Inspection on 27/07/06 for Overbury House Nursing & Residential Home

This inspection was carried out on 27th July 2006.

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

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

Other inspections for this house

Overbury House Nursing &... 15/07/09

Overbury House Nursing &... 14/02/08

Overbury House Nursing &... 05/03/07

Overbury House Nursing &... 26/10/05

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

CARE HOMES FOR OLDER PEOPLE Overbury House Nursing & Residential Home Staitheway Road Wroxham Norwich Norfolk NR12 8TH Lead Inspector Hilary Shephard Unannounced Inspection 27th July 2006 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 Overbury House Nursing & Residential Home DS0000065678.V306283.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. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Overbury House Nursing & Residential Home Address Staitheway Road Wroxham Norwich Norfolk NR12 8TH 01603 782985 01603 783425 admin@overburyhouse.healthcarehomes.co.uk 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) Healthcare Homes Limited Mr Robert Buttifant Care Home 50 Category(ies) of Dementia - over 65 years of age (50) registration, with number of places Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: Overbury House provides nursing and residential care for up to 50 elderly people who have been diagnosed with a dementia. The home changed ownership in August 2005 and is now owned by Healthcare Homes Limited. The home is a large detached building of traditional design with a number of modern extensions that have been added over the years. Further work is currently underway adding more bedrooms to the existing building. The resident’s accommodation is located on the ground and first floors. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgments for each outcome group. A total of 12 requirements were made as a result of this visit. Following a letter received from Healthcare Homes, amendments have been made to the content of this report regarding moving and handling and environment. What the service does well: What has improved since the last inspection? Some improvements have been carried out to the interior décor, particularly in the lounges. Staffs training opportunities have improved and they have recently undertaken moving and handling training, however from observations made during the Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 6 visit this has not been effective for one member of staff. Some staff have also achieved NVQ2 and 3 qualifications. What they could do better: Healthcare Homes bought the home in August 2005. They have recognized the areas where residents are receiving a poor quality of service and are currently addressing these. Care planning had deteriorated since previous visits to the home. Residents’ full range of needs are not identified, addressed or reviewed. Staff still need dementia care training and the manager advised this is planned for September 2006. Staff are still not having formal supervision. The way some residents are being offered choices regarding food and wearing protective clothing during meals has deteriorated since the last visit to the home. Medication is administered safely but there were some missing signatures on the administration records. Medicines are not being booked in on the medication administration records making it difficult to keep track of medicines received and administered. There are not enough staff on duty at key times to meet the residents emotional and social needs. This visit showed staff have been employed without being thoroughly vetted before hand. Recruitment practices were good at previous visits. The physical layout and design of the homes interior is not helpful to residents, it does not make the most of their abilities or help them to function in the way they are used to and access to the garden and other areas in the home is restricted. Some communal areas are not very comfortable or homely. The interior of the home has not been developed to meet the specific needs of people with dementia, however Healthcare Homes advise that the physical layout and design of the home has benefited from considerable expenditure since the previous inspection. Some carpets and flooring were stained and damaged and one bedroom smelled unpleasant. The manager advised these areas were being addressed. Although the regional manager regularly visits the home and monitors quality, there has not been any formal quality monitoring with residents and their relatives and it is not clear how they are involved in the way the home is run. The manager needs to handle relatives complaints and concerns better. Overbury House Nursing & Residential Home DS0000065678.V306283.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. Overbury House Nursing & Residential Home DS0000065678.V306283.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 Overbury House Nursing & Residential Home DS0000065678.V306283.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality in this outcome area is good. Residents benefit from having their needs assessed by the home before admission and because the home uses some of the information gathered as part of care planning. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The previous visit in October 2005 found that the manager visits prospective residents and their families before admission. The visit of 27 July 2006 found this had not changed and sometimes one of the deputy managers visits residents before admission on behalf of the manager. Information gathered at these visits is used as part of the assessment process in residents care plans. Case tracking at the July 2006 visit showed that a new resident had their needs briefly assessed before admission and most information had been used in the care plan. Overbury House Nursing & Residential Home DS0000065678.V306283.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is poor. The outcome of this group of standards will be good when the home implements new care plans and could be good if staff had a better understanding of how to care for peoples emotional and social needs. Residents care is compromised by poor care plans and by staff lacking the knowledge of how to deliver good care to people with dementia. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The last two visits in May and October 2005 found care plans had identified, reviewed and were meeting residents care needs. Care plans were looked at during the July 2006 visit as part of case tracking. The information contained in these was basic and brief and did not address the residents social or emotional needs and only some had been reviewed. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 11 Care plans were based on residents physical care needs and omitted any kind of life history making it difficult for the home to care for the resident’s whole range of needs. There was little evidence to suggest that residents or relatives had been involved in their care plans. Requirements have not been made regarding care plans because a new system is about to be implemented. Care staff continue to have a good understanding of residents physical needs as observed at previous visits but the July 2006 visit showed that not all staff are good at meeting residents emotional, social or specific dementia care needs. One resident was seen to be smartly dressed in a suit and it was clear that she liked to be dressed that way. Observations made at the July 2006 visit showed some residents with very complex mental health needs that staff were having difficulty addressing. Another resident had significant needs regarding moving and handling but his care plan omitted reference to this and staff were observed using incorrect techniques to move him. A requirement has been made regarding moving and handling. Some residents’ beds had rails fitted. The care plan of one of these residents was checked and omitted a risk assessment for the safe and appropriate use of bed rails. A requirement has been made under Standard 38. The visit carried out in October 2005 showed that the nurses safely administered medication. The July 2006 visit showed little change to the way medication is managed. Medication administration records (MAR) were difficult to audit because medicines received were not being entered on the MAR sheets and one medicine did not tally with the records. Some gaps were noted on one record sheet where staff had omitted to sign for medicines given. Because the regional manager is about to implement an audit system no requirements have been made regarding medication. Overbury House Nursing & Residential Home DS0000065678.V306283.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home gave residents more choices in ways to suit their abilities, consulted with residents and provided activities that they wanted, enjoyed and could participate in and provided better interaction and stimulation to residents. Residents’ emotional and social needs are not being addressed or met in ways that suit them and not all residents are being enabled to make choices. Staffing levels are too low to provide residents with enough stimulation and meaningful occupation tailored to their individual needs and care plans fail to address these areas. This judgement has been made using available evidence including a visit to the service. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 13 EVIDENCE: The previous visit in October 2005 showed the activities coordinator and care staff provided a good range of activities. The July 2006 visit found the activities coordinator was on holiday and little interaction between residents and staff was observed throughout the day. Staff were only able to describe how they cared for residents physical needs. One staff had been taking residents out for walks during the afternoon. One resident became increasingly distressed, agitated and aggressive during the afternoon and staff found it difficult to give her the attention she required because they had to attend to others. Good practice was observed whilst staff were feeding residents, as this was being done in a gentle and respectful way. Good practice was also observed with another resident who had forgotten she had eaten. Although staff knew this they offered her a second meal, which she enjoyed. Previous visit in October 2005 showed residents were offered and encouraged to make choices and these were visual choices as well as verbal and written. The July 2006 visit showed that the food was good, but there remained a lack of choice regarding the evening meal, which had not improved since the last visit. Some residents were given blue plastic aprons to wear during meals without being asked. Requirements have been made regarding activity provision, decision making and repeated regarding the evening menu. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home followed safe recruitment practices and the manager had a more professional way of managing peoples concerns. Residents care is compromised by poor recruitment practices. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The visit carried out in July 2006 found little change in the way complaints are handled. Staff said they would report any issues of concern to one of the nurses or the manager, however, evidence gathered over the past two years indicates that complainants have not always found the manager to be very open or approachable regarding their concerns. Staff files showed the home was failing to follow proper recruitment practices and this has been explored further under “Staffing.” A requirement has been made regarding managing concerns. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 26 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home provided an environment that met the needs of people with dementia. Residents are not being provided with an environment that makes the most of their remaining capabilities and capacity. This judgement has been made using available evidence including a visit to the service. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 16 EVIDENCE: Last full inspection visit in October 2005 found that the home was comfortable but several areas needed redecorating. The July 2006 visit found a lot of building work going on at the front and back of the home with part of the back garden fenced off. The environment was difficult to assess in depth because of all the building work and changes going on, however, signage wasn’t very clear throughout the home, residents names on their bedrooms doors were very small and difficult to see, some of the toilets were not labeled and the bedroom en suite doors looked the same as the doors to integrated wardrobes. One bedroom was not suited to the needs of the resident living there and although staff had a good understanding of this persons needs, his room had not been adapted to make the best use of his remaining abilities. Access to some areas within the home is restricted by the use of coded keypads and this was causing one resident significant distress. Residents are unable to access the garden without being accompanied. Residents are able to access their rooms on the ground floor and the first floor is accessible via a lift. Currently agency staff are doing a lot of the cleaning work and the home was clean except for an unpleasant odour in one bedroom. Because the manager plans to replace carpets, no requirements have been made. A requirement has been made regarding providing an environment that meets the needs of the residents. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is poor. The outcome of this group of standards could be good if the home followed safe recruitment practices, trained staff in dementia care, provided enough staff to meet the needs of the residents and made sure any training provided has been effective. Residents are not receiving the care they require because there are not enough staff available at key times, staff have not undertaken specialist dementia care training and some are using poor moving and handling techniques. Residents safety is at risk because of the homes poor recruitment practices and moving and handling techniques. