Care Home: Whorlton Grange Care Home

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What the care home does well There is up to date information available about the home for people to look at. People have their needs assessed before they are admitted to the home and written contracts are provided so that people know the terms and conditions for living at the home. Individual care plans that describe how their needs will be met are written for people living at the home and registered health practitioners meet their health needs. One person told us "If you are not very well she (the manager) is good. The doctor came last Tuesday to see me." Medication is managed appropriately and people are treated with respect and dignity. One relative made this comment "The care home treats everyone in their care with respect and consideration. They also maintain peoples` dignity often under difficult and trying circumstances." People are encouraged to take part in activities and contact with the community is encouraged. The home has a complaints procedure in place and people know who to complain to. Up to date adult protection procedures are in place for staff to follow. Whorlton Grange is a well-maintained clean and tidy home for people to live in. There are sufficient staff on duty to meet the needs of the people who live at the home. Staff hold recognized qualifications in care. The home has an experienced and qualified registered manager in post. Finances and health and safety issues are managed appropriately. The owner and manager have responded promptly to many of the recommendations we made during the inspection visits. What has improved since the last inspection? This is the first inspection of the service since Bhachu Care Ltd purchased the home. What the care home could do better: The home could consider how it could produce its information in alternative formats to meet the different needs and abilities of people who may want to live at the home. People are generally encouraged to make choices however choices at mealtimes are limited and should be encouraged more. This could be achieved by having menus that show what alternative meals are available and bu asking people what they would prefer. "We don`t have a menu, you take what you are given, and you get enough to eat, too much!" The staff should receive regular training updates in the protection of vulnerable adults. A systematic training programme should be put into place to ensure that staff skills are kept up to date. Management systems should be put into place to ensure that no one starts working at the home until all of the proper recruitment checks have been completed and copies of qualifications have been obtained. Quality assurance systems should continue to be developed, and a regular staff supervision programme should now be fully implemented and monitored. CARE HOMES FOR OLDER PEOPLE Whorlton Grange Care Home Whorlton Barnard Castle Durham DL12 8XA Lead Inspector Jean Pegg Key Unannounced Inspection 18th March 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Whorlton Grange Care Home DS0000070755.V360909.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. Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whorlton Grange Care Home Address Whorlton Barnard Castle Durham DL12 8XA 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) 01833 627491 01833 624492 Bhachu Care Ltd Mrs Janet Edith Swinburn Care Home 27 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (27) of places Whorlton Grange Care Home DS0000070755.V360909.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 only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Dementia over 65 years of age - Code DE(E), maximum number of places 12 Old Age, not falling within any other category, - Code OP, maximum number of places 27 The maximum number of service users who can be accommodated is: 27 New Service 2. Date of last inspection Brief Description of the Service: Whorlton Grange is a care home registered to provide personal care and accommodation for up to 27 older persons including 12 with dementia. Bhachu Care Ltd own the home. Whorlton Grange is a Georgian house situated in its own landscaped grounds in the village of Whorlton near Barnard Castle. The home does have an extension to the main house and provides both single and double room accommodation. Two of the single rooms are fitted with en-suites. All of the rooms are spacious and vary in size due to the age of the building. Passenger and stair lifts provide access to the first floor and specialist bathing facilities are available. At the time of writing this report fees for living at the home range from £382.50 per week for residential care and £402.50 per week for dementia care. Larger rooms and rooms with en-suite facilities have an additional charge of £20 per week. These charges do not include personal items such as clothing, hairdressing, private chiropody, newspapers etc. Fees and what they include should always be checked with the manager. Whorlton Grange Care Home DS0000070755.V360909.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 the people who use this service experience good quality outcomes. This inspection visit took place on Tuesday 18 March and Wednesday 26 March 2008 and lasted for 13 .5 hours. Evidence used for this report was taken from a variety of sources including information gained from: • Observations made during the two visits. • Records we looked at during the visits • Comments made by people who live and work at the home. • Results of surveys sent to people who live and work at the home and who have relatives who live at the home. We received 2 from people who work at the home and 2 who have relatives living at the home. What the service does well: There is up to date information available about the home for people to look at. People have their needs assessed before they are admitted to the home and written contracts are provided so that people know the terms and conditions for living at the home. Individual care plans that describe how their needs will be met are written for people living at the home and registered health practitioners meet their health needs. One person told us “If you are not very well she (the manager) is good. The doctor came last Tuesday to see me.” Medication is managed appropriately and people are treated with respect and dignity. One relative made this comment “The care home treats everyone in their care with respect and consideration. They also maintain peoples’ dignity often under difficult and trying circumstances.” People are encouraged to take part in activities and contact with the community is encouraged. The home has a complaints procedure in place and people know who to complain to. Up to date adult protection procedures are in place for staff to follow. Whorlton Grange is a well-maintained clean and tidy home for people to live in. There are sufficient staff on duty to meet the needs of the people who live at the home. Staff hold recognized qualifications in care. The home has an experienced and qualified registered manager in post. Finances and health and safety issues are managed appropriately. Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 6 The owner and manager have responded promptly to many of the recommendations we made during the inspection visits. What has improved since the last inspection? 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. Whorlton Grange Care Home DS0000070755.V360909.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 Whorlton Grange Care Home DS0000070755.V360909.