Inspection on 12/02/07 for Hale Place Farmhouse Residential Hotel for the Elderly

This inspection was carried out on 12th February 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

Hale Place Farmhouse Residential... 14/02/08

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

CARE HOMES FOR OLDER PEOPLE Hale Place Farmhouse Residential Hotel for the Elderly 79 Old Road East East Peckham Tonbridge Kent TN12 5EN Lead Inspector Justine Williams Key Unannounced Inspection 12th February 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hale Place Farmhouse Residential Hotel for the Elderly 79 Old Road East East Peckham Tonbridge Kent TN12 5EN 01622 871081 Address 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) Hale Place Care Homes Limited Kevin Hewlett Care Home 10 Category(ies) of Dementia (10) registration, with number of places Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: Hale Place Farmhouse is a care home for 10 older people with dementia. It is located in the centre of a village, which has a coffee shop, pubs, shops, library and churches and is on a bus route to all the local towns and villages. It was opened in 1988 and is a detached listed property and as its name implies was formerly a farmhouse. There is accommodation on the ground and first floor; there are six single bedrooms and two double bedrooms, five rooms have en-suite facilities with WC. There is a single and double room on the ground floor. There are television points in all the bedrooms and residents can choose to have a telephone point. There is no shaft lift to enable wheelchair access to the upper floor; a chair lift is fitted to the staircase. There is a large enclosed garden to the rear of the property with patio areas, pond and circular pathways. There is a garden to the front of the property with car parking for approximately four cars. The Garden Lodge next door provides accomodation for 3 more able bodied residents and although it is separately registered, residents can use the communal areas in the farmhouse, they share the garden, and meals are prepared in the Garden Lodge kitchen. The homes are not separately staffed, and to all intents and purposes are run as one. The current fees range from £600.00 to £675.00 per week, chiropody, hairdressing, ands personal toiletries are included. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was carried out on 12th February 2007 between 9.30 am and 2.30 pm by regulatory inspector Justine Williams. During that time the inspector spoke with residents, staff members and the registered manager. Feedback was given during and at the end of the inspection. The Garden Lodge next door was also inspected throughout this time. This report contains assessments made from observation, conversation and records. As part of the inspection process comment cards were sent to service users who live at the home and to GP’s, health care professionals, care managers and relatives of residents. The comment cards indicated good levels of satisfaction. Comments made included: “I’m happy here, I like the staff and other people” “I feel I would have to go a long way to find somewhere like this” “its very nice” “I have the highest regard for the staff” “I feel that the home is doing very well for service users” “I enjoy having my hair done” “the food is good” “the staff are kind and helpful” What the service does well: Hale Place continues to provide good quality of care for residents with dementia, because the home is small, there is good communication between staff and good knowledge of residents needs, strengths etc. The staffing levels are excellent allowing 1 to 1 support, close supervision when needed and varied activities. There is a stable committed staff team, who demonstrate a caring supportive approach and very good understanding of individual residents needs. The staff are well trained with most having attained NVQ qualifications. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 6 Prospective residents are thoroughly assessed and care plans were detailed allowing staff to understand the sometimes, complex needs of the residents. Residents are cared for with respect for their dignity and privacy. The physical environment is very pleasant, light, airy, and decorated to a high standard. The home enjoys excellent relationships with the local GP, and other health care professionals and with relatives and advocates of the residents. 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. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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 Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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): 3,6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents have their needs fully assessed before moving into the home, and are assured these can be met. EVIDENCE: New residents have their needs assessed by one of the senior carers, before moving into the home and soon after they move in. The assessment is thorough and allows staff to judge whether the home can meet the residents’ needs. All the residents are self funding and so their needs assessment includes all the items recommended for good practice. Prospective residents are invited to the home with a relative to have a meal meet the staff, and familiarise themselves with the environment, once on the waiting list they are sent newsletters and invited to join in activities such as an Easter celebration. The home does not provide intermediate care. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 9 Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents have a care plan detailing their personal, social and health needs, clear strategies must be included to manage challenging behaviour. Medication is well managed and will be further improved with more appropriate storage and improved documentation for PRN or “as required” medication. Residents are treated with respect and regard for their privacy and dignity. EVIDENCE: Each resident has a plan of care, which is drawn up with the involvement of the residents and or their relative depending on the resident’s mental agility. Most of the care plans seen were comprehensive and clearly set out the actions for staff to take to meet the residents needs. One resident who in the last 2 weeks has been displaying increasingly challenging and aggressive behaviour had not had their care plan updated to reflect this. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 11 The care plan must clearly detail how staff are to manage the challenging behaviour. All the care plans had been reviewed monthly and an annual review is carried out with the residents and their relatives where this is appropriate. All the residents’ records contained risk assessments for falls, and other risk assessments personal to the individual resident. Visits to various health care professionals are recorded, and when residents must attend appointments they are supported by staff or relatives to attend. All residents are assessed using a recognised tool for the risk of developing pressure sores, and the district nurse is contacted for treatment advice and equipment. All residents had an assessment for promotion of continence and aids and equipment are provided when needed. The home has good relationships with healthcare professionals, which help to meet residents changing psychological needs. All residents have a nutritional screen or assessment and the home clearly recognises the special needs residents with dementia have. Residents have visits from the chiropodist and other health care professionals arranged for them. The home is about to change the supplier of medication and will be using the Boots monitored dosage system, currently the local pharmacist supplies medication for residents in dosset boxes. There is a staff member dedicated to looking after medication; she is responsible for re