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Inspection on 26/06/07 for Parkhill Nursing Home

Also see our care home review for Parkhill Nursing Home for more information

This inspection was carried out on 26th June 2007.

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

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

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

What the care home does well

What has improved since the last inspection?

Training is seen as very important by the management team of the home and since the last inspection visit staff have undertaken various courses of training to make sure that they have the skills and knowledge to care for the residents in the best way possible. Improvements have taken place in the home that include a new central heating boiler, new carpets in the ground floor lounges and the refurbishment of a bathroom, including a new bathroom suite.

What the care home could do better:

Watching how staff supported residents during the inspection visit showed that residents are looked after well. However, care plans did not always identify the care being given in practice, as they were not detailed enough. Although most care needs appeared to be identified in the care plan, sometimes how those needs were to be met by staff was not. Information must be clear about how assistance is offered/given to residents in order that staff can look after and monitor residents in the most appropriate way. Policies and procedures in respect of medication administration need to be followed more rigorously to ensure the safety of residents.

CARE HOMES FOR OLDER PEOPLE Parkhill Nursing Home 319 Huddersfield Road Stalybridge Tameside SK15 3EP Lead Inspector John Oliver Unannounced Inspection 10:00 26th June 2007 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 Parkhill Nursing Home DS0000025448.V337107.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. Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkhill Nursing Home Address 319 Huddersfield Road Stalybridge Tameside SK15 3EP 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) 0161 303 8643 0161 338 6910 parkhillcare@btinternet.com Belmont Parkhill Limited Mrs Christine Holland Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability (10), Physical disability of places over 65 years of age (38) Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Services Users to include up to 38 PD(E), up to 38 OP and up to 10 PD. The registered manager to be supernumerary for 27 hours per week. A minimum of 238 qualified staff hours to be deployed per week. No more than 10 service users to be admitted who are between the ages of 39 and 65 years. 17th March 2006 Date of last inspection Brief Description of the Service: Parkhill Nursing Home is a late Victorian building with a purpose built extension, situated on Huddersfield Road, a short distance from Stalybridge town centre. The home provides nursing care for up to 38 service users and provides within that figure for a small number of younger adults who are disabled or service users who require personal care only. Accommodation is provided over three floors in primarily single rooms, although a number of shared rooms are available. Some rooms have en-suite facilities. Lounge and dining areas are available on each floor, in which service users can socialise and participate in activities taking place within the home. In addition, there is access to patios and garden areas with open views of the surrounding countryside. Fees start at £443:75 for nursing care and £323:66 (personal care only). Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection, which took place over a six – hour period on 26 June 2007. During the course of the inspection time was spent talking to residents, members of staff, visitors to the home and the registered manager. Other information was also used to produce this report. This included information provided by the registered manager in the Pre-inspection questionnaire that had been returned to the Commission for Social Care Inspection prior to the inspection being carried out. Time was spent examining records and some policies in the home and a tour of parts of the premises was also carried out. At the time of this inspection visit 30 people were living in the home. Residents and relatives spoke very highly of the services received in the home and of the support offered by the staff. Both the staff and management team demonstrated a positive approach to their roles and tried to ensure that residents were consulted about important matters including the way in which they wanted their care to be given. What the service does well: Daily routines in the home are very flexible, which allows the people living in the home the freedom to choose what they do and when they do it. Residents and visitors were very complimentary about the home, staff and management team. Comments from relatives and visitors seen on the day of the inspection visit included: * * * * “I am kept fully informed about mum’s health – she recently had new glasses”. “I have been here when medication is given out so I know mum gets hers”. “This is a brilliant home with a really nice atmosphere”. “Excellent team of staff here – I can’t fault it”. DS0000025448.V337107.R01.S.doc Version 5.2 Page 6 Parkhill Nursing Home Comments from residents seen on the day of the inspection visit included: * * * * “I really enjoy my food – it was lovely”. “The staff here are lovely – nothing is too much trouble” “I wouldn’t want to live anywhere else”. “If I had a complaint (and I don’t) I would speak with the manager – she is very nice”. The home is maintained to a very high standard, which helps to make it comfortable and homely for the residents. The grounds are also maintained to a high standard with pleasant seating areas at different points in giving residents and their visitors’ opportunities to enjoy the views of the surrounding countryside. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. 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. Parkhill Nursing Home DS0000025448.V337107.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 Parkhill Nursing Home DS0000025448.V337107.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective residents are fully assessed before admission into Parkhill. EVIDENCE: Those care files examined included evidence that full assessments of need had been carried out by the placing authority (Social Services) and by the home before any admission into the home took place. Where relatives are involved in the admission of a new resident they are asked to complete social histories for their relative in order to give staff background details about the resident’s previous lifestyle and to help staff maintain the individuality of the resident. Discussion with a number of staff confirmed that when a new resident was admitted into the home all information that had been provided about the Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 9 person was fully discussed and from this information a care plan was developed. The home operates a key worker system so that residents and relatives have a point of contact and to maximise continuity of care. It was confirmed by the manager that Parkhill does not offer the facilities of intermediate care. Parkhill Nursing Home DS0000025448.V337107.