Inspection on 09/06/08 for Garlinge Lodge

This inspection was carried out on 9th June 2008.

CSCI found this care home to be providing an Adequate service.

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

Garlinge Lodge 28/05/09

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

CARE HOMES FOR OLDER PEOPLE Garlinge Lodge 6 Garlinge Road Southborough Tunbridge Wells Kent TN4 0NR Lead Inspector Gary Bartlett Unannounced Inspection 9th June 2008 09:15 09/06/08 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 Garlinge Lodge DS0000071203.V365336.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. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Garlinge Lodge Address 6 Garlinge Road Southborough Tunbridge Wells Kent TN4 0NR 01892528465 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) raj22@onetel.com Sira Care Home Ltd Mr Ragiv Kamal Kumar Jugdharree Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Garlinge Lodge DS0000071203.V365336.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: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 14. Date of last inspection Brief Description of the Service: The premises at Garlinge Lodge were converted over 30 years ago as a care home for elderly people. It provides residential care for up to 14 people over the age of 65. It is owned and operated by Sira Care Home Ltd, a newly formed company with Mr Kritanand Ramtale as Managing Director and Mr Rajiv Jugdharree as co-director and home manager. The Homes staffing team comprises the Manager, senior care staff and care staff who work a roster that gives 24-hour cover. The Home also employs other staff for catering and domestic duties. Current fees range from £354 to £500 per week. Residents pay separately for hairdressing, chiropody, personal toiletries and newspapers at cost. Garlinge Lodge DS0000071203.V365336.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 1 star. This means the people who use this service experience adequate quality outcomes. This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Garlinge Lodge from 9:15 a.m. until 3:30 pm. During that time the Inspector spoke with some residents, 2 visitors, a visiting activities co-ordinator and some staff. Parts of the home and some records were inspected and care practices observed. The Manager had completed an Annual Quality Assurance Assessment, from which information was used to inform the inspection process. Residents, their relatives and health care professionals say they like the home and think there are generally good standards of care. Comments included: • ““We are satisfied with the care (resident) receives”. • “This is a lovely home to live in”. • ”I honestly feel very happy here”. • “This is a happy place on the whole”. The Care Homes Regulations 2001 and the National Minimum Standards for Care Homes for Older People refer to people who use the service as “service users”. People living at Garlinge Lodge prefer to be referred to as “residents”. Accordingly this shall be done in the text of this report. The Inspector would like to thank everyone involved for their contribution to the inspection. What the service does well: Residents say they enjoy living at Garlinge Lodge and are very happy here. The home provides a comfortable environment and the standard of cleanliness is good. There is an open and friendly atmosphere with good communication between residents, staff and visitors. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 6 Staff are good at helping new residents to settle in. There is encouragement for residents to partake in activities suited to their preferences and capabilities. Residents enjoy the meals which are of good quality. Staff recruitment process are robust to ensure only appropriate people work at the home. What has improved since the last inspection? 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. Garlinge Lodge DS0000071203.V365336.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 Garlinge Lodge DS0000071203.V365336.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, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Garlinge Lodge has good pre-admission procedures so that residents can be confident the home can meet their needs. EVIDENCE: The Manager described how a pre-admission assessment is made of each prospective resident. The assessment process includes recording the findings of the assessment, the detail of which then informs the initial care plan. He said prospective residents, their families, advocates, and relevant health care professionals are involved in the assessment process. Specialist advice is sought from external sources where required. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 9 Residents said they or their families had been able to visit the home before moving in. They also said staff had been very helpful in assisting them to settle in. A survey form completed by a relative included the comment: • “Spent a day in the home to make sure it was suitable”. Intermediate care is not offered at Garlinge Lodge. Garlinge Lodge DS0000071203.V365336.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, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Records of care must be more consistently maintained to reflect the quality of care given. More consistent adherence to guidelines for the recording of medicines would better protect residents. Residents’ health needs were met with good liaison with relevant health care professionals. Staff treat residents with respect and maintain their privacy and dignity. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 11 EVIDENCE: Each resident has a care plan and three were inspected in detail. Whilst it is evident they are being improved, the plans need to be more comprehensive with information about residents’ needs and capabilities. The care plans must be clearly directive so staff know how to meet residents’ care needs. The Manager is aware that records of daily care need to be more informative to comprehensively reflect the service given and is planning to address this by regularly reviewing them and giving staff guidance as necessary. Staff spoken with generally have a good understanding of residents’ individual preferences. There is a key worker system that should contribute to an effective exchange of information about residents’ health and welfare. Risk assessments are not always recorded or reviewed as a result of changes in welfare or incidents. One of the residents is independent, largely self-caring and often goes out on their own. Consequently, the scope and content of risk assessments needs to be more comprehensive. It is evident from records seen and discussion with residents and staff that residents have ready access to health care professionals as necessary. Comments made by residents during the inspection included: • “They look after you very well here”. • “I’ve been here for quite a while now and I am very happy”. A survey form completed by a relative included the comment: • “Staff have been excellent in getting a doctor in to attend my mother when she has had a small