Inspection on 11/05/06 for Potton House Nursing Home

This inspection was carried out on 11th May 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Potton House Nursing Home 20/02/08

Potton House Nursing Home 10/10/07

Potton House Nursing Home 19/04/07

Potton House Nursing Home 26/10/05

Potton House Nursing Home 04/07/05

Potton House Nursing Home 24/01/05

Potton House Nursing Home 08/06/04

Potton House Nursing Home 06/01/04

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

CARE HOMES FOR OLDER PEOPLE Potton House Nursing Home Potton Road Biggleswade Bedfordshire SG18 OEL Lead Inspector Sally Snelson Unannounced Inspection 11th May 2006 06:10 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 Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Potton House Nursing Home Address Potton Road Biggleswade Bedfordshire SG18 OEL 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) 01767 314782 01767 314862 Health & Care Services (NW) Limited Patricia Sandra Pearson Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24) Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home can accommodate a maximum of 24 service users. The home can continue to accommodate the identified service user who is aged under 65 years. The home cannot admit any other service users aged under 65 years. Date of last inspection 26th October 2005 Brief Description of the Service: Potton House is a purpose built care home with nursing situated in the grounds of Biggleswade Hospital on the outskirts of Biggleswade, a rural village, in mid Bedfordshire. Biggleswade has good road access and there is a limited bus service with the nearest train station in Sandy. Potton House provides places for up to twenty-four older adults with mental health care needs. The home is single story with accommodation separated into three wings. Each wing has eight bedrooms and its own living areas. There is also some additional communal space. The home has a large fenced garden and there is ample parking area at the front. All the beds at Potton House are block purchased by the Primary Care Trust. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sally Snelson, the lead inspector, undertook this key inspection, assisted by Ian Dunthorne. It took place over a nine hour period from 06.10 am. The manager was present throughout the majority of the inspection. During the inspection the care of three service users was case tracked. The case tracking involved looking at the care plans and other documentation of those service users and comparing their records to the care provided. Also as part of this inspection, and to provide information for a regional project, particular consideration was given to the standard of care of a service user who had a history of falls This report also includes information from speaking to service users, staff, and visitors on the day of the inspection and information obtained from various sources since the last inspection. What the service does well: Potton House provides a happy, inclusive environment for service users to live. It has a large secure garden, which gives service users the freedom to move outside the house and remain safe. Qualifed nurses and carers adequately staff the home. In addition a team of domestic staff keep the home clean and tidy. One visitor said to the inspector “I can honestly say all the staff are very good to me and my husband. Everyone seems to get on well” None of the service users were able to look after their own medication but staff ensure that medication is given at the correct time and a record kept of what is taken. The care plans are well written and any staff on duty can read about the care needs of any of the service users. This provides service users with continuity of care which is important for those with a diagnosis of dementia. A variety of activities were available and it was apparent that staff enjoyed supporting service users with the various activities. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 6 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. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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 Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 Quality of this outcome area was poor. This judgement was made using the available evidence, including this visit. Whilst the procedure for admitting a service user to Potton House was a panel decision it was impossible for the manager to fully assess the suitability of the home for a particular service user. This could have a detrimental impact on both staff and service users. EVIDENCE: The manager had ensured that all the service users who had previously not received a Service Users Guide or terms and conditions of residency received these. However the Statement of Purpose and the Service Users Guide had not been updated to reflect the latest management and staff changes. When revised these documents must be sent to the CSCI. Service users were admitted to the home following a referral from the Primary Care Trust (PCT). The manager stated that on occasions she did not have the Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 9 opportunity to meet with the service users or their families prior to admission and that if she did have this opportunity, it was a ‘meet and greet’ meeting as it followed the panel’s decision. The procedure was for a multi-disciplinary panel to make the decision that Potton House could or could not meet the service users needs and the manager to be told of the agreed date for admission. This form of admission procedure did not allow the manager to give consideration to staffing levels, staff qualification and experience, the needs of the service user and the general suitability of the home. This process meant that standard three could not be met. The staff team was made up of qualified nurses, both Registered General Nurses (RGN) and Registered Mental Health Nurses (RMN) and care staff. Most of the staff had a special interest and/or a qualification in dementia care and challenging behaviour. At the time of the inspection Potton House did not offer intermediate care. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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 of this outcome area was good. This judgement was made using the available evidence, including this visit. Care plans had been well written ensuring that all staff were aware of the care needs of the service users. Medication records were accurate and ensured that service users received their medication appropriately. EVIDENCE: The care plans for those service users tracked had been well written and included all the activities of daily living in sufficient detail. The care plans sampled had been reviewed monthly and updated as necessary. It was noted that one service user, who had recently started to fall, did not yet have a risk assessment. Despite this it was evident that staff were aware of the risk and were providing the appropriate care to prevent a fall. There were plans in place for the situation to be formally risk assessed. