Inspection on 13/12/05 for The Heathers Nursing Home

This inspection was carried out on 13th December 2005.

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

The Heathers Nursing Home 06/02/08

The Heathers Nursing Home 29/08/07

The Heathers Nursing Home 16/08/06

The Heathers Nursing Home 24/05/05

The Heathers Nursing Home 22/12/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Heathers Nursing Home Bowling Hill Chipping Sodbury South Glos BS37 6AX Lead Inspector Grace Agu Announced Inspection 09:00 13 December 2005 th 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 The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Heathers Nursing Home Address Bowling Hill Chipping Sodbury South Glos BS37 6AX 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) 01454 312726 01454 312726 Mr Hitan A Patel Mr Roger Tippings Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 4 persons aged 50 years and over who are receiving nursing care May accommodate up to 3 persons (aged 65 years and over) who are receiving personal care Manager must be a RN on parts 1 or 12 of the NMC Register Staffing notice dated 10/06/99 applies. Date of last inspection 24th May 2005 Brief Description of the Service: The Heathers is a Grade II listed Georgian manor house situated in Chipping Sodbury close to the town centre of Yate. There is access to public transport for surrounding areas and the centre of Bristol and the home is close to the Avon Ring Road and motorway system. It is a care home with nursing and offers accommodation in single and shared rooms. The accommodation for residents is on two levels and there is a passenger lift between floors. There are several lounges and a small courtyard to the front of the building for use in good weather. The home operates a No Smoking Policy, staff and service users who smoke must do so outside of the building. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced Inspection undertaken over nine hours to review the requirements made at the last inspection and also to review the care practice to ensure that it is in line with the Legislation and that current and best practice is followed at the home. At the last inspection five requirements were made in relation to different areas of service provisions at the home. It was pleasing to note that the home had made tremendous efforts to ensure that all requirements made were met, however, an immediate requirement was made, in relation to regular reviews of a care plans, at this inspection. The Manager and staff were seen, interacting with the residents, in a respectful, dignified and sensitive manner. An atmosphere of strong teamwork was noted throughout the home. A quick tour of building was undertaken and a number of records were viewed. Fifteen residents, four staff members and five relatives were spoken with during the inspection. What the service does well: What has improved since the last inspection? The home has an activities budget and an activity coordinator had been appointed to ensure that varied activities are provided and that residents are regularly stimulated based on individual needs and assessment. The home has created a training facilities on the ground floor to ensure that as many staff as possible attend ongoing training. The home has made new signs to ensure that visitors and friends were able to locate the entrance of the home without difficulty. Relatives have made positive comments regarding the new signs. The home recently signed up for the Investors in People Programme, which recognises support and better training for staff to enable them to provide high The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 6 quality care to residents. There is ongoing redecoration of the home and residents and relatives stated that areas already redecorated have uplifted the image of the home. 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 Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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 The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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): 1,2,3,4,5. The process of admission is well planned and managed with clear information to enable the residents to make a decision about the services provided at the home. EVIDENCE: The home’s service users guide remains valid and contains required information to enable prospective residents to make informed choice about monitoring the home. The care files of two recently admitted residents showed that the residents were assessed before admission to the home. One resident confirmed that his/her relatives visited the home before she/he was admitted. Another resident stated, “ I was informed of one months trial when I moved to the home. I like it here”. Care files viewed contained terms and conditions in relation to the services provided and fees to be paid. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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. The home offers care and support to residents throughout their life and towards the end however, it fails to provide reviews of care plans of identified residents. EVIDENCE: On the day of inspection five care files were reviewed. There was evidence of pre-admission assessment before admission of two new residents to the home. This assessment was to determine whether the home is suitable and able to meet residents’ needs. The residents are reassessed on admission before care plans are provided detailing how the assessed needs are to be met. This is followed up by monthly reviews and intervention as needs change. However it was noted that one resident admitted on 27/06/05 had care plans which had not been regularly reviewed. At a discussion, the Deputy Manager stated that the registered nurses are aware that care plans need to be reviewed monthly to reflect the changing needs of the resident. He would ensure that this is implemented. An immediate requirement was made to ensure that care plans are reviewed to meet the resident’s needs. It was agreed that this would be reviewed at the next inspection. All the care files reviewed were detailed and up to date. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 10 The care file of the resident with severe agitation at night was reviewed. The resident had bed rails applied with consent from the family. The resident is at risk of pressure area breakdown and had special equipment applied. The resident had a comprehensive care plan tailored to this specific need to ensure adequate protection. It was noted from daily entries that the care plans were followed. The care plans were noted reviewed daily when required. There were entries on 21/11/05, which stated that ‘leg gone through the bed side rail’, 26/11/05, ‘big gap noted in between bed rail due to agitation’. 