Inspection on 22/08/06 for Grenham Bay Court

This inspection was carried out on 22nd August 2006.

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

Grenham Bay Court 13/11/08

Grenham Bay Court 13/11/07

Grenham Bay Court 17/11/05

Grenham Bay Court 08/06/05

Grenham Bay Court 20/04/05

Grenham Bay Court 07/03/05

Grenham Bay Court 06/07/04

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

CARE HOMES FOR OLDER PEOPLE Grenham Bay Court Grenham Bay Court Cliff Road Birchington Kent CT7 9JX Lead Inspector Christine Grafton Unannounced Inspection 22nd August 2006 09:20 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 Grenham Bay Court DS0000034959.V306061.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. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grenham Bay Court Address Grenham Bay Court Cliff Road Birchington Kent CT7 9JX 01843 841008 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) juliemills@highmeadow.co.uk Grenham Bay Care Ltd Mrs Jacqueline Cross Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November 2005 Brief Description of the Service: Grenham Bay Court provides accommodation and care for older people. The home has 32 bedrooms, which are mainly used as singles, but there are 5 double sized rooms that can be used by people who wish to share. The majority of bedrooms are on the ground floor and most have ensuite facilities. There are a variety of lounge areas and there is a small garden to the rear. The home faces the sea in a residential area of Birchington, near Margate, within walking distance of most local amenities. The home has its own transport that can assist residents to access local shops and other places of interest in the area. There is unrestricted on road parking to the front of the property. Grenham Bay Court is owned by a private company that employs a manager who has the day-to-day responsibility for the home. Staff are on duty 24 hours a day, which includes a senior member of staff on all shifts during the day and two staff on wakeful duty at night. Senior staff are available on-call at night. Information provided by the registered manager in May 2006 states that the fees range from £311.65 to £455.00 per week. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report takes account of information obtained from various sources, including a visit to the home; telephone contacts; written information provided by the manager; surveys completed by, or on behalf of residents, relatives and care managers. 31 service user surveys were sent out and 28 responses were received. These indicated their overall satisfaction, including some comments and suggestions that were followed up during the visit. 13 out of the 31 relatives consulted responded and indicated their satisfaction with the home. Surveys were also sent to 7 care managers and 7 general practitioners. 3 care managers’ responses were received, 2 indicating their overall satisfaction with the home and one raised an issue that was followed up at the visit to the home. An unannounced visit took place on 22nd August 2006 between 09.20 hours and 16.35 hours and consisted of talking to the manager, staff on duty, residents, looking round the home, observing interactions between residents and staff and checking some records. The care of 6 residents was case tracked. At the time of the visit there was 31 residents. Information in the pre-inspection questionnaire completed by the manager in May 2006 states that the current fees for the home range from £311.65 to £455.00 per week. What the service does well: A particular strength of this home is the wide range of opportunities provided for residents to take part in activities both within the home and in the local community. Individual and group activities are organised. Minibus outings are arranged and residents are also sometimes taken out individually. Routines are flexible and residents can choose to stay in their rooms for as long as they wish, or to socialise in the lounges if they prefer. There are a variety of lounge and dining areas within the home, which are pleasantly decorated and furnished to create a warm homely environment. The majority of bedrooms are singles and most have ensuite facilities. The home is maintained to a good standard. Residents are provided with a well-balanced, varied diet and are given the option of two choices at dinner and tea times. Meals are unhurried and served in pleasant surroundings. Residents again commented that the food is good. Residents and staff commented on the nice atmosphere in the home. Residents said that the staff are very good, comments were made including: “I Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 6 can’t fault it here”; “it’s beautiful here”; “ everything is wonderful here”; “Staff are so nice, they’re happy in what they are doing, so it radiates back.” 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. Grenham Bay Court DS0000034959.V306061.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 Grenham Bay Court DS0000034959.V306061.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s statement of purpose and service users’ guide provide all the information for prospective residents to make a fully informed decision about moving into the home. The assessment process for prospective residents is generally satisfactory, but the recording needs to be developed to provide evidence that the person’s needs can be met upon moving into the home. It is not the general policy of the home to admit residents for intermediate care, so standard 6 was judged as not applicable at this inspection visit. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 9 EVIDENCE: The statement of purpose and service users’ guide provide the reader with a real ‘sense’ of the home. Copies of both documents are kept by the visitors’ book in the entrance hall. Residents are given their own copy of a large print version of the service users’ guide. The manager had recently reviewed and updated both documents, which were seen to contain all the relevant information. Residents are provided with a contract, or statement of terms and conditions of residence, specifying the fees, services provided, any additional charges and their rights and responsibilities. Trial visits are encouraged wherever possible. A prospective resident and relatives visited unannounced during the inspection and were shown round communal areas and one bedroom. The manager carries out pre-admission assessments of prospective residents at their own home, or previous abode, or sometimes this is done at the trial visit. Assessment records are kept and the manager confirmed that the assessment covers everything specified in the standards, but it was discussed that the documentation needs to be further developed to show more clearly that the home can meet the person’s needs on admission. Full assessments are carried out and recorded following admission. Some of the more recently admitted residents spoken to described moving into the home as a positive experience. The assessment process for one resident admitted when the manager had been on holiday was discussed. The manager confirmed the person had needs that the home could not meet and that upon her return, she had arranged for them to move to another more suitable home. Evidence was seen from observation, discussion with staff and in the case tracking indicating that residents’ needs are being met by appropriately skilled staff. Grenham Bay Court DS0000034959.V306061.