Care Home: Harley Grange Nursing Home

What the care home does well What has improved since the last inspection? All of the requirements made at the last key and random inspection have been met. The care plans now contain information that reflects individual needs and records that are fully complete showing that the health and well being of the residents is being met. The medication records are accurate with all medicines being signed for and the senior staff have received updated training in administering medicines. All of the staff have received updated mandatory training and are receiving regular formal supervision, to make sure that they are able to care for the residents and have the opportunity of discussing work and training issues with their manager. The home has been decorated, new furniture has been provided and a bathroom has been converted to provide a hairdressing and therapy room to give the residents a more pleasant place to live in. What the care home could do better: Nutritional drinks could be stored off the floor to make sure that they cannot become contaminated. Care plans could be made easier to follow by reducing the duplication of information in them. CARE HOMES FOR OLDER PEOPLE Harley Grange Nursing Home 25 Elms Road Leicester Leicestershire LE2 3JD Lead Inspector Thea Richards Unannounced Inspection 6th March 2009 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 Harley Grange Nursing Home DS0000001908.V374672.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. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harley Grange Nursing Home Address 25 Elms Road Leicester Leicestershire LE2 3JD 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) 0116 2709946 0116 2700409 harleygrange@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Ltd Mrs Jeanne Patricia Moitt Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34), Physical disability over 65 years of age of places (34) Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To admit the named person of Category DE(E) as identified in Correspondence in Application number V13892 dated 09/11/04 To be able to admit the named person of category PD (under 65 years) named in variation application No. V36842 dated 27 November 2006 The maximum number of persons the registered provider can accommodate in Harley Grange is 34. 19th August 2008. Random: 7th November 2008 Date of last inspection Brief Description of the Service: Harley Grange is a purpose built care home owned by Southern Cross Healthcare and is situated in Stoneygate, a quiet residential area two miles from the city centre of Leicester, which is easily accessible by public and private transport. The home is registered to care for thirty-four residents under categories OP (older persons) and PD (physical disabilities). The premises consist of two floors, which are accessed by use of the stairs and a passenger lift. There are a variety of facilities in the home including dining and lounge space and the residents have a choice of using a bath or a shower. The home has eighteen single bedrooms and eight double bedrooms all with en-suite facilities. A well-maintained garden is located to the rear of the building, which has level access for all the residents. There is information available in the reception area including the Registration certificate from the Commission for Social Care Inspection and the latest report. There was a current certificate of public liability insurance. Advice about advocacy services was available. The current fee level is those agreed by the local authority or PCT. The private fees for the home are £650:00 plus the nursing contribution. There are additional costs for individual expenses such as personal toiletries, optician, hairdressing and some recreational activities. Harley Grange Nursing Home DS0000001908.V374672.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 the people who use this service experience good quality outcomes. This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we (throughout the report the use of ‘we’ indicates the Commission for Social Care Inspection), spent five hours reviewing information received by the Commission for Social Care Inspection (CSCI) since the last inspection on the 19th August 2008 and a Random inspection undertaken 7th November 2008. The visit took place on the 6th March 2009 and lasted seven hours. During the visit we checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called ‘case tracking’. Case tracking means that we looked at the care provided to three of the residents. To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents and their families. With their permission the residents’ bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. We checked the Annual Quality Assurance Audit (AQQA) that the home had sent to us. This describes the services provided at the home for the residents, how the home is hoping to improve services and statistics about the residents and the staff. We looked at the comment cards that we had returned to us from the residents, relatives and the staff. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 6 During the visit we spoke with the manager, the operations manager, the residents, the staff and families and visitors to the home. What the service does well: What has improved since the last inspection? All of the requirements made at the last key and random inspection have been met. The care plans now contain information that reflects individual needs and records that are fully complete showing that the health and well being of the residents is being met. The medication records are accurate with all medicines being signed for and the senior staff have received updated training in administering medicines. All of the staff have received updated mandatory training and are receiving regular formal supervision, to make sure that they are able to care for the residents and have the opportunity of discussing work and training issues with their manager. The home has been decorated, new furniture has been provided and a bathroom has been converted to provide a hairdressing and therapy room to give the residents a more pleasant place to live in. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Harley Grange Nursing Home DS0000001908.V374672.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 Harley Grange Nursing Home DS0000001908.V374672.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, 2, 3. 6 is not applicable in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ needs are always assessed before moving into the home and they have good information to help them make the right choice about the home. EVIDENCE: The residents or their families who were ‘case tracked’ told us that they had seen the Statement of Purpose and had been given the terms and conditions. These documents are available in other formats including audio tape, large print and other languages to give as many people as possible the opportunity to read them. The manager or a senior member of staff always visits prospective residents to complete a pre assessment of the residents’ needs. This makes sure that the home has a full picture of the resident before they are admitted, they Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 10 also have the opportunity to visit the home. These assessments were seen in the residents’ care plans and the residents and the families spoken with told us that they had a visit before they came in. The staff spoken with told us that they always knew about the resident before they were admitted. The current registration certificate from the Commission for Social Care Inspection (CSCI) was displayed in the entrance of the home with the latest report from the CSCI and an up to date public liability insurance certificate. Harley Grange Nursing Home DS0000001908.V374672.