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Inspection on 08/08/06 for St Josephs Nursing Home

Also see our care home review for St Josephs Nursing Home for more information

This inspection was carried out on 8th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The resident surveys and residents spoken with confirmed that the providers continue to a high standard of care. Residents are able to have a bath everyday is they wish which many residents feel is important to them. The management also make every effort to ensure that resident`s needs are met. One resident who completed the survey commented " We find the staff very helpful. My wife and I have been married over 60 years. Before we came here we spent the days together sitting at home, the staff have made it possible for us to be together at night, sharing one room and we have another room as our sitting room so we can be together during the day. They identified our need. We are both very happy with the arrangement it`s like home from home. We are well cared for". Staff are provided with opportunities to undertake training. The home has successfully achieved the 50% ratio of care staff holding a National Vocational Qualification Level 2 or above. Staff were observed to be knowledgeable with regards the needs of residents. The domestic staff need to be congratulated for the high standard of cleanliness throughout the home. All areas were clean, tidy and free from offensive odours, including both sluice rooms.

What has improved since the last inspection?

Following the last inspection a number of rooms have been redecorated and new carpets fitted. A new refrigerator and dishwasher have been purchased. Risk assessment for residents who wish to self-administer medication have been undertaken.

What the care home could do better:

The providers do have a recruitment procedure however procedures need to be tightened in order to promote the safety of residents. Information obtained via the homes quality assurance and quality-monitoring systems must be collated and a report written. The report should be made available to residents and other interested parties. Records seen indicate that not all staff have received fire safety instruction at the intervals recommended by the fire authority.

