Inspection on 22/04/08 for Milverton Nursing Home

This inspection was carried out on 22nd April 2008.

CSCI found this care home to be providing an Good service.

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

Milverton Nursing Home 20/04/09

Milverton Nursing Home 17/12/07

Milverton Nursing Home 28/06/07

Milverton Nursing Home 22/05/06

Milverton Nursing Home 04/01/06

Milverton Nursing Home 04/10/05

Milverton Nursing Home 15/09/04

Milverton Nursing Home 05/04/04

Milverton Nursing Home 27/01/04

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Milverton Nursing Home 99 Ditton Road Surbiton Surrey KT6 6RJ Lead Inspector Jon Fry Key Unannounced Inspection 22nd April 2008 10:30 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 Milverton Nursing Home DS0000026253.V361908.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. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milverton Nursing Home Address 99 Ditton Road Surbiton Surrey KT6 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) 020 8399 4663 F/P 020 8399 4663 milvertonhome@btconnect.com Surbiton Care Home Limited Margaret Mary Rea Care Home 23 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0), of places Physical disability over 65 years of age (0) Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide nursing care and accommodation to service users of both sexes whose primary care needs on admission to the home are within the following categories:Old age not falling within any other category (Category OP) (no more than 23 persons) Service users with a physical disability who are over 65 years of age (Category PD(E)) (no more than 23 persons) Service users with dementia who are over 65 years of age (Category DE(E)) (no more than 10 persons) The maximum number of service users who can be accommodated is 23 28th June 2007 2. Date of last inspection Brief Description of the Service: Milverton provides nursing care for up to twenty-three older people, ten of whom may have dementia. The home is in a residential area of Surbiton near to shops and public transport links. Accommodation is provided within a mixture of single and shared rooms on the ground and first floor. There is a passenger and stair lift in use within the home. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We spent just over nine hours in the home over two separate visits and spoke to nine people who live there, two visitors, the manager and three staff members. We looked at records and documents kept by the service including three people’s care plans. Completed surveys were received from five relatives or friends of people who live at the home and three care professionals. The service sent us an annual quality assurance assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. This also gave us some numerical information about the service. What the service does well: What has improved since the last inspection? Extensive building work is continuing to extend and improve the environment for people living there. A new manager is in post. Staff we spoke to were positive about the home and felt that things were improving. Medication is well managed. Care plans are being made more individualised. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Milverton Nursing Home DS0000026253.V361908.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 Milverton Nursing Home DS0000026253.V361908.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): 1 and 3. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available to people about the service. Assessments are completed before people move in and these are kept under review. EVIDENCE: One relative or friend of an individual said “I am very pleased that we chose Milverton – it has a warm human non-clinical atmosphere”. Another person said “a lovely happy homely atmosphere prevails”. Milverton has produced a Statement of Purpose and a user guide. These are supplied to individuals and their representatives and provide good information about living at the home. We have recommended that the user Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 9 guide be produced in other formats such as pictures and audiotape. It would be good to see photographs of staff, the home and local places in the guide. We looked at the records the home keeps for three people who live there. We saw that an assessment of each person’s needs is carried out so that the service knows what support the person needs. As at the June 2007 visit, some excellent information about individuals has been gathered in the ‘getting to know you better’ questionnaire in use. This needs to be used consistently for all new people coming to live at the home and the information gathered put into the care plans. Milverton Nursing Home DS0000026253.V361908.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): 7, 8, 9 and 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans now give better information about peoples needs but could be improved further. Medication is managed well by the service. EVIDENCE: Comments from the people who live there included “very kind and helpful”, “quite pleasant” and “I’m quite happy here”. Relatives or friends of individuals commented “they are always well dressed and clean”, “excellent nursing care” and “they deal efficiently and sympathetically with their medical and physical needs”. One care professional commented that people living there “appear settled and contented”. Another care professional said that they thought the home needed to do some more work with people who have little or no communication to make sure their individual needs and preferences are being met. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 11 We looked at three care plans. These have been improved since the June 2007 inspection took place and have been made much more individual. We discussed ways to make them more even more person centred with the manager and senior nurse on duty. For example, where a care plan says ‘has bath weekly’, this needs to be developed to say exactly when, where and how the person likes to take their bath. It may be helpful for staff to write care plans for themselves to see how they would like their care to be delivered if they were living there. Risk assessments are carried out and kept under review. This makes sure that all areas such as risk of falls, developing pressure sores and nutritional intake are looked at regularly. Daily notes kept by staff should continue to be looked at. We saw that some of these still contain very repetitive and general statements. Daily notes should not only record physical care but also people’s engagement with others and with activities. Again it may be helpful for staff to review their own notes in a meeting and see how they could capture better quality information. It is recommended that the home look at developing life story books with the people living there and these could then be shared with others. There is already some good information on record for some people but this needs to be accessible and in use. Life story work may also help staff to relate to people as individuals and encourage more interaction. Staff could also develop their own life story books as part of this process. Medication procedures have been improved and we saw that records are kept well. We have recommended that medication kept in boxes have the opening date recorded to allow for easier auditing if required. People we spoke to said that they were able to see the doctor or other healthcare professionals as required. Records are kept of these visits by the home. We highlighted one issue where food and fluid records needed to be kept more accurately for individuals. Milverton Nursing Home DS0000026253.V361908.