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs were assessed and met. However, procedures for the administration of medication were not always followed which could place residents health at risk. EVIDENCE: Each resident had a detailed plan of care and examination of a selection of care plans demonstrated that some improvements had been made in the way in which meeting the resident’s needs had been recorded. Care plans contained a lot of information about the assessed needs of the individual resident and also linked risk assessments that had been carried out regarding such things as the risk from falls, moving and handling and, poor dietary intake. Since the last inspection visit in March 2006 the key worker role in the home had further developed and it was seen that the care plans and Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 11 risk assessments examined on the day of this inspection visit had been reviewed on a monthly basis. It was noted however that some statements written in care plans such as “offer assistance with bathing” was not enough when compared to the information detailed about the person needs in the assessment and moving and handling risk assessment relating to bathing. Lack of such information could place the resident at risk of their needs not being met in the most appropriate way. There was evidence that those care plans seen had been reviewed on a monthly basis and that discussions about them had taken place with either the resident and/or their representative. Information seen on files confirmed that other health care professionals such as GP’s, Chiropodist and Opticians were involved in maintaining the health of individual residents. Comments from one relative spoken to during this visit included: “I am kept fully informed about mum’s health – she recently had new glasses”. Medication Administration Records (MAR) were examined on the first floor of the home. Residents are identified prior to medication being administered to them by the use of photographs attached to the MAR. Staff with the responsibility for medication administration could be identified by the means of a staff signature sheet, which is also located in the MAR file. It was noted on one particular resident’s MAR that a variable dose of medication had been prescribed where one or two tablets could be administered as and when required. However, when this medication had been administered, the actual number of tablets given had not been recorded. This could place the resident at risk. The details on a number of MAR had been handwritten. These details had not been signed, dated or checked by an additional member of staff. This could place the resident at risk of the wrong details being recorded about the administration of medication. One resident had been prescribed medication that should be administered once daily. On checking the MAR it was recorded that 28 tablets were received into the home on 15/06/07. On the day of this inspection visit 16 tablets should have been left in the pack. On checking the amount it was found that 22 tablets were still left in the pack – demonstrating that someone had signed for Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 12 the medication but had not actually administered it. This could place the individual’s health at risk. Two residents were noted to be on Controlled Drugs and the administration of these was checked. Both the administration documentation and quantities of medication were found to be correct. The relative of one resident said: “I have been here when medication is given out so I know mum (and others) get hers”. Parkhill Nursing Home DS0000025448.V337107.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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily routines in the home demonstrated that residents were encouraged to maintain control over their lives, were encouraged to maintain contact with the community and are provided with a wholesome and well balanced diet. EVIDENCE: Routines in the home appeared flexible and allowed people the freedom to choose what (if any) daily activities they participated in. The home’s administrator is also an experienced activities organiser and has a number of hours allocated per week in which he can organise and plan suitable and requested activities for people living in the home. Available activities were advertised around the home and included: chairobics, reminiscence, sing-along and, ‘Sonas’ sessions. Residents with mild to moderate dementias are encouraged to attend the ‘Sonas’ sessions as they involve using senses such as touch, smell and sight and a range of relaxation Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 14 therapies. Residents are also encouraged to make use of in-house facilities such as the hairdressing room/visiting hairdresser. Ministers from the local churches visit the home on a regular basis and other visitors to the home commented that they were always made to feel welcome at any time and “(this is a) brilliant home with a really nice atmosphere”. Comments in the visitor’s book also included: “Nice to be met at the door with a smiling face”. Meal times were seen as an important part of the day. The lunchtime meal was a relaxed and social occasion. Residents spoken to were complimentary about the meals served and one resident said, “I really enjoy my food – it was lovely”. An opportunity to discuss meal times with a regular visitor to the home offered the following comments: “Since coming to live here mum has put on weight (she needed to)”, “I know everyone is offered choice because they (the cook) brings around the menus to ask what they (the residents) want”. “I know if mum asked for something they try to accommodate”. Parkhill Nursing Home DS0000025448.V337107.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and training measures were in place for staff to support residents to raise any issues of concern and to protect residents from neglect and abuse. EVIDENCE: The complaints procedure is displayed in the reception area of the home and the manager confirmed that a copy is given to residents and /or their representative on admission to the home. Information is provided in the form of a leaflet, which is detailed and includes the name and telephone number of the Commission for Social Care Inspection. One resident spoken to said: “If I had a complaint (and I don’t) I would speak with the manager – she is very nice”. A record of complaints is kept and the last one recorded was dated 07/06/07 and was made by the daughter of a resident. Although the record confirmed that the complaint had been concluded the details were not very clear. It is recommended that the complaints record include: the details of the complaint, the investigation process, the outcome of the investigation and the conclusion, which should also be signed and dated. Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 16 The Commission for Social Care Inspection had received no complaints since the last inspection visit in March 2006. Evidence was available to show that the registered manager had undergone training in Safeguarding Adults and that ongoing training in this subject was taking place with staff who work in the home. The manager also confirmed that no allegations of abuse had been made since the last inspection visit to the home in March 2006. Parkhill Nursing Home DS0000025448.V337107.