Inspection on 20/02/07 for Ashgrange House

This inspection was carried out on 20th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashgrange House 12/12/05

Ashgrange House 12/07/05

Ashgrange House 18/01/05

Ashgrange House 07/06/04

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 Ashgrange House 9 De Roos Road Eastbourne East Sussex BN21 2QA Lead Inspector June Davies Key Unannounced Inspection 20th February 2007 9:45 Ashgrange House DS0000021430.V325767.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 Ashgrange House DS0000021430.V325767.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. Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashgrange House Address 9 De Roos Road Eastbourne East Sussex BN21 2QA 01323 732544 01323 732544 ashgrangehouse@aol 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) Alliance Home Care (Learning Disabilities) Limited Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of residents to be accommodated is eight (8) Residents may also exhibit some forms of challenging behaviour That the resident identified can continue to live at Ashgrange House although he is over sixty-five years of age. Date of last inspection Brief Description of the Service: Ashgrange House is a detached property situated in a quiet residential area of Eastbourne, approximately half a mile from the town centre. Local shops and bus routes are a short walk away. Accommodation is provided on three floors, the home does not have a lift and therefore people accommodated at Ashgrange must be independently mobile. The home is registered to accommodate eight adults with a learning disability who may also have challenging needs. The registered providers are Alliance Home Care (Learning Disabilities) Limited. Fees are £1,100.00 to £1250.00 Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection carried out over a period of five hours. During this visit the inspector spoke with some of the residents, the staff on duty and the acting manager. The inspector also viewed all the documentation relating to the key standards inspected. What the service does well: What has improved since the last inspection? What they could do better: The central heating boiler was not working on the day of the inspection and bedrooms were cold. The acting manager has obtained quotations for the replacement of the boiler and this needs to be addressed as soon as possible. The formal supervision of staff needs to be brought up to date. Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 6 The paving slabs at the rear of the building need some attention to ensure that they lie evenly and do not pose a hazard to the residents when they are using the garden. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashgrange House DS0000021430.V325767.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 Ashgrange House DS0000021430.V325767.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2 and 4 Quality in this outcome area is good. Prospective residents know that their assessed care needs can be met by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector viewed the pre-admission assessments of three residents and a pre-admission assessment for one prospective resident. These pre-admission assessments gave an excellent overall picture of the prospective residents care needs, with detailed written evidence under each of the headings. Prospective residents are able to visit the home on more than one occasion to ensure that the home can meet their assessed needs and to ensure compatibility with the other residents living in the home. . Ashgrange House DS0000021430.V325767.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is good. Residents know that their personal goals are reflected in their individual plans and that potential risks are managed. Residents know that their views are listened to and that their records will be kept securely maintaining confidentiality. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector looked at three care plans all had been based on the preadmission assessment and contained detailed individual information as to how the care needs of the residents should be met both physically and socially. Evidence seen showed that when required, residents have input from other agencies to ensure their needs can be met. In instances where a resident shows physical aggressive behaviour, assistance is sought from the psychologist and specialist training is organised for staff to ensure they are aware of how to deal with this behaviour and manage it appropriately. Goals Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 10 are set for each individual resident according to their needs and these are monitored on a daily basis and re-assessed weekly. All care plans are reviewed regularly with an annual review taking place to which all relevant contacts will be invited, such as the care manager, home manager, key worker and relatives. Residents are encouraged to make decisions in relation to their daily lives. During the inspection the inspector witnessed both the manager and staff encouraging the residents to make choices, in regard to purchases, food they wished to eat and going out. Discussion also took place between the manager and a resident as to how the resident should manage his finances to allow for an expensive purchase. Resident wished to purchase a digital television for his room. Care plans showed that each individual resident is risk assessed, where risks are identified, a risk assessment is written with clear guidance to staff as to how the risk to that resident can be reduced to a minimum, these risk assessments are also updated at reviews. The inspector viewed the policy and procedures in place for a missing person. Ashgrange House DS0000021430.V325767.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is good. Residents are able to choose what activities they would like to participate in, their links with the community, family and friends are good and support and enrich their social and educational opportunities. The meals in this home are good offering both choice and variety and catering for special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Due to the level of disability and the ages of the residents, none are able to take part in employment, but some of the residents’ do attend college courses for cookery, arts and drama. Some of the residents’ craftwork is displayed in the dining room of the home. The staff said that residents’ are allowed to Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 12 make choices in regard to attending college courses and what courses the wish to take part in. Each care plan recorded the chosen activities of the resident. The inspector evidenced that residents take part in a wide range of activities, which included horse riding, bowling, hydro pool, bingo, car boot sales and attending the Gateway club. In the office are individual weekly rota’s showing what resident’s will be doing throughout the coming week. Resident’s are able to access the local community on a daily basis, visiting local shops, going for a walk, visiting the local pubs, going to the cinema and taking part in the weekly