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 11 All service users were routinely screened for nutritional and skin changes. These assessments were used to determine levels of care. For example, a service user with a high risk of developing pressure sores was nursed on an appropriate pressure-relieving mattress. All of the service users were weighed monthly and, where indicated, the advice of the community dietician was sought. It was noted that a service user who had been at the home for less than a month had not had any baseline observations taken although care plans had been written. Staff stated that it was normal practice to do baseline observation monthly for all service users and this particularly service user had been admitted since the last observations were taken. General practitioners (GP’s), chiropodists, opticians and physiotherapists visited the home regularly. The home had robust systems for the receiving, recording and administration of medication. There was a homely remedy medication policy that had been signed by the GP so that service users could have treatment for short-term pain and colds as necessary. Staff treated service users with respect and dignity. All the service users were dressed in their own clothes and were addressed appropriately. During the inspection staff and service users were observed to have good rapport. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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 of this outcome area was adequate. This judgement was made using the available evidence, including this visit. Staff spent time with individual service users, which provided them with mental stimulation during the day. The written menu did not encourage service users to make choices. EVIDENCE: On the day of the inspection there were no activities seen during the morning, however in the afternoon all of the staff spent time with the service users. Some walked around the grounds as it was a sunny day; others did colouring and tabletop activities, while others were offered a manicure. Activity care plans included information about the service users past life and hobbies and interests, provided by the service users families and friends. However there was no written documentation following an activity to indicate how a service user had enjoyed and reacted to the activities offered. Visitors stated that they were made welcome into the home and were pleased with the standard of care provided. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 13 Menu’s were viewed and appeared to include wholesome and nutritious food. Both breakfast and lunch were observed and the portion control was generous. In addition to this, several service users were observed to snack throughout the visit and food supplement drinks were also readily available. Although the menu was without choice for the service users, the menu did state ‘alternatives are available’ and this was apparent during the visit. The size of the main kitchen was clearly not fit for its purpose, including several pieces of equipment for example there was only one small Bain Marie the hand blender and liquidiser were domestic in style and size. The storage areas within the kitchen were also clearly insufficient for the size of home and number of service users and staff being catered for. For example, following the thrice weekly bread and milk deliveries storage of these items was difficult and reduced preparation areas further. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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 of this outcome area was good. This judgement was made using the available evidence, including this visit. Procedures were in place for complaints to be made ensuring that service users were safeguarded. The staff’s knowledge of the protection of vulnerable adults would keep service users safe. EVIDENCE: The complaints procedure was displayed within the home. There was also a clear and concise whistle blowing policy, which enabled staff to speak to a senior manager not directly involved in the running of the home. The manager stated that since the last inspection she had not received any formal complaints. She stated that the company had recently advised her that in addition to formal complaints any concerns raised should be documented. The reason for this became apparent when, following the inspection visit, the inspector received a regulation 26 visit report that indicated that a complaint about the colour of a service users bedroom had been investigated. This was an example of the confusion between a complaint and a concern and the need to document everything and not simply those considered a complaint and related to care. The majority of the staff had attended POVA training and staff, when interviewed, were able to discuss what they would do if abuse was suspected. There was evidence that the manager had dealt with an allegation against a member of staff in the correct manner. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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): 19.20,21,23,24,25,26 Quality of this outcome area was good. This judgement was made using the available evidence, including this visit. The environment was clean and well furnished which provided the service users with a homely environment. There was no easy way to distinguish between toilet doors and other doors which could be confusing to service users. The garden was large and secure, which allowed free access to the outside for service users. EVIDENCE: A team of domestic staff kept the home clean and tidy and free from any offensive odours. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 16 There were adequate communal facilities in the home to allow service users to sit in a quieter area if preferred, or to meet friends and family in private. There were a variety of chairs in the communal areas allowing service users to sit in a suitable chair that was comfortable to them. There was a selection of baths and bathing aids in the bathrooms. However most of the bathrooms and communal toilets were ‘cluttered’. It was apparent that these areas were used as storage for all types of equipment including hoists and wheelchairs. There was no easy way for service users to identify toilet doors from bedroom doors. The manager, who was considering having the toilet doors painted a different colour, had identified this as an issue. The home had a continual plan for refurbishment that included regularly redecorating service users bedrooms. New carpet had been laid in the hallways and the carpet in the large lounge was due to be replaced. A number of divan beds had been replaced with adjustable beds and more were on order. All those service users who remained on a divan were regularly risk assessed. The last inspection had identified dissatisfaction with the staff recreation room being used as a smoking room. Staff spoken to during the inspection were not concerned about this but the manager should review smoking facilities in line with the home’s smoking policy and the views of staff and service users. As already mentioned service users were not offered a choice of their main meal. The kitchen had limited preparation surfaces and storage areas which would be an issue if more choices were offered. The home benefited form a large secure garden area. The day of the inspection was warm and doors were open, allowing service users fee access to the garden. The gates to the garden were padlocked. The fire officer had visited twice and was happy with the arrangements but had not sent a report stating this. Discussion with staff indicated that they were aware of the fire evacuation plan for the home. Since the last inspection the fire doors had been fitted with door magnets and there was evidence that safety in the home was maintained. