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Inspection on 09/02/06 for The Polegate Nursing Home

Also see our care home review for The Polegate Nursing Home for more information

This inspection was carried out on 9th February 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 relatives and representatives are welcomed to the home and are complimentary about the service and the care provided at The Polegate Care Home. There is a variety of good nutritious food offered and fresh fruit is readily available. Meals are taken in comfortable and homely surroundings. The home is clean, safe and well maintained, which is appreciated by the residents and their relatives. There is a stable work force of reliable and caring staff, which work well together as a team. Feedback from residents regarding life in Polegate Care Home was positive.

What has improved since the last inspection?

The training records are kept up to date, which ensures that the staff have attended the training required to perform their job. The home has continued to upgrade the property and equipment, which benefits the residents.

What the care home could do better:

Since the last inspection, the home have negotiated a contract with Adult Social Care Department. and the Primary Care Trust, to admit up to twelve residents from hospital/G.P for short stay purposes to avoid admittance to hospital. However this is not reflected in the current Statement of Purpose and the CSCI were not informed. The pre-admission assessments for these residents were not completed by the home staff, thus not ensuring that the home can meet their needs. There were no care plans in place for staff to follow for these residents. The short stay visit should be up to 3 weeks, however one resident had been in the home for twelve weeks. It was an immediate requirement that an updated Statement of Purpose and policies and procedures be submitted to evidence that the home can meet the needs of these admissions. The documentation in regard to the health care needs of residents need to be accurate in respect of fluid input and wound care. The associated risk assessments need to be in more detail, so staff are fully aware of the care required. There were some minor shortfalls in the recording of medication administration. Nurses need to be pro-active in following up gaps and checking that the residents have received their prescribed medication. A regular audit of the medication charts performed by a designated person needs to be instigated to ensure good practice. There needs to be regular formal supervision of all staff.