supermarket shop, or just going for a drive in the car. One of the residents likes to follow their religious beliefs and attends the local Catholic Church with support from the staff. The home does have its own transport, but residents are also able to use local buses, taxis and trains if they wish to do so. On the day of the inspection one resident went out for a ride in the car and another two residents attended their chosen college courses in the afternoon. Staff support the residents in maintaining links with their families, evidence is available to show what contact they have with their families. Where some residents’ do not have family links the home encourages the residents’ to maintain links with friends they have made, and their was evidence to support that they have regular visits from friends, and are able to go out with their friends for a walk and a cup of coffee. Residents are also able to bring friends back to the home if they wish to. The home has a three-week menu plan, the residents themselves are consulted every three weeks, as to what food they would like on the menus. For those residents who have communication difficulties, the home has a menu book, which is entirely made up with pictures, and those residents are able to indicate the foods of their choice. This menu book is continuously updated to give residents a wider choice. At this menu planning meeting, the staff do exercise some control because there are residents’ in the home who need to lose some weight. The inspector viewed the menus, and found that they offered a balanced, nutritious and varied diet. On the day of the inspection the inspector sat with the residents at lunchtime, some residents had chosen to have cheese on toast while others preferred to have a cheese sandwich, the main meal of the day is served in the evening. The residents can choose where they wish to eat, but in the main they choose to use the dining room. Some residents need to have soft diets. Residents are weighed regularly and any concerns staff may have are reported to the residents G.P. Ashgrange House DS0000021430.V325767.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good. Personal care is offered in a way to protect the residents’ privacy and dignity and promote independence. The health needs of the residents are well met with evidence of good multi disciplinary working taking place on a regular basis. The medication in the home is well managed promoting good health. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From evidence gained from the care plans all the residents need some degree of support with their personal hygiene. Staff carry out this support in the privacy of the residents bedrooms or in communal bathrooms. Residents’ are able to choose when they wish to get up in the morning or go to bed at night. On the day of the inspection one of the residents’ had chosen to get up late. The residents are able to choose the clothes of their choice and each resident was dressed in an individual style. None of the residents require mobility support within the home, but some support by staff is required for two of the residents when they are out in the community. Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 14 Residents’ ages are between 37 and 70 years. At the present time the home is waiting for a visit from the continence nurse, to carry out an assessment. Residents have free access to their G.P. and are able to visit the G.P.’s surgery supported by a member of staff. Where more specialist care is needed the G.P. makes referral to the specialist. The residents’ also receive assistance from the community learning disability team as and when required. Residents are able to visit the chiropodist of their choice, they have six monthly dental check ups at the dentists, and they are able to visit the optician of their choice for regular eye checks. The home uses a monitored dosage system and most of the medication is bubble packed. The inspector carried out an audit of medication held in the home. There is a policy and procedure for the administration of medication and good practice guidelines. A list of staff trained to administer medication is displayed on the front of the medication cabinet. All MAR sheets had been correctly signed, for medication given to the residents. Medication left on the bubble packs agreed with MAR sheets. All medication is signed into the home correctly with one exception, this was pointed out to the acting manager, and she will ensure that future medications are properly recorded when received into the home. The inspector observed lunchtime medication being administered and this was carried out according to the homes procedures. At the present time the home has no controlled drugs. The medication cupboard was clean, and the acting manager confirmed that this cupboard is cleaned on a weekly basis. Ashgrange House DS0000021430.V325767.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. The home has a satisfactory complaints system with evidence those residents and others views are listened to and acted on. Staff have a good knowledge of adult protection issues, which protects the residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a recently reviewed complaint policy and procedures; this clearly states what actions should be taken if a complaint needs to be made, and the timescale in which the complaint will be dealt with. The home also has a complaint book where all complaints are recorded. Since the last inspection there has been one complaint, and this was recorded, investigated and dealt with appropriately. The home has clear policies and procedures for the protection of vulnerable adults. The inspector spoke with two members of staff who could clearly explain at what levels abuse could occur. There are no adult protection issues at the present time. Since the last inspection there have been two Adult Protection issues, which have been appropriately investigated and closed. The inspector also viewed the policy and procedure relating to staff receiving gifts from the residents. Ashgrange House DS0000021430.V325767.