Inspection on 08/02/07 for Teesdale Lodge Nursing Home

This inspection was carried out on 8th February 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

Teesdale Lodge Nursing Home 27/10/05

Teesdale Lodge Nursing Home 07/07/05

Teesdale Lodge Nursing Home 15/09/04

Teesdale Lodge Nursing Home 07/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Teesdale Lodge Nursing Home Radcliffe Crescent Thornaby Stockton-on-Tees TS17 6BS Lead Inspector Katherine Acheson Key Unannounced Inspection 8th February 2007 12:45 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 Teesdale Lodge Nursing Home DS0000000209.V329818.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. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Teesdale Lodge Nursing Home Address Radcliffe Crescent Thornaby Stockton-on-Tees TS17 6BS 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) 01642-612821 Cleveden Care Limited Susan Wyer Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is able to admit a maximum number of 10 service users with a physical disability aged 50 and above. Five named individuals who are under the age category are allowed to reside in the home. 27th October 2005 Date of last inspection Brief Description of the Service: Teesdale Lodge is registered to provide personal and nursing care to forty-four residents aged sixty-five and above. The home has a variation to registration that allows them to admit a maximum number of ten residents aged fifty and above within the forty-four registered beds. Teesdale Lodge is a single storey, purpose built facility providing accommodation to residents in the form of forty-four single bedrooms. All bedrooms have ensuite facilities, which comprise of a toilet and hand washbasin, all bedrooms meet the required amount of space. The home provides three lounge areas and a separate dining room. Each bedroom has television and telephone points, however pay phone access is available. The home is set in accessible grounds and provides car-parking facilities for visitors to the home. The cost of care at the time of the inspection visit ranged from £449 to £572 per week. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection of the home was carried out over two days the 8th and 9th of February 2007. On the first day of the inspection the Inspector arrived unannounced. The Manager of the home was aware of the second day of the inspection. On the 8th February 2007 the Inspector arrived at 12:45 and left at 17:00. On the 9th February 2007 the Inspector arrived at 10:30 and left at 14:30. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the government for Care Homes. Six residents, two relatives, two care assistants, the office administrator and trained nurses were spoken to during the inspection. A lengthy discussion also took place with the Manager. Numerous records including care plans, menus, quality assurance, complaints and staff recruitment and training records were examined. A tour of the premises was carried out. Prior to the inspection ten relative comment cards and ten resident comment cards were sent out to the home to give to residents and families asking them to complete and comment on the care that is received at the home. Six relative comment cards and three resident comment cards were received. Comments can be read in the main body of the report. Requirements identified at the last inspection in October 2005 were re-visited. The details of any issues identified at this inspection requiring action are to be found at the back of this report. What the service does well: Teesdale Lodge Nursing Home is a modern purpose built facility with all rooms having en-suite facilities. The building is light and airy and communal areas are homely. Residents’ rooms are pleasantly furnished, decorated and personalised with individual items of the residents own choosing. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 6 The home is well run and a good standard of care is provided to residents. One resident spoken to during the inspection said, “The staff are very nice and I quite enjoy the food”, another said, “The staff are very helpful and the food is excellent”. The home provides a three-course menu to residents with an alternative choice available at each mealtime. Mealtime was relaxed with a pleasant atmosphere. Residents and relatives spoke very highly of the food provided. Care planning was of an extremely high standard. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of prospective residents are carried out to ensure that the home can meet their needs. EVIDENCE: The Manager said that prospective residents receive an assessment that is carried out by a social worker or other health care professional to ensure that the home can meet their needs. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 9 Staff at the home then carry out their own pre-admission assessment to ensure that the needs of the resident can be met at home. Two resident files were examined at random during the inspection, both of which contained detailed assessments of the resident. The Home does not provide intermediate care. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a good standard of care. Care plans are detailed and specific to the individual, which will help to ensure that resident’s needs are met. Residents are mainly treated with respect and their right to privacy is upheld. Good procedures are in place to ensure safe practice in respect of the handling of medication. EVIDENCE: Two plans of care were examined at random during this inspection both of which were detailed and contained specific care and intervention required to assist the resident. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 11 One of the plans of care examined was that of a resident with complex care and nursing needs. The plan of care was exceptionally well written. Likes, dislikes and personal preferences were documented. Care plans were extremely detailed and informative showing clear evidence of choice and preference in the way care was to be delivered. Care plans were effectively evaluated on a monthly basis. Evaluations included a baseline of the resident’s capabilities, deteriorations and improvements made. Risk assessments were evident on resident files examined during the visit and included intervention required to minimise the highlighted risk. Risk assessments were also evaluated to confirm effectiveness. Five relatives were spoken to during the inspection comments made included, “I’ve been in the home a couple of years I think it is marvellous”. “The staff are very helpful sometimes they cant get here quick enough”. “I’m very satisfied”. “It’s quite nice really”. “The staff are approachable, I find the younger ones the best, the older ones are set in their ways” Resident and relative comment cards received prior to the inspection in respect of care received stated, “In all professions some people have excellent communication skills and are totally dedicated; to others it is a job. Teesdale Lodge is fortunate that a very high proportion of nursing staff and caring staff are highly skilled sympathetic and very dedicated”. “Every aspect of Teesdale Lodge is first class”. Residents spoken to confirmed that their dignity and privacy was respected. The home has a medication policy. Trained Nurses administer medication to residents at the home. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 12 Records were available to confirm that the home keep a record of all medication coming into the home and that of all medication returned for destruction. Medication was observed to be stored securely. During the visit a medication audit of the two residents files sampled at random during the inspection was carried out. Medication administration charts had been completed correctly and the stock balance of medication belonging to the residents was correct, matching up with medication ordered, received, administered and remaining in the home. Teesdale Lodge Nursing Home DS0000000209.V329818.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): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate and enjoyable activities do take place at the home, however are limited at present. Consideration is not always given to younger residents residing at the home. Residents are able to exercise choice and control. Visitors are encouraged and made to feel welcome at anytime. Food provided is varied, appetizing and appealing and provides residents with a wholesome balanced diet. EVIDENCE: The Manager said that the home is in the process of recruiting an Activity Coordinator to provide and arrange a plan of activities, entertainment and outings for residents. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 14 The Activity Co-ordinator will work twenty-five hours per week. Interviews had taken place with a successful candidate identified. In the interim activities have been planned and carried out by care staff working at the home and the Manager acknowledges that these have been limited in the absence of an appointed person responsible for activities. Twice a month recreation and motivation afternoons/mornings are provided for residents. Gentle exercise and stimulating motivational recreational techniques are carried out. This includes singsong, floor games, music and reminiscing. Entertainers come into the home on average once a month and perform/sing to residents. Recent trips out have included shopping to Teeside Park and Middlesbrough town centre. One resident spoken to during the inspection said, “The motivation classes are very good, the sing-a-long is nice”. One resident said, “I would like more activities, the home could do more like dominoes and bingo”. It was identified during the inspection through discussion with a resident, their family and Manager of the home that the home were failing to meet the social and recreational needs of a younger person residing at the home. This was pointed out to the Manager on the first day of the inspection. The Manager acknowledged this and on return to the home for the second day of the inspection had taken action to address the situation. The Inspector met with the resident and family again both of who were extremely happy with the new plan of activities that had commenced that morning and were arranged for the weeks ahead. Two out of three resident questionnaires received prior to the inspection said that usually activities arranged by the home that they could take part in the other said that the home never arranged activities that they could take part in because they were physically unable to do so. The home supports residents to practice their religion and that visits from clergy are available to the home, residents spoken to confirmed that this was the case. Residents interviewed spoke of flexibility in routine and freedom of choice. Residents spoken to during the inspection said that contact with family and friends is encouraged and that visitors are made to feel welcome at any time. A relative spoken to during the visit said, “I am always welcome I always get a cup of tea”. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 15 On the second day of inspection the mealtime of residents was observed. The lunchtime menu on the day of the visit was a starter of grapefruit or mushroom soup. The Main course was poached or battered fish and for desert ice cream, semolina, fruit or yoghurt. Mealtime was relaxed with gentle soothing music playing in the background creating a calm atmosphere. Tables were appropriately set, meals were well presented and residents were seen to be enjoying the food provided. Comments made in respect of food served included, “I had a bacon sandwich for breakfast, the Chef is great”. “The people in the kitchen are pleasant and courteous”. “The food is excellent, the Chef is excellent, and the puddings are absolutely glorious”. “I quite enjoy the food”. “The food is always nicely prepared and presented, we have three courses”. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are encouraged and supported to make any complaints they feel necessary, however, the complaint policy/procedure could be strengthened to include contact details of commissioning agencies such as Social Services and Primary Care Trusts. Adult protection procedures are in place, which help protect residents from abuse. EVIDENCE: The home has a complaints policy/procedure in place, which includes residents/relatives of their right to complain to any commissioning authorities such as the Primary Care Trust or Social Services, however does not contain their contact details. The Manager said that she would update the policy/procedure to include such details. The home keeps a record of all complaints; there have not been any complaints in the last twelve months. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 17 Residents and relatives spoken to during the inspection said that they would feel comfortable in raising and concern or making a complaint to the staff or the Manager of the home. The home has an adult protection policy and a copy of the Teeswide Guidance regarding the protection of vulnerable adults. Adult Protection training is provided to staff working at the home. There have been no adult protection referrals in the last twelve months. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. EVIDENCE: The Manager accompanied the Inspector on a tour of the home. The home is well maintained with appropriate and comfortable furnishings provided. Communal areas were pleasing to the eye, comfortable and homely. Bedrooms visited during the inspection were personalized and contained appropriate furnishings. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 19 It was identified at the last inspection that water temperatures in resident bedrooms were not taken and recorded on a regular basis. The Manager said that she had taken action to address the situation and that water temperatures of resident bedrooms are taken and recorded on a regular basis. Records were examined to confirm that this was the case. The home has a policy in respect of control of infection. Staff spoken to during the inspection said that there was always a plentiful supply of protective clothing. Appropriate laundry facilities were in place. On the day of the inspection the home was observed to be clean and odour free. One relative said, “The home is clean and the kitchen is spotless”. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment procedures are followed which helps to protect residents. Staffing levels are appropriate. Staff receive induction training and a rolling programme of mandatory training is provided for staff, however only a small percentage of care staff are trained to NVQ level 2 in care. Staff who are trained to NVQ level 2 in care will have the knowledge to provide quality care. EVIDENCE: There were thirty-five residents residing at the home at the time of the inspection. Staffing rotas examined informed the inspector that there were six care staff on duty on a morning, six on an afternoon, five on an evening and two on night duty. In addition to two trained staff on duty day and night. The Manager of the home works five days supernumerary a week. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 21 The Manager said that 23 of care staff working at the home have achieved an NVQ level 2 in care and that the numbers will increase to 46 in August and 68 by year end. Two staff files were examined at random during the inspection. Records examined contained two references, proof of identity and appropriate Criminal Record Bureau checks that had been received prior to the commencement of employment. Records were examined to confirm that all newly appointed staff complete induction training. The Manager said that induction training is provided by an external source and meets with the Skills for Care induction standards. Records were available to confirm that moving and handling, fire training and other training relevant to the job that staff do is undertaken on a regular basis. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, residents health, safety and well being is promoted. The home seeks the views of residents to ensure that it is managed with their best interest. Systems are in place to ensure resident’s money is managed appropriately. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 23 EVIDENCE: The Manager, Susan Wyer, is a first level Registered Nurse who has worked in the nursing and social care environment for many years. The Manager has completed her NVQ level 4 in Management and is awaiting certification. Residents and relatives spoken to during the inspection spoke highly of the Manager and staff team. One relative comment card received stated, “I usually visit Teesdale Lodge three times per week. I get help advice from staff when requested. We do regular reviews. Nearly four years few staff changes which is good management”. Quality assurance and quality monitoring practices are in place. Surveys are sent out to residents on an annual basis to see if they are happy with the home and care that is provided. The results of the survey are published and made available to residents and relatives. The home operates an effective system in which they look after the personal allowance of a number of residents. The home operates a rolling programme of servicing appliances and equipment. Records examined at random confirmed that the home’s fire extinguishers, fire alarm system, hard wiring and gas boilers are serviced on a regular basis. Records were available to confirm that tests of the fire alarm system are carried out. Water temperatures in resident bedrooms and communal bathrooms are taken on a regular basis by the home’s handyman. Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 24 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 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? 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 OP12 Regulation 16 Requirement Timescale for action 30/03/07 2 OP28 18 3 OP31 12, 18 The Registered Person must consult with residents and relatives to plan regular activities, entertainment and outings. Consideration must also be given to younger residents residing at the home. The Manager must continue with 30/11/07 her action plan in which to achieve 50 of care staff trained to NVQ level 2 in care or equivalent The Manager must provide 30/05/07 evidence of completion of her NVQ Level 4 in Management 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 OP16 Good Practice Recommendations The Complaints policy/procedure should be updated to include contact details of commissioning agencies such as DS0000000209.V329818.R01.S.doc Version 5.2 Page 26 Teesdale Lodge Nursing Home Social Services and the Primary Care Trust. The homes statement of purpose and service user guide should also be updated to reflect such information Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Teesdale Lodge Nursing Home DS0000000209.V329818.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!