Inspection on 11/02/08 for Scarsdale Grange Nursing Home

This inspection was carried out on 11th February 2008.

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

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

Scarsdale Grange Nursing Home 24/10/07

Scarsdale Grange Nursing Home 14/05/07

Scarsdale Grange Nursing Home 14/08/06

Scarsdale Grange Nursing Home 10/04/06

Scarsdale Grange Nursing Home 17/01/06

Scarsdale Grange Nursing Home 17/05/05

Scarsdale Grange Nursing Home 08/12/04

Scarsdale Grange Nursing Home 06/04/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Scarsdale Grange Nursing Home 139 Derbyshire Lane Sheffield South Yorkshire S8 9EQ Lead Inspector Marina Warwicker Key Unannounced Inspection 11th February 2008 10:00 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 Scarsdale Grange Nursing Home DS0000021804.V358106.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. Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Scarsdale Grange Nursing Home Address 139 Derbyshire Lane Sheffield South Yorkshire S8 9EQ 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) 0114 258 0828 0114 258 3897 scarsdale.grange@btconnect.com None. Mr John Martin Foster Mr Hassen Jeetoo Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three service users aged 60 years and over may be accommodated at the home. 24th October 2007 Date of last inspection Brief Description of the Service: Scarsdale Grange is a purpose built home, able to provide nursing care for up to 40 older people. The home is in a residential area of Sheffield, with good access to public services and amenities, such as public transport, shops and public houses. The home has two floors, accessible by a passenger lift. Each floor has communal lounge, dining rooms and bathing facilities. All of the bedrooms are single with en-suite toilet facilities. The home has a garden to the rear and a car park to the front. The weekly charges range from £355 to £481. These figures were obtained on the day of the site visit. Additional charges included newspapers, hairdressing and private chiropody. Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. An inspection of this care home was carried out on Monday 11th February 2008 between 10 am and 3.30 pm. The staff, the management and the people using the service were not informed of our visit and therefore it was unexpected. Eight people who use the service were consulted and five staff were spoken with. A further five people using the service, five relatives and three professionals who came into contact with the people were contacted by post and telephone to obtain feedback about the service. Comments received from the surveys have been included in the body of the report. Any comments received after the publication of this report will be shared with the management of the home. Time was spent observing and chatting with staff, the visitors and the people using the service. The manager was present during the inspection. The provider joined us during the latter part of the inspection and was present at the final feedback. The premise was inspected, which included bedrooms of people using the service, the communal areas and the service areas such as the kitchen and the laundry. Twenty four people were using the service on the day of the site visit. Samples of records such as the care plans, staff recruitment and training files were checked. We would like to thank the people who live at Scarsdale Grange, their relatives, the staff who took part, the manager and the provider for their contribution towards this process. What the service does well: The people who may wish to use the service and their representatives have the information needed to make an informed choice about the home. The management at the home assures the people that they are able to meet their needs. Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 6 The principles of respect, dignity and privacy are put into practice by the staff. The people receive a varied, wholesome and nutritious diet. 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 Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Scarsdale Grange Nursing Home DS0000021804.V358106.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 Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 & 5. People who use this service experience good quality outcomes in this area. This is a judgement reflecting the key standard. We have made this judgement using a range of evidence including a visit to the service. The people who may wish to use the service and their representatives have the information needed to make an informed choice about the home. The management at the home assures the people that they are able to meet the people’s needs. EVIDENCE: To check this outcome area we spoke to the manager and four staff. We checked the information available within the home; we spoke with the people using the service. We also checked the feedback from the surveys. There were copies of the service user guide and the statement of purpose available for inspection. The documents included information about the home and were informative. Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 10 The manager confirmed that none of the people using the service had contracts since most of them were funded by the social services. We informed him that all the people using the service at the point of admission needed to have a set of Terms and Conditions. These documents helped to establish the rights and obligations of the people using the service and also the registered provider. Terms and Conditions gave information as to who was liable if there was a breach of contract. Four care plans were checked and there was evidence that the people have had their needs assessed before moving into the home. Two of the staff and a relative confirmed that the people were given the opportunity to visit and move in on a trial basis before accepting permanent residency. Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10. People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. There is a lack of basic care for some who are ill and immobile. Individuals are not always involved in decisions about their lives, and it is not customary for the staff at Scarsdale to involve the people using the service to play an active role in planning the care and support they receive. EVIDENCE: Four care plans and feedbacks from surveys were checked. Five people using the service, three care staff and four relatives views were considered. The manager said that all care plans had been reviewed and updated with the help of the local primary health care older peoples’ team. The care plans checked did evidence this. Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 12 We have received some negative comments from relatives and staff about the care received by some people. During our direct observation we noted a person who was bedridden and was terminally ill. To maintain safety and comfort this person needed the staff delivering all personal care we found that the person did need her dentures to be cleaned. A comment from the staff survey said, “Did you know there is an arrangement for so many people to be got up by night staff to help the day staff. How does this promote choice for the poor people who are got up early in the morning?” We informed the management and they assured us that there are 4 persons who have specifically requested to be awoken early in the morning and this is performed by night staff who are still on duty. No other persons are awoken. There was confusion about respecting a person’s right and the staff’s responsibility to care for the person. This was an example; medical staff saw a person and s/he was prescribed oral medication. S/he refused to take the medication. Although the person’s condition seemed to remain the same but some of the baseline observations (Temp, pulse and blood pressure) were not satisfactory. The staff including the manager had not taken any further action since it was perceived that they had to respect the right of the individual and had previously obtained consent from the persons relative and G.P. to take such action. The management and the staff at the home have a duty of care for every individual using the service. The manager said that none of the people using the service on the day of the site visit were able to self medicate. The care staff said that the nurses administered medication and that they did not get involved in it. Four medicine administration records checked were completed and signed satisfactorily by the nurses. We discussed with one of the nurses the need for the care staff being aware of any changes to the medication of the people. We explained that the care staff were best placed to observe and report any ill effects or changes in the condition of the people using the service. The nurse accepted this as a good practice guide. At the meeting following the site visit we explained to the management the reasoning behind our above recommendation. Scarsdale Grange Nursing Home DS0000021804.V358106.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&15. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People receive a varied, wholesome and nutritious diet and are able to make choices about their life style, and receive support from the staff to restore their life skills. EVIDENCE: Five people using the service, three staff and one relative were consulted. Further feedback from the surveys was considered; the documentation and the direct observation on the day of our site visit were also taken into account when concluding this outcome area. There was a list of activities displayed to inform the people living at the home and the visitors. We saw the activities person encouraging groups of people playing dominos on the ground floor dining room. Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 14 Another said, “Often my X is fed up of listening to some residents being disruptive. The staff are unable to sort them out and this causes upset to the other residents during activities.” We witnessed a person shouting causing disruption in the dining room and some people using the service getting upset by the noise. However, the person responded to us chatting and wanted company. The management were already aware of this. When asked the management said that there were plenty of activities provided and that carers assist the activities co-ordinator in visiting those who do not wish to partake in any activities. The Manager also explained that when the weather improves there would be more outings for the people. Discussion took place with regards to care staff taking small groups of people out during their working day as part of care delivery. We observed that people were able to have visitors and the visitors were made welcome by the staff. The people said that they were offered plenty of food and drinks. The cook did a five weekly menu. She said that the menus were decided on the people’s likes and dislikes. When we checked, we found that the cook kept records and provided soft diets and other special diets as appropriate. On the day of the site visit during lunchtime the staff were seated with the people, helping those who needed assistance. The people were offered a choice of meals and the mealtime was unhurried in the dining rooms. Two people said, that the meals were good and the staff did well to get them all something they liked. The staff said that they recorded food and fluid intake when they were monitoring people’s nutritional status. On the day of the site visit people were offered lunch and those who needed help received the help. Scarsdale Grange Nursing Home DS0000021804.V358106.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&18. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Most people who use the service are able to express their concerns and have access to a complaints procedure. The people are protected from abuse by the local policies at the home. EVIDENCE: The home’s complaints policy was displayed at the entrance hall. The details with regards to the manager needed to be updated. Two staff said that they knew what to do in the event of a formal complaint. They were confident that they would try to alleviate the problems by listening to the complainants and putting things right straight away. The management has maintained the records of formal complaints. There had been one complaint since the last inspection. It had been investigated appropriately and records kept by the manager. We received comments from relatives that it was difficult to raise concerns with the management since they were defensive and gave excuses, instead of taking action to rectify the problems. This was shared with the provider on the day of the site visit who explained that regular relative’s meetings were being held and of those who attended no significant issues were raised. However, Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 16 the manager said that he would continue to help people resolve any problems they may encounter. We checked four staff files and all of them had records of satisfactory criminal record bureau checks. Such checks protect vulnerable people from unsuitable employees caring for them. The staff at the home continue to report any allegations or incidents of abuse to the appropriate local authority teams dealing with safeguarding adults. Two staff out of four said that they had received training on safeguarding adults in the last twelve months and the others were not sure. Scarsdale Grange Nursing Home DS0000021804.V358106.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): 19,22,24 & 26. People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The physical design and layout of the home encourages people to be independent and the home is being redecorated. However, it is somewhat disorganised, untidy and unhygienic in places. EVIDENCE: The tour of the premise included communal areas, bedrooms, bathrooms, service areas such as the kitchen, sluice room and the laundry room. The following observations were made on the day of the site visit. • • There was a programme of decoration in progress and generally the décor was satisfactory. Empty rooms were being used as temporary storerooms. DS0000021804.V358106.R01.S.doc Version 5.2 Page 18 Scarsdale Grange Nursing Home • General tidiness was an issue. We found people’s personal clothing and bags of clean incontinence pads stored in a general bath instead in individual’s rooms. Some of the findings in this section have been addressed under the health, safety and welfare (Standard 38) due to the impact they have on the people using the service and the staff working at the home. Scarsdale Grange Nursing Home DS0000021804.V358106.