Inspection on 18/07/07 for Bower Croft

This inspection was carried out on 18th July 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 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

Bower Croft 18/07/06

Bower Croft 20/10/05

Bower Croft 04/05/05

Bower Croft 08/03/05

Bower Croft 03/11/04

Bower Croft 15/01/04

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

CARE HOMES FOR OLDER PEOPLE Bower Croft Bower Croft 5 Bower Mount Road Maidstone Kent ME16 8AX Lead Inspector Eamonn Kelly Key Unannounced Inspection 18th July 2007 10:30 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 Bower Croft DS0000023896.V338759.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. Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bower Croft Address Bower Croft 5 Bower Mount Road Maidstone Kent ME16 8AX 01622 672623 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) naba@blueyonder.co.uk Dr Mohottalalage Navaratne Mrs Chandra Kanthi Navaratne Mrs Chandra Kanthi Navaratne Care Home 18 Category(ies) of Dementia - over 65 years of age (18) registration, with number of places Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2006 Brief Description of the Service: Bower Croft provides accommodation and support for up to 18 older people who have dementia. Resident’s bedrooms are on ground and first floors. A passenger lift and stair lift is available between the ground and first floors. A smaller stair lift assists residents with the steps to the second level on the first floor. All residents have single bedrooms. Most bedrooms have en-suite facilities. Bower Croft is situated in a quiet road a short distance from the centre of Maidstone; bus stops are nearby and a mainline railway station is in the town centre. Car parking is available at the premises. Residents, staff and visitors have access to a garden and patio area and, within the premises, to a lounge, visitor’s room and conservatory. Twenty-four hour support is provided with 2 members of staff (one awake and one asleep) on duty at night. Fees are as follows 1. Local Authority funded residents: £415 per week. 2. Privately funded residents: £415-£450 per week. Privately funded residents generally have bedrooms on the ground floor. Additional charges are made for hairdressing, chiropody, personal toiletries and personal spending. Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 18th July 2007 (10.30am-6pm). It consisted of meeting with residents, the owner manager, visitors and members of staff. Care practices were observed and discussed with members of staff. A variety of records was seen during the visit principally those that supported the care of residents. The manager provided the commission with a completed annual quality assurance assessment (AQAA) and this has been helpful in preparing this report. The improvements requested in the previous inspection report have been addressed or are close to completion. This report contains information about progress made since the previous inspection visit and about how further improvement is necessary for the welfare and comfort of residents. What the service does well: What has improved since the last inspection? Progress is being made in addressing the requirements contained in the previous inspection report. Written pre-admission information available to prospective residents and their supporters has improved. Support for staff has improved with all members of staff, following formal supervision, receiving better access to the training they need. The administration of medicines and associated recording is carefully carried out. Members of staff carefully record information about resident’s health during the day and night. Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 6 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. Bower Croft DS0000023896.V338759.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 Bower Croft DS0000023896.V338759.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): 2, 3, 5, 6. Residents who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents and their representatives receive good support at the time they are making a decision about residential care. This support would be improved if all new residents received an appropriate pre-admission assessment and their personal contract referred to the reasons for personal support and healthcare. EVIDENCE: Prospective residents and their supporters receive written information about services and facilities and, following agreement about admission, all new residents receive a personal contract. Either the new resident or a main supporter signs this contract. New personal contracts will, Mrs Navaratne says, include a section outlining the reason why the resident is entering residential care (eg. to receive support appropriate for a condition caused by vascular dementia…). The covering letter and personal contract covers all residents whether privately or local authority funded. Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 9 Some residents have been admitted in the past without adequate preadmission assessments but the position in this regard has improved. All prospective residents, Mrs Navaratne says, receive a thorough assessment the results of which are recorded. She says this progress will be continued and will include reference in the personal contract of the reason(s) for the person entering residential care and an outline of support to be given. If the circumstances of the resident change significantly to the extent that different and more appropriate support is required a new personal contract will be prepared and given to either the resident or his/her main supporter. This includes the admission of residents for respite care. The home does not have facilities to support residents direct from hospital for rehabilitation care and therefore Mrs Navaratne does not agree to such admissions. Mrs Navaratne visits prospective residents as part of the pre-admission assessment. There may be exceptions to this if the prospective resident lives far away from Kent. In such instances, detailed information (hospital primary care team report and care manager’s report) is received well in advance of admission. Each prospective resident is encouraged to visit prior to taking up residence and all initially take up residence for a period of time to enable both parties to make a judgement as to whether the home is suitable for their needs. Visitors say that they are satisfied with the care their relative receives. A number of residents also say they are satisfied with the care they receive. Bower Croft DS0000023896.V338759.