Inspection on 19/07/06 for Ashdene House

This inspection was carried out on 19th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashdene House 13/05/08

Ashdene House 21/05/07

Ashdene House 22/11/05

Ashdene House 01/06/05

Ashdene House 10/08/04

Ashdene House 02/06/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

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 Ashdene House 50 St Mildreds Road Ramsgate Kent CT11 8EF Lead Inspector Clair Brown Key Unannounced Inspection 19th July 2006 09:35 Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 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 Ashdene House DS0000023721.V302256.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 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. Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashdene House Address 50 St Mildreds Road Ramsgate Kent CT11 8EF 01843 592045 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) Ashdene House Limited Mrs Pauline Pollard Care Home 18 Category(ies) of Learning disability (18), Physical disability (18) registration, with number of places Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2005 Brief Description of the Service: Ashdene House is registered to provide residential care for up to eighteen adults with learning disabilities. Some of the residents have additional physical disabilities. The Home is situated in a residential area of the seaside town of Ramsgate, within walking distance of most local amenities. The Home has its own transport, which is regularly used to access amenities and events, both within the Ramsgate area and further a field. Ashdene is a large property, nestling neatly and discreetly into the other properties on the road, with a two storied building, referred to as the Cottage, within its grounds. This property accommodates three adults who can live more independently, with daily support from the care staff. There is ample on road parking to the front of the Home. The Home is owned by a private Company with the daily management of the Home being the responsibility of the Registered Manager. Staff are rostered to provide supervision and support to the residents on a twenty-four hour basis, including wake and sleep-in cover at night. The health care needs of the residents are met by the local primary health care team. Fees are: £680.00 to £1900.00 per week Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection consisted of an unannounced visit to the home on 19th & 21st June by one inspector. The inspection takes account of information received from a variety of sources including written information from the registered providers, relatives, service users, care managers and general practitioners. The previously made requirements and recommendation from other inspections were inspected and all key standards. Comment cards were completed by 9 service users. The inspector spent time talking to service users and the care staff to gain their views. A partial tour of the premises was conducted. Documents and records were seen and service users files were case tracked. What the service does well: What has improved since the last inspection? What they could do better: The information in individuals care plans needs to be regularly reviewed and updated and to include health assessments such as nutritional status. Confidential information should only be recorded in individuals’ specific files and not in communal records. Changes are needed to the procedures for administering medication outside of the home, to allow the member of staff giving the medicine to be the original person dispensing it at the home. Areas of the home need refurbishment and decorating, especially the cottage, the furniture in some areas needs replacing. The hot water temperatures require regulators to prevent scalding. The practices of the company for the handling Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 6 of service users money needs to change to comply with the regulations and ensure the service users are protected from financial abuse. Care staff need to attend appropriate training courses to enable them to have the knowledge & skills to care for those living in the home. 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. Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 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 Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 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): 125 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose provides prospective services users with sufficient information to make an informed decision. There is formal documentation for the assessment of needs of a prospective service user. The service user written contract should be reviewed and updated. EVIDENCE: The registered manager has reviewed and updated the statement of purpose. There have not been any admissions to the home since the last inspection visit. A pre-admission assessment tool has been produced in preparation for future use. The service user contract is now produced in a pictorial format which details the services provided for the fees paid, however these are not included in the written version of the contract. Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 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): 6789 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The quality of the information recorded at review meeting is detailed and informative but not transferred to the service users care plan. Care plans also contain risk assessments. Service users and other relevant parties are actively involved in the reviews of individuals needs. EVIDENCE: Two service users files were case-tracked. Both files contained care plans with assessments, the full assessments were vague and lacked sufficient detail. There was a lack of cross referencing between the various documents within the file. For example, the notes made during the review meetings that are attended by staff, service user, relatives and care managers are very detailed and provide a lot of essential up to date information and show evidence of progress being made to meet individual goals. However, this information is not transferred to the current care plan. The reviews of the care plans were over due and/or incomplete, the individual and generic risk assessments had not been reviewed for 11 months in one file. Some care plans failed to identify all of a service users needs, such as aggressive behaviours. Daily reports have improved but need further work to ensure all events are recorded Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 10 appropriately, one report failed to record a significant incident, a service users relative had died and later displayed aggressive behaviour, neither of these incidents were recoded in the appropriate place. Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Leisure activities are appropriate and individual. Service users are supported to maintain family and cultural links. A balanced diet is offered but this needs supporting with regular assessment of service users nutritional status. EVIDENCE: Service users were observed interacting with staff, these were relaxed and comfortable, service users seem to get pleasure from the variety of trips and outings available. Records and survey comments indicate a tendency to follow a routine and some could interpret this as institutional. For example a recent service users review discussed an incident where a service user had become aggressive whilst out and they had expressed a wish not to go. Relatives had questioned why the home had insisted on the service user going out and the reply was about the need for routine. The home does not carry out nutritional assessments for each service user to ensure an appropriate nutritionally balanced diet being offered. The home provides a variety of meals and choices, 7 service users surveys stated that they choose what they eat and 2 stated this is only sometimes. Other comments include “food not so good” and “like the food, activities and staff. One service user whose file was casetracked was born in Bangladesh and was a Muslim. Records in file showed the Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 12 home identified a local mosque for the service user to attend and have asked the family to take the service user every Friday for prayer. Service users were seen to go out into the local community to use local facilities with the support of the care staff. Leisure activities included trips out to the local amenities as well as trips to London. The Home has its own day centre, which provides in house activities. The registered manager stated that the company has a caravan, which service users go to for their holidays with 1:1 support provided. Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Medication practices need to improve for administering medication outside of the home. The service users are supported with personal care, whilst maintaining dignity. Health care appointments and regular checks up are accessed. EVIDENCE: The general practitioner (doctor) survey did not raise any concerns about the homes ability to meet service users health needs. Records in two service users files case-tracked, provide documentary evidence of a close working relationship with the doctors and that prompt action is taken to liaise with the healthcare professionals when needed. All 9 service users who completed the surveys stated they are well cared for and that the staff treat them well, 6 service users stated that the staff listen to what they say, 3 service users stated the staff only sometimes listen. Other comments included they “like the privacy” and “people are friendly” and “I am well looked after”. Observations of interactions between care staff and service users indicated that staff responding appropriately and respectfully to service users. All of the service users surveys stated that they attend regular meetings in the home. Medication practices continue to improve, with a method of secure Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 14 transportation of medication to the cottage has been introduced. A short medication audit was conducted by inspector who was accompanied by senior carer. Two incidents of medication running out this week for two different service users. Other medication records corresponded with medicines in the cupboards and quantities. The procedure for administering medication when someone is on social leave was discussed with staff who stated that the senior carer dispenses the medication into a travelling container which a different carer then administers whilst out. On return to the home, the carer then signs the mar chart. Discussed that this is not safe practice. Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure is now accessible to service users. Procedures for the handling service users monies are not vigorous and places them at risk of financial abuse. EVIDENCE: The complaints procedure has been produced in different formats including makaton. Service users files record the date that staff sat with them to explain the procedure. The service users surveys confirmed that they understand who to approach if they are unhappy. Service users monies are managed by the registered provider who is appointee for all of those living at the home. The home is sent pocket money for the service users, in the home, the procedure used is only a single signature process. Service users cannot easily access details of the account where their money is held, without formally requesting copies of the bank statement. A care manager was conducting a review at the time of the inspection visit, she expressed her concerns relating to the procedures for the handling and recording of the service users finances, this includes, the company taking service users benefits (DLA - mobility money) for transport when the provision of outings & transport is part of his care plan/contract. The care manager was not aware of any formal agreement for this practice taking in place (taking of money). Company is appointee and receives their benefits into its’ own bank account, previously the care manager has requested copies of bank statements, however these where 6 months old and not current. Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 16 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 25 28 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The main part of the building is maintained to an acceptable standard, however the cottage requires further refurbishment. EVIDENCE: The main part of the home is maintained to an acceptable standard, although the settee in the communal area cover is split and repaired with adhesive tape. The cottage communal areas have been refurbished, which now provides a pleasant environment for service users to relax in. The furniture purchased was second hand and will need to be checked to ensure it complies with fire regulations. The bedrooms and their furniture in the cottage are in need of total refurbishment, some of the beds and mattresses were seen to be no longer fit for use and need replacing. Radiators have been guarded and risk assessments completed. Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 17 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): 32 33 34 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of care staff are provided. The recruitment procedures are thorough. Staff have not completed sufficient training to ensure they have the competencies and skills to meet the needs of the service users. EVIDENCE: There were sufficient staff on duty at the time of the inspection to meet service users needs. It is acknowledged that additional staff are provided to enable service users to fulfil their wishes such as trips out. The most recently recruited member of the care staff file was examined, not all of the required information was found to be in the file, instead it was being held at the head office and made available on the second day of the visit. These records showed evidence of staff being employed with the required safety checks being completed before they start work. The member of the staff has a work permit, it was not for Allied Care or this particular home. The carer had completed the induction programme over a period of 3 months and had attended other in house training, such as food hygiene, first aid manual handling and H&S training. Sixteen out of the eighteen care staff had previously enrolled on the NVQ in care training, to date no one has completed the training. The majority of the other training is in house, some of the staff training such as manual handling has not been updated since 2003. The staff have not attended any training that is specific to caring for those with Learning disabilities, such as the LADAF training. Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 18 Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 19 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 41 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager has the experience to manage the home and has gained a formal qualification to support this. There is a basic Quality Assurance programme that needs expanding. Confidential information is not always recorded appropriately. EVIDENCE: The registered manager has completed the registered managers award. She also has a city and guilds advanced management in care and 9 years experience as a manager. The quality assurance programme is undertaken by the company supported by the registered manager conducting the surveys, however the findings from the surveys has not been collated and added to the report. Staff were actively encouraged to be involved in the inspection process and were at ease with this. They demonstrated that the homes management style is open and approachable. Some aspects of the management of the home are the handled by the company. The environmental records were not easily accessible to the registered manager, as these were held by the Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 20 maintenance person who was not working that day. All of the environmental certificates seen were in date. A document called the shift organiser tells staff their allocated responsibilities for their particular shifts, however staff are also using this document to record confidential information about the service users and their specific needs. Ashdene House DS0000023721.V302256.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 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 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 2 26 X 27 X 28 2 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 2 X LIFESTYLES Standard No Score 11 2 12 3 13 2 14 3 15 2 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 2 2 X 2 2 X Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 22 Yes 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 YA2 Regulation 14,15 Requirement Detailed pre-admission assessments must be conducted and fully recorded prior to a service user being admitted. Care managers assessments should be obtained prior to admission. (Previous requirement that will be assessed following an admission) The contract must state what services are provided for the fees paid. Previous timescale: 30/06/06 Timescale for action 30/01/07 2. YA5 5 30/11/06 3. YA6 12 13 15 4. YA12 4 12 1416 18 23sch1 All service users need must be 30/11/06 clearly identified in the care plan, all reviews of documents must be dated and accurate, with the cross-referencing of information between documents. Service users personal 30/11/06 development and progress in achieving goals and targets must be recorded in detail. Personal goals and support needed to achieve these must be clearly identified and actively worked towards. Previous timescale: 28/02/06 DS0000023721.V302256.R01.S.doc Version 5.2 Page 23 Ashdene House 5. YA17 12-15 17 26 sch4 Detailed records of meals provided for each service user must be kept. Nutritional assessments should be conducted for all service users and regularly reviewed. Previous timescale: 28/02/06 Staff who take service users out on social trips must not administer medication they have not dispensed. Current copies of bank statements should be accessible to service users and available in the home. Previous requirement: 28/02/06 Service users benefits must not be used to pay for services provided as part of the agreed care plan and must have written consent from an appropriate advocate (care manager etc) to do so. Service users monies must not be paid in to or held in the companies/ homes bank account. 30/11/06 6. YA20 12,13,14, 16,17,23 sch 3 12 17 20 23 sch4 30/11/06 7. YA23 30/11/06 8. YA24 12 13,23 Furnishing no longer fit for purpose must be replaced, the settee in the main house communal lounge, the mattresses in the cottage. The cottage bedrooms require redecorating and refurbishing. 50 of care staff must have the NVQ level in care (appropriate to caring for those with learning disabilities). Duty rotas must record the registered managers work hours. The duty rota must clearly record and identify staff being DS0000023721.V302256.R01.S.doc 30/11/06 9. YA32 18 28/02/07 10. YA33 17,18 sch 4 30/11/06 Ashdene House Version 5.2 Page 24 11. YA34 17,18 schedule 4 18 12. YA35 supervised and the appointed supervisor. Work permits must comply with the home office specifications, including the correct place of work. The induction programme must be updated to comply with skills for care. All staff should have individual training programmes. All staff must complete the mandatory course and the registered manager ensure these are updated at the relevant timescales. Next years quality assurance programme must be developed further to include more people’s views and the results of internal audits. Previous timescale: 30/06/06 Daily reports of care provided need to legible and be detailed, linking care provided to the care plan. Previous timescale: 28/02/06 Individual service users confidential information must only be recorded in their files. The use of communal records must stop. 30/11/06 30/01/07 13. YA39 10 12 15 17 24 sch4 30/01/07 14. YA41 15,17sch 3,4 30/11/06 15. YA42 12 13 17 23 sch 3 & 4 To contact the environmental health agency to clarify the correct hot food temperatures for serving. Action must be taken to ensure that hot water is administered at the required temperature, safeguarding service users from scalding. 30/11/06 Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 25 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. Refer to Standard YA20 YA23 YA34 Good Practice Recommendations The registered manager to assess the medication training to ensure it complies with skills for care requirements. A two-signature procedure should be used to record deposits of service users monies. The home should have copies of all of the recruitment documentation within the registered home. The duty rota should record the supervising person for new staff employed on POVA first checks. The registered manager needs to collate the information gathered through surveys, produce a report and action plan to add to the annual quality assurance report. The registered manager should ensure that all furniture purchased complies with current fire legislation. 4. 5. YA39 YA42 Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 26 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 Ashdene House DS0000023721.V302256.R01.S.doc Version 5.2 Page 27 - 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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