CARE HOMES FOR OLDER PEOPLE St Josephs Nursing Home East Street Littlehampton West Sussex BN17 6AU Lead Inspector Mrs S Rodgers Key Unannounced Inspection 8th August 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Josephs Nursing Home DS0000024215.V301678.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 Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Josephs Nursing Home Address East Street Littlehampton West Sussex BN17 6AU 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) 01903 721053 Franciscan Missionary Sisters of Littlehampton Sr Angela Baughen Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 24 male and/or female service users aged from 65 years, in the category of old age, not falling within any other category may be accommodated. Only service users over the age of 65 years may be admitted. Date of last inspection 25th October 2005 Brief Description of the Service: St Joseph’s Care Home is registered to accommodate up to twenty-four residents in the category OP (Old age not falling into any other category) N (Nursing). The service has charitable status and is registered to the Franciscan Missionary Sisters. The weekly fees range from £525.00 to £575.00. Additional charges include hairdressing, chiropodist, dentist, physiotherapist, newspapers and sundries. St Josephs is a purpose built establishment, and is located in the town of Littlehampton. Accommodation is provided on two floors: the first floor can be accessed by a vertical lift. All rooms are for single occupancy. Sr. Angela Baughen is the registered manager in charge of the day-to-day running of the home. The responsible individual on behalf of the service is Sr. Anastasia McGonagle. Inspection reports are made available to residents on request. St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over one day in August over 8 hours. The providers were required to complete a pre inspection questionnaire; this document was submitted to the Commission with accompanying documents by the due date. Information from this questionnaire will be included in this report. Resident surveys were also sent in order that residents were able to express their views on the service. Twenty-two were returned and comments form part of this report. Preparation for this inspection focused on a reviewing pre inspection material, reviewing resident’s surveys, review of previous inspection reports, provider’s monthly reports and general correspondence. During the course of the inspection the inspector toured the home, spoke with residents either privately in their own bedrooms or within the communal areas of the home in order to gain a sense of how the home is being run and how they experienced living at the home. One visitor was also spoken with in order to gain a view of the service their relatives receive. Four staff were spoken with in order to gain a sense of the support and training they receive in order to carry out their jobs and to gain insight into how their knowledge of the aims and objectives of the homes philosophy of care. From speaking with residents the inspector gained the impression that the standard of care provided by the management and the care team is of a high standard. The inspector also took the opportunity to observe the interaction between both residents and staff. It was noted that the atmosphere within the home was jovial and relaxed and that the staff carried out their duties in a respectful manner taking into account the dignity and privacy of residents. Following the last inspection carried out on the 25th October 2005 there were not requirements identified at that visit. 3 requirements were identified at this inspection. The registered provider is required to write to the Commission for Social Care Inspection by the dates indicated in the ‘timescales for action’ box to advise of action to be taken and timescale in which compliance with the regulations. Where standards have not changed from the previous inspections this report records that the findings were the same. St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Following the last inspection a number of rooms have been redecorated and new carpets fitted. A new refrigerator and dishwasher have been purchased. Risk assessment for residents who wish to self-administer medication have been undertaken. St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 7 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 Josephs Nursing Home DS0000024215.V301678.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 Josephs Nursing Home DS0000024215.V301678.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre admission assessment enables the management to determine that the needs of person admitted to the home can be met. Intermediate care is not provided. EVIDENCE: The pre admission assessments seen on all new admission indicate that health, personal and social of a prospective residents reviewed, information gained at this time is used to devise a care plan for the prospective resident prior to them being admitted to the home. Although there was on person who felt that they did not receive enough information of the service the majority were satisfied with the amount of information they received. Comments included “There was home visit for full discussion and an extensive tour of the establishment before deciding entry. It St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 10 was my own decision to come here, not made on my behalf. It had been highly recommended to me in the past”. Residents can visit St. Joseph’s for short breaks however rehabilitation services are not provided. St Josephs Nursing Home DS0000024215.V301678.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of residents are documented in individual Care Plans, which enables staff to monitor and maintain continuity of care. Residents are enabled to take responsibility for administering their own medication. Resident’s privacy and dignity was observed to be maintained. EVIDENCE: Four care plans were reviewed. Care plans contained all relevant information, including risk assessments for manual handling and nutritional assessments. Comments regarding care include “…Since arriving at St Joseph’s in March, my husband has received the highest standard of care. My son and I are delighted with his progress”. Care plans record visits to hospital and doctors or district nurses visit. Daily records are kept to monitor any changes in resident’s condition. St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 12 Systems are in place regarding the receipt, recording, storage, handling, administration and disposal of medicines. A senior nurse requests repeat prescriptions, these are sent to the local pharmacist. Records of all medicines requested are kept. Staff check and record all medication against the request list. The home has a contract with a licensed clinical waste company who collects all unused medication. Trained nurses administer medication; the home has a copy of each nurse’s signature and initials, which enable management to be clear as to who the administering nurse was. Records of medication administered were in good order. Residents are able to self-administer their medication. Since the last inspection risk assessments have been carried for those residents who wish to self medicate. This is to demonstrate that residents are able to and know when and how much medication to take and also that they understand their responsibility with regards storing their medication appropriately i.e. in a locked cupboard. During the course of the inspection the inspector was able to observe staff maintaining resident privacy and dignity by knocking on doors prior to entering their rooms. Residents who were asked confirmed that staff make sure that they are appropriately covered when being taken to and from the bathroom. St Josephs Nursing Home DS0000024215.V301678.