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Inspection on 12/04/07 for Birkin Lodge Care Home

Also see our care home review for Birkin Lodge Care Home for more information

This inspection was carried out on 12th April 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a good standard of care. Residents and relatives say that the staff are kind and caring. The staff are enthusiastic, well trained and well motivated. They say that they enjoy working as a team, have plenty of training. They take pride in the standard of care that they offer. There is a welcoming, relaxed, friendly and open atmosphere in the home. Residents, relatives and staff all say that they feel able to talk to the staff or the manager if they have any concerns. The nutritional services in the home are excellent. All the residents spoken to said how much they enjoyed their meals and praised the cooks for the trouble that they take to make sure everyone gets a good choice of what they eat and enjoys their meals.

What has improved since the last inspection?

The care plans have been reviewed and a new format is being introduced. The standard of record keeping and the information contained in the care plans has improved significantly. The procedures for the management and administration of medicines have been tightened. There are now more frequent checks on records. Cleaning at the home has improved and staff have been made more aware of infection control policies and procedures. Planning permission has now been granted to build a new laundry room. Recruitment processes are more robust. All new staff have been checked appropriately. The staff files are being re-organised to make them easier to check. The files of new staff have are in this improved format and those of staff who have been at the home for some time are in the process of being changed to this format.

What the care home could do better:

Whilst residents` rooms are in good decorative order, the communal areas are now looking rather tired and dingy. It is understood that the registered providers are currently obtaining estimates for redecoration and refurbishment of these area. It is essential that work to improve the environment be carried out in a timely way. The planning permission for the laundry room is now in place. The reprovision of this facility should now be considered as urgent. The storage of medication is sound but the clinical room would benefit from an upgrade to make more efficient use of the space. There are several wheelchair users in the home. The storage and maintenance of wheelchairs should be improved to ensure the safety of the residents.