CARE HOMES FOR OLDER PEOPLE The Polegate Nursing Home The Polegate Nursing Home Blackpath Road Polegate Eastbourne East Sussex BN26 5AP Lead Inspector Unannounced Inspection 09 February 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 The Polegate Nursing Home DS0000014027.V262180.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 Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Polegate Nursing Home Address The Polegate Nursing Home Blackpath Road Polegate Eastbourne East Sussex BN26 5AP 01323-485888 01323-484011 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) ANS Homes Limited Mrs Jacqueline Taylor Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That the maximum number of service users to be accommodated is forty-four (44). To care for chronically ill service users under the age of sixty-five (65) years under the continuing care criteria. 28th September 2005 Date of last inspection Brief Description of the Service: The Polegate Nursing Home was purpose built in May 1996 and accommodates up to forty-four service users with continuing care needs under the Health Authority’s eligibility criteria. The home is registered to provide care for service users falling in to the category of older people and those with a physical disability. The home was purpose built to provide single bedrooms with ensuite facilities to heavily dependent service users with a need for continuity of care from hospital. The resident’s accommodation is on two floors; each of these floors is provided with a large lounge. The lower floor has a dining room, which caters for all residents, and most group activities are held in this room. All areas of the home are assessable to service users, the corridors are wide enough to accommodate self-propelled / electric wheelchairs and the lifts are spacious. The rooms are spacious to allow room for hoists and other specialist equipment whilst maintaining a homely and comfortable environment. The décor of the home is pleasant, simple and well maintained and the furniture is of a good quality. There is a garden area with a patio that is accessible to service users in wheelchairs. There are suitable toilet, bathing and washing facilities provided to meet the needs of the service users, all with equipment designed for less abled persons. There are car-parking facilities to the rear of the property for approximately 25 cars. The home is in the centre of Polegate village, close to the shops, railway station and major bus routes The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 9 February 2006. It commenced at 10:00 am and was conducted over 6 hours. There were thirtysix residents living in the home on this day. The Polegate Care Home has recently been purchased by the BUPA Organisation. The methodology of the inspection included a tour of the building, inspection of documentation and records, the delivery of care for ten residents and informal interviews with eight residents, three relatives and five members of staff. The key standards not assessed at this inspection were looked at during the last inspection 28 September 2005. Since the inspection a minor variation document regarding changing the category of registration to the home has been received. What the service does well: What has improved since the last inspection? The training records are kept up to date, which ensures that the staff have attended the training required to perform their job. The home has continued to upgrade the property and equipment, which benefits the residents. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 6 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 Polegate Nursing Home DS0000014027.V262180.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 Polegate Nursing Home DS0000014027.V262180.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, 3 and 4. The Statement of Purpose and Service Users Guide give prospective residents the information required enabling them to make an informed choice about where they live. However at present it is not accurately reflecting the services being offered. Residents have been admitted to the home without a full and detailed pre admission assessment, thus not ensuring the home can meet their needs. EVIDENCE: A Statement of Purpose and Service Users Guide, which conforms to the Care Homes Regulations and National Minimum standards, is in place. It is available to all residents and their relatives and is written in a clear and user-friendly format. It has been updated by the new providers, and individualised to the home. One resident proudly showed her photograph in the brochure. However at the time of the inspection, the organisation have not updated the information to reflect the current services the home are offering to prospective residents. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 9 A selection of resident’s care files were seen, there were inconsistencies in the content of the pre-admission assessment and of the procedures followed to gain information regarding the needs of the prospective resident. This has an impact on the preparations made in order to meet the resident’s needs. Staff acknowledged that in some of these admissions they were not fully aware of the complexity and diversity of some of the residents. Residents have been admitted to the home since November 2005 that are not currently reflected in the Statement of Purpose and the CSCI had not been formally informed of this intention. An updated Statement of Purpose and policies and procedures of the proposed service need to be submitted. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Residents’ would benefit from a more comprehensive care planning system that guides staff in all aspects of personal and health care and that all risks are identified and planned for. It is not possible to evidence that the health needs of all residents are met. Feedback from the residents’ evidence that they feel respected and treated with consideration and courtesy. EVIDENCE: A selection of care plans were viewed and it was disappointing to find that the eleven recent admissions – did not have any care plans for staff to follow, one resident had been in the home for twelve weeks following surgery and the documentation available did not cover her needs. Six care plans of the longer stay residents were viewed and it was evident that some needs had been identified and planned for. However, some were incomplete, not regularly reviewed and there was no evidence to show that all The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 11 residents or their representatives are involved in compiling and reviewing the plans. The resuscitation status mentioned in a care plan needs to be discussed with the G.P and family and then reviewed on a regular basis. It was noted that the positive outcomes observed at this time are dependent upon staff knowledge and memories rather than full and detailed recording. From the lack of documentation is difficult to assess whether the health needs for all those residents are met, however the feedback from residents and visitors regarding the level of care and the dedication of staff was very positive. The fluid charts in place were found not completed between the hours of 5.00 pm and 07.00am the following day, this was brought to the staffs attention during the inspection as it indicates 14 hours without an offer of fluids. Documentation regarding specific residents wounds were not up to date, nor were residents care plans concerning speech and swallowing problems. The clinical rooms were clean and tidy, the equipment well maintained. There are policies and procedures in place for the storing, administrating, disposal and receipt of medication. The temperature of the fridge and room are recorded daily and of an acceptable temperature to maintain dressings and medications. The medication administration charts were viewed and some gaps were identified. Nurses need to be pro-active in following up gaps and checking that the residents have received their prescribed medication. A regular audit of the medication charts performed by a designated person needs to be instigated to ensure good practice. A self-administering policy is in place, but there were no residents at this time self-administering their medication. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 12 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): 15. The dietary needs of residents are well catered for and offers a balanced and varied selection of food that has been updated in line with the personal likes and choices of residents. EVIDENCE: Residents were observed enjoying their midday meal either in the dining room on the ground floor, in the lounge areas or in the privacy of their bedroom. Residents confirmed that they could choose where they take their meals. The dining area is pleasantly decorated, well furnished and the tables attractively set. The room is large and airy with natural light. The staff were seen supporting staff with their meal with patience and dignity. Two family members were seen taking lunch with the relative and one said he “comes every day to eat with his wife, the staff are wonderful and he is very happy with the care she receives”. The menus rotate on a four weekly basis and change according to the seasons. The menus are distributed daily to all residents and are also on display in the dining rooms. They demonstrated choice and variety and indicated a well balanced diet. Fresh fruit is readily available. The chef is well known to the residents and he visits them on a regular basis. He is kept informed of all changes to residents diet and receives regular feedback from staff. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 13 The residents were again forthcoming in their views of the food, and comments received included “ we get a choice everyday” “the food is very good” “ we get lots of fresh food” “The Chef is very talented”. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 14 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 and 18 The complaint procedure is clearly detailed in the Statement of Purpose and Services Users Guide and is available to residents and their families enabling them to share their concerns formally and confidentially. Staff interviewed had a good understanding and knowledge of Adult Protection policies and procedures, which protect the residents from harm and abuse EVIDENCE: There are appropriate complaint policies and procedures in place and it was confirmed that these are followed when investigating any concerns raised at the home. The complaint book was viewed and this demonstrated that all complaints are recorded, along with the outcome and action taken by the home to resolve the complaint. A recommendation is that the action taken also includes whether the complaint was found substantiated or not. The staff interviewed were knowledgeable of the BUPA complaint procedure and of how to start the process if the manager is not available. Two residents referred to the Service Users Guide (brochure) when asked if they knew how to make a complaint, whilst one relative said he had been given a brochure and was sure he had seen the complaints procedure in it. One other relative said she would talk to the nurse in charge if she had a problem. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 15 The Adult Protection policy in the home was found to be up to date and staff interviewed were knowledgeable about the systems in place to protect vulnerable residents. There is on-going training for all staff in Adult Protection. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 16 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, 20, 21, 22, 23, 24, 25 and 26. The home provides a comfortable, clean and safe environment for those living there and visiting. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the resident’s personalities and interests. There is specialist equipment in the home for residents’ use to maximise their independence. EVIDENCE: Since the last inspection the property has been decorated and the furniture upgraded. The overall impression is that of comfort and warmth. The residents are encouraged and enabled to personalise their rooms with furniture and pictures, and this was evident during the visit. All residents rooms conform to the National Minimum Standards in respect of equipment, such as call bells and furniture. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 17 All personal items are listed in the individual care plans. One resident said that her pink bedroom was her choice, but she is now going to change it to purple and silver. The accommodation for residents is found on two floors and each of these floors is provided with a large lounge. The lower floor has a dining room, which caters for all residents, and most group activities are held in this room. These communal rooms are non-smoking and residents wishing to smoke do so in their own rooms, following an individual risk assessment. There are suitable toilet, bathing and washing facilities provided to meet the needs of the resident’s, all with equipment designed for disabled and frail people. The home is well equipped with equipment to meet the needs of residents’, and the senior staff are aware of where to procure any specialised equipment. This, in conjunction with the input from the Physiotherapist ensures that the needs of the residents are fully met. This multi-disciplinary approach is recorded in the shared care records. All residents visited were seen to have access to call bells, and staff confirmed that those residents that are too frail to ring for assistance are checked regularly. There is level access to all areas of the home via a large passenger lift. The home has a legionella policy in place and all hot water outlets are thermostatically controlled and are tested on a regular basis. Random outlets were tested and were of the required temperature. All risk assessments for the building are updated regularly and the COSHH manual was seen and is available to all staff. Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection. All staff were seen wearing gloves and aprons appropriately. A relative remarked that the home was always kept clean and it never smelt offensive, he said that the cleaning staff always worked hard and he could only compliment them. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 18 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. Staffing levels were adequate to meet the assessed needs of the residents. EVIDENCE: The morning shift consisted of two trained nurses and five carers; the staffing levels were seen to be sufficient for the needs of the residents at this time. The afternoon shift was staffed by two trained nurses and four carers. The staffing levels need to be flexible according to the changing needs and numbers of the residents. The Polegate Nursing Home DS0000014027.V262180.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, 33, 35, 36 and 38. Residents benefit from a manager who is experienced and confident enabling her to run the home efficiently and effectively, including providing support to staff. Residents’ financial interests are safeguarded by the homes policies and procedures. All aspects of resident’s health, safety and welfare were found protected and promoted. EVIDENCE: The Manager is a first level registered nurse and has been a manager for five years within the organisation. She has a diploma in management studies. The manager has suitable qualifications and experience to run the home competently. She takes responsibility for the day-to-day running of the home The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 20 and is supernumery to the care and nursing staff; she is also on call for any emergencies. All the residents are aware of the manager and her role as she maintains a visible presence in the home. There are systems in place to safeguard resident’s financial interests; with policies and procedures in place for staff to follow in respect of gifts and rewards from residents and their families. Formal staff supervision is provided in accordance with the standards and is recorded and kept in the staff files, however the manager has acknowledged that she is behind at present. Staff training in moving and handling, infection control, COSHH, first aid, fire safety and food hygiene are undertaken and recorded, and all staff are receiving further training in nutrition, specific diseases such as motor neurone and diabetes and prevention of adult abuse. Documents relating to safe working practices and Health and Safety were available and found to be satisfactory as were accident records. A recommendation regarding the accident report is that more detail is written in the action taken when reviewed by the manager, and that an action plan to prevent recurrence of the incident is documented. Good practice was observed throughout the inspection regarding the moving and handling of residents. The Polegate Nursing Home DS0000014027.V262180.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 2 X 2 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4(1) (a)(b)(c) 14(1)(a) Requirement That the Statement of Purpose and Service Users Guide give an accurate reflection of the services provided by the home. That all service users have a full assessment performed by staff from the home prior to admission. That the home can demonstrate the capacity and ability to meet the prospective service users needs. The resuscitation status mentioned in a care plan needs to be discussed with the G.P and family and then reviewed on a regular basis. ( Previous timescale of 28/09/05 not met.) That a comprehensive plan of care is generated from a comprehensive assessment is drawn up for/with each service user, and it is reviewed at least once a month. That consultation with the service user/representative is evidenced when the care plan is The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 23 Timescale for action 01/04/06 2 OP3 09/02/06 3 OP4 14(1)(a) 01/04/06 4 OP7 15 (1) (a) (b) (c) 01/04/06 5 OP7 15(2)(b) (c)12(1) 01/04/06 6 OP8 13(1)(b) 17(1)(a) 7 OP36 18 (2) devised. That all documentation in respect of residents health needs are kept up to date, reviewed regularly and assessable to all staff as per schedule 3. That all staff receive regular formal supervision at least six times a year. 01/04/06 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3 Refer to Standard OP9 OP16 OP38 Good Practice Recommendations That an audit of the medication charts is commenced. That a more detailed action plan is documented on conclusion of a complaint. That a more detailed action plan detailing prevention of incidents is document on the accident forms. The Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Polegate Nursing Home DS0000014027.V262180.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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