Inspection on 05/03/08 for Temple Ewell Nursing Home

This is the latest available inspection report for this service, carried out on 5th March 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Temple Ewell Nursing Home 18/10/05

Temple Ewell Nursing Home 28/06/05

Temple Ewell Nursing Home 28/09/04

Temple Ewell Nursing Home 01/06/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Temple Ewell Nursing Home Wellington Road Temple Ewell Dover Kent CT16 3DB Lead Inspector Julie Sumner Key Unannounced Inspection 11:00 05th March 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 Temple Ewell Nursing Home DS0000026124.V359350.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. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Temple Ewell Nursing Home Address Wellington Road Temple Ewell Dover Kent CT16 3DB 01304 822206 01304 822208 yvonne@charinghealthcare.co.uk www.charinghealthcare.co.uk Charing Cross Investments Limited 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) Mrs Yvonne Mhlanga-Kayoni Care Home 44 Category(ies) of Learning disability (0), Old age, not falling registration, with number within any other category (0) of places Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing only - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 2. Learning disability (LD). The maximum number of service users to be accommodated is 44. Date of last inspection 11th July 2006 Brief Description of the Service: Temple Ewell Nursing Home is a purpose built, detached building, set into a hillside, which overlooks the village of Temple Ewell. The providers are Charing Cross Investments Ltd., who have a number of care homes in the region, and are experienced providers for the care of older people. The accommodation is provided on the upper 2 floors with laundry and staff facilities on the lower floor. The home has a large passenger lift giving access to all areas. The corridors and door widths are suitable for the use of wheelchairs. The majority of the bedrooms are single, and some have en-suite toilet facilities. There are 3 double rooms available for people who wish to share. The home has a variety of outside sitting areas, walkways, and a sensory garden, enabling service users to sit in sun or shade and with other people or in solitude. The registration of the home is for a total of 44 service users who need nursing care, and has conditions allowing up to 10 service users with learning disabilities, and up to 5 terminally ill service users, to be accommodated within Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 5 the 44 maximum limit. Fees range from £469.00 to £620.00 per week. The statement of purpose and service user guides are available from the home. Service user guides are also available in various formats made suitable for prospective people who may be interested in a placement here. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 6 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 report is based on information received about Temple Ewell Nursing Home including an annual quality assurance assessment completed by the manager and an unannounced site visit to the home lasting 7 hours. Information was gathered for this inspection in a variety of ways both prior to and during the visits to the home. Surveys have been sent out to residents, relatives, staff and visiting professionals. Those returned have been taken into account in this report. The visit included talking with residents, the manager, and staff. General observations were made during the afternoon of how people are supported. There was a tour of the building and various records were inspected. The people living in Temple Ewell Nursing Home were able to participate in the inspection by having conversations about their lifestyle and completing the surveys prior to the visit. There has been one adult protection alert raised since the last inspection and has now been closed. There were some recommendations made to the home for improved practice and a follow up meeting has been arranged. 2 requirements and 3 recommendations have been made as a result of this inspection visit. What the service does well: Clear assessments are carried out to make sure that people moving into the home can have their needs met. Care plans are well completed and showed good nursing care. The home makes sure that nurses have the opportunity to maintain and develop their nursing skills and competencies. The home provides good, varied outside entertainment and group activities for the people living in the home. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 7 Meals are provided to a good standard with attention paid to a balanced healthy diet including fresh fruit and vegetables. Care staff are supported by a nutritional support assistant. 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 Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 8 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 9 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 Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions are not made to the home until a full needs assessment has been carried out. EVIDENCE: Surveys received indicated that people are given sufficient information before making the decision to move into the home. There are currently 40 people living in the home. The initial assessment is completed with overall checklist of needs. A joint assessment is carried out by nurses and care managers. The support/care plan is based on these two assessments. A sample of 4 pre-admission assessments was viewed. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 11 Since St. Stephens opened the people who have learning disabilities and nursing needs are referred there. The home has retained its LD category but there are currently no residents with learning disabilities. The service user guide has been designed following the recommendation from the last inspection report. Intermediate care is not given in this home, so standard 6 does not apply. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team meets the health and personal care needs of the service users and their privacy and dignity are respected. The home have a good track record of responding to advice from other health professionals. EVIDENCE: Nurses complete the individual care plans based on information received including what has been reported to them by care staff. A sample of 4 care plans was viewed and all were well documented. The plan sets out action that needs to be taken by nursing and care staff. Risk assessments were seen for skin care, moving and handling needs and prevention of falls. Residents spoken with said that they had agreed to what was in their plan. Recently the nurses have been given more time and opportunity to evaluate care plans so that they accurately reflect ongoing needs. It is recommended that the manager look at the design of the care Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 13 plans and consider ways to make them easier for residents to read and understand. The nurses use a handover sheet which identifies any ongoing changes with residents’ medical needs, and is a reminder for any action which needs to be taken (e.g. blood tests, contact GP, check blood pressure) One of the staff who was previously a carer, trained in nutritional screening and has been employed for the last year as a nutritional support assistant. It is her role to monitor each person’s individual nutritional needs and make sure that any changes are responded to. Records of intervention needed are in the care plan including records such as weight monitoring. A sample of records was viewed in the care plans including nutrition plans to support any eating or appetite difficulties and any health concerns. Additional advice and intervention is sought from health professionals. The physiotherapist was in the home during the visit advising on individual mobility needs. The nurses incorporate advice from other professionals into the care plans. There was a discussion with the manager about obtaining individuals wishes and planning for possible future incapacity with reference to the Mental Capacity Act. Some of the nurses have recently received this training and it is the homes intention to put this knowledge into practice. Part of the lunchtime medication round was observed and discussed with the deputy manager. The clinical room was seen to be clean and tidy. Medication storage was viewed and fridges were running at the correct temperatures. Medication administration charts had been neatly and accurately completed. Correct procedures are in place for the disposal of unused medication including controlled drugs. The manager said she carries out a monthly medication audit. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are given the opportunity to take part in a variety of activities arranged in the home but most would benefit from more one-to-one activities and opportunities to go out. EVIDENCE: During the visit to the home it was very busy. 2 surveys state that they have to wait a long time to be let into the home. There is a good range of entertainment brought into the home including: pat dogs, art sessions, games, armchair movement to music, reflexology and singers performing in one of the lounges for those that want to listen and participate. The residents were being entertained by one of the singers on the day of the visit. The manager states in the annual quality assurance assessment that they plan to employ a social activities co-ordinator. Comments in surveys stated that people would like the opportunity to go out but this has not been offered. The home currently rely on relatives to provide this. The manager said that she spoke to all the residents and they were satisfied with the entertainment Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 15 provided but would like one-to-one activities including time to talk to the carers. A recommendation has been made to provide activities that are flexible and suit individuals’ expectations and preferences. Mealtimes are flexible and residents choose where they prefer to eat. The main meal is at lunchtime and the inspector ate lunch with the residents in the dining room. Residents spoke a little about life in the home during lunch and had a laugh with the care staff. A tour of the kitchen took place. There were good stores of food including fresh fruit and vegetables. The cook discussed her role and the records in there were also viewed including samples of menus, cleaning schedules and storage temperatures. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home learns from complaints and works well with other agencies to resolve any issues that have been raised. The people living in the home are protected and supported by the policies and procedures in the home. EVIDENCE: The complaints procedure is included in the service users’ guide in an abbreviated format, and is on display in the home’s entrance hall. There have been 5 complaints since the last inspection visit and all have been resolved. One complaint was raised as a safeguarding adults alert following a fall. A multi-agency investigation took place. It was agreed that there were some shortfalls in the homes practice and an action plan has been agreed. Some of the changes agreed had been put into place and were evident during the visit. The alert has been closed and there will be a multi-agency follow up meeting in a few months. Staff training in safeguarding adults is arranged as part of the regular training provided. 8 staff attended updates in safeguarding at one of the other homes in the company during the afternoon of the visit. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 17 When requested the home hold money and valuables for residents. Records are kept of all transactions on behalf of individuals and can be checked by them or their advocates. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The people living in the home would benefit from a fresher smelling environment. EVIDENCE: A tour of the home was undertaken with the manager. The home and grounds looked pleasant. There is a programme of maintenance for the home. A full time maintenance man is employed to undertake ongoing repairs and also carries out some of the buildings safety checks. Some new furniture and fixtures have been purchased including: new carpets in upstairs corridors, new lounge furniture, adjustable beds and new fire doors in the older part of the building. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 19 Bathrooms are fitted with integral hoisting facilities, and the home has grab rails and toilet surrounds fitted where needed. There are 6 hoists – which allows for one hoist for each bay area, a spare hoist, and a stand-aid. These had all been checked and serviced during the previous month. All rooms have nursing beds, and pressure-relieving equipment such as airflow mattresses and cushions were in evidence. Not all parts of the home were odour free. This was commented on in the surveys sent out prior to this visit. One of the comments said: “the home does not always have an air of freshness.” A recommendation has been made to resolve this. Staff have attended infection control training. Staff were observed using protective clothing and equipment appropriately. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using services are generally satisfied with the care they receive to meet their needs but there are times when they may need to wait a short time for staff support and attention. The manager is aware that there are some gaps in the training programme and plans to deal with this. EVIDENCE: Staffing rotas showed the same levels of care staff on duty as there were at the previous inspection visit. Comments in surveys and conversations with people living and working in the home indicated that they are happy with the care but want to have more time to talk and not be rushed. There have been changes made to staff break times to make sure this does not affect the number of staff available. Evidence indicates that additional care staff are needed. The manager commented that the staffing level is being reassessed to enable the home to meet the needs of higher dependency residents. The manager does need to make getting the staffing right a priority to make sure individual needs are being met and people have a good quality of life in the home. A requirement has been made for this. The home has a well established NVQ training programme. Over half of the care staff in the team have achieved the NVQ level 2 or above. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 21 A sample of 5 staff files were viewed and records checked. The home had made sure all the checks such as CRB/POVA and references had been carried out before they had started work. There was a photo of the member of staff in each folder viewed. The company provides training for the homes owned by them in the local area. A list of dates and courses planned that the manager can access was viewed. It had already been identified that there were some gaps in the timing of essential training. She said that staff start working in the home at different times and the current training is not flexible enough. Lists of staff due to attend planned training courses were seen in the office. The manager is working on an improved training matrix having consulted with the company. The manager has attended an update on training in moving and handling so that she can provide this training to care staff as needed. 8 staff attended safeguarding adults training during the afternoon of the visit based at one of the other homes owned by the company. The manager and her deputy regularly attend The East Kent Practice Development Group meetings to ensure that they are kept up to date in their practice. The new induction pack is being designed incorporating the ‘Skills for Care’ common induction standards. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a strong ethos of being open and transparent in all areas of running the home. EVIDENCE: The company have recently made some changes to the way the home is managed, by introducing a manager who will concentrate on the administrative running of the home, and a clinical manager who will be responsible for the care and nursing. The administrative manager will have lead responsibility and it is her intention to become the registered manager. The registered manager, Yvonne Mhlanga-Kayoni, is a nurse who has a diploma in general nursing and midwifery. She is going to be the clinical nurse Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 23 manager when the arrangements take full effect. She has many years experience supporting and nursing older people and has been managing the home for the last 18 months. She is currently studying for RMA, which she will finish in June this year. As part of her role she mentors trainee nurses. She explained that she will have time to carry out her mentoring and nursing role more effectively with the new management arrangements. The administrative manager, Jackie Osborn, was out on a training course on the day of the visit. The company have an established quality monitoring process. Surveys are sent out to relatives and other professionals either 6 monthly or annually depending on recent events or changes. Overall the feedback is positive about the home. A sample of the most recent surveys were viewed and discussed with the manager. Comments varied and highlighted issues that the manager responded to in an action plan. An overall development plan needs to be written for the home based on the outcome of the quality audit. A recommendation has been made for this. One issue raised in a survey sent out by CSCI prior to this inspection is the slow response to answering the front door of the home. This has been raised before in the homes quality assurance surveys and is evidently still ongoing. A recommendation has been made to make sure the front door is answered within a reasonable time. Policies and procedures are kept in a file in the office and are signed by staff. The home holds money for some of the individuals living in the home at present. Records are kept of transactions and a sample was viewed. The accident book was viewed. Accidents were well documented and all relevant incidents have been reported to CSCI under regulation 37. The manager says she monitors this and it is reviewed for trends and patterns. The manager looks at the forms filled in and completes action plans to minimise risk, reviews the care plan and looks at staff training needed. A recent incident highlighted the need to review health and safety practices in the home. The manager has risk assessed and written an action plan. Evidence of this being put into practice was seen at the visit. Fire prevention documentation was checked for fire training, fire alarms, fire extinguishers, and weekly fire checks. The maintenance man completes the records. Records indicated that the yearly fire training has been updated. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 24 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 x x 3 x x 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP27 Regulation 12(1-4) Requirement Timescale for action 02/05/08 2. OP30 18 (1a-ci-ii) Make sure there are sufficient staff on duty at all times to protect and support the wellbeing of each person living in the home. Timescale includes reassessment of staffing level and putting correct staffing level in place (using agency in interim if necessary). Make sure all staff have 02/05/08 necessary training to meet the assessed needs of all the people living in the home. 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 OP12 Good Practice Recommendations Review the design of the care plans and consider ways to make them easier for residents to read and understand. Provide activities that are flexible and suit individuals’ expectations and preferences. DS0000026124.V359350.R01.S.doc Version 5.2 Page 26 Temple Ewell Nursing Home 3. OP33 Create a development plan for the home to illustrate planned improvements, including responses to feedback from others and timescales for putting into practice. Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Temple Ewell Nursing Home DS0000026124.V359350.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!