages the finances of the home and is closely involved with the care in the home. There is evidence of constant review and improvement of systems within the home. Evidence from quality assurance feedback is considered and acted upon. At the time of this inspection, the home was taking appropriate steps to ensure the health & safety of service users, staff and visitors to the home. The maintenance man uses comprehensive check lists to record his duties. The new wing contains “state of the art” bathing equipment and has been completed to a very high standard with full regard to health and safety. Records were seen of comprehensive fire prevention routines. Regular servicing is carried out on the home’s fire detection and fire fighting equipment. Regular training is conducted for all staff. Fire alarms are tested weekly. There are regular Health and Safety meetings and a member of staff has been nominated to attend and raise matters of concern. Risk assessment is understood in the home and there are comprehensive assessments. There are servicing contracts in place in the home where required. Hoists servicing schedules indicated that these are according to LOLER regulations. Bedrails are in use for those service users with an assessed need. Regular checks are made by the home to ensure they remain safe. The home policy and signature of service user/representative were seen. The home maintains appropriate records relating to accidents at the home. The accident records include action to be taken and evidence of analysis. Measures required to ensure serviced users are taken including ensuring that all radiators are of a low surface temperature type which reduce the risk of injury to service users. Bath hot water outlets are thermostatically controlled to reduce the risk of scalding. Weekly checks are made to ensure that the temperature does not exceed the HSE recommended limit of 44C. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 23 Linden House Nursing Home DS0000029568.V321173.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 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 3 3 3 4 4 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 4 3 4 3 4 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 3 3 3 3 3 Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP7 Good Practice Recommendations Staff should review the care planning system with a view to including the short term care needs in the planning documentation. Linden House Nursing Home DS0000029568.V321173.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Linden House Nursing Home DS0000029568.V321173.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. 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