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 judgement was made using a range of evidence including a visit to the service. Residents receive good healthcare and personal support. Whilst care plan records contribute to this support, residents would benefit if each were to have an individual personal file and simpler, more direct care plans. EVIDENCE: Care plan records for residents are very complex. It was difficult to see, in the instances selected for checking, a distinct pattern for identifying care needs, meeting each care need and reviewing the intervention’s success. However, reference to other documents showed how this is done. There are many different charts and records maintained. A Waterlow chart is activated where a district nurse is providing support for a resident. Mrs Navaratne accepts that the system is complex and says that members of staff are familiar with the procedure. There is good information available for staff to understand resident’s care and support needs. The commission’s Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 11 advice is that old information should be removed (archived and/or shredded) and new assessments made at reasonably regular intervals with references to the actual condition of residents, their immediate support needs, improvement or deterioration noted and actions following review. The basis for this advice is that recorded information about the conditions of some residents is not entirely accurate and up-to-date and therefore intervention objectives are a little lacking. It would be preferable if each resident has his/her own personal file. They would benefit if this file contained a section for biographical information (including a better personal profile), care plan and daily record of events. The range of charts should be reduced to those that are directly important to the resident’s health, safety and comfort. Resident’s weights are taken regularly with the help of a chair scales and comparisons are made to previous recorded weights. Care plans include risk assessments relating to nutrition, falls and weight. Daily notes refer to visits by GP’s, district nurses, optician, chiropodist and dentist and referrals to a hearing clinic. A nurse from the district nursing team visits as often as necessary to provide dressings and assist with skin condition issues. Medication is stored in a lockable trolley. Medication requiring refrigeration is held in the smaller domestic (locked) fridge in the kitchen. A senior carer is responsible for medication: these members of staff receive training by an external organisation. Some creams were at the time of the inspection visit stored in the manager’s office; it was agreed that all medications including creams would be stored securely when not being used. Parts of medication rounds observed at lunch and evening meal times suggest that administration and storage of medicines is carefully and safely carried out. Much of the emphasis during this inspection related to the care in place for residents, meeting residents and staff and observing care practices. All observations suggested that staff treat residents with understanding of their physical and mental health conditions and with respect. Bower Croft DS0000023896.V338759.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 adequate quality outcomes. This judgement was made using a range of evidence including a visit to the service. Relatives and friends of residents are encouraged to visit. Residents would be better supported if they were helped to remain more physically and mentally active during the day. More emphasis on the variety of food and assistance of residents with feeding would also be beneficial. EVIDENCE: Visitors are welcome and are encouraged to visit as often as possible. Those met say their relative is well cared for. The premises are comfortable and suitable for visitors meeting residents. The three carers on duty had a positive attitude towards residents. They were enthusiastic and hardworking. They helped residents to be a little bit active during the late morning and afternoon. This was done by talking to them and involving some in an activity (eg. soft ball catching). Some residents are taken for short walks along the street. Others are helped to visit the garden. Some residents walked about the premises. The premises are suitable for this Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 13 purpose. Residents with dementia find it helpful to be able to move about easily and safely. Residents are able to sit either in the lounge area or in the conservatory. The latter is well shaded and well stocked with flowers: even on a relatively hot summer’s day it is of practical benefit to residents and staff. There is a radio and TV in the main lounge and not in the conservatory. Many residents bring their own possessions with them and these are either stored or displayed in their bedrooms. The annual quality assurance questionnaire (AQAA) and resident’s guide says three full meals a day are provided. The manager should assess the effectiveness of this claim as some anomalies were noted during the inspection visit. This included meals being removed when not eaten at lunchtime; nevertheless examples were also seen where residents received help with feeding. All residents received a small apple pie with a small amount of cold custard for dessert. Staff say that residents have said they prefer this. It is perhaps unusual for residents with dementia to be able to say that they