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 5. People who use the service experience good quality outcomes in this area. There is up to date information available about the home for people to look at. People have their needs assessed before they are admitted to the home and written contracts are provided so that people know the terms and conditions for living at the home. We have made this judgment using a range of evidence, including a visit to this service EVIDENCE: The information describing the service offered by Whorlton Grange had been updated to show the new provider name and contact details. A ‘Welcome to Whorlton Grange’ brochure is produced and given to the relatives of people living at the home. We discussed the advantages of using visual images in brochures to help people know what is being offered. We also talked about alternative formats that information could be produced in that might help people from different cultures and those with differing levels of ability. For Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 9 example, people with sight or hearing problems. In our relative survey we asked, “Do you or your relative get enough information about the care home to help you make decisions? Both respondents said “Usually.” We looked at the file of someone who had recently been admitted to the home and found that the care manager’s assessment was in place. In our staff survey we asked “Are you given up to date information about the needs of people” one said “sometimes” and one said “usually.” The staff we spoke to were able to describe the pre admission assessment process and identify who was responsible for completing it. People living at the home had written contracts with the care home. These contracts identified the rights and responsibilities of both parties and the terms and conditions that were in place for living at the home. Whorlton Grange Care Home DS0000070755.V360909.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. People who use the service experience good quality outcomes in this area. Individual care plans are written for people living at the home that describe how their needs will be met. Registered health practitioners meet the health needs of the people living at the home and medication is managed appropriately. People are treated with respect and dignity. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: We looked three care plans in detail. The home uses a structured format to prompt the identification of care needs and specific actions that need to be taken to deliver care in accordance with people’s wishes. For example preferred rising and retiring times, whether or not people like alcohol etc. We discussed how some of the care plans could be improved for example by including more detail about finances and social stimulation. These improvements were starting to be implemented by the time we made our second visit. Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 11 The records that we looked at showed that people were receiving visits from registered health practitioners. We also observed nurses visiting the home to attend to dressings and the people who live at the home confirmed that their health needs were attended to. We were told, “If you are not very well she (the manager) is good. The doctor came last Tuesday to see me.” We discussed with the manager the need for staff to be more detailed with their recordings about people. This had be addressed by the manager by the time of our second visit. We observed the lunchtime medication being administered and we checked the medication records and storage facilities after lunch. The way that the medication was managed was generally satisfactory however we did recommend that a more robust method of stock control be put into place. This was actioned straight away. We did not observe any behaviour that suggested that people’s privacy and dignity was not respected. One relative made this comment “The care home treats everyone in their care with respect and consideration. They also maintain peoples’ dignity often under difficult and trying circumstances.” Whorlton Grange Care Home DS0000070755.V360909.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. People who use the service experience good quality outcomes in this area. People take part in activities and contact with the community is encouraged. People are generally given the opportunity to make choices however choices at mealtimes are limited and should be encouraged more. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager confirmed that a part time activities coordinator was employed to work at the home and that most activities take place in the big lounge. We were told that some were group activities and some were one to one activities. We noticed that people were doing different things in the home for example one gentleman was working on a crossword book, another reading the paper and one lady was knitting. We also noticed staff playing a game of noughts and crosses with a small group of people during the evening. We spoke to one lady who told us that she usually visits her family twice a week. The manager told us that staff are encouraged to take part in activities. One relative commented, “I feel the clients would benefit from some sort of mental stimulation. When I visit the radio is on tuned into music for the staff not the Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 13 residents.” When we asked the manager about this she said that the people living at the home would indicate if they liked what was on the radio or not. Staff told us that the home had flexible routines. “Some people like getting up early and some watch TV to midnight.” And “Chats and stimulation take priority over tasks. Jobs can wait at this is home.” We observed people receiving visitors in the home and as stated earlier one lady told us about visiting her family twice a week. We were told that regular church services are held and that a mini bus is hired to enable people to go out on pleasure trips. The manager confirmed that there was some involvement in village life for example sports days and fire work displays. Individual preferences and choices form part of the prompts used to develop care plans. For example likes and dislikes. The rooms we saw and were invited into showed that people were encouraged to bring their own possessions with them. We observed a meal time and saw that staff were very helpful towards those that needed support and encouragement to eat. We also noticed that people’s preference for alcoholic drinks at meal times was supported. From the comments that were made to us we thought that people were not always actively given a choice about what to eat although there were alternatives available. “We don’t have a menu, you take what you are given, and you get enough to eat, too much. No complaints just quantity can put me off.” We discussed ways that the home could ensure that people were offered choices at meal times and knew that choices were available. The meals that we saw were nicely presented and people obviously enjoyed them. Whorlton Grange Care Home DS0000070755.V360909.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. People who use the service experience good quality outcomes in this area. The home has a complaints procedure in place and people know who to complain to. Up to date adult protection procedures are in place for staff to follow. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The complaints procedure was updated to show the correct role of the Commission for Social Care Inspection during our visit. The complaints procedure was on the notice board and in the service users’ guide. The people that we spoke to all confirmed that they knew who to speak to if they wanted to make a complaint. The relatives who responded to our survey indicated that the home was responsive to concerns made known to them. The home has copies of the up to date interagency adult protection procedures to follow. The manager said that the flowchart was being put in staff room for staff to follow. The staff we spoke to were aware of what to do if they suspected abuse in the home but were unsure as to whether or not they had received training in the protection of adults. Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. Whorlton Grange is a well-maintained clean and tidy home for people to live in. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: On our first tour of the building we noticed that some areas were not as tidy as they should be but we were aware that the home had had to alter it’s accommodation arrangements to compensate for the passenger lift being out of action. The engineers were present during our visit. The manager and owner had been in daily contact with the engineers to try to get the problems resolved. On our second visit the lift had been repaired and we found that the home was much tidier and had a very homely and lived in feel to it. We also noticed that the new owner had redecorated some rooms and replaced linen as part of the ongoing refurbishment programme put in place. The external grounds are very well kept and can be enjoyed form almost every part of the Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 16 building. The Fire Officer had visited the home in July 2003 and the Environmental Health Officer visited the home on 19 March 2008. During our first visit we made some recommendations for improving the management of soiled linen and the laundry area. These recommendations were implemented immediately. The owner also told us “staff training for infection control has been booked for the week commencing 31st March. This will be held over two days to ensure all staff are able to attend full training.” On each occasion we noticed that the home was clean and no offensive odours were noticed. Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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. People who use the service experience good quality outcomes in this area. There are sufficient staff on duty to meet the needs of the people who live at the home. Staff hold recognised qualifications in care but need systematic training to ensure that their skills are kept up to date. Management systems should be put into place to ensure that no one starts working at the home until all of the proper recruitment checks have been completed. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: During our visit we noticed that there were sufficient staff on duty to meet the needs of the people living at the home. For example there were four care staff on duty for twenty-four people plus the manager and deputy and domestic and catering staff. 75 of staff working at the home have a National Vocational Qualification in Care at level 2 or above. We checked some staff files and found that two people had not had all of the proper checks required before they started working at the home. The owner and manager took immediate action to ensure that the checks would be carried out. We also recommended that evidence relating to qualifications gained should be collected. The staff we spoke to and who returned surveys to us Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 18 confirmed that they had had proper checks carried out before they started working at the home. The training records held were not easy to follow however, we were able to see that the majority of training had been completed. Arrangements to deliver the training that was outstanding were made shortly after our visit and confirmed by the owner. The staff we spoke to and received surveys from confirmed that they had been inducted into the job. Opinion was divided as to whether the training kept them up to date or helped them to meet people’s needs. The relatives who responded to us said that the care staff had the right skills and experience to look after people properly. Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People who use the service experience good quality outcomes in this area. The home has an experienced and qualified registered manager in post. Quality assurance systems are being developed, as is a regular staff supervision programme. Finances and health and safety issues are managed appropriately. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The registered manager has been in post since 1994. She has a National Vocational Qualification in Care at level 4 and the Registered Managers Award. The deputy manager is working towards achieving the National Vocational Qualification in Care at level 4. Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 20 The owner visits the home every month and completes the report that is required by regulation. The owner forwarded us copies of these reports after the inspection visit. We were told that medication and care plan audits are being developed to form part of the quality assurance programme. We were shown an environmental audit that the manager and deputy had developed since our first visit. The records held for service user finances were satisfactory. We did discuss arrangements for banking monies held on behalf of people living at the home and the changes that the manager was planning to make to these arrangements. The home is not meeting the standard for recorded staff supervisions. Staff appraisals are up to date. We looked at safety and maintenance records held in the home. We found evidence of Fire Officer visits and Environmental Health Officer visits. All certificates seen were up to date. The owner told us that it is planned for the whole building to undergo a health and safety inspection. We were also told that the provision of door fireguards was being discussed with residents and their families. Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 X 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 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 3 4 5 6 Refer to Standard OP1 OP15 OP18 OP29 OP29 OP30 Good Practice Recommendations Consideration should be given to producing information in a range of different formats to meet different people’s needs and abilities. People should know that alternative menus are available and should be encouraged to make choices at meal times. Staff should receive regular updated training in the protection of vulnerable adults. Management systems should ensure that no one commences employment at the home before all of the proper checks have been completed. Evidence of previous qualifications should be gained for staff commencing employment at the home. A formal staff training and development programme should be put into place. This should be based upon a formal training needs analysis to ensure that staff are able to fully meet the assessed needs of the people who live at the home. DS0000070755.V360909.R01.S.doc Version 5.2 Page 23 Whorlton Grange Care Home 7 8 OP33 OP36 A quality assurance system should be fully developed and implemented, including stakeholder surveys, to ensure that standards are being maintained. Care staff should receive formal supervision at least six times a year. Whorlton Grange Care Home DS0000070755.V360909.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Whorlton Grange Care Home DS0000070755.V360909.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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