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 Quality in this outcome area is adequate. The premises are homely and provide good furnishings and fittings, but repairs or replacement of the heating system will enhance the residents’ quality of life. The home has good systems of infection control, for the protection of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector carried out a tour of the home, and noted that the communal lounge, dining room were well decorated, furnished and had a homely atmosphere. During the tour it was evident that the home has an ongoing programme of maintenance, renewal and redecoration. One bathroom on the first floor has recently been redecorated, and another bathroom on this floor is awaiting refurbishment. The inspector visited some of the residents’ bedrooms, all were very individual and reflected the interests of the residents Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 17 occupying these bedrooms. The inspector did note that the home was very cold and especially the bedroom on the second floor and in one bedroom on the first floor. The acting manager said that the gas boiler has not been working correctly for some weeks. The acting manager was able to show the inspector quotes she had obtained for replacing the boiler. Heaters have been purchased for the residents’ bedrooms, but use of these has to be monitored to ensure the residents’ safety. The acting manager was able to show the inspector a programme of maintenance and renewal. At the rear of the home there is a large secure back garden that residents can use at any time. On the day of the visit the premises was clean and tidy and free from offensive odours. The inspected noted that during a tour of the home, there were disposable gloves and plastic aprons in all communal bathrooms and in the laundry room. The laundry facilities are sited away from the kitchen area, the laundry floor is vinyl covered and impermeable to water. The inspector noted that an industrial washing machine is provided with sluicing and disinfecting programmes. Any fouled linen is placed into red alginate bags, which in turn are placed directly into the washing machine. The laundry room also had an industrial tumble drier. The staff have facilities for disposing of clinical waste. Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 and 36 Quality in this outcome area is good. Staff are multi skilled ensuring good quality care and support. Recruitment policies are consistent and residents receive care from staff that have been appropriately vetted. The arrangements for the induction of staff are good with the staff demonstrating a clear understanding of their roles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Of the twelve care staff employed at the home, eight of these staff have obtained NVQ level 2. During the inspection the inspector observed that staff interact well with the residents’ and have the understanding of issues that may trigger challenging behaviour. All staff have an understanding of the ageing needs of the residents, which includes incontinence and illnesses associated with age. The inspector looked at personnel files for four members of staff all files contained an application form, and the inspector noted that recent application Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 19 forms require a full employment history, with any gaps in employment explained, all files contained three references, and there were POVA first checks, and CRB checks obtained prior to employment and two forms of identification. New staff are also given the GSCC code of conduct. Appointment letters stated that staff are subject to a three-month probationary period of employment. The staff training matrix shows that all staff have completed or are in the process of completing mandatory training. A matrix for 2007 showed that all mandatory training will be covered this year as well as job related training. Evidence was available in staff personnel files to show that staff had completed an induction course to Sector Skills Council specifications. Training needs are highlighted for each staff member through the supervision and appraisal process. The inspector did note however that some staff supervision had not taken place for three months, and discussion regarding this took place with the acting manager. Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent, good, adequate or poor) The acting manager has a good understanding of what needs to improve in the home and planning to make these improvements are in place. The quality assurance system in the home is good with a variety of evidence that indicates views are sought from residents and other stakeholders, and that systems are checked to ensure a good quality of care for the residents. Health and safety is well managed ensuring that residents live in and staff work in safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager has been in post for a period of four months; previously she was the deputy manager in the home. She has a NVQ level 2 qualification and at the present time is undertaking her RMA, which she hopes to complete in April 2007. Evidence was available that she keeps herself updated with Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 21 training. The inspector spoke with staff on duty and all said that the manager is open and available for discussion at any time. The inspector observed the acting manager working with the residents in the home, and that residents were free to visit the office at any time during the day. The home has a quality assurance system in place, with evidence that questionnaires are sent to residents, staff, visiting professionals and families, these are sent out annually. There is an annual programme of maintenance, renewal and redecoration. Regular health and safety and fire risk assessments take place and these checks are recorded, and any issues found are addressed immediately. Monitoring of some systems used in home take place and findings are recorded, while other systems are checked these are not recorded, and the acting manager stated that this would be addressed. All staff have received mandatory training, but some of this training now needs to be updated, and the inspector saw evidence that these training courses have been booked and will take place during the coming year. On the day of this inspection staff were receiving fire awareness training. The inspector viewed evidence that all appliances used in the home had a current maintenance certificate. All windows in the home are fitted with window opening restrictors. Delivery of hot water is checked on a regular basis to ensure that it remains at 43ºC. The garden was safe for the residents to use, with the exception of a paved pathway along the back of the home where the paving slabs were a little uneven. The kitchen was well maintained and regular checks are kept refrigerators and freezers. The home has health and safety policies and procedures, and the inspector noted that sheets placed in front of these policies and require staff to sign when they have read them. The acting manager ensures that regular risk assessments are carried out on the building and a record is kept of these assessments. The home has a HSE accident book, and all accidents to residents/staff are appropriately recorded. Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 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 3 3 X 4 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 x Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23(2)(p) Requirement The registered provider must make repairs to, or renew the central heating boiler. Timescale for action 23/03/07 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 YA36 YA42 Good Practice Recommendations All staff must be receiving formal supervision every two months. The paved pathway at the rear of the home needs attention to ensure that residents are safe when using the garden. Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone Kent 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 Ashgrange House DS0000021430.V325767.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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