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Inspection on 15/02/06 for St Anselm`s Nursing Home

Also see our care home review for St Anselm`s Nursing Home for more information

This inspection was carried out on 15th February 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.

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

The registered manager of St Anselms has the competency, experience and skills to manage the home to a high standard. He demonstrates a clear sense of direction and leadership, which the staff and service users understand and relate to. The home is well managed. The care, health and safety of the service users is promoted and upheld at all times and all the staff have received the necessary training to undertake their roles. The manager ensures that the CSCI is kept informed of any significant events that happen at the home in accordance with the regulations. St. Anselms provides a relaxed, homely, comfortable friendly environment for service users to live in and for staff to work in. The premises are clean, pleasant and maintained to a good standard. Service users are well kept, well dressed and cared for. Physical, social and psychological needs are addressed and met. It was observed that the staff and service users have good positive relationships with each other. The staff know the service users well and can communicate effectively and interpret the need of the client group. The staff are aware a ware of the specific needs of the service users and do not try to rush them. The majority of the documentation is up-to date and of a good standard. The provider and manager make every attempt to keep abreast of all new information and developments. The manager of the home has set up links with other homes in the local area so they can offer each other support, develop skills and share information and new ideas. The out come is to improve the standards of care throughout all the homes and meet all the needs of the service users.

What has improved since the last inspection?

What the care home could do better:

The care plans of the service users are of a good quality and identify the majority of the needs of the service users and what care input is required to ensure the needs are meet. However it was evidenced that some of the care plans did not contain information on the dementia needs of the service users and how to deal with challenging behaviours. Staff need to be very clear on the action that is required in these instances. Some of the care plans need to be up-dated to reflect the changing needs of the service users. This was discussed at the inspection and the registered manager is going to address the issue. St. Anselms does have some quality assurance and quality monitoring systems in place. These need to be further developed and enhanced. Actions and outcomes need to be documented. This will assist the management to ensure that the home is meeting its aims and objectives as written in the homes statement of purpose. The home needs to ensue that all training is completed and that they have upto date photographs of the staff on file.