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Evidence gathered from previous visits to the home indicates there have been problems maintaining adequate staffing levels which have only improved following intervention from the Commission. The July 2006 visit found that there were not enough staff available at key times to meet the residents whole range of needs and a significant number of agency staff were being employed. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 18 The visit in May 05 showed adequate recruitment procedures in place however staff files seen at the July 2006 visit showed this not to be the case as 2 staff had been employed without having been thoroughly vetted. Visits in May and October 2005 found staff had not received dementia care training as part of induction and the July 2006 visit found some staffs knowledge about providing good dementia care was limited although they all seemed to be very caring and interacted with residents in a kind and gentle way. One new member of staff confirmed they had completed general induction training with a senior member of staff. Because the manager has planned dementia care training, no requirement has been made. The manager advised that 6 care staff have almost completed NVQ2 and one had completed NVQ3. 11 staff did moving and handling training in June 2006 however observations made during the July 2006 visit showed one staff member was not using proper moving and handling techniques. Staff said they thought the training opportunities had improved greatly since the new company had bought the home. A requirement has been made regarding staffing levels and recruitment practices. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home involved residents and relatives in how the home is run, if the manager completed dementia care training, if staff had regular supervision sessions and if bed rails were used safely and appropriately. Residents and relatives have not been given the opportunity to become involved in the service, their care is compromised because the manager has not undertaken dementia care training and staff have not had regular supervision, however, residents do benefit from a safe environment with the exception of a lack of risk assessments for bed rails. This judgement has been made using available evidence including a visit to the service. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 20 EVIDENCE: The current manager has been in post since 2003 with a few months break in service in 2004. He is a qualified Mental Health Nurse and achieved a Diploma in Management in 1986. He has not yet undertaken specialist dementia care training but the owners are addressing this. The home was taken over by Healthcare Homes in August 2005 and the manager has been involved in many changes in the way the home is managed. A regional manager visits the home at least monthly and undertakes quality monitoring at these visits. The visit carried out in May 05 found the home to be well managed but staff supervision was not taking place, staffing levels were too low and staff were not receiving dementia training in their induction. The previous visit in October 2005 found these areas had improved significantly, but care staff were still not receiving supervision. The July 2006 visit shows that these areas have deteriorated. Staff said they have not had any regular supervision sessions and would really appreciate this. The May 05 inspection showed there to be a quality monitoring system in place and results of this were displayed. The July 2006 visit found no survey had been completed and no available evidence to suggest that residents and relatives are being involved in how the home is being run. Information received by the Commission from the home in July 2006 indicates that staff have recently had fire training, fire drills are being carried out, fire equipment is regularly serviced and the home is completing weekly fire alarm checks. The building was checked for safety at the July 2006 visit and there were no areas of concern. Residents were kept away from the building work. Requirements have been made regarding the manager updating his dementia knowledge, quality monitoring, supervision and bed rails. Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 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 2 17 X 18 2 2 2 X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 1 X 2 Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? One 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 13 (5) Requirement The registered person must ensure that suitable arrangements are in place for the moving and handling of all residents. The registered person must ensure that residents are consulted with about their preferred activity, social and occupation provision and must ensure all residents are enabled to participate in their chosen activity/occupation. Residents must be provided with suitable emotional and social care appropriate to their needs. The registered person must enable and assist residents to make choices about the care they receive. The registered person must review the teatime menu to ensure a variety is offered to residents. Repeated, deadline of 30/11/05 not met. Timescale for action 31/08/06 2. OP12 16 (2, m, n) 31/10/06 3. OP14 12 (2) 31/10/06 4. OP15 16 (2,i) 31/10/06 Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 23 5. OP16 10 (1), 22 (1) 6. OP19 23 (1a) (2a, n) 18 (1a, b) 7. OP27 8. OP29 19 Schedule 2 9. OP31 10 (3) 10. OP33 24 (1, 3) 11. 12. OP36 18 (2) 13 (4c) (7) OP38 The registered person must ensure that the handling of complaints and concerns is conducted in a professional manner. The registered person must ensure the physical layout and design of the environment meets the needs of the residents. The registered person must ensure that at all times of the day and night suitably qualified and competent staff are provided in such numbers to meet the needs of the residents. A minimum of 1 care staff to 5 residents should be provided during the day. The registered person must not employ anyone unless full and satisfactory information is available about them as detailed in Schedule 2 of The care Homes Regulations 2001. The registered manager must update his knowledge to ensure he has the skills necessary for managing the care home. The registered person must ensure that the quality monitoring system includes appropriate consultation with residents and their representatives. The registered person must ensure that staff are appropriately supervised. The registered person must ensure that bed rails are only used to promote residents’ welfare and safety and full and accurate risk assessments are completed and reviewed as necessary. 31/10/06 31/10/06 31/10/06 31/08/06 31/12/06 31/10/06 31/10/06 31/10/06 Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Overbury House Nursing & Residential Home DS0000065678.V306283.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!