Care Home: Clumber House Nursing Home

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What the care home does well Residents are assessed before they move into the home to make sure their needs can be met there. People living in the home feel well cared for by the staff. Comments included "the staff are lovely / very nice". Links are retained with families, friends and the local community. There are enough resources provided so there is plenty of time for activities for residents to take part in. Thorough recruitment procedures, staff training and staff supervision ensure that residents are protected from harm.The home is clean and comfortable and residents are able to choose from a varied, nutritious menu so they stay well fed and healthy. The management of the home is based on openness and respect for residents and their friends and family so the home is run in the best interests of the residents. What has improved since the last inspection? The management of the home is now stable and the home is run in the best interests of the people living there. Intermediate care is no longer provided so some of the problems found at the last key inspection no longer apply. Care plans have improved and now reflect the type of care to be provided for each person living in the home. Medicines are now managed well so people living in the home can be confident they are receiving their medicines as prescribed by the doctor. The privacy and dignity of people living in the home is now maintained. The cleanliness of the home has improved and commodes and other equipment used by residents are cleaned regularly so that there is no risk of infection. The systems in the laundry are satisfactory so peoples` clothes are respected and cared for. Additional training has been provided to ensure that nursing staff and care staff have up to date knowledge and skills so that the most appropriate care is provided to the people living in the home. A quality assurance system is now in place and includes meeting with relatives, people living in the home and staff so their views can be heard and appropriate action taken as necessary. What the care home could do better: Refurbishment of the environment needs to continue to ensure that the home is a pleasant and safe place for people to live in. CARE HOMES FOR OLDER PEOPLE Clumber House Nursing Home 81 Dickens Lane Poynton Cheshire SK12 1NT Lead Inspector Helena Dennett Key Unannounced Inspection 6th March 2008 09:30 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 Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clumber House Nursing Home Address 81 Dickens Lane Poynton Cheshire SK12 1NT 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) 01625 879946 01625 879230 Grosvenor Care (Cheshire) Ltd Mrs Catherine Mintoff Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home with Nursing code N, to people of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP The maximum number of people who can be accommodated is: 36 Date of last inspection 13th September 2007 Brief Description of the Service: Clumber House was built in 1876 and was formerly a private residence that has been converted and extended. It is situated in its own grounds, close to the centre of Poynton on a bus route and within walking distance of local shops and amenities. The home has recently changed ownership and the new owners are Grosvenor Care (Cheshire) Ltd. Bedroom accommodation is on two floors and consists of twenty-six single bedrooms, twenty four of which have en-suite facilities. There is a passenger lift and two staircases providing access to the first floor. A registered nurse is on duty at all times to meet the needs of the residents. The scale of charges range from £402.37 - £500 per week. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This visit took place on 6 March 2008 over six hours. The visit was just one part of the inspection. The manager of the home was not informed of the date the visit was to take place, but a few weeks before the visit she was asked to complete a questionnaire to provide the inspector with some information about the service. The manager was also asked to distribute CSCI questionnaires to residents, relatives and health and social care professionals to help the inspector find out what they think of the home. Responses were received from one relative. Surveys were also given out to people living in the home during the site visit. Four were returned. These were positive about the standard of care in the home. During the visit the inspector spoke with the manager, staff, residents and visitors. She toured the premises and looked at various records held by the home. After the last key inspection the provider was asked to submit an improvement plan identifying the action they were going to take to address the requirements. This was received and the work identified in this plan has been completed. What the service does well: Residents are assessed before they move into the home to make sure their needs can be met there. People living in the home feel well cared for by the staff. Comments included “the staff are lovely / very nice”. Links are retained with families, friends and the local community. There are enough resources provided so there is plenty of time for activities for residents to take part in. Thorough recruitment procedures, staff training and staff supervision ensure that residents are protected from harm. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 6 The home is clean and comfortable and residents are able to choose from a varied, nutritious menu so they stay well fed and healthy. The management of the home is based on openness and respect for residents and their friends and family so the home is run in the best interests of the residents. What has improved since the last inspection? What they could do better: Refurbishment of the environment needs to continue to ensure that the home is a pleasant and safe place for people to live in. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People have their needs assessed before they move into the home so they can be confident that staff at the home can provide the care and facilities they need. EVIDENCE: Information about the home and the services it provides is available in every bedroom. The manager or a senior nurse usually visits a prospective resident at home or in hospital before they move into the home. This is to ensure that the person’s needs can be met at the home. The assessment document plus the social worker’s assessment are then used as a basis for drawing up a plan of care. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 10 A statement of terms and conditions is given to the person so providing them with the information they need. A copy of one person’s statement of terms and conditions was seen in their file. Intermediate care is no longer provided at Clumber House so standard 6 does not apply. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The care people who live at the home receive is based on their individual needs to make sure that all their care needs are met appropriately in a way that maintains their privacy and dignity. EVIDENCE: Three care files were looked at during the inspection visit. These contained assessments done before the person moved in, which formed the basis of the care plans. The assessments should include a continence assessment to ensure that the correct equipment is provided as necessary. The care plans looked at have improved since the last inspection as they now address the individual’s needs. However some of the care plans had not been evaluated to ensure that the care they receive is still relevant to their needs. Although risk assessments are in place, nutritional risk assessments are not documented for those people at risk of losing weight. There was evidence however, that people are given nutritional supplements and their weight monitored if staff think they are at risk. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 12 Care files showed that peoples’ healthcare needs were being clearly identified. Separate records are maintained of visits by GPs and other health care professionals. Care staff, as well as nursing staff, write in the daily records and this provides information on each person’s health and well being. Staff support people living in the home to access a range of community healthcare services, such as optician, dentist and chiropodist, where necessary. People living at the home were very positive about the care they receive. One lady described a situation where staff acted quickly in identifying a problem, resulting in her receiving treatment quickly so promoting her health and well being. The following comment was made on one of our survey forms: ‘The nurses look to our needs and the doctor is told when needed’. The recording of medication was good apart from one discrepancy in one of the medicine administration records. The nurse in charge of the medicines said she would speak to the person involved to gain clarity on the issue. The medicine storage arrangements were satisfactory. People living in the home said that staff showed respect towards them and confirmed that staff members always knock on their bedroom doors and await permission before entering. Members of staff were seen to deal with people in a respectful way. Discussion took place with members of staff and the manager regarding the fact that people who require a lot of care appeared to be encouraged to use one lounge. The manager confirmed that people are given a choice of where they wish to go or sit within the home. This needs to be clearly identified in the plan of care should a person not be able to make or tell staff their choice. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. There is a range of activities for people living in the home to take part in so they can keep active and stimulated. EVIDENCE: A full time activities co-ordinator is employed at the home and a weekly activity programme is available in the service user guide, which is placed in every bedroom. Activities include quiz shows, films, bingo and games as well as visiting entertainers. On the day of the inspection visit people were seen taking part in a quiz in the morning and musical entertainment was provided in the afternoon. People living in the home were happy with the range of activities provided. One person said ‘ … does his best to provide us with as many activities as possible’. Another person said ‘There is always something going on’. A person living in the home made the following comment on one of our survey forms; ‘They try hard to please us.’ Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 14 A relative on one of our survey forms made this comment: ‘Limited mental stimulation provided for residents other than TV. The person previously responsible for organizing resident’s activities has been appointed deputy manager. This issue is further explored under the management standards. One person told us that staff have enabled a volunteer to visit the home every Saturday to spend time with the people living there. ‘She helps manicure nails and assists people in any way that she can. This person has a meal with the residents every Sunday’. Another person told us that she is assisted to go out every week. A person from her local church visits and accompanies her to the local shops. There are good links established with the local churches. Church magazines are available and the local vicar and priest visit regularly Several of the people spoken with said they are offered choices and can suit themselves within reason. They confirmed they could get up and go to bed when they please and that staff support them if they wish to go out with relatives or friends. The manager told us that some people who need help with eating and drinking have their lunch earlier as there are more staff to assist them. Staff must make sure that people are given a choice on the time they want their lunch and where it is served and that this is clearly documented in the plan of care. Everyone spoken with was also very complimentary about the food that is provided at the home. They said the evening meals were particularly nice, although there does not appear to be a choice of main meal at midday. They told us that arrangements are made for a different meal to be served if someone does not want the particular meal on offer. The menus were looked at and appeared varied and nutritious. Bowls of fresh fruit were available around the home. There is a small dining area in the home. Tables were nicely set with tablecloths and condiments providing a pleasant place for people to eat Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home’s procedures and practices are effective in supporting the complaints process, so people living in the home can be confident that any concerns they have will be listened to and acted upon. EVIDENCE: There is a complaints procedure in place at the home. This is also listed in the service user guide. People living in the home knew what to do if they were unhappy with any aspect of the service or facilities. They said they felt able to approach staff if they had a concern or complaint. There is a safeguarding policy in place. All staff have had training in adult abuse and protection. Members of staff knew the action to take should an allegation or incident of abuse occur in the home. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 25 & 26 People who use this service experience adequate outcomes in this area. We have made this judgement using available evidence including a visit to this service. Although improvements have been made to the environment, more needs to be done to ensure that people have a pleasant and well-maintained environment to live in. EVIDENCE: Some improvements have been made to the environment since the last inspection. A maintenance man is employed and was carrying out work on the day of the site visit. The corridors have been repainted and new curtains purchased for the lounge area. There are still some signs of wear and tear with some bedroom door handles needing adjustment and some bed bases requiring replacement, as some are torn/split. This was identified at the last key inspection. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 17 Storage of bulky items such as wheelchairs remains a problem. A laundry basket and wheelchairs were seen stored in the sluice and blocking the sluice machine. This is not good practice, as it could lead to cross infection. The manager said that there are no other areas in the home to store these items safely. This should be explored further. Bedrooms looked homely and contained many personal possessions such as small items of furniture, ornaments and photographs. One of the bathrooms on the first floor was considered to be in need of refurbishment. The suite is mismatching and a wooden cupboard is also stored there thus detracting from a homely environment. The lighting in the smaller lounge was poor, making it difficult for people to read. One of the people using the lounge told us that they had told the manager about this and she has agreed to purchase additional lights. The manager told us these were on order. One person was seen sitting next to a hot radiator in their bedroom. This did not have a cover or a guaranteed low temperature surface. Although the person was not at risk at the time of the inspection visit, they could be placed at risk should they fall next to it. A risk assessment should be carried out and appropriate action taken to minimise risk. The cleanliness of the home has improved. An additional person has been employed to carry out domestic duties. All areas were clean and tidy with no unpleasant odours. The organisation of the laundry has also improved since the last inspection. A laundry assistant is now working every day in the laundry. Information provided to us before the site visit identifies that there is an intention to continue to refurbish the home and replace the flooring in the laundry in the next 12 months. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. There are enough suitably qualified and skilled staff working in the home to make sure the needs of all the people living there are met. EVIDENCE: There were plenty of staff working in the home on the day of the site visit. On the morning of the visit there were 31 people living in the home. Two qualified nurses, one senior carer, three carers and the activity organiser as well as the manager were working in the home. People living in the home were very positive about the staff and staff attitudes. The following comments were made: ‘staff are lovely and helpful’; ‘ all staff are good but some are excellent’. All said there appeared to be enough staff working in the home; they said their call bells are answered within a reasonable time. One comment received back on a survey form suggests that the home is short staffed at times. However the person goes on to say that agency staff are rostered in when there is a shortage. Concern was raised that this could affect the continuity of care. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 19 Two personnel files were looked at. These contained all the necessary checks required to ensure that the person is suitable to work in the care industry. Two members of care staff spoken with were very enthusiastic about their job. They said that the manager encourages them to attend training sessions and they felt supported in their role. They showed a good understanding of the principles of care and were very aware of the need to treat everyone as an individual. Both staff members said they have had supervision sessions with their manager. Most of the staff working in the home have achieved a National Vocational Qualification (NVQ) in Care. Members of staff told us that there is an induction process, which they have to complete to make sure they have the skills to carry out their role. One person’s records were looked at. Although a checklist had been completed to identify what training was given and the areas covered during the induction there was no record of whether the person was competent to carry out caring tasks and so there could be a risk that the needs of the people living in the home may not be met. This issue was also raised at the last key inspection. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home is well run and managed so ensuring that the health safety and welfare of the people living there is promoted and protected. EVIDENCE: The manager of the home is a registered general nurse with plenty of management experience. The company have recently appointed the activity co-ordinator as deputy manager. Discussion took place with the deputy manager regarding his changed role. He told us that another named member of staff will continue with the programme of activities for the people living in the home when he needs to undertake management duties. Because he is not a qualified nurse, a senior nurse has been identified as the person who makes decisions on clinical issues in the absence of the manager. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 21 People living in the home were very positive about the manager of the home. They refer to her as ‘Matron’. The following comments were made: ‘Matron is excellent she will do anything for you’. Another person said, ‘Matron is very good she is very friendly’ A comment received back on a survey form said ‘The standard of care provided is adequate but is notably better when matron is on duty’ Members of staff told us that the ‘matron’ was approachable but firm and expected high standards from the staff. Meetings are held regularly for staff and relatives so that they can be kept informed of issues affecting the home. The manager had discussed the outcome of the last key inspection at the last relatives’ meeting and had told them of the action to be taken to make sure that people living in the home receive good care. Questionnaires are sent out to people using the service and their relatives. Action is taken by the manager to ensure that any issues brought up are addressed. Small amounts of money are held on behalf of the people living in the home. Receipts are kept and staff make sure that two signatures are obtained for all transactions. The manager told us that all of that all of the equipment has been serviced in accordance with the manufacturers instructions. All staff have now had moving and handling training so residents can be confident staff have the skills to care for them appropriately. Fire safety checks are carried out regularly. Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 X 18 3 2 X X 2 X X 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations Nutritional risk assessments and continence assessments should be carried out when a person is first admitted to the home so that appropriate action can be taken for those people deemed at risk. People’s choices about their care and daily life should be recorded in their care plans to make sure that these choices are promoted and respected. The furniture in the bedrooms should be checked and any broken items should be replaced or repaired. 2 3. OP7 OP24 Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Regional Contact Team Unit 1, Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Clumber House Nursing Home DS0000069125.V352599.R01.S.doc Version 5.2 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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