Inspection on 13/02/06 for 3 Ashley Avenue

This inspection was carried out on 13th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

3 Ashley Avenue 28/11/08

3 Ashley Avenue 19/01/07

3 Ashley Avenue 04/08/05

3 Ashley Avenue 26/01/05

3 Ashley Avenue 29/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 3 Ashley Avenue 3 Ashley Avenue Folkestone Kent CT19 4PX Lead Inspector Lisbeth Scoones Unannounced Inspection 13th February 2006 09:15 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 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 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 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 Adults 18-65. 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. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 3 Ashley Avenue Address 3 Ashley Avenue Folkestone Kent CT19 4PX 01303 252787 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) Blythson Limited Mr Richard Emrys Jones Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Richard Jones to have completed NVQ 4 in Management and Care by 2005. This has now been completed 4th August 2005 Date of last inspection Brief Description of the Service: 3 Ashley Avenue is one of four Proactive Development care homes in Folkestone owned by Blythson Ltd. It provides personal care and support for 3 service users with a learning disability. It is a semi-detached house comprising three floors with a small and larger back garden. Residents single accommodation is situated on the first floor. The home is adjacent to no 5 Ashley Avenue, which is owned and managed by the company. The home is located in a quiet road within walking distance of the shops and other amenities. The registered manager for both homes is Mr Richard Jones. The company also provides supported living services within the community in their own home to individuals who have developed through the residential services. 24 Hour support and an on-call service is provided. The environment is of a high standard, well furnished, peaceful and welcoming. Staffing levels are high. During the day, staff are provided on a two to three basis, managed by a team leader. At night, a member of staff undertakes a sleep-in duty. A senior member of staff is always on call. As part of the programme of care, the home provides daily structured meaningful, individualised activities. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5.5 hours and comprised discussions with 2 of the 3 residents (one resident had recently left for work), the manager, training manager and other member staff on duty, a tour of the communal areas and a review of records. What the service does well: What has improved since the last inspection? What they could do better: No requirements were made at this inspection. Whilst the home continues to provide an excellent service for its residents, two recommendations were made in respect of medication and record keeping management. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 6 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. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not inspected on this occasion. It was noted that the Statement of Purpose and Service User Guide on display in the office were dated 2006, evidencing regular review. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Residents know that their personal goals are reflected in their individual plans and that their views are listened to and their records kept securely. Residents make decisions about their lives with assistance as needed and they are consulted about all aspects of their life in the home. Staff enable the residents to take risks as part of an independent lifestyle. EVIDENCE: 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 10 At the previous inspection, the manager said that care plans need further finetuning to become a truly individualised record for each resident. Since the inspection, further work has been undertaken in respect of assessment, gaol setting and evaluation. The format used for this purpose incorporates: career planning, communication, daily living, home life, money management, selfcare, social relationships, work and study skills and work life. Every resident has a care plan, which covers all aspects of personal and social support and health care needs. The initial care plan is discussed and objectives set with the resident who is constantly involved in the updating and reviewing process. Care plan reviews occur every other day during handover of a shift for which a comprehensive handover file is used. Handover files contain detailed daily records, incidents reports, the daily task planner, risk assessments, completed nutrition charts and weekly review signed by the resident. An accountability sheet is used at handover. In addition, residents have a weekly and monthly care plan review with the manager. The filing system of weekly reviews was discussed and it was ascertained that not all reviews had in fact been undertaken weekly. A resident confirmed, that he has a weekly one to one but the manager acknowledged that the recording of some of these had been delayed. The manager said that he is reviewing the weekly review format and that two-monthly care planning meetings have been introduced, which would incorporate “action to be taken”. It is evident from conversations with the residents that staff respect the residents’ rights to make decisions about every aspect of their lives within a risk assessment framework. Every new activity introduced is covered with a risk assessment. It was agreed that the contents of residents’ care files would be reviewed, as some of these may no longer be relevant. Residents are provided with training about their personal safety as e.g. in road awareness. It was observed that staff assist the resident in problem solving in an empowering manner. During house meetings and weekly reviews, staff provide the residents with the information they need to participate in the dayto-day running of the home. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Residents are provided with many opportunities for personal development. They are able to take part in suitable appropriate activities both as placements in the community and leisure activities. Residents are encouraged to have close links with their relatives and develop personal relationships. Residents’ rights are respected and responsibilities recognised. Residents are offered a healthy diet and take part in the preparation of a choice of meals. EVIDENCE: Moving towards independence is part of the ethos of the home. An assessment tool for living in the community has recently been introduced. Residents are encouraged to use problem-solving techniques and counselling/therapy is offered as part of the contract. Residents have a structured week, which includes voluntary and paid work and attend college for a variety of courses as e.g. IT, cookery, French and communication. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 12 Staff encourage and support residents to attend local colleges and adult education schemes. They help residents with benefits and finance problems. Staff support residents’ community participation and residents attend pubs, leisure centres, go shopping etc. The company provides a vehicle and residents use public transport services as appropriate. A resident said, “a member of staff makes things fun and regularly takes me for bike rides and shows me interesting sights like the railway museum.” The inspector did not meet with the work place coordinator who is currently expanding the range of options available to the residents. These include work placements, college courses and placements at the Learn Direct Centre, which focuses on literacy skills through the use of computers. Two residents are studying English /one resident mathematics at GCE level. Education within the home is encouraged. Residents’ involvement in conservation, expeditions and excavation work is being explored as well as the development of particular skills or interests. The participation in the Duke of Edinburgh Award scheme is also under discussion and the placement coordinator and one of the Directors are attending a course with this in mind. An allotment has been purchased for the residents’ use. Employers of work placement would be asked for formal feedback every two months. Residents are offered a range of entertainment and leisure facilities. Three holidays a year are provided up to 30 days. Residents are involved in the planning of these. Such holidays provide opportunities for independent living skills. The residents spoke enthusiastically about a much-enjoyed recent holiday in Wales. A Trip to the South of France is planned for the summer. An illustrated newsletter, written with residents’ input, to keep relatives and care managers informed of their progress and enjoyment has recently been introduced. Visits to relatives are encouraged. Residents regularly visit their families. A resident said how much he had enjoyed a recent visit. A resident said he had enjoyed a recent overnight stay with his brother. As already referred to, residents are provided with weekly counselling. Residents from other Proactive homes meet on a regular basis. They share holidays and visit each other’s homes for parties, theme nights and barbecues. Last year, Proactive homes competed for the “best kept garden” and a friendly football match in fancy dress raised £20 for Comic Relief. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 13 As part of promoting independence, all residents have a responsibility for housekeeping tasks, which include cooking, cleaning and gardening as identified on the daily planner. A resident said that his tasks around the house vary from week to week. This week the task was dusting; another week it would be hovering. All residents have keys to their bedrooms. Service users are encouraged to make choices in relation to all aspects of life as e.g. outings, what to eat, what to wear, which TV programmes to watch, how to spend pocket money etc. Guidelines on getting up and going to bed times are included in the contract. At the previous inspection it was recorded that home operates a scheme that links participation in agreed daily tasks to monies earned or lost (participation charge). Participating with agreed tasks would earn the service users monies to spend on activities at the weekend. Not participating would lose them monies. The idea was first introduced during a house meeting and is proving successful and residents enjoy the challenge. The scheme is included in service users’ contracts of residency. See also standard 18. Residents assist in devising menus, which are healthy and varied. Nutritional assessments are carried out. Staff and residents prepare meals and eat together in a pleasant dining area. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Residents receive personal support in a manner that they choose and require. Residents’ physical and emotional health care needs are met. Good medication administration systems ensure that residents’ medication needs are met but a protocol for the administration of “as required” medication needs to be devised. EVIDENCE: Staff encourage residents, with due regard for privacy, to be as independent as possible. Life skills activities include cooking, dealing with laundry, computer skills, literary and numeracy skills, budgeting as well as social skills. See also standard 11 in respect of personal development and standard 16 in respect of the “participation charge”. It is evident that staff know the residents, their likes, dislikes and preferences very well. Residents are supported to take control of and manage their own health care. Health checks are carried out when required including visits to well- men clinics. Such visits are recorded on a “medical page”. It was recommended that any follow up be recorded. Residents are registered with a GP and prompt referrals are made to appropriate specialists when required. Residents have access to a dentist. A chiropodist attended a resident on the day of the 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 15 inspection. One resident is regularly seen by a speech therapist. The home has a policy on the administration of medication and staff have received medication training. MAR charts and other records pertaining to medication were examined and had been well maintained. An initials list is maintained. A resident is prescribed medications to be administered on an “as needed” basis. It was recommended that a protocol be devised and referred to in the care plan. For a resident who self-administers, it was recommended that an assessment of competence be carried out and regularly reviewed. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Residents know that their views are listened to and acted upon. Residents are protected from abuse. EVIDENCE: There was recorded evidence that residents are encouraged to use the home’s complaint procedure. It is evident that staff encourage and enable the residents to discuss any concern they may have. All complaints are investigated according to timescales set out in the written complaints procedure. Staff said that they are trained in adult protection issues as evidenced on the home’s training matrix. There is an adult protection policy and flow chart, stating the steps to take if an AP alert were to be made. The home has robust recruitment procedures, which include CRB and POVA checks and the obtaining of 4 references. See also standard 34. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Residents live in a homely, comfortable, clean and safe environment maintained to a high standard. EVIDENCE: The home provides a welcoming, safe, tastefully decorated and furnished, well maintained environment for the residents with pleasant well-tended front and back gardens. There is a patio area, which may be used for barbecues. All areas visited were clean and odour free. There is a daily cleaning planner and residents are encouraged and expected to participate. Section 26 reports confirm that the directors keep a close eye on cleanliness, hygiene and tidiness in the home. The training matrix includes formal infection control training. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Residents know that they are supported by staff who are aware of their role and responsibilities. Residents are supported by competent and qualified, supervised, well-trained staff. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: Richard Jones is the manager for 3 and 5 Ashley Avenue, registered with the CSCI and recently achieved the Registered Managers Award. Care is provided in teams, consisting of a team leader and residential social worker. Roles and responsibilities are clearly set out in their job descriptions. Staff are first introduced to the home’s aims and values at induction. This is further reinforced at house meetings and during supervision. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 19 The home provides two to three staff during the day and one member of staff at night for sleep-in duties. A senior member of staff is always on call. Since the previous inspection, some staff have left and new staff employed. A resident said that he had been introduced to a new member of staff who was to start soon. One vacancy remains for a support worker. The company’s flexi staff fill the gaps left by illness and holidays. Through induction, on going training, monthly staff and residents’ meetings, the manager ensures that the staff have the necessary knowledge of the disabilities and conditions of the residents. It is evident that the home is committed to staff training and, as confirmed on the Proactive training calendar, all statutory training is scheduled twice a year. Additional specialist training is provided to meet the needs of the residents. Up to the time of the inspection, the company employed an Operations Manager who was Proactive’s training coordinator. The organisation of staff training is currently being reviewed and induction/foundation training in accordance with LDAF put on hold. The company’s managers are LDAF mentors. A recently appointed team leader discussed the process of his recent recruitment. He said that he was “impressed by the company’s high standards”. A sample of staff files confirmed the home’s robust recruitment procedures. It is the home’s policy to obtain 4 references. The induction training includes equal opportunities and knowledge of disability legislation. There are daily handovers whereby the manager is always present. The manager said that there is an open door policy. A recent development is the setting of objectives for each member of staff. Such objectives would be discussed at supervision. All staff have monthly, formal supervision as agreed in the contract. A supervision matrix is in place. Appraisals are undertaken annually. The member of staff interviewed said he feels supported by management. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 The manager provides clear leadership with all the staff who demonstrate an awareness of their roles and responsibilities. Residents benefit form the ethos of the company and the open and inclusive management approach. The home regularly and consistently reviews its performance through a series of systems of self-review and consultation which include the views of the residents and relatives. The health and safety of residents and staff are promoted and protected. EVIDENCE: Richard Jones is the registered manager with a recently completed NVQ level 4 in management. Mr Jones continues to demonstrate a commitment and enthusiasm to provide a quality service for the residents and a good working environment for the staff. It is evident that the manager promotes an open culture and communicates a clear sense of direction and leadership. It is evident that residents and their relatives are always included and their views sought and acted upon. Every two days, at the change of shift, there is a 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 21 comprehensive handover. There are regular staff meetings both formal and ad hoc as situations arise. The member of staff interviewed said he feels well supported by the manager and the manager said the Directors support him and provide training opportunities. Residents’ meetings take place every month and are minuted. As already referred to in standard 6, individual weekly care reviews are carried out with the residents, the manager and team leader. An excellent review, monitoring and audit programme is in place in addition to the annual development plan stating the home’s aims and objectives. The Directors formally visit the home and produce detailed, monthly reports in accordance with Regulation 26. These demonstrate a clear health and safety audit of the premises and services provided and include interviews with staff and residents. The reports include an action sheet which identifies the timescaled action to be taken when deficits are found and which member of staff is resposible for carrying this out. The home uses a daily task planner which incorporates the standard of cleanliness and safety and maintenance checks. These tasks are planned on a 4 weekly basis. Staff attend regular statutory and refresher training. Daily health and safety checks are undertaken and recorded. Regulation 26 reports comment on regular fire drills, smoke detector maintenance and contents of first aid kits. A resident said that he takes part in regular fire drills in the home. Qualified people test appliances and there are on call arrangements for maintenance. Risk assessments to ensure safe working practices are carried out and signed by residents and staff. The manager is vigilant in reporting accidents and incidents to the CSCI in accordance with Regulation 37. 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 4 x LIFESTYLES Standard No Score 11 4 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 4 4 x x 4 x 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 23 N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations That a protocol for “as needed” medication be devised 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 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 3 Ashley Avenue DS0000023141.V281236.R01.S.doc Version 5.1 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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