Inspection on 08/05/07 for Norton Court Nursing Home

This inspection was carried out on 8th May 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.

Other inspections for this house

Norton Court Nursing Home 25/11/08

Norton Court Nursing Home 30/05/08

Norton Court Nursing Home 30/05/06

Norton Court Nursing Home 07/11/05

Norton Court Nursing Home 24/05/05

Norton Court Nursing Home 13/10/04

Norton Court Nursing Home 20/05/04

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

CARE HOMES FOR OLDER PEOPLE Norton Court Nursing Home 2 Norton Court 201 Norton Road Stockton-on-Tees TS20 2BL Lead Inspector Jane Bassett Key Unannounced Inspection 8th May 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 Norton Court Nursing Home DS0000000192.V338048.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. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norton Court Nursing Home Address 2 Norton Court 201 Norton Road Stockton-on-Tees TS20 2BL 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) 01642 558234 01642 363858 www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mr Adrian Peter Webb Care Home 50 Category(ies) of Dementia - over 65 years of age (0), Mental registration, with number disorder, excluding learning disability or of places dementia (0) Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate up to 4 individuals who are aged 55 years or above with Dementia care needs. 30th May 2006 Date of last inspection Brief Description of the Service: Norton Court is a 50-bed care home providing both personal and nursing care for older people with mental health needs including dementia. It is a two- storey purpose built home providing single accommodation, 42 with en-suite toilet facilities. A passenger lift gives residents access to the first floor. There are 3 lounges and dining facilities that are available for residents as well as a patio area situated at the rear of the building. The home is situated approximately two miles from Stockton town centre and is close to local amenities, shops and public transport. The home provides a car park for use of visitors. The home currently charges fees £353 & £486 per week. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection report includes information obtained from a pre inspection questionnaire and two relative / visitor surveys received by CSCI. During the inspection the home was visited twice, the first visit was unannounced. During the visits, which lasted a total of nine hours the inspector walked around the building and looked at documentation including staff records and residents files. The inspector spoke to three residents, three family members, three staff members, and the manager. A short observational inspection was carried out to give an insight into the general well being of individuals and staff interaction with the residents. What the service does well: The home provides a friendly environment where all are made welcome. Staff were able to demonstrate a good knowledge of individuals and their care needs. Communication is good and all who spoke to the inspector said the home was well run. Comments received indicated the manager was open and approachable; he is a good listener who takes action about any concerns raised. Comments received included ‘our relative is really cared for beautifully by all the staff’, ‘the care is always spot on’ and ‘this is home from home’. Interaction between residents and staff was seen to be generally good. The inspector observed some very good examples of staff supporting residents in activities and socialising. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: There must be a consistent approach to assessments carried out prior to the admission of a resident. These must contain sufficient information to allow a judgement to be made as to whether the home can meet the individual’s needs. Work must continue to develop the assessment and care planning records to reflect individual’s current physical, health and social needs and how these are to be met. Plans of care must be regularly reviewed to meet changing needs and reflect consultation with resident and or their representative. The manager should ensure that all staff give support and assistance to residents in such a way as to promote the individuals preferences and dignity. Further work should be carried out in relation to a number of environmental issues identified during this inspection. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 7 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. Norton Court Nursing Home DS0000000192.V338048.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 Norton Court Nursing Home DS0000000192.V338048.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): Outcome for standard 3 was looked at. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective people who use the service and their representatives have the information needed to choose a home, which will meet their needs. The needs of prospective residents are usually fully assessed, however this is not always the case. EVIDENCE: During the inspection the files of two residents recently admitted were examined. One file was seen to contain sufficient information, including activities of daily living, medical health, mental health and social history of the resident. The file of the second resident contained no information from the authority funding the care and only limited information gathered by staff at the home. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 10 The manager described the normal procedure prior to admitting a new resident; this included obtaining information from other professionals, visiting the prospective resident and encouraging the resident and / or family to visit Norton Court. A group of relatives who spoke to the inspector confirmed that they had visited Norton Court prior to making a decision. They told the inspector they had been made to feel welcome and were given sufficient information. The home does not provide intermediate care. Norton Court Nursing Home DS0000000192.V338048.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): Outcomes for standards 7, 8, 9, & 10 were looked at. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is generally based on their individual needs. The principles of respect, dignity and privacy are usually put into practice. EVIDENCE: During the inspection four residents files were examined. One was seen to contain new documentation in relation to assessment and care planning. Information in this file was found to be comprehensive and included sufficient detail with regard to care needs and how these are to be met. The new documentation included cornel scale for depression in dementia, and capacity for consent to treatment /investigation. Other assessments included a dependency rating tool, nutrition, manual handling, falls risk, and general risk assessment. The file also contained evidence of discussion and agreement. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 12 The other three files contained plans of care, assessments and reviews however information was not always as comprehensive. It was also difficult to ascertain how current some information was as some documentation was not dated. There was no evidence of discussion and agreement seen in these three files. The manager told the inspector that it is hoped to transfer all information onto the new documentation by July 2007. All files contained daily records and evidence of contact with other health professionals such as GP’s. The home operates a Key worker system. Discussion with staff confirmed they had a good knowledge of individual residents needs and how these are met. The inspector was able to observe the interaction between staff and residents; this was seen to be generally good. A number of staff were seen to communicate well with residents, making eye contact and talking at a pace and pitch that was appropriate to the individual. However there were times when communication was limited and solely initiated by the resident’s requests. It was seen that three of the residents were wandering without shoes or slippers. Staff explained that one of these residents constantly removed footwear. The inspector observed the assistance residents were given to move from place to place. The majority of times this was done in such a way as to support and guide the resident, however on two occasions it was noted that the resident was being ‘lead’ by the staff member walking ahead of the resident, limiting the support and observation. Relatives who spoke to the inspector told her they were happy with the care their relative receives, comments included ‘the care is always spot on’ and ‘ our relative was looked after well when they were ill’. Other comments received included ‘our relative is really cared for beautifully by all the staff’ and ‘its good to see when there is real caring and understanding’. A random audit of the medication procedure identified no major concerns with ordering, storage and administration of medication. The home uses a blister pack system. Hand written entries on Medication Administration Records were seen to contain two signatures as recommended at the previous inspection. Staff confirmed medication is administered by qualified staff. Staff have access to an up to date BNF and pharmaceutical guidance. Norton Court Nursing Home DS0000000192.V338048.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): Outcomes for standards 12, 13, 14, & 15 were looked at. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service are generally offered the opportunity to make choices about their lifestyle. Social and recreational activities are made available. EVIDENCE: Whilst it was difficult to get direct feedback from residents the inspector observed a generally good interaction between residents and staff. The home employs a part time activities coordinator who works with small groups and individual residents. Staff told the inspector that due to the limited capacity and frailty of the residents activities were limited. Activities that do take place include bingo, games and some entertainment. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 14 Family members who spoke to the inspector told her that residents had especially enjoyed the activities at Christmas and Easter. Relatives also said they were always made to feel welcome and refreshments were always offered, one person said ‘ this is home from home’. They also spoke of the assistance staff gave to ensure their relative was enabled to attend a family wedding. The manager told the inspector it was planned that all information regarding individual residents social history and preferences would be recorded in the new documentation. Staff interaction with residents in the lounge area was seen to be generally reactive to resident’s requests and not proactive despite a continual staff presence. The home has a four-week menu offering a choice of meals. A lunchtime meal was observed. The meal offered was well presented, of a good quality and wholesome. Staff interaction was good. A number of residents required assistance with eating their meal. Staff were seen to sit with and communicate with the resident in an unhurried manner. The majority of residents appeared to enjoy the meal served, however a few were seen not to eat it. The inspector saw little or no evidence of an alternative being offered. It was noted that tablecloths and placemats are now being used at meal times as recommended at previous inspections, making it a more pleasant environment to eat in. Norton Court Nursing Home DS0000000192.V338048.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): Outcomes for standards 16 & 18 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service or their representatives are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. EVIDENCE: The complaints procedure is available to residents, relatives and staff. Relatives who spoke to the inspector confirmed they were aware of who to contact should they have any concerns. One family member told the inspector the staff and manager are approachable and ‘things get done’. Information in the pre inspection questionnaire stated the home had received 3 complaints in the last 12 months. The manager told the inspector that following investigation all were partially substantiated. Records seen confirmed complaints had been recorded and responses were given to complainants. Staff who spoke to the inspector were able to demonstrate through response to questions the action they would take in relation to any concerns identified. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 16 The manager of the home has in the past demonstrated appropriate responses to concerns raised. Evidence seen indicated staff have received training in relation to prevention of abuse and the ‘no secrets’ guidance. Information leaflets about elder abuse were seen to be available to both staff and relatives. Norton Court Nursing Home DS0000000192.V338048.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): Outcomes for standards 19 & 26 were looked at. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, generally well maintained and comfortable environment. EVIDENCE: On the day of inspection the home was found to be generally clean, tidy and odour free. An unpleasant odour was noted in one bedroom, the manager told the inspector that he was to have discussions with the family about a more appropriate flooring. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 18 A number of areas have been improved, the hall way, ground floor lounge and a number of bedrooms have been decorated. The home has purchased new shower chairs, action has been taken to replace broken toilet seats, rusting waste bins and lounge curtains. Weeds have been removed from the guttering. A new call bell system has been fitted. The home has also provided new furniture in the majority of the bedrooms, however it was seen that handles had broken off some of the wardrobes and cabinets. The manager told the inspector the handles are to be replaced. It was also noted that a number of bedroom curtains were missing hooks leaving curtains hanging away from the rail, some beds had no valance exposing the plastic base to the divan and a large number of pillows were lumpy. Bath and shower rooms were seen to looking old and worn with marked paintwork, tiles and flooring. Action should also be taken in relation to the following ●Flooring to one ensuite toilet where it was seen to have bubbled and lifted away from the floor. ●Refurbishment of bathing and shower rooms, ● Water damage to the ceiling and wall of ground floor bedroom. ● No head board in one bedroom, ● Damage to door and frame to one first floor bedroom. ● Missing boxing in to pipe work and snapped light cord in one toilet. ● Missing cushions to 3 armchairs in first floor lounge. Norton Court Nursing Home DS0000000192.V338048.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): Outcomes for standards 27, 28, 29, & 30 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who currently use the service. EVIDENCE: During discussion with staff and relatives the inspector was told staff are busy, however there are sufficient staff to meet the needs of the residents. A staff rota was seen, which met the levels of staffing as laid down by Four Seasons Health Care. The rota indicated that there was always one first level nurse on duty, however they did not always have a mental health qualification. Eight members of staff, including some of the qualified nurses, have completed dementia awareness training, further training is planned. All staff have access to a dementia care manual. The inspector was given to believe that staff can meet the needs of the current residents. The home must ensure that staff qualifications and training are taken into account when new residents are to be admitted. The inspector was told that one resident was receiving one to one care between the hours of 8am and 8pm. Staff who spoke to the inspector confirmed this was the case, however it was not possible to identify who was allocated this role from the staff rota. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 20 Information gathered from the pre inspection questionnaire, staff records and documentation seen indicated staff have received training in relation to prevention of abuse, fire safety, moving and handling, safe handling of medication and documentation and record keeping. Other staff have completed diabetes awareness. Eye care training was planned to take place the day after the inspection. 50 of care staff have completed NVQ at level 2 or above. The cook is currently working towards level 3 in food hygiene. The inspector looked at a file of one member of staff who had been recently recruited. This was found to contain all the appropriate documentation including CRB, references, interview record sheet and induction training. Norton Court Nursing Home DS0000000192.V338048.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): Outcomes for standards 31, 33, 35, 36, & 38 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems. EVIDENCE: The manager of the home is a first level general nurse with a number of years experience with this resident group. He is currently working towards the NVQ 4 in management. All staff and relatives who spoke to the inspector told her the manager was open and approachable. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 22 Comments received from relatives included ‘we are kept informed’ and ‘nothing is to much trouble’. The manager carries out regular audits on medication, care plans and accidents. Regulation 26 visits take place and reports were made available. The manager has also to complete a 3 monthly team audit that looks at all aspects of the service provided. Staff told the inspector handovers take place at the start of each shift, there are regular staff meetings and monthly supervision. Documentation seen during the inspection indicate accidents are recorded appropriately, hot water temperatures and fire alarms are checked and recorded. The home continues to use a joint bank account for the retention of resident’s personal monies, however individual computerised records are maintained for each person. Information in the pre inspection questionnaire indicated maintenance of the home and equipment takes place as required. Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 23 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 2 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 3 X 3 Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 24 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 OP2 Regulation 14 Requirement A full assessment of need must be carried out for each prospective resident to ensure the home can meet their needs. Work must continue to ensure that resident’s needs are assessed and plans of care developed that demonstrate how care needs are to be met. Timescale for action 01/08/07 2 OP7 15 01/08/07 3 OP7 15 4. OP19 23 Plans of care must be regularly 01/08/07 reviewed and contain evidence of discussion and agreement with the resident and / or their representative. 01/10/07 Action must be taken in relation to the following; ● Flooring to one ensuite where it has lifted from the floor. ● Water damage to ceiling and walls in one bedroom. ● Damage to door and doorframe to bedroom. ● Missing in boxing to pies and snapped light cord in toilet. The home must ensure that staff including qualified nurses have the appropriate qualifications DS0000000192.V338048.R01.S.doc 5. OP27 18 01/10/07 Norton Court Nursing Home Version 5.2 Page 25 and training to meet the needs of existing residents and any residents to be admitted to the home in relation to mental health and dementia care. 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 OP10 OP12 OP15 OP19 Good Practice Recommendations The manager should ensure that all staff give support and assistance to residents in such a way as to promote the individuals preferences and dignity. Details of resident’s social history and preferences should be recorded within plans of care. Residents should be offered an alternative to the main menu. Action should be taken in relation to the following. ● Missing handles from bedroom furniture ● Curtains hanging from rails without hooks. ● Lack of valances to beds with plastic covered divans ● Lumpy pillows ● Missing headboard. ● Refurbishment of bathing facilities. The manager should continue to work towards obtaining his management qualification. Individual bank accounts should be obtained for residents. 5. 6. OP31 OP35 Norton Court Nursing Home DS0000000192.V338048.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Norton Court Nursing Home DS0000000192.V338048.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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