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Inspection on 17/06/05 for Walton House Nursing Home

Also see our care home review for Walton House Nursing Home for more information

This inspection was carried out on 17th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

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 home had good links with the local community, and a number of the local churches attended the home to do religious services. The food was highly praised by most service users, who were offered a choice of food at each mealtime. Especially popular was the homemade pastry. Information in the care plans was very detailed, and covered very specific detail about how individuals liked care to be provided to them. Reviews of the care had also been done monthly, and involved service users, some of whom had signed their own records.

What has improved since the last inspection?

Since the last inspection the manager has worked well to look at areas where improvements were needed, and taken action to make improvements. For example, when comments are received about the quality of care in the home, the manager has spoken to staff and offered training to improve their performance. Some areas had been identified by relatives using the complaints procedure, and the outcome for the service users had been an improvement in the quality of care they received. Some policies had been altered to make sure they gave clear guidance to the staff at the home about how to react to some situations, including if an allegation of abuse is made. The procedure to follow and contact numbers had been made available so action could be taken promptly if issues arose. A number of areas of the home had been refurbished, and this improved the general presentation of the home.

CARE HOMES FOR OLDER PEOPLE Walton House Nursing Home 188 Chorley Road Walton-le-Dale Preston PR5 4PD Lead Inspector Helen Lindsey Unannounced 17 June 2005 09:30 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 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. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Walton House Nursing Home Address Walton House 188 Chorley Road Walton-le-Dale Preston PR5 4PD 01772 628514 01772 697200 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) St Andrews Health Care Limited Mrs Jane Lyth Care Home with Nursing 44 Category(ies) of Old age, (OP) 44 registration, with number Terminally ill (TI) 3 of places Dementia - over 65 years of age (DE(E)) - 1 Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 44 service users to include: 2 Up to 44 service users in the category of OP (Old Age, not falling in any other category). 3 Up to 3 service users in the category of TI (Terminally Ill). 4 One named female service user in the category DE (E) - (Dementia aged over 65 years). 5 The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 6 Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. Date of last inspection 22 November 2004 Brief Description of the Service: Walton House is a care home providing 24-hour personal and nursing care. The home is registered for 44 service users. Walton House is privately owned and operated by St Andrew’s Health Care Ltd. Responsibility for the day-to-day running of the home is that of the registered manager, Mrs J Lyth. The home is located in Walton-le-Dale, near to shops, pubs, post-office and other town amenities. It has a car park at the main front entrance and a garden area with flowerbeds and a patio with seating at the rear. The home is a two storey “purpose-built” building. Bedroom accommodation is on the ground and first floors. The majority of bedrooms are single, however a number of companion rooms are available for those who wish to share. There are no en-suite bedrooms. There is a passenger lift. Accessible toilets and bathrooms are located on both floors near to bedroom and living rooms. There is a lounge area on each floor. Dining facilities are situated on the ground floor Corridors are wide and fitted with grab rails. Other appropriate aids are provided in bathrooms to assist service users with mobility problems. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, carried out by two inspectors and started at 9.30am. It took place over 4 ¾ hours. The inspectors spoke to 9 service users, 4 members of staff, registered manager and responsible individual. Staff and care records were examined, and a full tour of the premises was undertaken. As part of the inspection process the inspectors used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. Since the last inspection there have been three complaints investigated by provider and appropriate action was taken to resolve the areas of concern. What the service does well: What has improved since the last inspection? Since the last inspection the manager has worked well to look at areas where improvements were needed, and taken action to make improvements. For example, when comments are received about the quality of care in the home, the manager has spoken to staff and offered training to improve their performance. Some areas had been identified by relatives using the complaints procedure, and the outcome for the service users had been an improvement in the quality of care they received. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 6 Some policies had been altered to make sure they gave clear guidance to the staff at the home about how to react to some situations, including if an allegation of abuse is made. The procedure to follow and contact numbers had been made available so action could be taken promptly if issues arose. A number of areas of the home had been refurbished, and this improved the general presentation 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. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 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 standard(s) 3 The pre admission procedure was consistently applied so that the home was able to determine if the needs of the people coming to live at the home could be adequately met, although the resident or their representative had not been involved in this process and therefore had not been given the opportunity to express their individual needs. EVIDENCE: The standard of pre admission work carried out at Walton House was adequate to ensure that the needs of each person had been appropriately assessed prior to admission, so that the home was able to determine if the assessed needs could be met. For those residents placed by social services care management summaries gave a clear picture of identified need and how those needs were to be met. Pre admission assessments carried out by the home were adequate, although this process did not involve residents or a representative. The home should not be providing accommodation to residents unless the resident or a representative have been given the opportunity to be involved in the preWalton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 9 admission process. The registered nursing input required by those receiving nursing care had been assessed by an NHS registered nurse, to ensure that the correct amount of funding was provided in accordance with assessed nursing needs. The care of three residents was ‘tracked’ during the course of the inspection. In all three cases a plan of care had been developed, based up on the information obtained prior to admission to the home. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 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 standard(s) 7,8 and 9 The care planning process was in general thorough to ensure the personal and health care needs of residents were consistently met, although the social care needs of residents had not been adequately considered. Risk assessments were not detailed enough to ensure the safety of residents. Medications were generally well managed. EVIDENCE: Care records seen showed that each resident had a plan of care drawn up using information from the pre-admission assessments. The plans of care were detailed and well written documents, providing clear guidance for staff as to how individual needs in relation to personal and health care needs were to be met and therefore promoted the welfare of those living at the home. However, the plans of care did not adequately incorporate the social care needs of the residents and how the home was going to support residents in continuing their leisure interests. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 11 The plans of care had been drawn up with the involvement of the resident or their representative and had been reviewed each month and any changes in the condition or care of residents had been appropriately reflected. Although risk assessments were in place, in relation to bed rails and falls, these were too brief and needed to be improved to ensure the continued safety of residents. Risk assessments in relation to bed rails must include the reason for their use, the risks associated with their use and management strategies to reduce or remove the risk. When asked about the care they received comments from those living at the home included, “the staff are grand, I have no complaints about them’ and ‘ I am happy living here’. Staff were seen to be treating residents with respect and dignity by knocking on bedroom doors before entering and by speaking to them respectfully. Induction records showed that staff received instruction about how to make sure that residents’ right to privacy and dignity were upheld. Staff were particularly good at finding out exactly what residents wanted and how much they could do for themselves so they could encourage their ability to self-care and make decisions as far as was possible. Risk assessments had been conducted for those at risk of developing pressure sores. The incidence of pressure sores, their treatment and outcome were recorded within the service user’s plan of care. Appropriate pressure relieving equipment had been provided in accordance with the plan of care and advice had been sought from the tissue viability nurse. A service user who needed such support said ‘I am well cared for, they come and help me turn every two hours’. Evidence was available to demonstrate that a variety of external professionals had been involved in the care of those living at the home to ensure health care needs were being met. Medications in general were well managed. Policies and procedures were in place, the medication administration records were kept up to date and medications were stored appropriately. Hand written entries had been signed, checked and countersigned to reduce the possibility of incorrect transcribing. The medications returned to the pharmacy for destruction were recorded in a book. However, the last returns had not been dated and the collecting pharmacist had not routinely signed for medications received. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 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 standard(s) 12,13 and 15 Choices were offered to the service users in the home, but in some areas they were limited due to other factors, such as the availability of staff. EVIDENCE: Care records showed that individuals had been asked about their likes and dislikes and the routines they like to keep, which mean staff could support them to continue in their preferred routines, as was their choice. Communication with service users was seen to be upbeat and right to meet individuals communication skills. Choices were being offered, such as ‘do you want to go to the lounge, or go to your room for a rest?’, and in offering drinks and snacks. Service users said that ‘ the staff help me with what I want’. However some service users felt their choice of what time to get up, or to go down stairs was limited by the availability of staff who were often very busy, especially in the morning. Service users also felt social activities in the home were limited, and said ‘I would like more activities like dominoes and cards’. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 13 The menu offered a choice at each meal, and staff checked with individuals what they wanted that day. The menu had a good range of meals, including fresh fruit and vegetable’s, and many meals were cooked from fresh produce. Service users said ‘the food is pretty good, especially the pastry on the pies’ ‘I cant complain about the food, its good’ and ‘the food is grand’. Staff knew the importance of ensuring a nutritious diet for everyone, and meals were seen to be well presented, with staff giving discreet support where needed. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 The home had a satisfactory complaints procedure which ensured that all complaints would be acknowledged and investigated. The protection of vulnerable adult policies demonstrated that those living at the home were, as far as possible protected from abusive situations. EVIDENCE: The home had a complaints procedure that was available through the home, and in the service user guide, that was available in each bedroom. The record of complaints to the home showed that suitable action had been taken if any problems were identified. The staff knew what to do if an incident of abuse was suspected, and the telephone numbers of agencies that should be contacted were on the wall in the office, to make sure action was taken quickly. Service users knew who the manager was at the home, and knew they could raise any concerns with her. One service user said ‘I feel safe’. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 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 standard(s) 20,21,24 and 26 The home provided a well maintained, comfortable and homely environment ensuring adequate safety for those living there. EVIDENCE: The home was clean and well presented throughout. A number of rooms had been redecorated such as the dining area, conservatory and the upstairs lounge. An ongoing plan was in place, and other work such as replacing windows and furniture was on-going. A number of bedrooms and bathrooms were also due to be re-decorated. A number of new beds had been purchased for those needing adjustable beds to ensure service users comfort. The external grounds were well maintained and a pleasant patio area was available to the rear of the building. Service users felt their rooms were comfortable, and those who chose to spend large amounts of time in their rooms had the facilities they needed. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 16 Visitors commented that the building was clean when they visited. Staff felt the newly decorated rooms were bright, and the small lounge was now used more because it was more welcoming. Staff confirmed that they had done training about health and safety, and appropriate infection control measures were seen to be in place. All staff were carrying a hand wash with them to prevent cross contamination. Some rooms had been fitted with locks at the request of the service users. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 The staffing levels were not determined in accordance with the dependency of those who lived at the home in order to ensure that all assessed needs were being fully met. The recruitment procedure was not thorough enough to ensure that the people living at the home were adequately protected. EVIDENCE: There was a staff rota in place showing which staff were on duty at any time during the day or night and in what capacity they were employed. The staffing levels met the minimum requirements of the previous regulating authorities. At the time of the inspection there were a high percentage of service users who were totally dependent on care staff to meet their needs. The home should now consider utilising a recognised tool to determine staffing requirements in accordance with the dependency levels of the people who live at the home. At the time of the inspection the home was clean, tidy and pleasant smelling. The records of four staff members were examined. There were no written references on one file and only one on another. Criminal Record Bureau Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 18 disclosures had been obtained for all four staff, although POVA first checks had not been undertaken for two. All staff had received terms and conditions of employment and had been issued with the General Social Care Council codes of conduct. Qualified Nurses’ registrations had been verified with the Nursing and Midwifery Council to determine their eligibility to practice. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33 and 36 The home was monitored well by the manager to ensure it was running effectively for the service users. Appropriate staff support and development was in place. EVIDENCE: Service users knew the management structure of the home, and felt the manager was good. The manager had continued to attend training courses to make sure their knowledge was up to date, and was dealing with complaints in an effective way to resolve any concerns that were raised. Records showed that where complaints were seen to be founded, the manager made sure problems were resolved, by taking action, such as getting training for staff. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 20 Feedback about the service was being requested in a number of ways, including service user questionnaires, relative questionnaires and service users meetings. An internal audit was also undertaken by the manager to spot check the quality of care offered to individuals, and steps taken to improve quality if it was seen to be below standards. These systems were working well to improve the quality of care offered at Walton House. However some issues were identified during the inspection about the pressure on staff time and the attitude of some staff. One service user complained that a small number of staff had the attitude of ‘what the hec do you want’. Although others said ‘the night staff are grand, as well as the day staff’ ‘ they are here in two minutes if I press the buzzer, they help me with what I need’. ‘ I feel confident in the staff’, and ‘the staff are grand’. The home had also been achieved the Investors in People award which gave external scrutiny to the homes systems to ensure they were in line with good practice. Staff supervision, appraisal and training plans were all completed to make sure the staff were able to do their jobs, and staff felt there much more training available now, which was really good. Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x 3 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x 3 x x Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 22 yes 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 3 Regulation 14(1)(C) Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so there has been appropriate consultation regarding the assessment with the service user or a representative of the service user.(Previous timescale of 31st January 2005 not met) The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated, including those at risk of falling and the safe use of bed rails. The registered person shall make arrangements for recording, handling, safekeeping, safe administration and disposal of medicines received into the care home.(Previous timescale of 31st January 2005 not met) The registered person shall not employ a person to work at the care home unless, the person is fit to work at the care home and he has obtained in respect of that person the information and Timescale for action 31st August 2005 2. 8 13(4)(C) 31st August 2005 3. 9 13(2) 31st August 2005 4. 19 19(1)(a) (b)(c) 31st August 2005 Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 23 documents specified in Schedule 2 of the Care Homes Regulations. 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 7 Good Practice Recommendations The service users’ plan of care should incorporate any social activity or leisure interest and should demonstrate how the home is able to support the service user in continuing to maintain their interests. Service users should be supported to make choices about daily routines, and when to do activities of daily living. The ratios of care staff to service users should be determined according to the assessed needs of residents, and a system operated for calculating staff numbers required, in accordance with guidance recommended by the Department of Health. The home should now consider utilising a recognised tool to determine staffing requirements in accordance with the dependency levels of the people who live at the home. 2. 3. 12 27 4. 27 Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Walton House Nursing Home F57 F08 S25584 Walton House Nursing Home V233920 170606 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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