CARE HOMES FOR OLDER PEOPLE Birkin Lodge Care Home Camden Park Hawkenbury Tunbridge Wells TN2 5AE Lead Inspector Wendy Mills Key Unannounced Inspection 12th April 2007 09:30 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 Birkin Lodge Care Home DS0000044478.V336217.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. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birkin Lodge Care Home Address Camden Park Hawkenbury Tunbridge Wells TN2 5AE 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) 01892 533747 birkin.lodge@fshc.co.uk Four Seasons Homes (No 6) Limited (A wholly owned subsidiary of Four Seasons Healthcare) Mrs Aline Ongley Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Subject to 25 beds being used for Nursing Care, 5 of which may be used for Terminally Ill. 10th October 2006 Date of last inspection Brief Description of the Service: Birkin Lodge is a large detached property set on the outskirts of Tunbridge Wells. It is about five minutes walk away from local shops, church and post office. There is a large public park close by. The home provides residential and nursing care for up to fifty older people. The accommodation is arranged over three floors. Fifteen bedrooms have ensuite facilities and all bedrooms have a staff call point, television point and some have a telephone point. There are two large lounge /dining rooms and a smaller quiet lounge. The upper floors can be accessed by stairs or a shaft lift. The home is surrounded by well-maintained gardens that are suitable for wheelchair users. There are areas for car parking to the front and side of the building. Current fees range from £317 to £620. In some cases there is a contribution from the Primary Care Trust towards the cost of nursing fees. Additional charges are made for hairdressing, chiropody, newspapers, toiletries and outings. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit lasted five and a half hours. During this visit we spoke to residents, their relatives and supporters, and staff, to find out what they thought of the home. We made both direct and indirect observation throughout the visit. A tour of the home was made to see if it suits the needs of the residents and is clean, well decorated and safe. We looked at documentation, including care plans, activity records and health and safety records to make sure they are well kept and up-to-date. Finally, we had an in-depth discussion with the registered manager, Mrs Aline Ongley. Information given to the Commission for Social Care Inspection (CSCI) by the home itself and by other sources, for example, health and social care professionals, prior to this visit, was also taken into consideration. What the service does well: What has improved since the last inspection? The care plans have been reviewed and a new format is being introduced. The standard of record keeping and the information contained in the care plans has improved significantly. The procedures for the management and administration of medicines have been tightened. There are now more frequent checks on records. Cleaning at the home has improved and staff have been made more aware of infection control policies and procedures. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 6 Planning permission has now been granted to build a new laundry room. Recruitment processes are more robust. All new staff have been checked appropriately. The staff files are being re-organised to make them easier to check. The files of new staff have are in this improved format and those of staff who have been at the home for some time are in the process of being changed to this format. 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. Birkin Lodge Care Home DS0000044478.V336217.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 Birkin Lodge Care Home DS0000044478.V336217.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate pre-admission assessments are made. This ensures that only those residents who are suited to the home and whose needs can be met are admitted to the home. EVIDENCE: The care plans of recently admitted residents were examined. All contained comprehensive pre-admission assessments. There was also good evidence that the care plans were being regularly updated as the wishes, likes and dislikes of residents become clearer. Residents said that they had been able to visit the home before moving in. Some said that they did not visit but that their relatives had. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 9 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, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health of the residents is promoted. This enables them to maintain their independence and a sense of well being for as long as possible. EVIDENCE: The format of the care plans has been changed since the last inspection. There are now sections for each aspect of care, for example, there is a section for recording health needs, one for activities, one for likes and dislikes, one for expressed wishes in respect of end of life issues, and so on. A member of staff spent time explaining the way she used the plans. She was able to easily locate any information that was requested during this visit. Staff spoke very enthusiastically about the way the care plans had changed and said they now found it easier to record day-to-day issues. They said that they feel the new format helps them provide better and more appropriate care for the residents. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 10 Nutritional services in the home are excellent (these are also dealt with under Standard 15). Records are kept of intake of food, weight and actions taken if a resident is noted to have a poor appetite or to have lost weight. The medication round and a peg feed were observed. The staff administering these were noted to be efficient, skilled and caring in the way they carried out the procedures. All staff on duty were seen to be respectful, competent, gentle, caring and kind. Residents and relatives said that the staff are “absolutely marvellous”. Infection control procedures have improved since the last inspection. Staff are very aware of the need to use universal precautions. Sharps boxes are labelled correctly and there are sound systems for the disposal of clinical waste. Staff and relatives said that the home is clean but felt that cleanliness could still be improved. The environment in the communal areas is now rather tired and difficult to clean. A refurbishment programme would enable cleaning to take place more effectively. Records show that Hospital appointments are made when necessary. GPs are contacted and there is good liaison with local health and social care professionals. One resident said “They call the doctor for me if I need her, they’re very good like that. I think this is because they get good training here. You notice the difference if there is agency staff on duty – they’re not so good at things like that”. The medication round and a peg feed were observed. The staff administering these were noted to be efficient, skilled and caring in the way they carried out the procedures. All staff on duty were seen to be respectful, competent, gentle, caring and kind. Residents and relatives said that the staff are “absolutely marvellous”. Storage of medicines is safe. There are locked medicine trolleys in a locked room. However, this room would benefit from refurbishment to allow for better storage of items such as dressings and peg feeds. On the day of this visit, boxes of peg feeds were stored in a way that made it difficult to reach the wash hand basin. The pharmacy inspector made a very thorough inspection of all aspects of medication during a random visit last autumn. It was good to note that her advice has been taken and improvements made in the way that medicines are administered and recorded. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 11 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, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities and nutritional services are very good. Residents are consulted and have a good range of choice about how they spend their time and what they eat. This helps maintain their independence and control over their own lives. EVIDENCE: Residents said that they are very happy living in the home. Many said that they enjoy the garden. They said that they are free to do what they please. Relatives said that they thought the home “did very well” on entertainment. There are visiting musicians and other entertainers. An activity co-coordinator leads several sessions each week. The type of activities include art and craft work, reminiscence work, indoor games and cards. The local library supplies large print books. Likes and dislikes, interests and preferences of the residents are recorded in the care plans. There is an up-to-date record of activities. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 12 On the day of this visit, representatives from a local church were visiting the home to hold a short service and administer Holy Communion. Several residents said that they enjoy the organised activities and some said that they prefer to stay in their rooms as they have all they need there. “I have my television and phone and plenty of books so I don’t feel the need to go downstairs.” Friends and relatives said that the home always makes them feel welcome. One lounge has facilities for making hot and cold drinks and relatives said that they greatly appreciate this. One said, I come a long way and it’s really nice to make myself a drink – it means I don’t have to trouble the staff”. The quiet lounge upstairs is furnished as a lounge might have been in the past. This reflects the experience of some of the residents. One resident said that “It gets us all talking about our lives and it’s surprising what you remember”. All spoke very highly of the meals and the choice of food. They praised the cooks for the way they offer further choice if the meal they had chosen from the menu did not appeal to them by the time they came to eat it. One resident said, “The cook is wonderful”, “we have lovely meals, plenty of choice and even if we’ve asked for something and then don’t fancy it the cook comes out and asks us what we like. Nothing is ever too much trouble for her!” Other comments were, “I get plenty to eat – too much sometimes”. “We can have a cooked breakfast every morning, I have bacon and eggs, I really enjoy this.” “They know what to give mum when she is not feeling like eating. I know I can trust them to give her the right things to eat”. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sound policies and procedures for dealing with complaints and protection from abuse. This means that the views of the residents and their supporters are respected and acted upon EVIDENCE: There have been no formal complaints since the last inspection. The manager said that day-to-day concerns are dealt with as they arise. Residents said that, “they look after us very well here.” One said, “It’s never the same as your own home but I’ve accepted it now and they are all kind, I’ve no complaints.” Relatives said that they had never had any cause to complain. They said that if they ever have any concerns they speak to the senior nurse or senior member of the care staff on duty and they, “Always sort it out”. The staff spoken to all had a good understanding of the policies and procedures in respect of protection of vulnerable adults. They said that they would have no hesitation in reporting any concerns directly to the manager. One said, “The manager is very easy to talk to and I would go straight to he if I was worried at all that a resident was being harmed.” Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 14 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, 22, 23 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is welcoming, homely and comfortable. Investment is now needed to improve the laundry and communal areas. EVIDENCE: The environment is welcoming and homely. Bedrooms are redecorated when they become vacant and are personalised to give a homely feel. There are three lounges. The smallest lounge has been decorated and furnished in an old fashioned style that many of the residents can relate to. The two larger lounges and corridors would now benefit from a programme of redecoration and refurbishment. The manager said that estimates are currently being obtained for this work. The lighting in the lower ground floor lounge is dingy and this room would benefit from brighter and more modern lighting. A maintenance person is employed in the home and there is an up-to-date maintenance book. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 15 Outside there is a well-maintained, accessible and safe garden. Residents and their relatives said that they enjoy walking around the path or sitting in the garden when the weather is good. Many of the residents are wheelchair users and storage of their wheelchairs when not in use presents a problem. It was not immediately clear which wheelchairs belonged to individual residents, whether or not they were privately owned or which wheelchairs had been left by previous residents. It is strongly recommended that a wheelchair audit be carried out to ensure all wheelchairs are adequately maintained and are assigned to individual users. During a tour of the home a wheelchair cushion was found in a bathroom. And some footplates were not with the wheelchair for which they were intended. Several of the infection control concerns raised at a previous inspection have now been addressed. A new cleaner appointed and cleaning has improved. Staff awareness of the need to take universal precautions is much better. However, the new laundry room has yet to be built and so the laundry still presents an infection control risk. The manager said that staff are much more aware of this risk now and are extra vigilant. Planning permission for a new laundry has now been granted. The manager said she hopes that work will begin on this soon. On the day of this visit no offensive odours were noted Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 16 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, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good staff morale, training and recruitment practice mean that a competent and well-motivated workforce cares for the residents. EVIDENCE: Since the last inspection the manager has begun to re-organise the staff files. All files for new staff are arranged into sections. This makes it much easier to access the information. The files of all staff appointed within the last six months and a sample of the files of longer serving staff were examined. All contained evidence of appropriate pre-employment checks having been made. They also showed that staff have taken part in appropriate training. During the course of this visit, several members of staff were spoken to. All said that they have good training opportunities and that they are very happy working in the home. “We have good team working”. “The senior staff are very supportive”. “I think that we care for the residents very well. We all enjoy this work and want to make the residents as comfortable as possible”. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 17 Agency staff are only used to cover sickness. Staff and residents said that they prefer it when the “home’s own staff” are on duty. Relatives and residents said that they think there are enough staff to meet their needs but one said, “there are occasions when the staff seem a bit pushed”. When questioned further it seems that this is at certain key times. The home should look at the possibility of re-arranging rosters so that more staff could be available at these pressure times (eg, just after lunch – meds rounds, need of toilet, etc. and 4-5pm when some residents with dementia can become unsettled. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 18 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): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed but could improve still further is the registered providers were more proactive and ensured that environmental improvements are made more quickly. EVIDENCE: Relatives said that they can talk easily to the manager and that she always finds time for them if they have any worries. Residents said that the manager is “very nice” and arranges things like hospital appointments and transport for them. They said that the manager listens to their views. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 19 Staff said that there is an open and honest atmosphere in the home and that the manager listens to their concerns. The manager clearly had a good understanding of care practice and has tried to comply with previous recommendations and requirements placed by CSCI. There are regular residents meetings, one-to-one staff supervision and staff meetings. A sample of health and safety certificates was examined. All were up-to-date and in order. No health and safety hazards were noted during a tour of the home. Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 3 X X 2 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 Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP26 Regulation 23(2)(a) Requirement The registered person shall having regard to the number and needs of the residents ensure that: The physical design and layout of the premises to be used as the care home meets the needs of the residents. The registered person must provide an adequately size laundry to provide clean and dirty areas with safe and good infection control and ventilation for the registered 50 residents. An action plan to be submitted to CSCI stating when the work will begin and estimated completion date. The above requirement stands with an extended timescale. (Timescales 31/12/05, 12/03/06 and 31/10/06 have not been met.) 2. OP26 23(2)(d) The registered person shall have regard to the number and needs of the residents ensure that all parts of the home are kept clean and reasonably decorated. With particular attention concentrated DS0000044478.V336217.R01.S.doc Version 5.2 Page 22 Timescale for action 31/07/07 Birkin Lodge Care Home on communal areas and damaged corridors. An action plan is to be submitted to the commission of the work commencing and estimated completion date. The above requirement stands with an extended timescale. (Timescales 31/12/05, 12/03/06 and 31/10/06 not met). 31/07/07 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. Refer to Standard OP22 Good Practice Recommendations An audit of wheelchairs stored in the home should be carried out. This should identify the individual resident who uses the chair, track the maintenance records and identify place of storage. The clinical room used for the storage of medicines to be tidied to ensure easy access to wash hand basin and improve storage of liquid feeds. 2. OP9 Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Birkin Lodge Care Home DS0000044478.V336217.R01.S.doc Version 5.2 Page 24 - 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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