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): 27,28,19&30. People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The staff employed by the home are in the main trained and in sufficient numbers. For the most part the staff are delivering the care in line with the people’s identified needs. The staffing organisation did not support the smooth running of the service. EVIDENCE: Four staff recruitment files were checked with the help of the manager. Most information required by the Care Homes Regulations 2002 was found. The following gaps were identified during the checks. • • Out of two nurses files one did not have a valid registration since the Nursing and Midwifery Council PIN number had expired a month before. One recently employed staff did not have a full employment history to ensure that s/he had relevant experience and capacity to work at the home. The manager explained that every new member of staff shadows other staff until the Management are satisfied with that person’s ability. DS0000021804.V358106.R01.S.doc Version 5.2 Page 20 Scarsdale Grange Nursing Home No staff members are allowed to perform functions for which they are unqualified. Two care staff said that they had induction when they started which lasted a week when they shadowed staff. The manager said that he was in the processes of reviewing the home’s induction programme. On the day of the site visit we were unable to access the staff training records and therefore we were unable to monitor the progress made by the management since the last inspection in October 2007. The manager informed us that all staff had received training on fire safety and moving & handling. Scarsdale Grange Nursing Home DS0000021804.V358106.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): 31,33,36 & 38. People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The home is run in the best interests of people, but the management needs to develop more effective communication with relatives and staff, monitoring of health & safety and supervision of staff. EVIDENCE: The manager is qualified and experienced in managing care homes. The manager was appointed in August 2007. Many improvements have been made and the requirements from the previous inspection have been met. Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 22 However, there were some of the areas we found still needed attention and some areas compromised the health & safety of the people who live and work at the home. • The management did not have an efficient system to monitor that all the people using the service were receiving a good standard of basic personal and nursing care. This could be achieved by staff being competent and also staff being accountable for their actions. The manager said that a meeting was held recently with the ‘residents and relatives’. Given some of the negative comments we received, there is a need to develop communication with relatives. The system for maintenance and repairs of equipment within the home needs to be improved. The kitchenette area in the dining room immediately after lunch had been served had a microwave, which was dirty with a splattering of food. At that time we also noticed open containers of food left lying around in this area. When we inquired to find out who was responsible for cleaning, the care staff said it was the kitchen staff and vice versa. This illustrated to us the non-compliance with food safety and hygiene standards within this particular part of the home. Also the lack of monitoring by the management. The maintenance person regularly checked the hot water temperature of the taps where people had access. The recommended temperature is between 41oC to 43oC. On occasions the temperature had been below the recommended limit i.e. 30oC and 32oC and this was recorded in the book but no action had been taken. We highlighted this to the provider and commented that the recording of the temperature had been carried out as a task instead of using the information for risk assessment and to prevent people harming themselves. • • • • When we discussed this matter with the management, the provider perceived that the people were not getting scalded since the water temperature was lower. Therefore this was not a problem. We explained that when people are subjected to washing and bathing in cool water especially older people they could soon become hypothermic; but typically they would feel cold and unhappy which is unsatisfactory. Three staff said that they have had supervision in the last three months. The manager said that he was in the process of organising regular supervision for all staff. Two staff said that they reported all the incidents and accidents to the person in charge of the shift. One of the staff said all the forms were checked by the manager. Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 23 Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 1 3 X 3 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 2 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X 3 X 3 X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X 3 X 1 Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 12,13&16 Requirement The management must ensure that all people receive the appropriate personal and health care all the time. Immediate 11/02/08 The home must have sluicing facilities and a sluicing disinfector, which must be in working condition, so that the staff are able to comply with the policies for infection control and the safe handling and disposal of clinical waste. The staff that are competent and trained must meet the needs of the people using the service. To achieve this the staff must ensure that they have access to equipment required to carry out their jobs. The staff according to their seniority must take ownership and responsibility to supervise other team members so that the people receive the appropriate care. Timescale for action 12/03/08 2. OP26 13,16 08/03/08 3. OP27 17,18 12/04/08 Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 26 4. OP33 26 The quality assurance and the quality monitoring systems must be improved to ensure that the home meets its aims and objectives and the stated purpose to ensure people’s welfare and safety. The management at Scarsdale Grange must ensure as far as is reasonably practicable to promote and protect the health, safety and welfare of the people using the service and the staff working at the home. This must be achieved by addressing the matters raised with regards to the safe working practices under the heading ‘Management and Administration’. 12/04/08 5. OP38 13 (6) 12/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP2 Good Practice Recommendations The people using the service should have a copy of the contract for the provision of services and facilities by the provider. The people should also have a copy of their Terms and Conditions in respect of the accommodation provided including the amount and method of payment of fee. The agreement helps to protect the rights and obligations of the people using the service and the provider. It also outlines who is liable for any breaches in the contract and thereby transparency is promoted. The management should be proactive, visible and receptive to comments by people using the service, the visitors and the staff. 2. OP16 Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 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 Scarsdale Grange Nursing Home DS0000021804.V358106.R01.S.doc Version 5.2 Page 28 - 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!