27/11/05 ‘found rammed against the bed rail with arm dangling through the bars’. There was a bedrail risk assessment on 7/12/05; these were discussed with the Manager and Deputy Manager. The Manager stated that the home noted during reviews that the specialist equipment caused more agitation to the resident and it was removed. The resident sleeps better and there had been little or no agitation at night and there had not been any occurrences with the bedrails. The home would continue to review the bedrails risk assessment if there were any more incidents. The inspector is satisfied with the actions taken by the home relation to the above. One resident spoken with stated that “staff are good, they look after us well”. Another resident stated “I get up when I want, staff answer the bell when I ring”. One relative mentioned that “mum’s care is very good, staff are kind and caring”. It was noted that the home uses the Braden Scale tool to predict pressure sore risks on all the care files reviewed. This risk assessment was reviewed monthly to monitor the risks and appropriate intervention put in place to prevent occurrence of pressure sores. There was evidence of wound care plans, along with treatment required for managing the wounds in the care file reviewed. There was evidence of General Practitioner (GP), Dentist, Chiropodist and Optician visits. Care staff were noted knocking at doors and waiting for an answer before entering residents’ rooms to assist them with personal care. Two residents interviewed confirmed that staff treated them with respect and closed the doors when assisting them with using the toileting and bathing. There was evidence in the care files viewed of details of residents wishes in the event of death. Staff interviewed are aware of policies and procedures for dealing with a dying resident at the time of death. Two staff members spoken with are aware of the importance of keeping information about residents confidential. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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): 12,13,14,15. The home enables residents to maintain contact with family, friends and community. It also provides meaningful activities and choice in respect of meals and meal times. EVIDENCE: Residents spoken with confirmed that the home supports them to remain in contact with their family and friends. One resident stated, “My daughter comes every week”. Another resident stated “two friends visit weekly to take him/her out to the shopping centre and to the pub afterwards. Another friend also comes to see me”. I am quite happy here. This resident was case tracked following his/her comment at the last inspection. Staff spoken with confirmed that the visitors are not restricted from coming into the home. The home’s visitor’s book evidenced that there are a number of regular visitors to the home. The provider stated at the inspection that new signs have been installed outside the building and that relatives have made positive comments in relation to the improvement of the signs. The home’s activities programme was reviewed. The Manager stated that the home now has a monthly budget to provide activities for residents. One existing staff member has been appointed to organise activities for residents The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 12 and this has made a big difference. The care staff will be an attending activities training programme designed specifically for older people living in care homes. The provider Mr Patel stated that he was motivated to provide a monthly budget in response to the negative comments made by residents and relatives. It is aimed that the activities developed will provide better and more stimulation to all the residents and particularly those residents who prefer to stay in their rooms and those being nursed on the bed. Information about weekly and forthcoming activities were noted. Displays in the lounge and the dinning area to included Monday: Hair and Beauty, Tuesday: Armchair exercise, Aromatherapy, Wednesdays: Bingo, Thursdays: Quiz time, Communion once a month, Friday: craft, Saturday: cinema and supper night, Sunday: fun & games, church service once a month. Trips in summer to Slim Bridge and the garden centre and in December to the Mall for Christmas shopping. The residents are scheduled to attend the Pantomime in Chipping Sodbury in January 2006. There is also a library service to the residents. The menu on the day contained a choice of two nutritional meals at lunchtime. Residents interviewed stated that they enjoyed the food. The chef stated that all staff working at the home have attended basic food hygiene training. The certificates were noted displayed in the hallway. The kitchen was noted to be clean. The manager stated that there is a risk assessment of the kitchen kept in the folder for kitchen staff to access when necessary. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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): 16,17,18 Residents are enabled to complain and are confident that the home is able to protect them from harm and abuse. EVIDENCE: The home’s complaint procedure contains required information to include how to contact the Commission for Social Care Inspections if residents or their relatives were not satisfied with the outcome of their complaint. This procedure was noted displayed at the entrance hall. There were no recorded complaints in the complaints book viewed. One relative interviewed stated that she is satisfied with her mothers care; she is aware of the complaints procedure however she had no complaints. The home has a policy on Protection of Vulnerable Adults from Abuse and staff have attended training. There is also a Whistle Blowing Policy and procedure to enable staff to report bad practice without fear of reprisal. Two staff members interviewed stated that they would report any suspected incidents of abuse to the Manager. Two new staff recently employed had Criminal Record Bureau disclosures in their files. It was noted that these were obtained before commencement of employment. Evidence from the records showed that Registered Nurses working at the home had their own Personal Identification Numbers verified by the Nursing and Midwifery Council (NMC) before commencement of employment and periodically to ensure that residents are adequately protected. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 14 Two residents spoken with stated “they felt safe at the home”. Two residents interviewed confirmed that the home supported them to vote at the last election using the postal voting system. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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): 19,26 The home has a generally well-maintained environment, however, it has not provided a clean room for one identified resident. EVIDENCE: Generally, the home was found tidy, clean well lit, warm, comfortable and suitable for its stated purpose. It was also noted to be well maintained with on going refurbishment. However, it was noted when touring the building that one resident’s room had unpleasant odour. This was discussed with the management team and a requirement was made for the room to be deep cleaned or the flooring replaced to ensure that the resident enjoyed a pleasant and clean environment. Residents were noted sitting in the lounge relaxed and enjoying each other’s company. Staff were noted well presented in uniform and were noted wearing disposable aprons when serving and assisting residents with meals. This demonstrated that infection control and principles of hygiene are being followed at the home. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 16 Residents interviewed stated that they felt comfortable at the home. The laundry was noted to be clean and tidy, the laundry assistant stated that she had attended training on Control of Substances Hazardous to Health (COSHH) along with other domestic staff. Their certificates were noted displayed in the hallway in the laundry area. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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 The recruitment procedure of the home is robust and offers protection to residents at the home. There are adequate numbers of staff that are competent to meet the needs of the residents. EVIDENCE: At the last inspection, two requirements were made in relation to training of laundry and domestic staff on Control of Substances Hazardous to Health and general staff training on First Aid. It was pleasing to note that these requirements have been met. It was also noted that the home has made tremendous efforts in organising various training relevant to meeting the needs of all the residents. The home has created a large training facility from a former office on the ground floor to ensure that as many staff as possible attend ongoing training. The home manager stated at a discussion that the home recently signed up for the “Investors In People” programme designed for organisations to demonstrate commitment to staff training. This is commendable. Staff interviewed demonstrated knowledge of their roles and responsibilities in relation to meeting the needs of the residents and confirmed that the organisation had invested resources into their training needs. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 18 Evidence from the staff records and discussion with the manager and staff showed that staff have attended training on Protection of Vulnerable Adults, Manual handling, fire safety and First Aid. Induction of anew staff member is ongoing until the person is competent to work independently. It was also noted that more than 50 of all care staff have either completed or working towards the National Vocational Qualification (NVQ) at level 2 and 3. This is also commendable. The manager stated that the home recently purchased booklets from the Alzheimer’s disease society to provide information to staff on dementia and how it affects older people. These booklets are issued to all staff members. Staff records viewed evidenced that staff are receiving supervision however not regularly, the manager stated that he is aware of the importance of regular staff supervision and would ensure that this implemented. This will be reviewed at the next inspection. The staff rota on the day of inspection showed that the home had adequate numbers of nursing, care staff and domestic staff on duty to meet the residents needs. Residents interviewed confirmed that the home provided adequate numbers of staff to meet their needs at all times. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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): 31,32,33,34,35,36,37,38. The home is well managed; it also ensures that there is adequate protection in relation to health and safety of residents, staff and visitors. EVIDENCE: Mr Tippings remains the competent registered manager of The Heathers Nursing Home. Mr Tippings along with the Deputy Manager and Mr Patel (Provider) have recently commenced the Registered Manager’s Award to enable them to support staff members to provide high quality care for the residents. Residents, relatives and staff spoken with on the day commented positively and highly of Mr Tippings ability to manage the home. One relative stated, “The manager is approachable and would listen and take notice. He would inform me if mum’s condition changes”. One resident stated “Roger and Robin (Deputy Manager) are very good, I love it here, I would not like to go to any The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 20 other place. Another relative stated “ Roger and the management are open and considerate, staff are kind and we are always made welcome when we visit the home”. Two staff members stated, “Roger and management are very supportive. We can talk to them with ease”. Mr Patel stated at a discussion that the organisation is committed to supporting the manager and his team and would ensure that the home is provided with adequate resources for high quality care of residents. Mr Patel commended the manager and staff for their hard work, commitment and loyalty to the home. A ‘thank you’ letter from the Director to all staff in relation to their hard work and good care given to residents was displayed in the lounge. The home has different ways of monitoring the quality of its services. These include, residents and relatives questionnaires. On the recent questionnaires seen, areas monitored included, care of residents, food and activities. The results were collated on a graph and the results were satisfactory. The manager stated that the home would focus on areas with lower scores to ensure that any deficiencies are addressed. Other ways used to audit the service are checking records of complaint, reviewing the Care plans, observing staff interaction with residents and managers daily visit to residents when on duty. Staff meeting and resident/ relative meetings provide a forum for discussion in relation to service improvement. The fire logbook is well maintained as well as the home’s maintenance book. There is evidence that staff have attended fire lectures and regular fire drills. The manager stated that the home recently met with a fire officer to obtain advice about residents wishing to keep their doors wedged open and that the advice will be implemented. There is a service record of the lifts, hoists, nurse call system and portable appliance tests (PAT) of all electrical appliances. Accidents are recorded and followed up. Policies and procedures in the home include Whistle Blowing, medication, confidentially and complaint. The home does not act as appointee to residents and no personal allowances of residents are managed by the home. All residents’ records were noted securely locked away. Staff supervision was discussed in the previous standard. The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 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 3 3 3 3 X 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 22 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 OP26 Regulation 23 Requirement Ensure identified resident’s room is deep cleaned and free from odour at all times or provide alternative flooring. Regularly review care plans for identified residents need. Timescale for action 13/01/06 2. OP7 15 13/12/05 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 The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 The Heathers Nursing Home DS0000062576.V266273.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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