Inspection on 04/09/07 for St David`s Nursing Home

This inspection was carried out on 4th September 2007.

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

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

Other inspections for this house

St David`s Nursing Home 12/12/06

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE St David`s Nursing Home 52 Common Lane Sheringham Norfolk NR26 8PW Lead Inspector Hilda Stephenson Unannounced Inspection 4th September 2007 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 David`s Nursing Home DS0000068537.V350267.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 David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St David`s Nursing Home Address 52 Common Lane Sheringham Norfolk NR26 8PW 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) 01263 822671 01263 820005 caroline@st-davids.com Lakeshore Healthcare Limited Mrs Caroline Whitbread Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2006 Brief Description of the Service: St David’s is a care home providing personal care and nursing care for up to 35 older people. The home has recently been acquired by Mr Jeffrey Manning of Lakeshore Healthcare Limited. The registered manager is Caroline Whitbread. The home is situated near to the town centre of Sheringham, Norfolk. The home is well situated in a residential area and within easy access of local amenities. The accommodation for residents is on both ground and first floors of the building and there is a shaft lift. The home is set in extensive gardens with established trees and lawns. There is off street parking to the front of the premises. The fees range from £347.00 to £567.50 per week. Additional charges are made for personal requisites, private telephone facilities, newspapers, hairdressing and private chiropody. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit to St David’s took place on the 4th September 2007 as an unannounced inspection to check the outcomes of the key standards. These standards were inspected, although not all the elements have been examined. The evidence gathered to publish this report was obtained by speaking to twelve of the thirty three residents, two visitors, six staff and the manager during the day and checking through care records, policies and procedures. Further evidence was gathered from comments received through the numerous comment cards that were returned to the office from both residents and relatives prior to the visit and the information documented within the Annual Quality Assurance Assessment completed by the manager of St David’s. Part of the inspection involved a tour of the building and the home was found to be clean, tidy and free from odour. The majority of residents were either in their bedrooms or sitting in the lounge and garden areas, with several entertaining visitors. The home provides both nursing and residential care for older people. What the service does well: This nursing and residential home is managed by a competent manager who has worked at the home for two years. The manager is a trained nurse with a vast experience in caring for older people. She is also an Adult Protection trainer who networks with other local homes to teach awareness on adult protection issues. A clear and concise assessment of care and medical needs is undertaken prior to residents moving into the home. The care plans are stored in resident’s own rooms so they can access their own records whenever they wish and are fully involved when the plans are reviewed. These contain detailed and comprehensive health and social care needs to enable staff to care for residents as individuals. Residents are cared for in a homely environment on the outskirts of the town of Sheringham. Each resident’s bedroom contains their personal possessions and is decorated according to their taste. The Proprietor visits the home approximately once a week to offer support to the manager, staff and residents. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 6 They have invested in providing specialist equipment to enable the residents to be cared for adequately to ensure that nutritional needs, pain relief and pressure care is in place for those who are frail, within a homely environment. This home continues to provide facilities for residents who wish to smoke. What has improved since the last inspection? What they could do better: The inspection concluded with two requirements and one recommendation issued to the manager. The complaints policy displayed on the notice board should contain up to date information of the names and addresses of other agencies to complain to. The provider must implement monthly-unannounced visits to audit the service under regulation 26. The doorbell was out of order and should be repaired. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 7 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 David`s Nursing Home DS0000068537.V350267.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 St David`s Nursing Home DS0000068537.V350267.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): Quality in this outcome area is good, Standards 1,3,6 were checked. This judgement has been made using available evidence including a visit to this service. Written information is given to residents prior to admission to define the facilities offered at the home. All residents are admitted after an assessment of their needs. EVIDENCE: There has been a change of proprietor following from the last inspection. The Statement of Purpose and Service User Guide has been updated to include the change of details. These documents are available in residents’ bedrooms. The manager explained the admission process for prospective residents and this was verified after speaking to a recently admitted resident, who confirmed that they had received the written information, with their relatives visiting the home to see the allocated bedroom prior to the admission. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 10 The manager visited the resident beforehand and asked questions about the level of care that would be required so she could arrange for any specialist equipment that was required. The pre-admission details contained personal wishes and needs about the level of care that was required, with instructions for the care staff on how to attend to them on an individual basis. This made up part of the care plan until the nurse in charge wrote a more detailed plan of care during the initial assessment period over the first four weeks. The home admits residents for intermediate care needs for those who may need nursing care, occupational therapy and physiotherapy for short periods. St David`s Nursing Home DS0000068537.V350267.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): Quality in this outcome area is good All the above standards were checked. This judgement has been made using available evidence including a visit to this service. Resident’s health care needs are generally met. Residents or their Next Of Kin are involved when their care plan is compiled and reviewed to ensure that their individual needs are met. Safe medication administration procedures are in place to ensure residents receive the correct prescribed medical treatment. EVIDENCE: Three care plans were looked at and the same residents spoken to during the day about their care. The residents care plans were thoroughly examined and found to contain clear, concise information regarding the physical, mental and social needs of each individual. Each of the care plans contained risk assessments in relation to their moving and handling needs, medication involvement, with indicators in place to monitor nutritional needs by assessing pressure care and weight management. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 12 Since the last inspection the home has developed a more person centred approach with the care plans and obtain more details about each resident’s past life before they were admitted to the home, which is good practice. The care plans are kept in individual resident’s bedrooms and residents can read their care plan at any time. The nurse keeps each resident up to date with any changes that require implementing regarding their nursing needs. The nurse explained that expertise from the community nurses was sought when specialist pressure equipment was required. Specialist services such as chiropody, physiotherapy, dental care and psychiatric services were regularly sought for those who required these. The manager confirmed that residents admitted from other areas tended to register with the local GP surgery, although some local residents have stayed with their own GP surgery. The local GP practice has a designated GP who visits the home on a weekly basis to review resident’s immediate needs,and also visits when required. Information from the three residents was obtained by speaking to them, each confirming they knew who their nurse was and that they could read their records whenever they wished. Each resident also confirmed that they felt ‘well looked after, by the staff. Residents confirmed that the staff at the home uphold their privacy and dignity at all times, assisting them back to their rooms or the quiet lounge if they require a quiet area. It was observed that staff knock on residents’ bedroom doors before entering their rooms. Twelve residents were spoken with and two relatives during this site visit. Several residents stated that they prefer to spend time in their own room and this was respected by the home. The trained nurses on duty administer all medication and the lunchtime round was partially observed. The medication records were checked for the three residents involved with case tracking and found to be accurate. The trained nurses regularly audit the medicines to ensure no out of date medicines are kept. The manager confirmed that the local PCT pharmacist had visited the home recently to ensure that no risks are taken with the medication procedure. St David`s Nursing Home DS0000068537.V350267.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): Quality in this outcome area is good All the above standards were checked. This judgement has been made using available evidence including a visit to this service. Residents are generally content with the food offered. Social activities are adapted to suit resident’s individual tastes. EVIDENCE: The home employs an Activities Co-ordinator who arranges social gatherings throughout the year, one example being the musical afternoon enjoyed by residents the previous week. The notice board at the entrance contained information of the future social arrangements. A cream tea and raffle inviting relatives was arranged for two days time. An activities list was posted on the lounge notice board and included weekly exercise classes held every Monday, quizzes and games every Wednesday and a film show with an ice cream interval was in place every Friday. The Activities Co-ordinator also obtains background information on each resident, during one to one discussion, so any assistance with personal hobbies and interests are able to be supported by the staff. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 14 Comments received from relatives confirmed that they could visit anytime and felt welcomed by the friendly staff. They also confirmed that they were offered tea with their relative and privacy. It was observed that staff respected those residents who did not wish to take part in activities and preferred to stay in their room, although it was noted that some staff were sitting talking with residents at various times during the day. Many residents were too physically frail to take part in more organised activities. It was noted that the home provided talking books, music and reminiscence discussions. During this visit it was observed that a large number of residents sat outside in various parts of the garden enjoying the sunshine. Several residents who required assistance had their food cut up or staff assisted them in a dignified manner. One resident was seen to have some difficulty eating, although refused help from staff and was provided with protective clothing. The written comments received prior to inspection tended to be negative with one stating ‘too much mince’ and the ‘beef is too large’; the menu was checked and the chef was informed to monitor this. Verbal comments regarding the meals were positive on the day of inspection. The kitchen was found to be clean and the chef was preparing lunch of chicken pie, cod mornay and various salads with three options for dessert. The dining room is situated in the conservatory, so meals are transported and served direct from the hot trolley by the chef. Residents are asked their preferences on a weekly basis, although the chef confirmed that this could be altered if a resident’s condition changed. The meals appeared to suit the majority of residents and the chef regularly visits residents to seek their opinion when the menu is changed. The last Environmental Health visit issued three requirements, all three having been competed. Some residents were too frail to sit at the table in the dining room area, so staff respected their wishes to eat their meals where they sat in their own rooms having tables and adapted equipment provided. The home monitors the nutritional needs of residents and checks the weight of residents especially those who are vulnerable. Chef confirmed that food and supplements are available outside meal times. St David`s Nursing Home DS0000068537.V350267.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): Quality in this outcome area is good Standards 16 & 18 were checked. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are confident that the manager would deal with their complaints satisfactorily. Residents are protected from abuse. EVIDENCE: No complaints were received through the collection of the comment cards from residents and relatives. Although, one relative wished to speak with the Inspector during the site visit due to having some concerns and this was arranged. The Home has a complaints procedure that is available for residents to read within the care plan held in the bedroom. The Statement of Purpose also states how to complain and the Manager states she is always available to listen to anyone with any concerns. On talking to the residents it was clear that they are happy to talk to the Manager or the trained nurse of any concerns or worries. The Home has not received a complaint since the last inspection.The complaints policy displayed on the general notice board has out of date information and this is required to be updated. See Requirements The manager is an Adult Protection trainer and organises training sessions for the staff and networks with other local homes to include their staff in the teaching sessions. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 16 Staff spoken to during this visit confirmed they felt confident in their knowledge of various forms of abuse and how they put this into action to protect their residents they care for. The staff feels able to report any concerns to the manager and all residents spoken to feel the service offered is correct and all staff treat them appropriately. St David`s Nursing Home DS0000068537.V350267.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): Quality in this outcome area is adequate Standards 19 & 26 were checked. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, clean and reasonably well-maintained home. EVIDENCE: A tour of the building was undertaken. A requirement was issued from the previous inspection to improve some of the ‘tired’ areas of the home. The new proprietor has changed the carpets on the ground floor corridor, redecorated the quiet lounge, ground floor corridor, ground floor toilets, first floor smoking room, adding modern pictures in the lounge and TV room and table lamps have been placed throughout the home, although there are still improvements to be made to dark bedrooms and the first floor office area. The large conservatory is used as the dining room, organised games and entertainment. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 18 All areas of the home are accessible to residents; the garden had several areas containing furniture for the use of residents who enjoy sitting outside. The home provides an extensive range of equipment designed for the comfort and safety of the residents in the form of specialist beds, chairs and hoists. The home employs a maintenance manager who checks fire equipment and organises fire training for staff. A fire risk assessment of the building is in place and records of regular maintenance and redecoration were also in place. Some comments received from relatives and residents stated that some areas of the home remain dark; a large tree blocks sunlight into some residents’ bedrooms and the proprietor may need to enquire whether the tree could be trimmed. It was noted that the front door bell was out of order and it was recommended that this should be fixed as soon as possible. See Recommendations The bedrooms are on two floors with a shaft lift in place. Eight of the bedroom have en suite facilities. There is one double bedroom, although the manager stated that this is currently being used as a single bedroom. All areas of the home were clean and tidy. The home has comfortable furnishings and residents’ bedrooms contained personal possessions to maintain individuality All residents’ personal laundry is carried out at the home by designated staff. St David`s Nursing Home DS0000068537.V350267.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): Quality in this outcome area is good. All the above standards were checked. This judgement has been made using available evidence including a visit to this service. Well-trained competent staff care for residents, although the numbers of staff can be short at times of sickness and holidays. The home has a good clear recruitment procedure in place to ensure the protection of vulnerable adults. EVIDENCE: Staff spoken to throughout the day had been in post for a while and the rota showed the correct number of staff on duty. During this visit the manager and personal assistant, two trained nurses, four carers, the chef and kitchen assistant, laundry assistant and maintenance staff and two domestic staff were on duty. The manager explained that care staff numbers had been adapted to suit the needs of the current residents, with an extra member working at busy times, although numbers during the afternoon had been reduced. Comments obtained prior to the inspection indicated that residents and relatives thought there were not enough staff on duty and this could be explored further. Residents spoken to thought the staff were very competent and caring and assisted them at times that suited them. It was observed that the call bell did not ring for long when residents wanted some attention from staff. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 20 The training and supervision records were available along with the initial induction training records these were particularly of a good standard. The last member of staff employed at the home was a carer and the manager had followed a good clear recruitment procedure, obtaining references and the relevant checks before staff commenced. Eight of the fifteen care staff have achieved the NVQ level 2 training and a further three care staff have commenced NVQ level 3 training in care skills. St David`s Nursing Home DS0000068537.V350267.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): Quality in this outcome area is good Standards 31,33,35,36 & 38 were checked. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is managed with their best interests at heart. Resident’s health, welfare and safety needs are promoted and protected. EVIDENCE: The manager has been in post for two years, is a trained nurse with vast experience in caring for older people. She is a trainer in Adult Protection awareness and regularly holds teaching sessions for staff from St David’s and other local homes. She is still to complete the Registered Managers Award. A comprehensive Annual Quality Assurance Assessment document had been completed and returned to the Commission that gives clear details of the management responsibilities carried out in the home. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 22 The home has gathered residents’ and relatives’ views on the quality of the service, which has given a broad view of certain aspects of the care. Two graphs of the results were shared with the Inspector. One thing the proprietor needs to do is to implement a regular audit of the service by undertaking a monthly unannounced visit as required by the Care Homes Regualtions, (Regulation 26). See Requirements Staff confirmed that regular staff meetings are held and that the manager organises individual appraisal for staff, although regular supervision sessions with staff were recommended. The manager holds personal spending money for some residents and these records were checked and found to be correct. Records show that health and safety issues are attended to with regular maintenance of fire equipment and training. The accidents and deaths rates at the home showed no abnormalities. Risk assessments for individual residents were seen in care plans, with general assessments following the homes policy and procedures to ensure the safety of the staff too. Residents who were spoken to confirmed that their views are listened to. Twelve residents and two relatives were spoken to during this visit to the home. Plus comments received from comment cards confirmed that the home is managed in an open and friendly manner. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP16 Regulation 22.2,7 Requirement The complaints policy on the main notice board is required to update the names and addresses for an alternative for people to be able to complain. The provider is required to monitor the service using the recommended monthlyunannounced Regulation 26 visits and send the reports to the Commission. Timescale for action 30/10/07 2 OP33 26.1,3,5 30/11/07 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 OP19 Good Practice Recommendations The front doorbell must be repaired. St David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 David`s Nursing Home DS0000068537.V350267.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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