problem”. Whilst feedback is mostly positive, it is evident from comments made by residents and their relatives in person and on surveys that staff are not always attentive to details. Comments included in the homes own surveys included: • “Need the reading glasses to be with her in the daytime, not left in the bedroom”. • “Her hearing aid is not always in properly and the batteries have not been changed”. The Manager acknowledges this can have a negative impact on quality of life and explained he is reminding staff of their responsibilities and arranging further training where required. Medicines are only administered by staff who have been trained to do so and there is an up to date list of these people with specimen signatures. Most Medication Record Administration Record (MAR) sheets are computer generated by the pharmacist but some are hand written. These must be must Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 12 be signed by the person completing them and countersigned by a second person checking their accuracy. The owner undertook to address these matters to lessen the potential risk to residents. Residents feel that staff are kind and gentle, this was confirmed by observation and discussion with visitors. Staff are considerate of the age of residents and treat them with courtesy. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 13 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choice and control over their daily lives as far as is practicable and to maintain links with friends and relatives. Residents enjoy the meals which are of good quality. EVIDENCE: Residents have opportunities to take part in activities at the home and the weekly programme of activities is displayed in the dining room. During the inspection a visiting activities person conducted an afternoon session that included quizzes and general knowledge questions. The majority of residents were present and took part with enthusiasm. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 14 Other activities include the fortnightly gentle exercise session, current affairs discussion and music therapy. One resident continues to go out independently on a daily basis. The Manager said that outings can be organised but take up is variable. The home doers not possess its own transport. Residents say that, within reason, they can get up and go to bed when they chose. It seems all except one like to get up early as night-staff have made the beds by the time the morning staff arrive at 8:00 am. A hairdresser is available at the home regularly as does a religious minister. Family and friends feel welcome and know they can visit at any reasonable time. During the inspection a number of visitors were seen in the home and the visitors book records regular visits by families, friends and others. The design of the Garlinge Lodge provides seating areas within the communal areas where residents can entertain their visitors, in addition to the privacy of their own room. Residents are encouraged to take responsibility for their own financial affairs and to use their money as they wish. Where a resident can no longer manage their own money, family or an advocate will be used. An experienced cook, of whom residents and staff spoke very highly, provides good quality meals that meet the dietary needs of the residents. A menu offers a choice of main meal. It was, however, observed that staff do not always remind residents of this, thereby potentially denying them their preferred option. Mealtimes are relaxed; staff are patient and helpful and allow residents the time they need to finish their meal comfortably. The home keeps a record of meals provided and it is recommended that a record be kept in respect of each resident if they eat an alternative meal not listed on the menu. Residents’ weights are regularly checked so that their diet can be reviewed if there is concern about weight gain or loss. A survey form completed by a relative included the comment: • “Excellent food. Well presented. When my mother had trouble with her teeth, the staff ensured her meals were liquidised or mashed so that she could cope”. Garlinge Lodge DS0000071203.V365336.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can feel confident that any concerns or complaints will be taken seriously and addressed. There are policies and procedures to protect residents from abuse. EVIDENCE: The complaints procedure is readily available to residents and their relatives. They said they feel confident that they would be listened to and any necessary action would be taken. A visitor said: • “Any little problems are always sorted out very quickly”. The Annual Quality Assurance Assessment received prior to the inspection indicates there have been no complaints received since it was registered in December 2007. The Commission has not received any complaints about the home in that time. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 16 There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The Manager and other staff spoken with have a sound understanding of safeguarding adults procedures. There have not been any alerts raised. Garlinge Lodge DS0000071203.V365336.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, 22, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Garlinge Lodge provides a homely environment and comfortable place in which to live. EVIDENCE: Garlinge Lodge is a large building set at the end of a quiet road near the centre of Southborough. Shops and other facilities are near to hand. It has been used as a care home for many years and some corridors are narrow. The Manager said careful consideration is given to residents’ abilities when allocating bedrooms. All floors are served by a shaft lift. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 18 Residents spoken with like their rooms, those on the top floor are the more mobile and if a need is identified for a move downstairs this is facilitated whenever possible. All the bedrooms are for single occupancy. The home has a main lounge and a pleasant conservatory/dining area, both were being well used during the inspection and some residents were choosing to alternate between spending time in communal areas and their rooms. There is a garden with a patio area to the rear and side of the home that residents can have access to with assistance. It is recommended handrails be fitted alongside the paths in the garden so residents can use the garden more independently and safely. The Manager said there is an ongoing programme of redecoration and refurbishment. Worn furniture and carpets are gradually being replaced, including old and damaged commodes. The Manager said he would remind staff there is a stock of newly purchased bed linen and the worn and threadbare sheets are to be thrown away. Staff say the bathing facilities are adequate for the needs of the residents, there being three bathrooms. One of these is small and rarely used. Residents say they consider there to be enough toilets. Some support frames around the toilets are not secured, posing a potential hazard for residents. Infection control is generally well maintained in the home but would be further enhanced if all staff observed good practice guidelines in regard to wearing protective aprons at appropriate times. The Manager undertook to ensure staff followed procedures. This negated the need to issue an Immediate Requirement Notice. The standard of cleanliness is good and a resident commented on how clean their room is kept. Garlinge Lodge DS0000071203.V365336.