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to satisfy their social, religious and recreational interests, which assists them to live a fulfilled life with in the home setting. Residents are assisted to maintain contact with family, friends, and representatives and access the community. Residents are assisted to exercise choice over their daily lives. Residents are offered a well-balanced and varied diet. EVIDENCE: Service users spoken with confirmed that they have the opportunity to take part in the homes programme of activities. Activities include quizzes, tea and chat clubs, tamarisk centre and music and movement. Comments received via the survey indicate that residents are generally satisfied with the activities on offer. “ The staff are taking us to see the regatta…” “There are quizzes and outings” and “the staff give us a nice cup of tea, before taking us to Mass in wheelchairs daily, it is my pride and joy , a lovely start to the day. I look St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 14 forward to it. Sr. Angela arranged a coach and took us to ST. Philips RC at Christmas for a carol concert, and refreshments, a very enjoyable evening. In June another Sr. took us on a coach to Arundel to see the Carpet of Flowers a magnificent sight, we enjoyed it”. One resident felt spoken with on the day of this visit said that they did not always know what activities are taking place. It would be good practice for the management to either display the weekly/monthly programmes or give individual copies to those who want one. Residents confirmed that they were able to take part in the planned activities or pursue their own interests as they wish. Residents told the inspector that a hairdresser attends the home weekly. Residents spoken with confirmed that they are enabled to maintain contact with family, friends and representatives. One visitor spoken with confirmed that she is made to fell welcome to staff and is offered regular refreshments Residents said that they are able to exercise choice and control over lives. Those who were asked said they are assisted to develop and maintain an independent lifestyle within their own capabilities. One resident commented “It is a bonus having ‘individual TV’s, radios and phones in our own rooms. We are not herded into communal rooms to have to watch obligatory TV”. Resident’s confirmed that food provided was of a good standard. A four weekly menu is followed, it was confirmed that the menus get updated at regular intervals. Menus submitted with the pre inspection questionnaire documentation indicate that a varied well balanced diet is offered. Liquidised meals were appropriately served with each ingredient liquidised and presented individually. Alternatives to the main meal are available. Comments include “More please its all so appetising”, “we are satisfied with the meals here, there is always a good selection to choose from, nicely presented” and “ Really lovely and a good variety, excellent, delicious. All home cooked, by two brilliant chef, served with a smile, piping hot…..”. St Josephs Nursing Home DS0000024215.V301678.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints system is in place. Systems are in place to protect residents from abuse. EVIDENCE: There is a clear complaints procedure, which is included in the Statement of Purpose and Service User Guide. The procedure clearly identifies whom a complaint should be addressed to and the timescales in which a complaint will be dealt. Residents were clear as to whom they can raise concerns with. Resident’s comments included “ Sister Angela always around never rests”, “Sr. Angela” and “we fell comfortable asking any of the staff for our needs and feel free to approach any of the Nursing staff if we have any problems. The records of complaints were reviewed. Residents who were asked were aware of the compliant procedure and said that they would use it if required. All residents spoken with confirmed that they would be able to raise any concerns that they have with Sr. Angela or her care team. Residents confirmed that they know how to make a complaint. “We have no complaints that we can think of. If there was a problem we would ask to speak to the home manager or the sister in charge of the floor”. St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 16 Staff receive training in adult protection. The home has a copy of the local authorities Adult Protection procedures. Staff are aware of their responsibility to “Whistle Blow” should they suspect abuse of a resident. Staff spoken with during the course of the inspection demonstrated that they know what action they must take to report a suspected incident. They were also aware of the types and indicators of abuse. St Josephs Nursing Home DS0000024215.V301678.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well maintained, clean, pleasant and hygienic. EVIDENCE: Whilst touring the home the inspector was able to establish that the physical environment is well maintained. The pre inspection questionnaire indicates that some bedrooms have recently been redecorated and new carpet fitted. One empty room was in the process of being redecorated at the time of this inspection. Risk assessments have recently been undertaken with regards the physical environment both inside an out. The standard of cleanliness throughout the home was excellent. All areas of the home were clean and free from any odours including the sluice rooms. St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 18 Comments about the cleanliness of the home from residents include “spotless”, “like a palace”, “the standard of cleaning is excellent. The areas are always clean and fresh” and “ Quite immaculate, the two toilets always fresh and clean. No dust is allowed to settle for ling by our hard working cleaners and our rooms are cleaned and hovered daily”. St Josephs Nursing Home DS0000024215.V301678.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff were on duty in sufficient numbers to meet the needs of the current resident. The skill mix of staff was observed to be appropriate. There is a recruitment procedure in place. Staff are encouraged to undertake training appropriate to the need of resident. EVIDENCE: Information submitted with the pre inspection material and duty rotas seen at the inspection indicate that staff are employed in sufficient numbers to meet the needs of the current residents. Records seen and staff spoken with at this inspection evidence that staff receive induction training and are offered the opportunity to undertake a National Vocational Qualification. The pre inspection questionnaire demonstrates that 50 of care staff have obtained an National Vocational Qualification in care level 2 or above. The home does have a recruitment procedure however at the time of this visit it was noted that for one staff member one reference was missing. For another new member of staff there were two “to whom it may concern” letters. St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 20 Sr. Angela confirmed that new references had been sent for however they were not on file and there was no evidence to demonstrate that verification of the to whom it may concern letters had been sought. References must be obtained prior to a new employee starting employment. Staff were observed to be relaxed, confident and competent. The inspector noted that they were also respectful when talking or assisting residents. Residents commented “Staff are very good”, “I only have to ring my bell and help comes at any time” and “Staff are always attentive”. St Josephs Nursing Home DS0000024215.V301678.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being managed in an appropriate manner. The financial interests of residents are safeguarded. Resident’s views of the service are sought. The health and safety of residents is promoted. EVIDENCE: Sr. Angela is an RN who has many years experience in the care sector. She has recently obtained her Registered Managers Award. Residents and staff spoken with told the inspector that they feel able to approach the manager with any concerns that they may have. Comments such as “ I am very happy here in my new home. I like being here and the staff are excellent and see to my every need. Sr. Angela is a great manager and takes wonderful care of us all and staff” and “for six weeks Sr. Angela kept my husbands room available St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 22 whist we were waiting for his discharge form Worthing hospital…” were forwarded to the Commission. A quality audit and quality monitoring system has been started. However the outcomes of survey and the monitoring process should be collated. This information should be used to develop a report which identifies what the service does well, what needs to be improved, how improvements will be made indicating the timescales for action. The inspector was advised that residents handle their own personal finances. Residents can if they wish ask for some money to be held in safekeeping. Appropriate systems are in place to record transactions. Pre inspection material submitted to the commission indicates that regular maintenance checks are carried out in order to promote the health and safety of residents. Staff receive training in safe working practice however some staff have not had fire safety instruction at the recommended intervals of 3 monthly night staff and 6 monthly day staff. Accident records were available and were in good order. St Josephs Nursing Home DS0000024215.V301678.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 St Josephs Nursing Home DS0000024215.V301678.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 2 Standard OP29 OP33 Regulation 19 24 Requirement All recruitment checks must be undertaken prior to any new employee commencing duties. The registered persons shall establish and maintain a system for reviewing and improving the quality of care provided at the care home. All staff must receive fire safety instruction at the recommended intervals of 3 monthly night staff and 6 monthly day staff. Timescale for action 14/09/06 14/11/06 3 OP38 23 (4) (e) 14/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Josephs Nursing Home DS0000024215.V301678.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Josephs Nursing Home DS0000024215.V301678.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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