CARE HOMES FOR OLDER PEOPLE St Anselm`s Nursing Home St Clare Road Walmer Deal Kent CT14 7QB Lead Inspector Mary Cochrane Unannounced Inspection 15th February 2006 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 St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 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. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Anselm`s Nursing Home Address St Clare Road Walmer Deal Kent CT14 7QB 01304 365644 01304 380514 allsaints.nursinghomes@virgin;.net 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) Mrs Aileen Jordan Mr Mark Redman, Mrs L A Redman, Mrs Irene Lane Mr David Paul Weller Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (25) St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Patients detained under Sections of the Mental Health Act may not be admitted to the home Patients must be aged 50 years and over Date of last inspection 16th August 2005 Brief Description of the Service: St. Anselms is a registered nursing home, which provides care for up to 25 with mental health needs and dementia. The home is a large detached building, set in its own grounds, in a quiet residential area of Walmer, Deal. It is near to local shops and facilities, Walmer Castle and the sea, and is within easy reach of the towns of Deal and Dover. It is run by a partnership, with all of the Providers actively involved in the running of the home. Accommodation is provided over 4 floors (lower ground, ground, first and second floors), and all floors can be accessed via a passenger lift. The communal areas in the main building consist of a large lounge, conservatory and dining area. There is also another small quiet lounge area for service users. The home has a gatehouse, which has recently been renovated to provide reception and office facilities, minimising disruption to Service Users in the main building. The home provides full laundry facilities The grounds provide a number of pleasant areas for Service Users enjoy in the better weather. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the 2nd inspection at St. Anselms this year. This visit was unannounced and lasted from 10.00a.m until 3.30p.m. The majority of the key standards were looked at during the previous inspection in August ‘05, so the inspector focused on the 1 requirement and 2 recommendation identified in the previous report and the outstanding key standards. The homes registered manager was not on duty but he was contacted and came to home immediately to assist with the inspection. The registered provider/nurse director was also available and helpful throughout the day. At the time of the visit the home was full with 25 service users in residence. The deputy manager was on duty and she was assisted by 5 health care assistants. The newly appointed activities co-ordinator was working from 9a.m –12p.m and there was also a student nurse on placement from Christ-church College. There was also a cook and other ancillary staff. The provider/nurse director was available at any time throughout the shift to offer extra support and an extra pair of hands if the need arose. The following methods of inspection and information gathering were used: discussion with registered manager and provider, one-to-one discussion with staff, spending time with service users, observing interactions, care interventions and activities, reading and discussing assessments, individual support plans, risk assessments, selected policies, staff files and staff training and other documentation. The overall impression of the homes is that it provides a good quality of care for the service users. Due to their illnesses many of the service users have difficulty understanding and communicating verbally but through observation and looking at behaviours and documentation the majority seem content and secure within the homes environment. The service users who were able to verbalise reported that they were satisfied with the care they receive. They reported “the staff were very good and would do anything for them”. They also said “ the staff were very kind and patient with the more challenging service users and had endless patience”. The staff were seen to be caring and respectful. They reported that they had developed good relationships with the service users and they were able to anticipate and meet the individual needs of the client group. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 6 What the service does well: What has improved since the last inspection? In the last month the home has employed an activities co-ordinator whose role will be solely dedicated to providing appropriate and fulfilling activities and leisure pursuits for the service users. At the moment she works from 9a.m – 12pm but the manager hopes to develop her role as time goes on. Staff and service users reported that there has already been an improvement and the home is beginning to develop more structured meaningful day for service users to benefit from and enjoy. The daily reports written by the staff at the end of each shift now contain all the necessary information of the care given to the service users. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 7 All the staff at the home now receive the support and supervision to undertake their roles effectively. The registered manager is going to ensure that all staff receive a minimum of 6 formal supervision sessions in a year. Annual appraisals have also been completed. 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. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 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 St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 3 The homes statement of purpose and service users guide provide the information necessary for prospective service users to make an informed decision about the home before moving in. Each service users has a contract in place so they know what services they are paying for and what is not covered by their fees. Service users are thoroughly assessed by trained staff prior to admission to ensure that the home will be able to meet all their needs. The home does not provide intermediate care therefore standard 6 was not inspected. EVIDENCE: St. Anselm’s statement of purpose is comprehensive and the service user guide gives clear information about the home. It contains all the required information out lined in schedule 1 of the care homes regulations. The homes statement purpose and service users guide are up-dated to reflect any changes in the home. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 10 Each service users has a contract/terms and conditions of residency, which states what is included in the fees, and what is not. It was noted at the inspection that it was not clear whether the home provide service users with transport and holidays as part of there fees or whether this was an extra cost. This was discussed with the registered manager and provider and they are going to ensure that this is made clearer for the service users and their families/representatives. There are sound policies and procedures for assessment and admission to the home that include pre-admission assessment and trial periods. Inspection of the assessments of 3 recently admitted residents showed that appropriate preadmission assessments had been undertaken and were of a good standard. Information is gathered from hospital staff, care managers and relatives. The assessment is carried out using the ‘Basoll’ system, which explores all the relevant areas of care including communication and behavioural needs, social needs, medical and psychiatric history, mobility and mental cognition. The assessment is then kept within the service users file and is the basis for the development of an individual care plan. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&8 The home provides care plans for all the service users. They need to contain information on all aspects of health, social and personal care to provide staff with the information they need to satisfactorily meet the service users needs. Standards 9,10 & 11 were inspected and met at the previous inspection. EVIDENCE: The inspector looked at a sample of care plans at this visit. On the whole the plans are of a good standards but it was evidence that there are some gaps. There was no information in the plans on how to meet the needs of service users with dementia. The home is registered to provide care for people with dementia so this omission needs to addressed to ensure that the staff have the information necessary to deal with the specific needs of the individual service users suffering with this condition. The registered manager also needs to ensure that there are robust guidelines in place for dealing with challenging behaviours. The home has recently experienced behaviours that are very challenging and although restraint has not been necessary to date the registered manager needs to make sure that the staff have the information available should the need arise especially as this was identified in the initial assessment. The staff also need to ensure that the care plans are kept up-to St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 12 date to reflect the changing needs of the service users. The registered manager has delegated this responsibility to the trained nurses at the home. The identified health needs are now addressed in the plans and information was documented when changes in treatment had occurred follow reviews from the consultant or the G.P. Risk assessments are in place. The risks pertaining to each individual service users are identified and the action to minimise the risk is recorded. There has been an improvement in the information documented in the daily records. Daily reports are completed at the end of each shift. Information was recorded concisely and accurately reflecting the events that occurred during the shift. Daily reports where cross-referenced with the care plans and there was evidence to show that the staff are adhering to and following the individuals care plan. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 The home is making every effort to ensure that the residents are able to enjoy an interesting and fulfilling lifestyle. The other standards in this section were inspected and met at the previous visit in August’05 EVIDENCE: Since the last inspection the management of the home have looked at the improving the quality and amount of activities and leisure pursuits it offers to the service users. In the past month the home has employed an activities organiser who is solely responsible for organising and encouraging service users to participate in activities. At the moment she works from 9a.m –12p.m the registered manager hopes that this role will develop. The home are going to seek input from the specialist O.T attached to the local older peoples team to ensure that they are heading in the right direction. The activities are being organised on a weekly basis and a record is kept of the activities undertaken and who participated. At the time of the inspection a trip was being organised for the following day to the RAF museum. The registered manager is now ensuring that the number of St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 14 staff on duty at any one time is reflective on the activities and needs of the service users. The service users and staff reported that there has already been an improvement in activities both in side and out-side the home. They reported that they are more planned and structured. They felt that this was a very positive move. Activities are organised in groups and individually pending on the abilities and interest of the service users. The staff reported that they are now able to act more spontaneously. This suits some of the service users at the home. Activities provided include sit and keep fit exercises, reminiscence, games and singing afternoons, or one to one care using games or books. The home has a good selection of library books, videos, C.D. Aromatherapy sessions are available, and service users often like to go out for walks by the sea, or in the town. One service users reported that he had recently been on a short break to Brighton, which he had enjoyed, and 2 other service users had been on an annual holiday. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The staff have a good awareness of Adult Protection issues. This protects the residents from abuse. EVIDENCE: Policies and procedures are in place for the protection of adult abuse. Staff have received adult protection/POVA training and have a good awareness of the whistle-blowing procedures. Staff said that they would be prepared to use the whistle-blowing procedure should the need arise. The home has no involvement with the finances affairs of any of its’ service users. Some of the service users manage their own finances, relatives manage the majority of service users finances and 3 are dealt with by solicitors. The service users are protected from all types of abuse. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 16 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): These standards were met at the previous inspection in August ‘05 EVIDENCE: St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 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 The staff have a good understanding of the needs of the residents. This is evident from the positive relationships between staff and residents. Staff morale is good. Recruitment practices are sound and the level of training is good. Staff are working in sufficient numbers to ensure all the needs of the service users are met at all times EVIDENCE: St. Anselms employs 9 qualified staff (not including the provider who is a qualified nurse and is on site on a daily basis to assists as necessary.) 14 health care assistance and 2 flexi staff. They have recently employed aparttime activities co-ordinator. There are also 2 cooks, domestic staff an administrator and a part time maintenance man. The home also accepts student nurses from Christ –Church College for placements. The staff reported that they enjoy working at the home and receive the support and training that they need to undertake their jobs effectively. The registered manager and registered provider reported that all mandatory training is up-to date and on-going. The inspector was able to evidence this by looking at some of the staff files and staff also said that they have received the required training. Courses have been booked in advance to keep them up to date. There are systems in place to ensure that staff receive a very thorough induction programme. However it was evidenced at the inspection that a member of staff who commenced work in November ’05 had not completed the St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 18 induction programme. This was discussed with the registered manager and he is going make sure that it is completed. The management would be able to identify training needs more easily if they developed a training matrix. The registered provider started to do this before the inspection ended. At the time of the inspection there was 1 qualified nurse on duty and 5 health care assistants plus the part-time activities co-ordinator and a student nurse. On the afternoon shift there were 4 staff members. There are 3 waking staff on every night. The number of staff on duty depends on the needs of the service users. There was evidence to show that the number and skill mix of staff provided are able to meet the needs of the service users. All the service users spoken to reported that there is enough staff on duty at any one time to meet their needs and nothing was too much trouble. The inspector observed that the staff are pleasant and happy in their work and were seen to be attentive and caring towards the needs of the service users Over 50 of staff employed by the home have received and obtained NVQ level 2 or above. The inspector looked at the files of the 2 most recently employed staff. A robust recruitment process is adhered to using equal opportunities. References are sought before employment is commenced and POVA/ CRB checks are in place. All staff receive a terms and conditions of employment. It is now necessary to include a recent photograph of the staff in their files. Passport or driving licence photos are not acceptable. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 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): 33,35 & 36 Quality assurance and monitoring needs to be further developed to ensure the aims and objectives of the home are being met and the views of the service users/representative are acted on. The finances of the service users are protected. All staff receive the supervision and the support they need to carry out their jobs effectively. EVIDENCE: The home has started to develop quality assurance and quality monitoring systems. The views of the service users are sought annually by sending out questionnaires and the home receives fed-back from student nurse who have placements at the home. This now needs to be extended to the relatives, visiting professionals and others who have input into the home. Annual internal St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 20 audits need to be developed. The registered manager then needs to be able to measure the success of the aims and objectives of the home and the outcomes of the monitoring. There also needs to be evidence that the management have acted on the information they have received to further improve the care that they deliver. The home has very little involvement with the finances of the service users. Relatives or solicitors manage all the monies. If service users require anything the home purchases it for them from its own funds and the relatives/solicitors are then billed and receipts forwarded. A record is kept of this. This system works well for St.Anselms. A few of the service users at the home are able to manage their own money and the registered manager offers them assistance if any problems occur. All the care staff are now receiving regular supervision. The home needs to ensure that they receive a minimum of 6 formal supervision sessions within 12 months. Annual appraisals have also commenced. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 3 X X St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 22 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 OP7 Regulation 15(2) Requirement Timescale for action 2 OP33 24,26 The home needs to ensure that the service users care plans identify all the needs and are up- 31/05/06 dated as required to reflect the changing needs of the service users. (Outstanding requirement from the previous inspection. Timescale of the 30/11/05 not met) Effective quality assurance and quality monitoring systems, 30/06/06 based on seeking the views of service users, are in place to measure success in meeting the aims, objectives and the statement of purpose of the home. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 23 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 Refer to Standard OP29 OP30 Good Practice Recommendations To ensure that all staff have an up to date photograph on file. The registered manager needs to ensure that induction training is completed. St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 St Anselm`s Nursing Home DS0000026117.V267450.R01.S.doc Version 5.0 Page 25 - 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!