Inspection on 02/04/08 for St Catherine`s Nursing Home

This inspection was carried out on 2nd April 2008.

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

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

Other inspections for this house

St Catherine`s Nursing Home 06/08/08

St Catherine`s Nursing Home 10/12/07

St Catherine`s Nursing Home 08/06/07

St Catherine`s Nursing Home 23/01/07

St Catherine`s Nursing Home 28/06/06

St Catherine`s Nursing Home 08/03/06

St Catherine`s Nursing Home 21/09/05

St Catherine`s Nursing Home 24/11/04

St Catherine`s Nursing Home 13/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE St Catherine`s Nursing Home Queen Street Horwich Bolton Lancashire BL6 5QU Lead Inspector Grace Tarney Unannounced Inspection 2nd April 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Catherine`s Nursing Home DS0000005697.V361677.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. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Catherine`s Nursing Home Address Queen Street Horwich Bolton Lancashire BL6 5QU 01204 668744 01204 668727 st.catherines@fshc.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tameng Care Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Christine Isabel Clarke Care Home 61 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30), of places Physical disability (1) St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 61 service users to include:Up to 30 service users in the category of DE(E) (Dementia over 65 years of age) Up to 30 service users in the category OP (Old age not falling within any other category) Within these numbers Nursing care can be provided for up to 30 service users One named service user in the category PD (Physical Disability) The registration to revert to the original respective categories should the named service user leave the home. 10th December 2007 2. Date of last inspection Brief Description of the Service: St. Catherines is a purpose built Home with accommodation on the ground and first floors. The home is situated within walking distance of Horwich Town Centre and the local shops. It is close to a main bus route and not too far from the motorway network. Car parking is provided to the front of the home and garden space is provided to the sides and rear. The home is registered to provide accommodation to 61 residents and offers nursing and personal care services. However, because the two double rooms are now used only as single rooms, the maximum number of services users at any one time is reduced to 60. There is a dedicated dementia care unit. All rooms are for single occupancy; one room has en-suite facilities. This unit has its’ own lounges and dining room. The bedrooms on the first floor are for the nursing and residential residents and are reached either by stairs or a passenger lift. There is a lounge and dining room on the first floor and lounges and dining rooms on the ground floor for both the Residential and Dementia Units. Most of the toilets and bathrooms have aids to assist any resident with a disability or mobility problem. The provider informed the inspector that the fees within the home ranged from £349.93 to £391.41 per week for those residents funded by local authorities, in addition to the free nursing care funding given. For private residents who pay for their own care the fees range from £435 00 to £496.00. Additional charges are made for private chiropody, hairdressing and newspapers. This information was received on the 2/04/08. St Catherine`s Nursing Home DS0000005697.V361677.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 0 star. This means that people who use the service experience poor quality outcomes. For the purpose of this inspection, only the Dementia unit was looked at in detail. The home was not told that the inspection was to take place. The site visit by an inspector and a pharmacy inspector took place over 8 hours. During our time at the home we looked at care records and medicine records to check that the health and care needs of the residents were being met. We also looked at the menus in detail, to check what the residents had for their breakfasts, lunches and evening meals. We also checked how many staff were provided on each shift to make sure the residents’ needs were being met, and also looked at how the staff are trained to do their jobs properly. In order to get further information about the home we also spent time speaking to 1 relative, 2 qualified nurses, 2 care assistants and the activities organiser. What the service does well: What has improved since the last inspection? Management have recruited a full time Registered Mental Nurse for the Dementia Unit. This should help to ensure that their mental health needs are identified and met. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 6 New low surface heat heaters have been installed in the bedrooms on the Dementia Unit. This means that the bedrooms are now warmer and heated safely. Refresher training has been provided in the protection of vulnerable adults and moving and handling to ensure that the residents are protected from harm. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. People are properly assessed before they are admitted to the home and this gives an assurance to everybody, that a person is only admitted if the staff feel that they can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Before any resident was admitted to the home a senior member of staff from the home undertook an assessment of their needs. The assessment looks at what help and support the prospective resident needs in all aspects of daily life. The 2 assessments looked at were detailed and gave a clear indication of the residents’ needs and what they could and could not do for themselves. Standard 6 does not apply. The home does not provide Intermediate Care. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 9 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. Quality in this outcome area is poor. Not all the care plans are as up to date as they should be and do not always contain enough information about the residents’ condition or needs. This puts the residents’ health and well being at risk. Some poor practice when administering and recording medicines is placing the health and well being of residents at unnecessary risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care plans were in place for each resident. The care plans of five of the residents on the Dementia unit were looked at. We were told that the staff were in the process of updating and rewriting the care plans and we saw evidence that this was happening. Three of the care plans looked at were detailed and gave enough information to show what the residents needs were and how the residents were to be looked after. The care plans were looked at regularly to report any changes that may have occurred and then updated where necessary. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 10 The staff looked at whether or not there was any risk in relation to the residents developing pressure sores, any risk of falling and also if they were at risk due to problems with their diet and fluid intake. They also looked at and they wrote down, how any resident was to be assisted with being moved around and by how many members of staff and what equipment, if any, was to be used to assist in safe moving and handling. The care plan of another resident however was not as up to date as it should have been. The residents’ needs were changing frequently and were intensive but staff were not reviewing the care plan and the risk assessments, as and when his needs changed. The care plan of another resident showed that this resident had a pressure sore. The staff had written down the details of how the sore was to be cared for but there was not enough information in the care notes to give a true record of the condition of the sore at any one time. Management later told us that the pressure sore had healed. There was however no documentation to support this. This resident also had no care plan for eating and drinking despite there being some concerns about her inability to eat without help. Staff were also not reviewing the care plan and risk assessments as often as they should have been. We spoke to a visiting relative whilst on the Dementia Unit who said she was happy with the care provided. As part of the inspection a specialist pharmacist inspector looked at how medicines were handled. We looked at the medicines stock and records, whilst observing the morning medicines round, and found the majority of medicines were packaged in a blister system supplied by the pharmacy, this helped staff administer them in an organised way. We found that medicines contained in this system were usually administered correctly. However when we checked medicines contained in traditional packets and bottles we found the stocks did not always add up correctly, some had been missed and for others stock was missing. We found at least twenty examples of medicines stock being incorrect that showed they had not been given to residents correctly. Going without prescribed medicines can seriously affect the health and wellbeing of a resident. We checked the stocks and records of controlled drugs (medicines that can be misused) and found mistakes. Four different residents prescribed some strong pain relief patches failed to have them replaced on time on numerous occasions, this means that they could have suffered unnecessary pain. One daily record indicated increased pain for a resident on one of the occasions when the patch had been forgotten. We checked the care plan for one of these residents and found no information about how their pain was to be managed. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 11 Having a clear written care plan helps ensure residents receive the right medicinal treatment. We looked at how medicines were ordered and recorded. On one occasion a telephone consultation with the GP had resulted in confusion over the correct dose of a medicine used for agitation. It was evident that this resident had received the wrong dose on at least five occasions. Receiving the wrong dose of a medicine can seriously affect the health and wellbeing of a resident. Staff said that all medicines were given after meals but medicines that should be given before food were not being identified, this is because the records did not highlight the correct time and staff were not reading the information leaflets that should be supplied with the medicines. Giving medicines at the right time helps them work correctly. We looked at care plans and the daily records for medicines prescribed as ‘when required’ and we found some of these lacked sufficient detail to ensure they were given correctly. Care plans should say when and under what circumstances medicines should be administered but this information was often missing. Of particular concern was the lack of detail of how medicines used for anxiety and agitation were to be used. Having detailed written care plans is important to help ensure residents receive their medicines correctly. We saw some evidence of regular monthly checks being carried out by the managers. However these checks had not identified the type of mistakes we had found because they were not detailed enough in the right areas. Checks on medicines handling are important because they help ensure medicines are administered as prescribed and help ensure staff are competent. The manager said all relevant staff were formally observed administering medicines, this is important to ensure they are following the homes’ own procedures and current professional guidance. However given the number of mistakes found during this visit the competence of some of the nursing staff can be seriously questioned. Staff confirmed that the importance of ensuring privacy, respect and dignity is part of their initial training. The residents looked clean and comfortable and were suitably dressed. We saw that a visiting chiropodist was attending to some of the residents in the lounge/dining room. This does not protect the dignity or the privacy of the residents. The unit manager agreed to speak to the chiropodist straightaway and change the practice so that the residents would be attended to in their own rooms. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15. Quality in this outcome area is good. The residents find some enjoyment with the activities provided and their dietary needs are being met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents’ routines of daily living and their social interests were recorded in their care plans. An activity co-ordinator is employed full time and a programme of activities and events, was displayed in the reception area. The staff told the Inspector that they felt the activities provided were acceptable for the residents. Most of the residents on the dementia unit were taking part in the activity on the day of inspection and seemed to be enjoying themselves. We did not eat with the residents but watched what they were having for breakfast and lunch on the Dementia Unit. Breakfast and lunch was served from a heated trolley and staff told us that they felt the food was good and there was plenty of it. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 13 There was a choice of main meal and dessert at each mealtime. The food looked appetising, was served hot and the residents were asked if they wanted second helpings. Fresh fruit was available in the lounge and also given out when the mid morning and afternoon drinks were being served. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. Staff have a good knowledge and understanding of what abuse is, thereby reducing the possible risk of harm to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A detailed complaints procedure was in place and was displayed in the reception area. The complaints procedure was also included in the Service User Guide. It is easy to understand and gives an assurance that complaints will be responded to within 28 days. A record is kept of any complaint made and includes details of the investigation and any action taken. We have recently been made aware of a complaint that has been made to the management of the home and we know that it is presently being investigated. Training in the protection of vulnerable adults has been undertaken by nearly all of the staff. Management have also recently introduced refresher training to make sure that staff know very clearly what abuse is and what they need to do to protect the residents if any allegation of abuse is made. We also spoke to staff to ask what action they would take in the event of an allegation. They were all very clear about what they should do. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is adequate. The residents live in suitably adapted, comfortable surroundings that are continually being improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The environment was not looked at in detail on this inspection visit. We looked at the lounge and dining areas, some of the bathrooms and toilets and the corridors. The lounges/dining rooms were clean and warm. The corridors were bright and nicely decorated. The decor and flooring in most of the toilets and bathrooms remained in need of attention. We were told that management plan to start the refurbishment of the bathrooms and toilets in the very near future. Hand washing facilities to reduce the spread of infection, were in place in bedrooms, bathrooms and toilets. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 16 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 & 30. Quality in this outcome area is adequate. Enough staff are provided to meet the needs of the residents. The unsafe system of managing medicines shows that not all staff are suitably trained and competent. This puts the residents at risk of harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Inspection of the duty rotas and a discussion with the staff showed that there was enough staff on duty over a 24-hour period to meet the needs of the residents living in the Dementia Unit On the Dementia Unit 24-hour nursing care continues to be provided by suitably qualified nurses who are supported by trained care assistants. It was noted that the duty rotas did not have the full name of the staff, or their job role. Also the rota was written in pencil that could be erased. To make sure that there is a very clear record of just who is or was on duty at any one time, the full names of staff need to be written on. The Standards about NVQ training in care and the recruitment of staff were not looked at during this inspection visit. There were no issues of concern from the last inspection and the Standards had been met. Induction training is provided for all newly employed staff. This is to make sure that they understand what is expected of them and that people are cared for properly and safely. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 17 We also saw evidence of further training that had been undertaken. Refresher training in moving and handling and the protection of vulnerable adults had been undertaken for nearly all of the staff. In addition training in basic food hygiene, first aid, health and safety, fire safety, care planning, infection control and other relevant topics had been undertaken or were being planned. Despite the staff being trained with regards to medicine management, there were serious concerns about the way that staff managed the medication systems and their understanding of how and when certain medicines were to be given. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 18 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. Quality in this outcome area is adequate. To protect the health and wellbeing of the residents, the systems in place for assessing staff competence need to be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is not yet registered with the CSCI. She is a Registered General Nurse and a Registered Health Visitor. She has years of experience in care of the elderly, both in the NHS and the private sector. She has achieved the Registered Manager’s Award and keeps herself updated both with clinical and management subjects. Staff told the Inspector that they felt supported by the manager and comments were made that she was very hard working. However despite management St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 19 undertaking regular checks of the medicines they were not detailed enough to uncover the mistakes made. The manager has the overall responsibility to ensure that staff are competent and knowledgeable so that they are able to care for the residents safely. The Standards about checking out the quality of care and services were not looked at during this inspection visit. In addition the Standards about residents finances and the checking of services and equipment were also not looked at on this visit. There were no issues of concern from the last inspection and the Standards had been met. St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x x x x x St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 21 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(1) Requirement To ensure that the care needs of the residents are met the care plans must be detailed and accurate and give a true picture of the residents condition and needs at all times. When a problem has been identified a care plan to address the problem must be in place. So that any changing needs of the residents can be identified and acted upon, care plans and risk assessments must be reviewed regularly. Medicines must be given to residents as prescribed because receiving medicines at the wrong dose, wrong time or not at all can seriously affect their health and wellbeing. Care plans must be detailed for medicines prescribed as ‘when required’ or, as a ‘variable dose’ to help ensure they are given correctly. To ensure that the residents live in a pleasant environment the DS0000005697.V361677.R01.S.doc Timescale for action 30/04/08 2 OP7 OP8 15(2)(a) 30/04/08 3 OP9 13(2) 03/04/08 4 OP9 13(2) 04/04/08 5 OP19 16(2)(c)& 23(d) 30/06/08 St Catherine`s Nursing Home Version 5.2 Page 22 6 OP30 7 OP31 flooring in the bathrooms and toilets must be refurbished or replaced and the decor must be attended to. (Previous requirement for the 31/03/08 not complied with) 18(1)(a) To ensure the health, safety and 18(1) well being of the residents, (c)(i) management must ensure that staff are suitably trained and competent in medication management. CSA.2000 The manager must be registered Section 11 with the Commission for Social Care inspection 30/04/08 30/06/08 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 OP10 Good Practice Recommendations To protect the residents’ privacy and dignity staff should make sure that visiting professionals, such as chiropodists, attend to the residents either in their own room or in a designated private area. To make sure that there is a very clear record of just who is or was on duty at any one time, the full names of staff and their designation need to be written on the staff rota. 2. OP27 St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Catherine`s Nursing Home DS0000005697.V361677.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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