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff meet the care needs of the residents, with privacy, dignity and respect. EVIDENCE: The ‘case tracked records were found to contain good individual evidence of the care being given to the residents and reflected the care that the residents needed. There was evidence that the residents and/or their relatives have been involved in planning the care. The residents and the families spoken with told us about the care that they needed and that they were happy that they received it. There are records of the involvement of G.P.s, district nurses, chiropodist, optician, where needed in the care plans, showing that thorough health care is being provided for the residents. The residents and their families spoken with said that they could see the doctor and other health professionals when they needed to. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 12 There was evidence that the care plans are regularly reviewed and the residents and the families spoken with confirmed that they had been involved and were aware of the care to be given and that they were happy with it. The daily record of care was up to date and contained details about the residents’ day and night. We saw residents being treated with dignity and respect when staff spoke with them and undertook their care, particularly when moving them. They were seen to be knocking on the residents bedroom doors before they went into them. The staff sat down with the residents and spoke with them individually. There are records of the residents meals and drinks that make sure that the residents are eating and drinking properly. These included the residents’ weight, which makes sure that they are not losing or gaining large amounts of weight. There were risk assessments in place to cover all the identified risks for the residents and how the staff should manage those risks. This makes sure that the residents and the staff are protected from any risks that have been identified, without restricting their activities. Medication records for the case tracked residents were in order. Medicines are given by the nursing staff who have regular updating in medicines. We saw that the medicines were administered individually and the residents were seen to be taking them. Medicines are supplied in a ‘monitored dosage system’ where each tablet is in a separate ‘pop out’ card, which is a safe method of administration, helping to make sure that the resident is always given the right medicines. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of medicines. The manager carries out a monthly written audit of the medicines and the medicine sheets to make sure that they are correct. The controlled (dangerous) drugs and records were checked and found to be in order. Boxes of fortified drinks were stored on the floor in the treatment room, these should be stored on shelf or plinthe to prevent them becoming contaminated. There was a self-medicating policy in place but there were no residents looking after their own medicines at that time. Harley Grange Nursing Home DS0000001908.V374672.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. Quality in this outcome group is good. This judgement is made using available evidence including a visit to the service. The residents enjoy the activities that they want to and have their spiritual and nutritional needs met. EVIDENCE: The staff were seen to be spending individual time with the residents reading the newspaper, playing softball and talking to them. The T.V was on in the lounge, which the residents told us that they were enjoying Activities that were on the notice board and the residents and the staff told us were enjoyed included bingo, board games, hand massage and manicures, singing, talks, non cooking recipes, music and dance, memory games and discussions. There is a regular church service held every six weeks and clergy can visit whenever the residents would like. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 14 A hairdresser visits weekly, which the residents enjoy. The staff, the residents and the families spoken with told us that they were happy with the amount of activities, although there were some comments in the surveys returned that said they would like more. There was evidence in the daily records and in the care plans about the activities that the residents take part in. All the families spoken with said that they were made very welcome in the home, which we saw whilst we were there. The residents spoken with said that the food was good and that they had a choice of what they had. The menus were varied and were discussed with the residents at residents meetings. Comments made by the residents included: ‘ The food is good and the staff look after me well’ We spoke with the residents during their lunch, which was served attractively and they told us that they were enjoying. Fruit served in manageable pieces was seen to be offered to the residents when drinks were being served, the residents told us that they appreciated this and enjoyed it. The cook has been in the home for two months and is happy with the quality and amount of food supplied. He is aware of different diets such as vegetarian and diabetic and provides pureed diets in an attractive way. Most of the staff were seen to be sitting with individual residents helping them with their meals, however one carer was seen to be standing over a resident. This could make the resident feel intimidated by the carer and that they didn’t have time for them. Harley Grange Nursing Home DS0000001908.V374672.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. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. There are systems in place to support and protect residents and staff are aware of the processes. EVIDENCE: There is a complaints policy in place which gives the details of how to complain and who to complain to in the home if they needed to. This was found to be thorough in the details of any complaint and the dates. This could be made available in a large print and other languages if it was needed, which would make sure that as many people as possible could read it. It is also available on audio cassette. The home has received no complaints since the last inspection on 19th August 2008. The Commission for Social Care Inspection has received no complaints or concerns. The residents and the families spoken with were aware of the policy, of how to complain and who to complain to. They were happy that their concerns would be listened to and acted on. The staff spoken with were aware of how to handle any complaints. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 16 The staff spoken with were able to describe how they would deal with an allegation of abuse, knew the areas where abuse could happen and could describe the process that they would go through if they suspected any abuse. They confirmed that they had had training in safeguarding adults and whistle blowing and the manager and the records seen supported this. All of the staff have either got an NVQ at least at level 2 or have started the award, during which they receive training in safeguarding as well as the training given in the home. They were confident that the management would handle any issues correctly. We looked at the accident book, which had been completed correctly. These practices make sure that the residents are safe from any abuse and that any concerns are handled correctly. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 17 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, 24, 26. Quality in this outcome group is good This judgement has been made using available evidence including a visit to the service. The residents are protected by the policies and procedures in the home to provide a safe and pleasant environment. EVIDENCE: Harley Grange is a large converted house in Stoneygate, a suburban area between Oadby and Leicester. The home was warm, clean, homely and welcoming on our arrival. There is a lounge and a dining room on the ground floor, with bedrooms on both floors. The first floor can be reached by the stairs or by the passenger lift in the home. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 18 The lounge and dining room were clean, bright and well decorated, with suitable seating for the residents. All of the bedrooms seen had been personalised and were found to be clean and well decorated. The residents spoken with were happy with their rooms and said that they were able to bring their own belongings in with them. There was evidence of equipment in the home to help the residents, such as wheelchairs, special mattresses and hoists. There was a good provision of bathrooms in the home and these were found to be clean and clear of any items that could cause a hazard for the residents. A bathroom on the ground floor has been turned into a hairdressing and beauty salon for the residents, which they told that they enjoyed. There was a patio area and grounds that were easily reached by the residents and made a pleasant place to sit and walk for them. The residents and the families spoken with were happy with the cleanliness of the home, and told us that the staff worked hard to keep it clean. There are staff employed to complete the cleaning in the home and they have had training in health and safety. The cleaning products are stored in a locked cupboard, which we saw. This was confirmed by the staff spoken with and by the manager. The records for hot water testing were up to date and all the temperatures were within the recommended levels. The fire records for testing alarms and fire drills and training were looked at and found to be up to date. Harley Grange Nursing Home DS0000001908.V374672.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, 30. Quality in this outcome group is good. This judgement is made using the available evidence including a visit to the service. The recruitment policy and the training meet the residents’ needs and protect their safety. EVIDENCE: We looked at three staff files and the required information was complete in all of them. This included evidence of identification, adequately completed application forms, two written references, a Criminal Records Bureau (CRB) check and a Protection of Vulnerable Adults check. The manager makes sure that all the required documentation is in place before an employee starts work. This was confirmed by the staff spoken with, who told us that they could not start until they had all the paperwork in place. The staff spoken with confirmed that they had received recent training in moving and handling, dementia awareness, challenging behaviour, safeguarding of vulnerable adults and first aid. The manager has a matrix with all the training courses that are arranged and when the staff need to attend them. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 20 The residents and the families spoken with felt that the staff were well trained to do their job and that there were usually enough staff to look after them. We did see an incident when there were no staff in the lounge and a resident was calling for five minutes before someone came. We saw the induction programme that all the staff complete and it contained all the rquired mandatory training needs. Most of the care staff either hold a National Vocational Qualification (NVQ) at least at level 2 or are in the process of completing it. The National Vocational Qualification is a qualification for care staff to make sure that they receive training in the needs of the resident group whom they are caring for. Harley Grange Nursing Home DS0000001908.V374672.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, 36, 37, 38. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. The residents’ safety is protected by the practices in the home that is run in their best interests. EVIDENCE: The manager, a trained nurse has managed the home for several years has achieved the registered managers’ award and is registered with the Commission for Social Care Inspection. There are regular meetings held for the residents and for their families, to discuss activities and menus in addition as to how the home is meeting their needs. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 22 The manager holds an out of hours ‘surgery’ so that families who are working have the opportunity of speaking with her. She does speak with the residents on a daily basis and with the visitors. The residents and the families spoken with confirmed this. There is an annual quality questionnaire sent to the residents and their families and the questionnaires that we saw on the visit confirmed this. The families and the residents told us that they had completed the questionnaires. We received positive comments from the residents and the families at the visit amongst which were that the staff were very supportive of them and their relative. The residents’ accounts were seen and all in order, and always had two signatures on each entry. This makes sure that the resident and the member of staff handling the money are protected. We saw that receipts were obtained for purchases. There was evidence from the staff spoken and from the records seen with that they are having regular, formal supervision with their ‘line manager’. Formal supervision of the staff gives them and their ‘line manager’ the opportunity to discuss work and training issues and needs. There are regular staff meetings held, confirmed by records held and by the staff spoken with. All the areas of health and safety such as hot water temperatures and fire drills and alarm testing were found to be in order. Harley Grange Nursing Home DS0000001908.V374672.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 X 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 3 X 3 X 3 3 3 3 Harley Grange Nursing Home DS0000001908.V374672.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. 2. Refer to Standard OP7 OP9 Good Practice Recommendations That the care plans are reorganised to make sure that they are easier to follow and avoid repetition. That fortified drinks are stored off the floor to avoid the risk of contamination. Harley Grange Nursing Home DS0000001908.V374672.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Harley Grange Nursing Home DS0000001908.V374672.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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