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 at least once during a 12 month period. 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. Care plans provide the staff with all the information they need to ensure residents’ health, personal and social care needs are met. Medications are well-managed promoting good health. Residents are treated with respect for their dignity. EVIDENCE: From the case tracking it was clear that the improvements in care planning noted at the last inspection have been further developed and staff are now more confident in completing them. The assessment documentation is very detailed and care plans include clear instructions for staff on how to provide care. Risk assessments pay particular attention to the prevention of falls, with good instructions for moving and handling assistance, actions to reduce the risk of Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 11 pressure sore development, nutrition and hydration. Any special requirements such as glucose monitoring for residents with diabetes and risks associated with high or low blood glucose levels, or catheter care, have been well documented. Details of health monitoring were evident with clear records of contacts with doctors, hospital appointments and visits from community nurses. Care plans have been regularly reviewed and updated. It was possible to gain a complete picture of the person and their needs from reading the care plans and the information in them matched that given by the residents themselves. Only a brief audit of the medications was carried out. Medication storage is good, with two medication trolleys and a metal cupboard with an appropriate controlled drugs facility. The medication administration (MAR) sheets were on the whole well recorded. A controlled drugs register is used and being properly maintained. Written protocols for the administration of ‘as required’ medications and the recording of verbal orders have been drawn up. Staff were seen treating residents with kindness and respect. Residents commented that the staff are very helpful and confirmed that their dignity is respected when assistance is provided. Those residents spoken to as part of the case tracking felt that their care needs were being met. Grenham Bay Court DS0000034959.V306061.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 at least once during a 12 month period. 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. Residents are provided with plenty of opportunities to take part in a range of meaningful activities and are enabled to exercise choice in their daily lifestyles. Meals are provided in pleasant surroundings, are well balanced, varied and offer choice to meet residents’ tastes and needs. EVIDENCE: Since the last inspection, a new activities coordinator has been employed to work two and a half days during the week. Activities are planned to provide both individual and group activities within the home and minibus outings are arranged. Activities include fortnightly visiting musical entertainers. During the visit, the activities coordinator took a resident out to the local shops in the morning and a game of magnetic darts took place in one of the lounges in the afternoon. Residents spoke of their enjoyment in participating in the activities organised, for example, a recent strawberry tea in the home’s garden, a minibus trip to Sandwich, with a fish and chip lunch and ice creams Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 13 and a tea dance in a local hall. A resident commented that the activities coordinator “stimulates us” and went on to say that they do quizzes, sewing, chat about the old times and go out sometimes. Another resident said, “they took me out in a wheelchair the other day and I hadn’t been out for ages – that was nice”. The activities coordinator keeps a record of activities and an activities plan. Residents and staff spoke of weekly visits by a hairdresser, visits by a clergyman, a monthly communion service and they said they have lots of visitors. Residents confirmed they are encouraged to exercise choice in all aspects of their daily living. Residents spoken to said that the food is good. Menus offer two choices of main meal with a starter consisting of soup, prawn cocktail, melon, or Florida cocktail. The four-weekly menu plan indicates a varied, nutritious diet. The two separate dining areas are arranged with linen tablecloths, napkins and a large selection of condiments. The front dining areas have large picture windows that overlook the sea and provide a very pleasant setting. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 14 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 inspected at least once during a 12 month period. 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. Residents know that their complaints will be listened to and acted upon. Policies and procedures are in place to safeguard residents from abuse. EVIDENCE: The home’s complaints procedure is prominently displayed with details of how to contact the commission. There is a complaints file by the visitors’ book with a selection of complaints forms that visitors may take away to complete if they wish. Residents spoken to said they had no complaints and made positive comments about the home. There have been no complaints since the last inspection. The staff-training matrix indicates that staff have attended training on abuse and challenging behaviour. Written guidance on the management of aggressive behaviour is displayed in the office and detailed policies and guidance on abuse are included in the staff policies and procedures file, which is readily available. The abuse policy had recently been reviewed and updated. The manager stated that abuse is discussed within the staff formal supervision sessions. In-house training has also been provided by the High Meadow organisation’s own trainers, on dementia in the elderly. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The decoration and furnishings of the environment provide residents with an attractive, comfortable and homely place in which to live. The home’s maintenance procedures ensure residents’ safety. EVIDENCE: Lounges, dining rooms and bedrooms are decorated and furnished to a good standard. Building maintenance is ongoing. All areas of the home were seen to be clean, odour free and generally in good repair. Residents said they like their bedrooms, which are all individual and personalised, with the majority having ensuite facilities. A number of residents have brought items of their own furniture into their rooms. There are two adapted bathrooms and rooms are equipped with adaptations and equipment to suit individual needs. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 16 There are plans to install a new lift and connecting corridor at first floor level. Two comments were made about this in the residents’ and relatives’ surveys, asking how long it would be. The manager explained that the delay had been due to changes in building regulations, but it is anticipated that work will start this year. The procedures in place for the control of infection include: the provision of appropriate hand washing facilities and plastic aprons and gloves readily available for use throughout the home. There is a sluice facility for the cleaning of commode pans and the industrial washing machine has a sluice cycle. Water-soluble bags are used for soiled articles. Cleaning was being done during the morning of the visit. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. 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. Staff rotas are well thought out and make sure that there is enough staff on duty to meet residents’ needs, with the appropriate skill mix and deployment of staff to ensure safety. Suitable recruitment procedures are in place to protect residents. The management needs to make sure that all the required paperwork is at the home to support this. EVIDENCE: Comments in the majority of the 28 service user surveys returned indicated residents’ views that there is usually enough staff available, who usually listen and act on what they say. There were some comments that only sometimes staff are available when needed and one that it sometimes takes a long time for staff to answer the call bell. Residents spoken to at the visit indicated that staff always respond when asked for assistance, or if they ring their bell. Many residents praised the carers saying that they are very good. Rotas provided with the pre-inspection questionnaire and at the visit indicate an average of six carers on duty in the mornings and four in the afternoons, plus a housekeeper and laundry assistant weekday mornings. There is additional staff on duty every day for cooking and the activities coordinator Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 18 works two and a half days a week. The manager is supernumerary and there is also a part-time administrator and maintenance person. The manager uses the Department of Health guidance to calculate the number of staff required, based on residents’ dependencies. On the morning of the visit there were seven carers on duty to care for 31 residents and they were appropriately deployed between the various different areas of the building. From observations of dependency levels, discussion with the manager, talking to some residents and analysis of the rotas, it was clear that there were sufficient numbers of staff on duty to meet residents’ needs. An up to date staff-training matrix was provided and the manager confirmed that seven out of the current care staff team of thirteen have achieved their National Vocational Qualification (NVQ) level 2 in care. New staff undergo a basic first week induction programme, followed by the more comprehensive Skills for Care programme that is usually completed within the thirteen week probationary period. The staff training matrix indicates that staff are encouraged to attend a variety of short courses to equip them with the sills needed to do their jobs. Two staff files were sampled and seen to contain most of the necessary information, including application forms, references and evidence of criminal records bureau checks. The management have used a recruitment consultancy to recruit some staff from abroad. Most of the paperwork is kept at the management head office and photocopies are kept at the home. It was discussed that the manager needs to make sure that all the required documentation is kept on file at the home. The manager interviews applicants when all the preliminary checks have been completed. There were no interview records in the files, although the manager stated she does complete them. The manager said that she makes sure that the foreign applicants can speak English to a suitable level. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager runs this home well, with the support of the registered providers and their senior management team, who between them make sure that residents benefit from the management style that has been created. Residents’ and staff views are regularly sought, listened to and used to inform the home’s business plan. Appropriate safety procedures are in place to protect residents. EVIDENCE: The manager has been registered since the last inspection and has the relevant qualifications and skills. Residents commented that the manager is very approachable and always sorts things out if needed. A resident said that Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 20 the manager has developed good team working and because the staff are happy in their work this is reflected in the care received. Another resident remembered completing a quality assurance questionnaire and said that residents’ views are responded to. Residents and staff spoken to were appreciative of the management style, saying that the manager provides clear leadership and has created an open, positive atmosphere at the home. Staff spoke of feeling valued and enjoying their work at the home. The manager holds regular staff meetings and minutes of a recent meeting indicated that the management had recognised the hard work and commitment of the staff team. Residents’ meetings are also held to share information and ascertain residents’ views. The manager and senior staff team provide regular formal supervision to all staff. They aim to do this every two months and a copy of the format used was seen to cover the job structure, strengths, weaknesses, concerns, best practice and an action plan. Annual appraisals are also carried out and training needs identified. Where the home holds small amounts of spending monies on behalf of some residents, appropriate procedures are in place to protect their financial interests. Records were seen to correspond with monies kept. The staff-training matrix indicates that sufficient staff are trained in first aid, health and safety, moving and handling, fire awareness and food hygiene. Environmental risk assessments had recently been updated and the fire safety logbook indicated that weekly fire bell tests are carried out and that the last staff fire instruction took place on 11th July 2006. No health and safety risks were identified on the tour of the building. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 21 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 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 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 3 3 x 3 3 3 3 Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. 1. 2 3 Refer to Standard OP3 OP19 OP29 Good Practice Recommendations To further develop the pre-admission assessment record to provide more detail to clearly show that the home can meet the person’s needs upon admission. That the planned installation of a new lift goes ahead this year. To keep interview records on staff files and to review staff files to make sure that they contain all the information specified in the regulations. Grenham Bay Court DS0000034959.V306061.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 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 Grenham Bay Court DS0000034959.V306061.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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