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): 12, 13, 14 and 15. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers an adequate range of activities. This area needs to be developed particularly for people who have dementia. Mealtimes still need improvement to make them a positive occasion for everybody involved. EVIDENCE: Feedback from people who live there was mixed about the activities provided. Individuals said “I’d like to do more”, “could have more activities”, and “not much”. Other people said “we go out and we have had several entertainers” and “I’m never lacking in something to do”. Professionals who returned surveys said “I feel there needs to be more support with social needs” and “more activities should be considered – users are sometimes just sitting in the lounge”. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 13 The manager told us that the activities person would be increasing their hours to be at the home five days a week. This is positive and should be built upon so at least four to five hours of dedicated activity time is available for every day of the week. A programme of activities is in place and includes movement to music, bingo, card games and fun with hats. Other entertainment has included the pat a dog scheme, visiting entertainers and parties. The home could look at expanding this to include people helping in creative ways with more daily life activities such as cooking, cleaning, gardening and laundry. One person who lives there told us that they had already been helping with some gardening. We have strongly recommended that a suitable adapted vehicle be purchased for the home. This is already under consideration by the owners. On both days we visited, we saw people with dementia sometimes sitting for long periods without any interaction or engagement. This is an area that the service really needs to work on to make sure that everybody’s wellbeing is looked after. A staff member ideally needs to be in the main lounge area during the day and this person could then be spending quality time engaging with individuals. On the first day we visited, we saw the manager organising staff to provide some activities and this worked well to create interaction and engagement. The staff team could look at the routines in place and see if they could try different ways of working. This may help to increase time spent with individuals and ensure person centred rather than task based care. People at the home generally enjoy the food provided to them. Individuals said “the food is excellent”, “quite satisfied”, “a good cook” and “it’s ok – I never feel that I’m hungry”. One Relative or friends of an individual reported that the individual they knew “does not look forward to meals”. We watched the mealtimes on both days we visited the home. The food was served and people supported to eat where needed in a satisfactory manner but it did not feel like a social occasion. Exceptions to this were the manager sitting and eating with people in the dining room on the first day we inspected and two staff chatting while supporting people to eat on the second visit. The use of napkins rather than bibs is also very positive. Staff could try some different ways of working such as protected mealtimes, varying sittings, using serving bowls rather than plating meals and having staff eat with the people who live there. It may be helpful to have a staff member responsible for mealtimes who could look at how to make them positive social occasions for both the people living there and the staff. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 14 The menus should be developed in picture formats to make them as user friendly as possible. Buffets, finger foods and having snacks always available could be used particularly for people with dementia. Milverton Nursing Home DS0000026253.V361908.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): 16 and 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at Milverton can be confident their concerns will be listened to and acted on. EVIDENCE: A relative or friend of an individual said “the manager and the senior nursing staff have always been willing to discuss any worries I have”. The complaints procedure is on display in the hallway and is included in the user guide. There have been no complaints made since the last inspection. People we spoke to said they would speak to any of the staff or the manager if something was not right. A concern was referred to the Local Authority at the time of this inspection and this was looked into using Safeguarding procedures. The home co-operated fully with this investigation and the issues were found to have been dealt with appropriately by the service. Staff receive training in Safeguarding Adults and procedures are in place for reference. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 16 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): 19, 24 and 26. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home generally enjoy a satisfactory and clean living environment. There is still extensive building work going on at the home which makes it difficult to properly assess these Standards. EVIDENCE: It is still difficult to properly assess the environment with the large amount of building work going on. The extension to the rear of the property is near completion but building works will continue to alter and improve the main building. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 17 A relative or friend of an individual said the lounge is “very overcrowded – hopefully extension to building will improve situation”. Two people we spoke to talked about the disruption from the building work and how they were looking forward to getting back into the garden with their friend or relative. We saw that the lounge area can still become quite congested at times due to the limited space available. The extensive re-modelling should provide larger communal areas for the people living there when finished. Individuals we spoke to were happy with their bedroom accommodation and we saw that the home was kept very clean and hygienic. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are generally happy with the care they receive. Staff recruitment practices are good and individuals receive satisfactory training opportunities. EVIDENCE: People who live at the home were very positive about the staff who work there. Their comments included “so friendly”, “like real friends”,”they are nice to me”, “they really have looked after me” and ”always polite – very much so”. Relatives or friend of individuals said ”most of the staff appear to be very caring and sensitive to patients needs”, “the staff seem to be capable and efficient” and “the staff are very caring”. One person said “sometimes a bit overbearing”. The majority of people we spoke to said that they thought there were enough staff on duty to help them. The three staff members spoken to all felt that there were enough staff on each shift. As stated previously, we think that the activities provision at the home could still be improved upon. The routines in Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 19 place could be looked at to help staff spend more quality time with people in the lounge or individually. We looked at the documents the home has to have before new staff can start work, for three staff members. All the documents, including two written references, a Criminal Record Bureau (CRB) check, proof of identity and a full employment history were in place. In the AQAA, the home told us that all the staff working in Milverton, irrespective of their position, undergo mandatory training in moving and handling, infection control, food hygiene, fire safety and First Aid. We looked at records for three people and saw that recent training had included manual handling and Health and Safety. Planned training included infection control and resuscitation. We saw that one new staff member had received an induction to the home and a checklist completed for this. The service needs to make sure that the Skills for Care Common Induction Standards are used for each new staff member. We did not see these records when we visited. In order to support the development of the service, we have strongly recommended that care staff have more training around dementia, person centred care and care planning. The service should seriously consider including dementia training as mandatory for all staff. It is also recommended that the manager look at increasing the numbers of staff meetings. This may give more opportunities for the staff to discuss their practice and how the service could be developed. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 20 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): 31, 32, 33, 35, 36 and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well run. There are good arrangements to make sure that the health and welfare of people using the service is protected. EVIDENCE: A new manager has been in post since late 2007. Staff spoken to were positive about the changes in the service since the new manager started work. We saw the manager doing some really positive role modelling for care staff while we there. This is crucial to ‘set the scene’ for staff and communicate to them that social and emotional care is a very important part of their job. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 21 A system for staff supervision is in place. This means that staff meet with their manager to discuss their work. The staff we spoke to said that they had supervision and we saw that there were records kept of these sessions. The home had just sent surveys to individuals and their relatives or friends in to ask what they think of the service. Meetings are held with people living at the home and for relatives. Items discussed included food, transport and possible daytrips. Health and Safety is well managed and good records are kept of the regular checks carried out. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 22 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 X 3 X X 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 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 23 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 OP8 Regulation 17 (2) Requirement In order to make sure that food and fluid intake can be assessed properly when required, records kept need to be accurate and fully maintained. The manager must apply for registration with the CSCI. Timescale for action 01/07/08 2. OP31 CSA 2000 11 (1) 01/07/08 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 OP1 Good Practice Recommendations The user guide to the home should be made available in a variety of formats such as audiotape or pictures. Photographs of staff, the home and local places should be included in the user guide. The ‘getting to know you’ assessment format needs to be consistently used to make sure that good quality person centred information is captured. This should then be used to inform the care plan from when the individual moves in. DS0000026253.V361908.R01.S.doc Version 5.2 Page 24 2. OP3 Milverton Nursing Home 3. OP7 Other assessment documentation should be reviewed to make sure that good quality person centred information is being captured. The home should continue to look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. The plan in place should direct the care to be person orientated and less task based. Care plans need to give specific information about how the person likes the care and support to be delivered. Life story books should be developed with people living there. Care staff could also make their own books for sharing. 4. OP7 Daily notes need to be looked at to make sure that good quality useful information is being recorded. Care staff should review and discuss these in a team meeting. It is recommended that medication kept in boxes have the opening date recorded. The organisation should seriously consider further increasing the hours for activities in the home. All care staff should be responsible for the provision of social activities. The job of the activities co-ordinator could be changed to be more of an organisational / supporting role for care staff. 5. 6. OP9 OP12 7. 8. OP12 OP15 It is strongly recommended that a suitable vehicle be purchased for use by the home. Menus should be presented in user-friendly formats such as pictures or large print. Mealtimes could still be made a more positive occasion and an opportunity for people to interact. Practices such as protected mealtimes, varying numbers of mealtimes, using serving bowls, having more buffets and finger foods available and staff eating with people who live there should be considered by the home. 9. OP27 10. OP30 The routines in place should be reviewed to make sure that the care being delivered is person centred not task orientated. The focus should be to increase the time available for staff to interact with individuals. It is strongly recommended that all staff receive further DS0000026253.V361908.R01.S.doc Version 5.2 Page 25 Milverton Nursing Home training in person centred care and caring for people with dementia. This should cover person centred approaches, effective communication and the use of activities. Training in caring and supporting people with dementia should be mandatory for everyone working at the home. 11. 12. OP30 OP30 Induction for care staff should be mapped to Skills for Care standards. Staff meetings should be held at least monthly. This may encourage more reflection and discussion within the staff team. Milverton Nursing Home DS0000026253.V361908.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Milverton Nursing Home DS0000026253.V361908.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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