Care Home: Ennerdale Nursing & Residential Home

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What the care home does well The home provides a good level of care to service users which is clearly evidenced in the records held in the home. The home is bright and welcoming and is designed to meet the individual needs of service users. Service users are free to choose and enjoy their own lifestyle within the home and are encouraged and assisted to do so. A comprehensive programme of exercise and rehabilitation is provided for service users accommodated for intermediate care. Meals are nutritious and appetising and snacks and drinks are available 24 hours each day. Staff are highly trained to ensure that the needs and preferences of service users are met. What has improved since the last inspection? The Bridge Unit on the first floor has been opened since the last inspection and provides personal care to people who have dementia. The programme of redecoration and improvement of the home continues and it is evident that every effort is made to provide service users with a comfortable and homely environment. The sensory garden is now complete and provides a pleasant area where service users can sit and enjoy the colours and scents of the plants and flowers. CARE HOMES FOR OLDER PEOPLE Ennerdale Nursing & Residential Home Longmoor Lane Fazakerley Liverpool Merseyside L9 7JU Lead Inspector Jeanette Fielding Unannounced Inspection 09:30 7th May 2008 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 Ennerdale Nursing & Residential Home DS0000069159.V362174.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. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ennerdale Nursing & Residential Home Address Longmoor Lane Fazakerley Liverpool Merseyside L9 7JU 0151 530 1457 0151 524 3160 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) www.bupa.co.uk BUPA Care Homes (ANS) Ltd Mrs Karen Southern Care Home 61 Category(ies) of Dementia (61), Old age, not falling within any registration, with number other category (61) of places Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To people of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of people who can be accommodated is 61. Date of last inspection 31st July 2007 Brief Description of the Service: Ennerdale stands in the grounds of University Hospital Aintree (Fazakerley Hospital site) but is an independent care home, owned by a national company, BUPA Ltd. It is a large two-storey building with its own gardens and there is car parking at the front of the home. The home consists of four units. It provides personal care for 13 older people with dementia in a separate unit on the ground floor and another for 15 people on the first floor. A unit on the ground floor is used to provide intermediate care for up to 14 older people and the first floor is nursing care unit for 19 older people. All bedrooms are for single occupancy and each unit has its own lounge and dining facilities. Fees at the home are in the range £403 to £590.11 depending upon the category of service required. The home is not far from rail and bus routes to Liverpool city centre, shops and other community facilities. These are not however within easy walking distance for most older people. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This unannounced inspection was conducted on two days over a period of ten and a half hours. This was the key unannounced inspection and was carried out as part of the regulatory process. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Discussion took place with the registered manager, nurses, care staff, service users and visitors to the home. The manager completed the Annual Quality Assurance Assessment document to provide detailed information regarding the home and the service provided. Questionnaires were issued to staff and service users to obtain their views of the service. What the service does well: What has improved since the last inspection? What they could do better: Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 6 Arrangements for additional toilet provision on the Bridge Unit was identified as being necessary and the manager contacted the Estates Department of BUPA during the course of the inspection. 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. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment is undertaken on all prospective service users to identify their needs and to ensure that those needs can be met. EVIDENCE: All prospective service users and their families are provided with a detailed information pack regarding the facilities and services offered by the home. Service users and relatives who completed the survey forms, or were spoken to on the day of the site visit, said that the information provided was excellent and certainly helped them to choose their service provider. Two relatives confirmed that they had visited the home prior to making a decision and had spoken with unit managers who were extremely helpful. The Statement of Purpose, Service User Guide and additional information is also available in the foyer of the home. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 9 All prospective service users who are accommodated for long term care are fully assessed prior to admission. The home uses the ‘QUEST’ format for the assessments. All assessments are written down and the information is shared with staff so the manager can be confident that the staff are able to meet the persons needs. The assessments inspected provided evidence that the people’s health, care and social needs are identified prior to their admission to the home and provide sufficient information for the initial plan of care to be prepared. The assessment also identifies specialist equipment that may be necessary and for this to be provided in preparation for the persons admission. People who are admitted for Intermediate Care are assessed in hospital, or in their own home, by appropriately trained staff from the Primary Care Trust. Since the last inspection, discussion has taken place with the PCT with a view to improving these assessments. Inspection of the assessments provides evidence that they have improved and provide the home with additional information regarding the needs of the service users. People who are accommodated for Intermediate Care usually stay in the home for six to eight weeks and have the services of Physiotherapists and Occupational Therapists to assist with their rehabilitation to enable them to return home. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans are prepared to enable the staff to identify and meet the service users individual needs and preferences. EVIDENCE: Individual care plans are prepared for all service users. The home is divided into four separate units and so care plans were inspected on each of the units. All were found to have detailed care plans which were reviewed and updated on a regular basis. It may be more beneficial for nutritional assessments to be reviewed following the monthly weighing of service users rather than waiting until the date of the next review. This was discussed with the manager who will look at this. The care plan for one service user was identified as requiring updating in respect of moving and handling and this was immediately addressed by the unit manager. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 11 The care plans provide staff with detailed information regarding service users medical, health care and social needs and preferences. Risk assessments are prepared together with risk management plans to reduce or remove any potential risk to the service users. The daily records completed by the staff team are detailed and informative and provide evidence that the service users individual care needs are met. Records are held of visits to and by GP’s and other healthcare professionals. It was evident that the instructions given by these professionals had been adhered to. Assessments are in place with regard to the use of bed rails and permission for the use of these had been obtained. Turning charts and fluid balance charts had been accurately completed. The home has a comprehensive policy and procedure for the administration of medications, which has recently been updated, and inspection of the medications and relevant records show that the procedure has been followed. Some entries on the Medication Administration Record sheets were handwritten and appropriate information was recorded. Care should be taken to ensure that handwritten entries are clearly written. All medication rooms were clean and organised. Detailed information was recorded for nutrition that is administered via PEG lines to ensure that all staff are aware of the procedure to be followed. Personal care is given to service users in the bathroom or their own bedroom as appropriate to protect their privacy and dignity. Service users spoken to confirmed that staff knock on their door prior to entering and this was observed during the site visit. One service user said ‘The staff are always polite and courteous. They are discrete and tactful all the time.’ Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A selection of meals is offered to residents to provide them with a well balanced and nutritious diet to meet their needs and preferences. EVIDENCE: The home has a structured activities programme which is tailored to the individual needs and preferences of the service users. Comments in the survey forms that were distributed include ‘There is always something going on and the Hobby girls are great’, ‘A good activities programme’ and ‘Activities are always well organised, are varied and are fun. Organisers are always enthusiastic and involve everybody’. Ministers of religion visit the home on a regular basis and provide services and will minister to service users individually on request. Visitors are welcome at all times for service users who are accommodated for long term care. The programme of rehabilitation within the Intermediate Care Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 13 Unit is structured and so visiting hours are restricted. Information regarding visiting can be obtained from the home. Improvements have been made to the dining facilities within the home to provide a more homely and pleasant environment. The menus provide evidence that a varied and balanced diet is offered to all service users. A choice of meals is available and special diets can be provided on the advice of the GP or dietician or at the request of the service user. The home provides a ‘Night Bite’ system to ensure that food is available 24 hours each day. In the units for service users who have dementia, the menu for this is in pictorial format. This menu is clearly displayed in the dining room. The dining rooms are attractive, with tablecloths, table centres and place mats. Service users spoken to during the site visit said that the meals were good and confirmed that a choice was available. One service users said that the food was always hot and she enjoyed everything so much that she sometimes had difficulty in deciding which meal to have. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected from abuse through a robust complaints procedure and a well-trained staff team. EVIDENCE: The home has a comprehensive complaints policy and information on how to make a complaint is detailed within the information pack for service users and also displayed on notice boards within the home. The records held in the home provide evidence that all complaints have been dealt with in a timely manner and appropriate action taken where necessary. As part of this site visit, a survey of the manager, staff and service users was undertaken in relation to safeguarding. This survey provided evidence that all staff had been appropriately vetted prior to commencing work at the home to ensure that service users were protected. All staff spoken to were aware of the home’s policy and procedure for the protection of the service users and have been given training on the different types of abuse. The home has prepared a detailed action plan for staff to use in the event of abuse being suspected. This information document is displayed on the wall in each of the offices and contains full information about the action to be taken with regard to Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 15 informing the Safeguarding Adults Team and the management of BUPA. All staff spoken to were aware of where this information was held and were able to demonstrate that they had the knowledge and understanding of the processes and procedures. Service users said that they were confident that their relatives, the staff and manager would take appropriate action if there were any concerns. One service user confirmed that she had full information on who to contact as it was detailed in the information pack that she had been given. Ennerdale Nursing & Residential Home DS0000069159.V362174.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, 21, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements continue to be made to the home to provide service users with a comfortable and homely environment in which to live. EVIDENCE: The home is a purpose built care home which provides care in four separate areas. Intermediate Care Unit - Stananought. All bedrooms in this area are decorated and furnished to a good standard but are less personalised than other areas of the home as service users are accommodated for short term rehabilitation care. It is evident that efforts Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 17 have been made to make the rooms homely and welcoming. An area of the wall in the dining room has been damaged by water and requires redecoration. A programme of high cleaning in this room is necessary with particular reference to the window frames. The manager stated that plans are in place to address this. Nursing Unit – Tarleton. Bedrooms are bright and welcoming, with many having been personalised to a high standard to reflect the personality and lifestyle of the service users. Improvements have been made to the bathing facilities within this unit to now provide adequate and sufficient facilities for the service users. The lounge has a homely feel to it, having been decorated and