Inspection on 27/01/06 for St Giles Private Nursing Home

This inspection was carried out on 27th January 2006.

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 Giles Private Nursing Home 25/04/08

St Giles Private Nursing Home 06/09/06

St Giles Private Nursing Home 13/07/05

St Giles Private Nursing Home 08/02/05

St Giles Private Nursing Home 16/07/04

St Giles Private Nursing Home 16/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE St Giles Private Nursing Home Tile Cross Road Garretts Green Birmingham West Midlands B33 0LT Lead Inspector Lisa Evitts Unannounced Inspection 27th January 2006 09:45 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 Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Giles Private Nursing Home Address Tile Cross Road Garretts Green Birmingham West Midlands B33 0LT 0121 770 8531 0121 770 8146 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) St Giles Care Limited Sibongile Malevu Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home is registered to accommodate 48 adults over the age of 65 who are in need of nursing care for reasons of old age and will include one named individual, who is 48 years of age and is in need of nursing care whilst alternative private housing is arranged. One named individual who was 48 years of age at the time of admission and in need of nursing care can be accommodated and cared for. Up to five service users between the ages of 55 and 65 years who are in need of nursing care can also be accommodated and care for in this home. 13th July 2005 2. 3. Date of last inspection Brief Description of the Service: St Giles is registered for 48 older people, who require nursing care. The home is also registered to accommodate up to five people between the ages of 55-65 who are in need of nursing care. St Giles is situated in Garrets Green, close to public transport links and has facility for off road parking. The home is purpose built and the accommodation is spread over two floors. All bathrooms are on suite with toilet and washbasin. Bathing facilities are shared, with a mixture of assisted baths and floor draining showers on both floors of the building. Dining facilities and lounges are communal and the home also has a hairdressing salon. Kitchen and laundry facilities are based on site. The home is a non-smoking environment and a shelter is provided outside for this purpose. St Giles employs an activities coordinator and a wide range of activities are on offer. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was undertaken by two inspectors over one day and was assisted throughout by the Registered Manager and Proprietor. There were 44 residents living at the home on the day of the inspection. Information was gathered from talking with the staff and residents and from examining care records. CSCI had received an anonymous complaint, which was investigated during the inspection. The elements of the complaint were not upheld and further information pertaining to this can be found in the main body of the report. No immediate requirements were made at the time of the inspection. This is the second statutory inspection for the 2005-2006 year and it is recommended that this report is read in conjunction with the previous report. What the service does well: What has improved since the last inspection? St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 6 Both of the dining rooms have been re decorated and a smaller sitting room on the first floor was in the process of being decorated. This ensures that the home is comfortable and homely for residents to live in. The home manager has become the Registered Manager of the home. Recruitment procedures have improved and this ensures that residents are cared for in a safe environment. 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 Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 The home provides prospective residents and their representative’s with relevant information about the home and this enables them to make a decision as to the suitability of the home. The home has comprehensive pre admission assessments in place. EVIDENCE: The statement of purpose had been revised since the last inspection and this was detailed with all the required information. The home manager undertakes comprehensive pre admission assessments, for all prospective residents to the home. These were found on all files reviewed and this ensures that the resident know that the home can meet their needs prior to admission to the home. The home does not provide intermediate care. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 & 10 Resident’s health and personal care needs are generally well met by the care staff. Improvements are required in respect of care planning to ensure that care plans reflect the current care requirements of the resident and provide staff with sufficient information to follow in order to meet the identified needs of the residents. EVIDENCE: The inspectors sampled four care files. Generally care plans provided good detail for staff to follow. Hoist and size of sling was recorded, along with type of pressure relieving equipment the resident required, and this ensures that staff know exactly what care requirements the resident has. The exception being a care plan regarding wound care was confusing as it was unclear from the documentation whether the wound had healed or was still present. Biographies had been completed and this recorded personal likes and dislikes. There was evidence that care plans are being evaluated, however staff are not consistently changing instructions on the care plans, as changes in conditions/needs occur and this does not ensure that staff have up to date information to follow. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 10 One example of this was a resident who’s care plan stated that they could walk for short distances and transfer with assistance of one, however the resident was now using a hoist and a wheelchair. This change in needs was not evident from reading the care plan. Monthly weights had been recorded and there was evidence of food intake charts being used to record food intake for residents who required soft diets or who had lost weight. This ensures that weights are monitored and appropriate action taken by staff. A recent admission into the home had been seen by the General Practitioner (G.P) and had been commenced on antibiotic treatment, however no care plan for the acute need had been written. Dependency scores, pressure risk scores and nutritional scores were undertaken and reviewed each month. Staff must ensure that the total scores are calculated correctly as adding the score incorrectly can determine different actions to those, which may be required. Personal risk assessments were in place and provided good details of the risk and actions to be taken to minimise the risk. Separate sheets for recording of G.P visits and other healthcare professionals are kept and this aids with finding information and monitoring care needs. There was evidence that G.Ps, chiropodists, speech therapists, opticians, dieticians and dentists had been to the home to see the residents as required. The home has been allocated a G.P by the Primary Care Trust, who will visit twice weekly and as required for residents who wish to register with him and the manager is in the process of discussing this with the residents and their representatives on an individual basis. Records are kept when residents have baths or showers and indicated that residents have specific days identified for this, however the residents are having them more often than when allocated. Staff were able to state ways in which to maintain residents dignity and privacy when carrying out personal care. The management of medication was not inspected on this occasion. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 13 Residents are able to choose the activities, which they wish to participate in, and this promotes their independence and individuality. Residents are encouraged and supported to maintain relationships with family and friends. EVIDENCE: The home has an open visiting policy and relatives were seen to visit throughout the inspection. The staff complete a biography for the residents, and identify personal interests. The activity coordinator keeps an individual log of activities, which the residents participate in. The home has an activity programme in place which includes quizzes, reminiscence, knitting, colouring, painting, pets for therapy, sewing, bingo, jigsaws films, progressive mobility and church services. The home also organises entertainers and outings. The manager had photographs from Christmas and it was pleasing to see that residents who had to remain in their rooms, due to care requirements or personal choice, had also been involved in the festivities. The manager plans to put the photographs on display in the corridor. A display of one resident crossstitch pictures was on display in the small sitting room. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 12 One resident stated that the activity coordinator was away from work but the carer had sat and helped her with some colouring. This is commendable as shows that staff assist residents to meet all of their needs and not just personal care needs. Another resident stated “I join in the singing and quizzes if I can” St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The complaints procedure is comprehensive and is accessible to the residents and their representatives should they need to make a complaint. The home has systems in place to protect the residents from abuse. EVIDENCE: The complaints procedure is clearly on display in the main entrance area of the home and provides relevant information should anyone need to make a complaint. CSCI have received a number of anonymous complaints, which the home manager and registered provider have investigated, following the homes complaint procedure. The elements of the complaints have not been upheld. During the inspection CSCI investigated an anonymous complaint, which had been received, and the elements of this were not upheld. Complaints are recorded along with details of any investigations and statements obtained. There were no complaints recorded which CSCI were not aware of. It is recommended that the home keep an audit log to ease with the tracking or reoccurrence of complaints. Comments from residents included: “I would call the carers if I was unhappy and they would sort it out” “The problem would be sorted out” Other residents indicated that that the provider regularly speaks to them and they would inform him if they had any concerns. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 14 The home has an adult protection policy in place and this was in line with the multi agency guidelines. Staff interviewed were able to give appropriate answers to questions asked by inspectors, surrounding allegations or suspicion of abuse. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 & 26 St Giles provides a homely, comfortable and clean environment to live in, where residents are relaxed and secure. Resident’s rooms are individualised and provide residents with adequate facilities to meet their needs. EVIDENCE: A full tour of the building was not completed, but areas seen were homely in style and found to be clean and odour free. Furniture, fixtures and fittings are all of a high standard. The home was of a comfortable temperature. Residents were observed to be seated in communal lounges while others had chosen to stay in their rooms. Since the last inspection both of the dining rooms have been re decorated and a smaller sitting room on the first floor was in the process of being decorated. This ensures that the home continues to maintain its homely and domestic character, while ensuring a pleasant environment for residents to live in. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 16 Bedrooms seen were found to contain many personal possessions and this ensures that the residents are in as comfortable environment as possible. One resident said, “My bedroom is alright, I have everything I need” and a relative commented that “Its nice they have their own rooms” One element of an anonymous complaint received by CSCI was pertaining to security of the building and this was not upheld. Visitors to the home are required to ring the bell so that staff have to give access into the home and are aware who is in the building. All visitors into the home are requested to sign in and out of the building and the doors are all linked into an alarm system, which would alert staff if anyone tried to enter the building. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Residents are supported by adequate numbers of staff to meet their assessed needs. There are robust recruitment procedures in place to ensure the safety of the residents. Staff receive an induction programme and further training to ensure they have the knowledge and skills to work competently within their roles. EVIDENCE: There are currently no staff vacancies as the home is fully staffed. There have been anonymous complaints made to CSCI regarding staffing levels. Staffing rotas have been reviewed and these provide evidence that there are adequate numbers of staff on duty to meet the assessed needs of the residents. Bank staff hours had been reduced due to the home having a number of empty beds and the same number of staff not being required, this is acceptable. Sickness and absence is clearly noted on the duty rota and the manager is clearly identified if working as the nurse in charge of the shift. One member of staff was noted to have worked a late shift followed by a night shift and this practice must cease, as it does not allow the staff member any rest period, and therefore does not ensure that staff are fit for duty. It was not clear from the rota what time the late shift had commenced and this information should be clearly recorded on the duty rota. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 18 Staff have signed 48 hour working time waivers and work extra shifts to their contracted hours if they wish to do so. No staff worked more than 60 hours per week, however it is recommended that individual risk assessments are completed for staff who choose to work this amount of hours, in order to ensure they are safe. Comments from residents included: “Care staff always come when you call them” “You always get help when you want it” “Staff are very good, they help you when you need it” “Staff are very good and they know what to do” The home currently has seven members of staff who have completed training for NVQ Level 2, and another three staff are working towards this. Two staff have also completed training for NVQ Level 3. Three staff files were reviewed and were found to contain all the required information, including two references and POVA first checks. There was evidence of induction programmes and evidence that staff had received training in moving and handling, health and safety, fire training and food hygiene. Staff spoken to stated they would like training on specific health conditions and the manager and proprietor were informed of this at the time of the inspection. Staff were able to demonstrate a good knowledge of the residents who they were caring for, were able to state their needs and how they would assist them to meet these needs. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,37 & 38 The Registered Manager ensures that a good standard of service is provided at the home. Improvements are required to quality assurance systems in order for the home to demonstrate that it is run in the best interests of the residents. EVIDENCE: The home manager has successfully completed her application to become the Registered Manager of the home. The manager is a qualified nurse and a moving and handling trainer. She has enrolled onto the Registered Managers Award training course and it is recommended that this should be completed by June 2006. A member of staff described the manager as “relates well to the residents and is a role model” The providers make visits to St Giles frequently, however one of these visits must generate a Regulation 26 report, which must be sent to CSCI as required. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 20 It was evident from residents and staff that the providers regularly visit and monitor the standards of care provided by St Giles by speaking with the residents and their representatives, however the home needs to formalise the quality assurance system and develop a rolling programme. This must take into account the opinions of residents, staff and relatives and external healthcare providers. Audits should be carried out and an annual report should be produced, which includes an action plan and timescales. A member of staff stated that there had “been lots of good changes” since the current owners took over the running of the home and it appeared that staff felt supported by the owners. One resident meeting has been held since the last inspection and minutes indicated that residents were happy at St Giles. The next meeting is planned for March. Accident forms are completed and the Manager completes a monthly audit of accidents/injuries, which have occurred. In addition to this a three monthly review is also undertaken. A staff fire drill had taken place recently and fire records and water temperature checks were maintained appropriately. Correction fluid has been used on some of the care planning documents. This practice must cease and if errors in recording are made, then this should be crossed out with one line and initialled by the person writing the entry. St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X 3 3 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X 2 3 St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 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(1)(2) Requirement The care planning system must be further developed to include: * Care plans for specific acute medical conditions must be written (Previous time scale of 18/05/05 and 30/09/05 not met) Care plans for behaviour must be written, including detail of management techniques. (Not assessed on this occasion) Care plans must reflect the current care needs of the resident and must be updated as changes occur. The nursing staff must adhere to the policies and procedures for medicine management at all times to ensure the service users needs are met (Not assessed on this occasion) The quantities of all medicines received or balances carried over from previous cycles must be recorded to enable audits to be undertaken to demonstrate whether medicines are DS0000024893.V280388.R01.S.doc Timescale for action 31/03/06 2. OP9 13(2) 14/07/05 3. OP9 13(2) 14/07/05 St Giles Private Nursing Home Version 5.1 Page 23 4. OP9 13(2) 5. 6. OP27 OP32 12 (1)(b) 13 (4)(c) 26 7. OP33 24 8. OP37 17 administered as prescribed and also staff competence in medicine management (Not assessed on this occasion) All medication must be administered as prescribed at all times. (Not assessed on this occasion) The manager must ensure that staff have adequate rest periods in between shifts. The registered provider must supply a copy of the written report of the findings of their visit to CSCI monthly as required by Regulation 26 (Previous timescale 0f 08/05/05 and 30/09/05 not met) The quality assurance system requires further development to take into account the views of resident, relatives and staff and an annual report produced Correction fluid must not be used on any documentation. 13/07/05 03/03/06 31/03/06 30/04/06 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP9 OP16 OP26 OP27 OP30 Good Practice Recommendations Advice must be sought to confirm the suitability of all medicines administered via a PEG tube. (Not assessed on this occasion) It is recommended that the manager keep an audit log of complaints received for ease of monitoring. It is recommended that infection control audits are undertaken regularly It is recommended that individual risk assessments are completed in respect of staff who choose to work more than 48 hours per week. It is recommended that the manager arrange for staff DS0000024893.V280388.R01.S.doc Version 5.1 Page 24 St Giles Private Nursing Home 6. 7. OP31 OP24 training on specific health condition conditions. The home manager must complete the Registered Managers Award by June 2006. The home should provide pillows that are fit for purpose and staff should utilise the appropriate equipment available to assist service users to be in an upright position whilst in bed. (Not assessed on this occasion) St Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Giles Private Nursing Home DS0000024893.V280388.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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