Inspection on 16/07/08 for Ashmore House

This inspection was carried out on 16th July 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Ashmore House 18/09/07

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Ashmore House 99 Carlton Hill Herne Bay Kent CT6 8HR Lead Inspector Eamonn Kelly Key Unannounced Inspection 11:00 16th July 2008 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashmore House Address 99 Carlton Hill Herne Bay Kent CT6 8HR 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) 01227 365420 ashmorehouse_carehome@hotmail.com www.ashmorehousecarehome.co.uk Mr Baboo Ramchurn Mrs Gowree Ramchurn Mr Baboo Ramchurn Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - (OP). The maximum number of service users to be accommodated is 9. 2. Date of last inspection 18th September 2007 Brief Description of the Service: Ashmore House provides residential accommodation for up to 9 older people. Bedroom accommodation is on the ground and first floors with access to the first floor via stairs and stair lift. Five bedrooms are single and two are shared. The premises are about 5 minutes walk to the seaside and local amenities. Weekly fees are from £325-£350. Additional charges are made for hairdressing, chiropody, newspapers and private phone costs. The resident’s guide contains information about services and facilities. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 Star. This means that people who use the service experience good quality outcomes. The inspection took place on 16th July 2008. The methodology used to produce the report included reference to the AQAA (annual quality assurance assessment) submitted by the owners, meetings with the owners and a member of staff, meetings with or observation of seven residents, check of the premises and checks of records used in the care and support of residents. A visitor also provided a view about how the service is conducted. The outcomes of the previous inspection report were checked. Checks were also made of information known to the Commission about the service. In keeping with the Commission’s policy of looking closely at specific regulations and standards from time to time, some emphasis was placed on this occasion on how well the service meets Standards 18 and 29 (protection and recruitment). The previous report contained no requirements but in the section entitled “What they could do better” the owner’s commitment to improving the service was outlined. Good progress has been made in these areas of practice. This report contains no requirements or recommendations. What the service does well: What has improved since the last inspection? Residents now receive a copy of a personal contract that includes the rights and responsibilities of both parties. Full pre-admission assessments are carried out. These include a description of the actual support necessary to meet prospective resident’s assessed needs. This information forms the basis of the subsequent care plan and the care plan then becomes an active operational tool for the owners and members of staff. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 6 The high dependency levels of most residents including those needing 2:1 attention day and night has led to a review of staffing levels to help ensure appropriate support for them. Greater efforts to improve the mobility of residents are being made. Assistance from a psychotherapist is obtained in one case to help with the resident’s mobility. Some residents currently have aromatherapy, massage and reflexology treatment. Residents are being encouraged to, for example, dress each day and have their meals in the dining room. Medication procedures have been reviewed and improved. For example, medicines are now stored more securely. Relevant aspects of safety procedures have been reviewed, for example, portable appliance tests are carried out at admission stage and annually thereafter, infection control procedures have been improved and procedures relating to safe moving /lifting of frail older people have been updated. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 6. People who use the service experience good quality outcomes. This judgment was made using a range of evidence including a visit to the service. Prospective residents and their supporters receive initial advice and guidance to help them assess the quality, facilities and suitability of the home. EVIDENCE: Prospective residents and their representatives receive assistance and guidance to help them decide if the home is able to meet their support needs. They receive a detailed written guide that contains information about services and facilities. The owners are considering the admission of people with dementia and, as part of this possible change of direction for the service, are reviewing the service user’s guide to show how this support would be provided. All residents receive a personal contract that contains relevant information on the rights and responsibilities of both parties. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 9 Mr and Mrs Ramchurn carry out an assessment of prospective resident’s support needs with assistance where necessary from Social Services’ care managers. A number of residents have support needs associated with the onset of dementia as well as substantial mobility problems needing support by two members of staff. The care plan record begun at this stage outlines the support needs of the prospective resident and how these needs would be met. The admission procedure has recently been reviewed to ensure that new admissions are made in accordance with the home’s registration. The premises are not suitably equipped or staffed for the purpose of providing intermediate support (short-term recuperative care). Long-term care and short periods of respite care for residents are provided. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10. Residents who use the service experience good quality outcomes. This judgment was made using a range of evidence including a visit to the service. Residents receive good healthcare and personal support and care plan records assist in progressing this care. EVIDENCE: Resident’s care plans have a great deal of information about residents support needs and, according to a member of care staff, they are an increasingly effective operational tool for staff. Mr and Mrs Ramchurn stated that they are using care plans to identify the changing needs of residents and record how support should be provided. There is good information about each resident’s background in individual care plans. Mr Ramchurn stated that members of staff are increasingly involved, as suitable training evolves, in the preparation and upkeep of care plans and support tools such as weight charts, Waterlow scores and risk assessments. During the inspection visit, members of staff treated residents with understanding and respect. Based on profiles of residents discussed during the Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 11 inspection and information about how they are supported also indicate a high level of understanding and respect for clients. Residents have good access, according to profiles of residents discussed during the inspection, to local NHS community services. There is close contact with local PCT nurses who, for example, provide and change dressings. A visitor who has a long-term association with the service said that residents receive very good social and healthcare support. Provision of aromatherapy and massage services is a recent innovation and this service is highlighted in the new brochure. Residents have good access to dentists, chiropodists and opticians according to current care plans. The AQAA states that only those members of staff who have received specific training are allowed to administer medication and update MAR sheets. Medication records are completed when administration takes place. No controlled drugs are kept at the premises so special facilities are not required. An up-to-date photograph of each resident is kept with his/her MAR sheet. The AQAA also states that a lockable medication trolley has been ordered. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15. Residents who use the service experience good quality outcomes. This judgment was made using a range of evidence including a visit to the service. Residents receive support in keeping physically and mentally active. EVIDENCE: Residents may receive visitors at any reasonable time and the home encourages this continuing contact. Residents met during the inspection said that they are satisfied with the support provided by the home. A visitor who has a long-term association with the service said that residents are supported in keeping physically and mentally active; this visitor regularly helps in the case of one resident with such activities. The AQAA states that increasing efforts are being made to involve resident’s family and friends in helping with day-to-day activities. Some residents have the on-set of dementia and mental health difficulties such as depression. The owners are considering the admission of residents who have dementia and are looking closely at how support services should be developed in line with this possible change of direction for the business. They recognise, they say, the need for further staff development in helping such residents and current residents. In some of the profiles discussed during the Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 13 inspection, it was clear that members of staff are gaining relevant experience in working effectively with people who need specialist support. Some of this knowledge and experience is accruing from attendance on the RVQ Certificate in Dementia Care. Since the previous inspection, residents are receiving better support to meet their needs on a day-to-day basis and increase their mobility. It is recognised, according to staff, that this reduces their exposure to isolation and helps to improve their mental and physical alertness. The quality assurance selfassessment (AQAA) outlines the range of indoor activities provided and states that, over the next 12 months, these would be improved. During the inspection, photographs taken on outings and of events within the premises were seen. The guide to the service and new brochure states that “We (provide) indoor and outdoor activities on a regular basis in which residents are encouraged to participate subject to their needs and abilities. Monthly visits by a member of the local church take place and (other religious services) are available at your request”. Members of staff have a good understanding of each resident’s personality and, for example, where a resident has very significant hearing impairment and is blind a member of staff communicated very effectively with the resident and made sure the resident was comfortable. Members of staff have very good contact with residents and work hard to keep them engaged with conversation and other interactions. The AQAA states that residents are strongly encouraged to say what they feel and to give their views about any issue they feel affects them. Some residents said that they would appreciate more regular smaller opportunities for exercise such as assistance with using the garden. This feedback was discussed with the residents and owners during the inspection and residents were given assurances by the owners that their views would be acted upon positively. Since the inspection, the Commission was advised by Mr Ramchurn that this issue has been satisfactorily addressed. The fact that residents state openly what they want is a good indication of the way the owners are involving them in all aspects of services. During the inspection, time was spent with five residents having lunch in the dining room and with two who receive their meals in their bedroom. Residents said that they are very satisfied with the meals they receive. Members of staff said that residents are offered some choice for evening tea and that this always includes a hot meal at this time. A record is kept where residents have eating problems, support during meals is provided and supplement drinks are given where necessary. Some members of staff are being enrolled on the NCFE Certificate in Nutrition and Healthy Eating. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 14 Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. People who use the service experience good quality outcomes. This judgment was made using a range of evidence including a visit to the service. Residents are protected from abuse by the vigilance of owners and staff. EVIDENCE: Residents and visitors are involved in saying how improvements would be of benefit to them. This was confirmed through sight of a copy of the recent and first resident/relative/staff meeting. Mr Ramchurn said this initiative would now take place regularly as part of new quality assurance measures. Copies of surveys completed by relatives and residents also indicated that such consultation is taking place. The service has a complaint’s procedure that is understood by staff, residents and relatives. Reference to this is included in the resident’s guide. The Commission has received no complaints about the service during the past year and the owners confirmed that no safeguarding issues are currently in progress. A compliment’s book indicated that visitors were satisfied with the service provided. The annual quality assurance assessment (AQAA) submitted by the owners to the Commission states that members of staff are aware of all the necessary procedures relating to protection of residents. Specific training on the wider implications of POVA (protection of vulnerable adults) forms part of the improvements in staff training and development being put in place. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 16 Mr and Mrs Ramchurn said they are making all staff aware of Kent and Medway social services’ safeguarding procedures. They also say they are aware of the circumstances where events affecting residents (ie. “notifications” under Regulation 37) must be reported in writing to the Commission. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Residents who use the service experience good quality outcomes. This judgment was made using a range of evidence including a visit to the service. The premises are suitable for use by frail older people. EVIDENCE: The premises have five single and two shared bedrooms. Five residents live on the first floor and four are accommodated on the ground floor. The premises have a stair lift. Resident’s bedrooms are comfortable and well equipped as is the lounge. The garden is suitable for use by frail older people. Radiators are covered for the safety of residents. Hot water outlets accessible to residents are temperature controlled and are manually checked, as stated by Mr Ramchurn, each week for safety reasons. The AQAA gave details of improvements to the premises as follows: Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 18 • Fitting of “Dorguard” devices to doors at the request of residents and/or relatives. • Carpets replaced in three bedrooms. • New table and chairs in the dining room and • Replacement of the boiler. A copy of a recent Environmental Health inspection indicated that no requirements for improvement were made and the home has received a “Very Good” rating for hygiene under a scheme promoted by the Food Standards Agency. During the inspection, the premises were clean and tidy and are well maintained. The AQAA contained declarations by the owners relating to safety checks and associated safety certificates being up-to-date. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30. Residents who use the service experience good quality outcomes. This judgment was made using a range of evidence including a visit to the service. Residents are in the care of a staff group that is receiving opportunities for personal development to enable them to address resident’s support needs. EVIDENCE: Staff files (and the statement in the AQAA) indicate that all job applicants complete application forms, references are taken up and CRB checks are carried out. The owners carry out formal supervision at appropriate intervals. This has led, for example, to the identification of specific individual training needs, enrolment on agreed courses and agreement of the types of longerterm RVQ/NCFE appropriate for the service. The staff rota is adhered to, according to Mr Ramchurn, to ensure that there are sufficient staff on duty at all times to meet the current assessed support needs of residents. Apart from both owners who work full-time at the premises, there are five carers and a domestic worker. Two further carers are being recruited. Mr and Mrs Ramchurn say they are confident that there will then be enough staff available to meet the support needs of residents. Good progress is being made on staff development. All carers have completed NVQ Level 2 in Care. Members of staff are completing a further set of courses (RVQ and NCFE) in anticipation of providing support for residents with higher Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 20 levels of dependency, for example, dementia. A senior carer has completed the RVQ Certificate in Dementia Care. This member of staff said that an outcome from this training is new insights into how people with dementia could be better supported and examples of such initiatives were given. The AQAA states that this momentum on staff development would continue over the next twelve months particularly in view of possible plans to admit residents with higher dependency needs. Mr Ramchurn has completed the RVQ certificate in equality and diversity. He has also attended a short course on dementia organised by the Alzheimer’s Society. Three members of staff are completing the Certificate in Infection Control. It is hoped that the domestic worker would achieve this qualification in due course. Mrs Ramchurn has completed the Registered Manager’s Award and NCFE Certificate in Food and Nutrition. A carer is undertaking NVQ Level 3 in Care. All new staff would, according to the owners, undertake induction to the standard recommended by the relevant training agency (Skills for Care) for the care sector,. The owners intend to review the position relating to staff training on moving/handling of vulnerable people and to bring this up-to-date if necessary. They also intend to review whether or not a member of staff on each shift holds a first aid certificate. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Residents who use the service experience good quality outcomes. This judgment was made using a range of evidence including a visit to the service. Residents have the benefit of living in premises where the owners are addressing the need to make improvements so that the home is run in the best interests of residents. EVIDENCE: The registered owners are registered nurses (RGN). Both have the experience and qualifications to enable them to run a care home. It is clear that resident’s access to better social and healthcare has improved since Mr and Mrs Ramchurn took over the business last year. Their commitment to quality assurance measures is improving the comfort of residents and their longer-term care and support. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 22 The AQAA states that the service does not hold cash on behalf of residents. Where residents receive services that are additionally charged for, they are invoiced every 2 months. Receipts are kept and accounts of all transactions are maintained. The policy of the home is that residents or a main supporter retain responsibility for their financial and legal affairs. Mr Ramchurn made a declaration in the annual quality assurance assessment (AQAA) that all safety certificates and checks are in place and up-to-date. This included the statement that all electrical appliances receive annual checks by an electrician and that appropriate certificates are maintained. Fire safety procedures are followed and fire safety records are, according to the AQAA, up to date. Mr and Mrs Ramchurn are improving and developing systems that monitor practice and compliance with the plans, policies and procedures of the home. This report contains details of the important improvements carried out over the past year. An important aspect of this progress is the introduction of staff/relative/resident meetings and the continuation of quality assurance surveys. Mr Ramchurn is aware of the need to promote safeguarding and has developed a health and safety policy that meets health and safety requirements and legislation. He is aware of the need to plan the business activity of the home and manage the finances and resources to deliver the business plan. The home has a significant burden in maintaining a good service within the limitations of current fees and the nature of the premises. In the AQAA, Mr and Mrs Ramchurn outlined the barriers to improvement and how they are overcoming these barriers. Checks show that records are up to date. Recruitment procedures have improved over the past year and successful efforts are being made to add to the numbers of staff available. Care plan records are becoming good operational tools for staff. The support being provided to staff has gathered pace and the additional initiatives planned are designed to address operational barriers identified by the owners. Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashmore House DS0000069412.V367329.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!