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): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are provided with an environment that is clean, safe and comfortable to live in. EVIDENCE: A tour of the home provided evidence that an on-going programme of refurbishment and maintenance was being carried out. Those bedrooms seen were furnished to a high standard and the way rooms had been personalised reflected the character of the individual resident whose room it was. Since the last inspection visit it was confirmed that a new central heating boiler had been fitted, a new carpet had been fitted in the ground floor lounge and a bathroom had been refurbished, including a new bathroom suite. Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 18 It was noted however that a number of doors were not closing into their rebates properly and as some of these doors could be fire doors it is strongly recommended that an audit of all doors be carried out and adjustments made where necessary to ensure the safety of the people living and working in the home. The maintenance person had recently left their employment with the home and the manager was in the process of recruiting a suitable person to this post. This was to ensure that daily maintenance of the premises such as replacing light bulbs etc. could be maintained. The cleanliness throughout the home was seen to be of a very high standard and no unpleasant odours were detected anywhere in the building. The grounds surrounding the home were also very well kept with lots of plants in baskets and tubs. A very pleasant and safe patio area is also available for residents to use and other garden furniture has been placed at different points in the grounds giving residents and their visitor’s opportunities to sit and enjoy the views. The laundry area was sited away from the kitchen area and was appropriate to meet the needs of the people living in the home. Parkhill Nursing Home DS0000025448.V337107.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): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff are employed in the home with staff training and development helping to ensure staff are competent to carry out their jobs. A robust recruitment and selection process helps to protect residents from unsuitable people working in the home. EVIDENCE: Observation of staffing levels during this visit to the home and the examination of staffing rotas provided sufficient evidence to demonstrate that residents’ needs were being met by an appropriate number of staff. Staff training records and discussion with staff on duty confirmed that regular training took place and that the majority (65 ) of care staff hold the National Vocational Qualification (NVQ) Level II. Discussion with one visitor offered the following comments about staff working in the home: Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 20 “Although staff are always very busy they remain very nice and they keep me informed about mum’s health” and “Excellent team (of staff) here – I can’t fault it”. Discussion with one member of staff offered the following comments: “We always have enough staff on duty – the managers are always out and about and will help us if needed”. During a discussion with one resident the following comment was made: The staff here are lovely – nothing is too much trouble”. Policies and procedures are in place for the recruitment of staff and the files of the latest members of staff to be employed in the home were examined. All necessary documentation was in place and all pre-employment checks had been satisfactorily carried out before the individual started work. Such thorough pre-employment checks helps to safeguard residents from unsuitable people being employed to work in the home. Parkhill Nursing Home DS0000025448.V337107.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): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living in the home benefit from having the support of a manager with skills to provide a good quality service and procedures in place to promote their interests and well-being. EVIDENCE: The residents living in the home benefit from a committed team of staff and because staff turnover appears to be low that helps to provide continuity in meeting care needs. The manager operates an open management style, and encourages both residents and staff to make use of this ‘open door’ policy. Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 22 There is a very clear management structure within the home and comments from staff included: “Good management team – any problems get sorted – we have regular staff meetings” and “I get my 1 – 1 supervision”. The management team of the home carries out a regular Quality Audit of the service by using questionnaires that are sent to residents and their families/representatives. However, the manager said that response to this type of audit is not always good but one member of staff also confirmed “We (the home) have lots of support from families”. The manager confirmed she found that both the resident and staff meetings held in the home gave her more information about how the service was/was not meeting resident’s needs and used the information gathered from these meetings to develop an ‘action plan’. There was evidence that the registered provider visits the home on a regular basis and provided support to the manager and management team. It is the policy of the home to support and encourage residents to manage their own finances for as long as possible. Most residents had the support of their relatives to manage personal allowances and only a small amount of money was held by the home for which written records of all transaction carried out are kept. The manager confirmed that all Health and Safety policies and procedures were reviewed on a regular basis and were kept up to date. Information provided by the manager prior to the inspection visit taking place confirmed that all equipment used in the home was regularly maintained and serviced and records were kept. A random selection of these records were examined and were found to be in order. Parkhill Nursing Home DS0000025448.V337107.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 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 3 X 3 X 3 3 X 3 Parkhill Nursing Home DS0000025448.V337107.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 OP9 Regulation 13 (2) (4) (a) Requirement Ensure that all medication is administered to residents in exact accordance with the prescribers’ directions. Medication records must be completed to accurately evidence the amount of medication administered to a resident. Timescale for action 30/07/07 (b) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations It is recommended that information contained within a care plan on how assistance is to be provided to a resident be more specific than just a statement saying “assistance to be given”. Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 25 2 OP9 3 4 OP16 OP19 It is recommended that when a new entry is made on a Medication Administration Record by hand that the person making the entry signs it and a second person checks it for accuracy and counter signs it. It is recommended that the complaints record includes details of the complaint, the investigation process, the outcome of the investigation and the conclusion. It is recommended that an audit of all doors be undertaken to ensure that they all close into their rebates properly. Parkhill Nursing Home DS0000025448.V337107.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North West Regional Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Parkhill Nursing Home DS0000025448.V337107.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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