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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 of this outcome area was good. This judgement was made using the available evidence, including this visit. The quality and quantity of the staff team ensured that service users were well cared for. Service users were kept safe as robust recruitment procedures ensured that staff had the necessary checks, and were confirmed as being suitable to work with vulnerable adults, before taking up an appointment. EVIDENCE: At the start of the inspection the inspector meet the night staff. On duty were one nurse and two carers because one carer had unexpectedly gone off sick. Independently all of the night staff stated that there were normally four on duty and that they were happy to cover for absenteeism in an emergency when bank or agency staff were not available. The morning shift started at 7.00am and all of the staff coming on duty attended the handover. It was noted that staff arrived early and left late to cover the hand-over period, for which they were not paid. There was a good skill mix of staff who bought an appropriate range of experience and qualification to the team and were able to meet the needs of the service users accommodated. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 18 Staff spoke highly of the training they were offered and there was evidence that since the last inspection the amount and variety of training provided had improved significantly. A number of staff were being supported to complete NVQ courses. There was a training matrix that was kept up to date and the inspectors confirmed that a staff member who identified updating her fire training as a need also had this need reported on the matrix The company had introduced an induction and foundation course linked to skills for life. This had yet to be introduced to all the staff. Staff all wore uniform and put on disposable gloves and aprons as necessary, however it was noted that a number of the staff providing care wore jewellery, which could cause injury to a service user or a staff member. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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): 31,32,33,35,36,37,38 Quality of this outcome area was adequate. This judgement was made using the available evidence, including this visit. The service users and staff within the home appeared to benefit from the leadership and ethos of the manager, as demonstrated by the inclusive atmosphere within the home. Some out of date policies and procedures could put service users at risk. Robust Quality Assurance systems were not evident and needed to be fully implemented to measure the homes success in meeting its aims and objectives. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 20 EVIDENCE: The manager was working out her notice period but had agreed to stay until a suitable replacement could be found. Since the last inspection a deputy and an administrative assistant had been appointed. The manager had worked hard to implement most of the requirements made at the last inspection and staff and visitors stated that she was approachable, knowledgeable and friendly. She had almost completed her Registered Mangers Award (RMA) and stated that she had benefited from this training even though it had been a lot of work to study and run the home. The home had sent out satisfaction questionnaires in April. The manager was aware that for these to be useful and meaningful they should be sent to a wider group of stakeholders and the results should be evaluated and used to influence change. Personal money, held by the home, for those service users tracked was checked. All were found to be accurate with receipts reflecting expenses. Supervision had been reintroduced at the beginning of the year and it was clear that all staff had had been supervised in January with a second supervision booked for March. However when the staff member had been off duty or sick on the date of their March supervision the session had not been rebooked and it was therefore going to be difficult for them to meet the six supervisions a year required. There was a comprehensive selection of policies and procedures available in the staff room. However these documents had not been formally reviewed since March 2003. It was noted that some hand written changes had been made. For example the medication policy had a hand written comment about the changes that had been made to the collection of medicines. This change had been written in one section of the policy but another section. Care plans were stored in the nurses office but not in a locked cabinet. This was not considered to be a secure storage as visitors entered this room to sign in and out of the home. Fire checks and lighting and water checks were carried out and recorded appropriately. Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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 2 x 1 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 2 X 3 2 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 2 2 3 Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 23 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 2 3. 4 5 6 7 Standard OP1 OP3 OP15 OP21 OP24 OP30 OP33 Regulation 4(1) 5(1)5(2) 14(1) 16(2) 23(2) 16(2) 12,18 24 Requirement The manager must review and update the Statement of Purpose and the Service Users Guide. The manager must have the opportunity to assess service users prior to admission. Service users should be offered a visual choice of meals at mealtime. Bathrooms and toilets must be kept clear of ‘clutter and not used as storage areas. Adjustable beds must be provided for all service users. All staff must have an induction training that is documented. The registered persons must ensure that a quality assurance system is implemented. This must seek the views of service users, their relatives and other professionals. A report of the findings and any recommendations must be compiled and made available to the CSCI. This requirement has been partially met and should be met in the increased timescale given. Timescale for action 01/08/06 30/06/06 01/08/06 30/06/06 01/01/07 30/06/06 01/08/06 8 9 OP36 OP37 18 17 (3) 10 House Nursing Home 17(1)(a) OP37 Potton Staff must be supervised six 01/08/06 times a year. Policies and procedures must be 01/08/06 reviewed and kept up to date. Service users records must be 30/06/06 DS0000017688.V289476.R01.S.doc Version 5.1 Page 24 kept secure. 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 5 Refer to Standard OP5 OP8 OP12 OP16 OP26 Good Practice Recommendations Service users and their families should be given the opportunity to visit the home prior to admission. Baseline observations should be completed on service users at the time of admission. Care plans should reflect service users reaction to the activities provided. Documentation of a visitor or a service user raising a concern with the home should be recorded. It is recommended that the registered persons review current smoking practices within the home with a view to ensuring a safe and comfortable working environment for all staff. Toilets should be easily identifiable. 6 OP21 Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Potton House Nursing Home DS0000017688.V289476.R01.S.doc Version 5.1 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. 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