furnished in a domestic style. First floor EMI unit – Bridge. This area has been registered and made available for use since the last key inspection. All areas were redecorated and considerable refurbishment has taken place. Colour orientation systems are in place, with doors being painted yellow, to aid service users to find bathrooms and toilets. Hand rails along the corridor are painted bright green to assist service users who have visual difficulties. One of the bathrooms has been converted to a shower room, but the WC has been removed. This has resulted in a lack of WC’s being available as one of the two WC’s is within a bathroom. Discussion took place with the manager who is to contact the property and estates department within BUPA to look at the problem with a view to providing additional facilities. Ground floor EMI unit – Whitfield. Some redecoration remains outstanding in this area but plans are in place to address these within the next few weeks. Bedrooms are decorated and furnished to a good standard and efforts have been made to provide a warm and homely environment. All areas of the home were fresh with no unpleasant odours present. On the first day of the site visit, some issues were raised in relation to improvements within the home. On the second day of the site visit, the manager confirmed that arrangements had been put in place for these to be addressed. One service user confirmed that she had been involved with choosing the colour scheme within her bedroom and that her family had provided appropriate colour co-ordinated items to further enhance the room for her. The home is set in extensive gardens which service users are free to use as they wish. Secure areas are provided for service users who are at risk of Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 18 wandering away from the home. Service users spoken to during the site visit, commented favourably about the new sensory garden. This is a designated area which is particularly attractive. Some of the survey forms completed by service users also gave favourable comments regarding this area. A small number of maintenance issues were identified as requiring attention on the first day of the inspection and these had been addressed by the manager by the second day. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 19 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust recruitment policy and procedure to ensure that residents are protected. Staff are well trained to safeguard the residents and to meet their individual care needs. EVIDENCE: The staff rotas inspected provide evidence that sufficient staff are employed by the home to meet the needs of the service users. Designated staff are employed for the individual units to provide a consistent level of care. The home employs qualified nurses, senior care assistants, care assistants, catering staff, housekeeping, maintenance and administration staff to ensure the smooth running of the home. The home follows a robust recruitment procedure. All prospective staff are required to complete an application form prior to being called for interview. Records are held of the interview. Two references are taken and checks are made through the Criminal Records Bureau and Protection of Vulnerable Adults registers to ensure that service users are protected. Evidence of training and previous experience are required to be produced. Nurses are required to be Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 20 registered with the Nursing and Midwifery Council and evidence that they remain registered is verified by the home. All new staff complete a comprehensive induction training programme and evidence of completion of this is held on their file. A high number of training courses are offered to staff to further develop their knowledge and understanding. Staff spoken to during the inspection confirmed that they were required to undertake ongoing training and said that they enjoyed these as it gave them greater insight into the care that they gave to the service users. A selection of staff files were inspected and all were found to be well maintained and up to date and contained evidence of completed training courses. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 21 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of residents, relatives and other healthcare professionals are sought on a regular basis to enable improvements to continue. The home is management to a high standard to ensure the protection and best interests of the residents. EVIDENCE: The registered manager of Ennerdale is a qualified nurse who holds a recognised care management qualification. She has considerable experience of managing care homes for older people and was able to evidence on going training and personal development. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 22 During the course of the inspection it was clear that the manager had a good understanding of the needs of each of the service users in the home and was fully up to date with their care arrangements and individual expectations. Staff and service users spoke highly of the manager, her style of management and her commitment to the care that the home provided. Discussion with service users with regard to complaints provided evidence that, whilst no complaints or concerns were identified, they would feel extremely comfortable in discussing these with the manager and were confident that any issues that were raised would be addressed. Monies held for service users are placed in an appropriate interest bearing account and under the BUPA system interest is allocated to individual account records. Regular staff meetings are held and provide a forum for open discussion and exchange of information. Residents and relatives meetings are also held and detailed records of issues discussed are held. The home provides comments cards in the reception area of the home to gather the views of service users, relatives and other visitors to the home. Questionnaires are issued to service users and/or their visitors on a regular basis to further obtain their views of the home and the services provided. Maintenance contracts are in place and safety certificates inspected were found to be well maintained and up to date. BUPA’s Operations Manager makes regular unannounced visits to the home and produces a report of these visits. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 23 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 3 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 3 X 2 X X 3 X 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 4 X 3 X 3 X X 3 Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 24 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 OP21 Good Practice Recommendations A review of the toilet facilities on the Bridge Unit should be undertaken with a view to increasing the number of facilities provided. Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Ennerdale Nursing & Residential Home DS0000069159.V362174.R01.S.doc Version 5.2 Page 26 - 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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