all prefer the same thing at the same meal. Two members of staff swap each day as carers/cooks. At teatime, residents received a sandwich and slice of cake. A cooked component was not available. Staff say a cooked component is sometimes available on other days. Residents looked a little ill at ease at the end of their tea on this day with many fingering their serviette and looking confused. A resident in her bedroom did not eat her meal and it had lain there for some 30 minutes before a member of staff attended. The resident was confused and isolated. Where it was agreed an insubstantial meal was provided, there is no appropriate reference in care plans of how the resident might be assisted in having better meals. This might include, if necessary, the provision of supplement drinks (eg. ensure). In this instance a resident appeared to be very depressed, isolated and losing weight. In such circumstances, staff said that the resident is stubborn and routines could not be positively influenced. Since the inspection, Mrs Navaratne conffirmed that residents receive supplement drinks and such arrangements are specified in care plan records. By phone following the inspection visit, Mrs Navaratne indicated that residents have asked for a lighter meal at teatime because too much food lies in their stomach and prevents them sleeping and being comfortable at night. Teatime ended at 5.40pm and national minimum standards requires provision of a 4th meal (supper) each day. Members of staff say that there are a number of activities arranged for residents. Some spontaneous activities (softball, discussion) were witnessed during the inspection visit. Staff spend time with residents on a 1:1 basis. They say there are occasional visits by a musician and group activities such as bingo are provided. However, there is no chart displayed of activities planned Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 14 and delivered each morning and afternoon. An activities co-ordinator is not employed as would be expected in a residential home registered as providing specialist care for people with dementia. It is generally expected that at least one hour per week per registered resident (therefore 18 in this case) of activities is available from a qualified and experienced activities co-ordinator with planned activities displayed. Such professionalism is likely to be of direct benefit to residents and to staff who could provide similar activities at other times. Members of staff report that many residents are restless at night. It is important that resort is not made to medication (for sedation) and that mental and physical stimulation is provided throughout the day to enable residents remain physically and mentally active and to help them sleep well at night. Bower Croft DS0000023896.V338759.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. Residents who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents are protected from abuse by the good care practices and vigilance of the owner manager and members of staff. EVIDENCE: There is evidence that relatives and friends of residents are asked to give their views (informally and via questionnaires) about services and facilities. Members of staff take notice of this feedback. The home has a complaints procedure and the resident’s guide includes a copy. There have been no formal complaints in the last year. Nevertheless the owner encourages, as stated above, feedback about services as part of the commitment to quality assurance measures. Members of staff have a good understanding of their responsibilities under protection of vulnerable adults (POVA) procedures. They receive guidance and training on this important topic. Mrs Navaratne says she has a good understanding of local authority guidelines on adult protection measures and follows the guidelines. Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 16 Bower Croft DS0000023896.V338759.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, 20, 21, 26. Residents who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. The premises are suitable for supporting frail older people. EVIDENCE: Resident’s bedrooms are on ground and first floors. A passenger lift and stair lift is available between the ground and first floors. A smaller stair lift assists residents with the steps to the second level on the first floor. All residents have single bedrooms. Most bedrooms have en-suite facilities. In one case two single bedrooms have a linked en-suite. Some bedrooms are just adequate for their purpose. Most are fully suitable. There are excellent communal lounge and conservatory facilities: these are important for people with dementia to walk with ease, in safety and in comfort. External facilities are also of benefit to residents, staff and visitors. Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 18 The domestic worker works for 18 hours over 6 days a week and as a carer for 12 hours over two shifts. The premises were clean and without unacceptable odours. Some bedrooms have lino surfaces; most have carpets. There are sufficient bathrooms and WC’s. In one case packs of continence pads are stored (some in open packs): Mrs Navaratne said a smaller number would be stored communally for convenience in a cupboard with the remainder stored elsewhere. There are useful signs on doors to help residents retain some independence. Mrs Navaratne intends to have essential refurbishment carried out soon, for example, five bedrooms (numbers 1, 4, 6a, 6b and 7) will be redecorated including new floor covering, new furniture and replacement of beds and fabric. Corridors will be re-decorated. The floor of the laundry will be repaired. Mrs Navaratne provided access to a comprehensive environment risk assessment. Bower Croft DS0000023896.V338759.