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, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel there are adequate numbers of staff on duty and that the staff are caring people. EVIDENCE: People applying to work at the home have to complete an application form, attend an interview, provide references and satisfactory POVA and CRB checks. The files of the two most recently recruited staff show that appropriate checks are made prior to them commencing duties. The Manager was advised that the staff application form should be updated to comply with current employment legislation and facilitate the recording of a full employment history as required by Regulations. New staff are required to undertake an induction programme and there is a programme of training. The Manager is developing a training matrix to readily identify staff’s individual training needs. The staff rosters seen indicate staffing levels are geared to peak times of activity. Residents say they consider there to be enough staff available to support them as and when needed. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 20 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, 37 and 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 run in the best interests of residents and there is an open and friendly atmosphere. EVIDENCE: Mr Jugdharree qualified as a Registered Mental Nurse in 1993, since which time he has had experience of working in Elderly and EMI Units, Acute Admissions and most recently, for the last three years, in a rehabilitation unit for younger adults, which has included responsibility for community outreach work and working closely with families. He has recently completed a Managing Change Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 21 workshop and a Safeguarding Adults Awareness course in July 2007; he also has a Higher Education Diploma in Health Care Studies and the NVQ at level 4 in Management, awarded in 2005 and is an NVQ Assessor. The atmosphere is relaxed and friendly and staff and residents find the Manager approachable. The home has some quality assurance processes including resident/relative surveys. The Manager said it is intended to include health care professionals and Care Managers in future surveys. Residents are encouraged to manage their own monies with most having family or advocates who act on their behalf. The home prefers not to become involved in looking after residents’ monies. The door leading from the dining room to steep stairs to the lower floor needs to be fitted with a clear vision panel to improve safety is for residents and staff. The standard of cleanliness in the kitchen and surrounding area is good. In December 2007 the home was awarded the Borough Council’s “Gold” award for food hygiene for the third year running. Food items are not being dated when opened as required by food hygiene regulations. The Manager said this would be done with immediate effect. There are records of fire systems checks and fire drills/training. However, there are some out of date fire procedure notices displayed around the home. The Manager undertook to remove them. Staff spoken with have a good understanding of emergency procedures. The Manager stated that records of maintenance and safety checks are in order. These were not inspected on this occasion. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 2 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 2 Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 14(2)(b), 15(2), 17 Schedule 3, Schedule 4 Requirement The registered person shall maintain records as specified in Schedules 3 and 4. The registered person shall keep the service user’s plan under review in that service users’ care plans and records must be specific in detail of information required to show what their care needs are and how they are met. All service users must have an accurate care plan by the given timescale, if not sooner, which is thereafter maintained. The registered person shall ensure that unnecessary risks to the health and safety of service 3.users are identified and so far as possible eliminated in that risk assessments must be more comprehensive and recorded in response to incidents and changes in residents welfare. Comprehensive risk assessments must be in place by the given timescale, if not sooner, and maintained thereafter. “The registered person shall DS0000071203.V365336.R01.S.doc Timescale for action 30/10/08 2. OP7 13(4) 30/10/08 3. OP9 13(2) 30/06/08 Page 24 Garlinge Lodge Version 5.2 make arrangements for the recording, handling, safekeeping, safe administration of medicines” in that hand written Medicine Administration Charts must be signed by the person completing them and countersigned by a second person checking their accuracy. To be completed by the given timescale, if not sooner and maintained thereafter. The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety in that freestanding support frames around toilets must be secured. 4. OP22 13(4) 31/07/08 5. OP38 23(4)(d)( e) To be completed by the given timescale, if not sooner and maintained thereafter. “The registered person shall 30/06/08 after appropriate consulation with the fire and rescue authority make arrangements for persons working at the care home to receive suitable training in fire prevevtion; and to ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home and, so far as is practicable, service users, are aware of the procedure to be followed in case of fire, including the procedure for saving life” in that all out of date fire procedure notices must be removed. Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP15 Good Practice Recommendations It is recommended that a record be kept in respect of each resident if they eat an alternative meal not listed on the menu. It is strongly recommended that staff tell residents the alternatives available when asking them their preference of meal. It is recommended handrails be fitted alongside the paths in the garden so residents can use the garden more independently and safely. It is strongly recommended the staff application form is updated to comply with current employment legislation and facilitate the recording of a full employment history as required by Regulations. It is strongly recommended a clear vision panel is fitted to the door in the dining room that gives access to the stairs leading to the lower floor. OP15 OP19 OP37 5. OP38 Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 26 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 Garlinge Lodge DS0000071203.V365336.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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