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 judgement was made using a range of evidence including a visit to the service. Residents are in the care of members of staff who are increasingly receiving the training they need to support people with dementia. EVIDENCE: At least three carers are on duty each day. Two attend at night, one awake and one asleep. The latter has a staff sleep-in room. Two members of staff swap as cook and carer. The domestic worker also works as a carer on separate shifts. Senior carers have additional responsibilities for staff supervision and maintaining the comfort and safety of residents. Improvement has occurred in staff training in the previous months and Mrs Navaratne says this will continue. She and all care staff will complete the VRQ Certificate in Dementia Care with Bexley College or another provider in the next 12 months. This is an important qualification for staff providing specialist care for people with dementia. Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 20 An agency recruits most carers from Poland, Romania and India. Many are hospital-trained nurses in these countries and most are not undertaking “adaptation courses” (to obtain UK registration with NMC). Staff files indicate that 2 references are obtained, CRB/POVA checks are carried out, a contract of employment and staff handbook is provided, formal supervision is carried out and new members of staff receive induction training. Mrs Navaratne feels that the induction procedure meets the standard required by the care sector regulatory body (Skills for Care). The examples seen were satisfactory but care needs to be taken that staff receive the support they need for the first six months of employment and that this is recorded and verified. Whilst police checks are carried out in the country of origin of staff, a UK CRB is also obtained (although until recently the procedure for obtaining CRB checks did not comply with current regulations). All carers including those with nursing experience and qualifications in other countries receive NVQ and mandatory training. One has completed NVQ Level 3 in Care and a further two are undertaking this qualification. Four carers have begun NVQ Level 2 in Care. The inspection visit identified instances where residents are depressed and isolated. Members of staff need to have appropriate to enable them to care properly for such residents. According to staff, all staff have received fire safety training and fire safety procedures are practiced and checks are recorded in the fire safety log. There are some deficiencies in enabling all staff to achieve the required levels of mandatory training particularly in moving and handling (and updates) and infection control. However, Mrs Navaratne is making good progress in arranging required training. Bower Croft DS0000023896.V338759.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): 31, 33, 35, 38. Residents who use the service experience adequate quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents live in a residential home that is managed effectively and that is conducted in their best interests. EVIDENCE: Mrs Navaratne is a registered nurse (RMN), has extensive NHS experience, has achieved the registered manager’s award (RMA) and has additional qualifications in law and accountancy. Mrs Navaratne believes she has progressed operational procedures to the extent that members of staff are able to assume most of the responsibility for Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 22 running the premises on a day-to-day basis. A number of factors have, in her opinion, led to this position: staff training has improved, procedures are in place to protect residents and enable smooth operation, friends and families are well received and involved and staff are aware of the general needs of residents and how these needs must be met. Mrs Navaratne’s absences are a decision by the owner to leave the running of the home largely in the hands of staff. She feels that current arrangements are of benefit to residents and their supporters. It is therefore important for Mrs Navaratne to ensure that operational procedures and future training initiatives continue to serve the interests of residents. This report indicates areas where quality assurance measures are necessary for this purpose. To achieve the present position Mrs Navaratne has recruited a small group of staff that, with increasing levels of training and on-going in-house support, are multi-skilled and competent. This includes (in addition to planned and scheduled training initiatives) a commitment to enabling all carers to achieve the Certificate in Dementia Care within about the next 12 months so that claims to provide a specialist service for supporting older people with dementia are upheld in practice. Provision of essential training normally regarded as essential or mandatory that is currently lacking is part of this evolutionary process that is within sight of being achieved. Mrs Navaretne’s assertion that these initiatives will be achieved within reasonable timescales (ie. within about 12 months for the Certificate in Dementia Care, 12-24 months for all carers to achieve NVQ levels 2 and 3 in Care, and 18-24 months for mandatory training for all staff) is acknowledged. Following misunderstandings in the past about the safekeeping of resident’s possessions, procedures have been tightened. In cases recently relating to resident’s monies, the correct actions were taken to protect the interests of residents. Families or independent advocates now (in all but one instance) look after resident’s legal and financial affairs. The annual quality assurance assessment (AQAA) states that all essential safety certificates and associated documents are in place and are up-to-date. Bower Croft DS0000023896.V338759.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 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 Score x 2 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 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 2 x 2 x 3 x x 3 Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bower Croft DS0000023896.V338759.R01.S.doc Version 5.2 Page 25 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 Bower Croft DS0000023896.V338759.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!