ordering, checking and auditing medicines. None of the residents self medicate, they are either unable or prefer to have staff look after and administer their medicines. All staff have undertaken competency based medication training and they are all about to be trained in the Boots system. Specific instructions on when to give PRN medicines and in particular those with a sedative effect have been developed. Advice from the GP on the prescription is usually brief and will state for agitation, very specific and individual instructions agreed by the staff and other health care professionals where possible should be written in to the care plan, not just on the MAR sheets. The medicines are stored in a locked cupboard in one of the communal areas with extra stock and the medication fridge being stored in the staff toilet, the manager plans to move the medicine into a more appropriate area and this should be done as soon as possible. Comprehensive records of administration, and medicine received and leaving the home were seen. At the last inspection the inspector asked that written consent from the GP be sought for staff to monitor a residents blood sugar, as it involves an invasive procedure, this has been addressed. Staff were observed caring for residents in a sensitive and caring manner, with respect for residents privacy and dignity. Residents were wearing their own clothes and are assisted to dress appropriately. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 12 Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents enjoy the lifestyle and recreational activities at the home, and are encouraged to maintain contact with relatives, friends and the local community. Residents are helped to exercise some control over their lives, and are assisted making choices. Residents receive an appealing well-cooked diet, which many of them help to prepare and cook. EVIDENCE: The home does not employ a member of staff to run activities, but one member of care staff undertakes the role of planning trips, events and the programme of activities in the home. Staff are employed in sufficient numbers for them to run activities on a daily basis. One the day of the visit one member of staff was doing the crossword with 2 residents, other residents were listening to music, looking at magazines, etc. the weekly activity plan was on display on the notice board. Clear efforts are made and documented to run activities of interest to the residents, for example a couple of residents enjoy gardening, and they help Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 14 with gardening, others enjoy cooking and baking and they are involved on a daily basis if they wish to help in the kitchen. Another resident likes to do her own ironing occasionally and she is supported to do this. Residents may take part as much or as little as they wish. The Manager produces a newsletter approximately once every 2 months and these include information about trips residents have been on, photos of residents enjoying various activities etc. Recent trips have included, the Hop Farm, a day out in Eastbourne, pub lunches, parties etc. Staff support residents to pop into the village for a coffee, or for some shopping etc. Residents may receive their visitors in their own rooms, in one of the 2 lounges or one of the 2 conservatories. Residents were observed being offered choices by staff, from what to have for lunch, to what activities they wished to participate in. Residents enjoy a well cooked, nicely presented and varied menu. There is always a choice at each meal time, and special care is taken to ensure residents who are nutritionally vulnerable are offered frequent snacks. Fresh fruit and vegetables are offered daily and there is a strong emphasis on home cooking and baking. Meals are cooked in the Garden Lodge and bought the very short distance plated with covers. Residents said the meals were hot enough and said they enjoyed the food very much. Residents were enjoying fresh vegetables with their meal and some were enjoying a glass of wine with their meal. Special diets catered for at present are diabetic and soft diets. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know how to make a complaint if they need to and are protected from abuse, by the home’s policies, and training of staff. EVIDENCE: Hale Place has a clear complaints procedure for residents and relatives. The home has not received any complaints for many years, the manager said there is a pro-forma for the recording of complaints. Minor issues are dealt with swiftly but without recording them and the actions taken, it is recommended that a record be kept to evidence the home listens to and acts upon issues bought to their attention even if they are not complaints as such. Residents are protected by the homes policies on adult abuse. Staff have received training in this area and updates are organised regularly, adult protection is also covered in the induction for new staff. The home does not have any adult protection alerts at present, and has not had any for some time. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, comfortable, well maintained home. EVIDENCE: The home’s layout is suitable for its stated purpose with plenty of wandering space for residents, and a very well maintained secluded and secure garden. Many areas of the home have been redecorated recently and new furniture purchased for some resident’s rooms. Some refurbishment and building work has been completed, and the manager plans more building work to extend the storage facilities and to provide a covered walkway between the farmhouse and the garden lodge. The grounds were tidy and attractive, one of the courtyard areas has a pond at ground level and a high pond at chest height, the lower pond is fenced off, for safety purposed but can still be viewed and enjoyed, the higher pond has been Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 17 risk assessed to ensure residents cannot climb into it, and should be re assessed annually and as new residents are admitted, who may be more athletic. The pre inspection questionnaire received as part of the inspection process indicates that the home meets the requirement of the local fire service and environmental health department. The home was clean and smelled fresh and pleasant. The home has laundry facilities but most of the laundry is done by a laundering service off site. The home has an infection control policy. Liquid soap and disposable hand towels, and pedal operated bins with lids are supplied in all communal toilets, in line with good practice. Some medication, build up drinks and vacuum packed clean linen is being stored in the staff toilet. Opened linen packs are not returned to this area, and medication once in use is not stored here. Removal of these items will better protect residents from any potential infection control hazards, the actions of staff to minimise hazards should be included in the infection control policy, until other arrangements for storage can be made. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by the numbers and skills of the staff. Residents are protected from abuse as far as possible by a safely recruited staff team. Staff receive the training they need to do their jobs. EVIDENCE: Staff spoken with said there are a minimum of 4 staff and up to 6 staff on duty in the day time, with one waking and one sleeping night staff. One member of staff is allocated to the lounge once it is in use. Domestic staff are employed in sufficient numbers to ensure the home’s high standards relating to meals and cleanliness are maintained. 70 of staff have attained NVQ qualifications and there is a structured induction process. The home has employed a new member of staff since the last inspection and the recruitment file contained all the required documentation and checks. The manager is aware of how to refer to and check the POVA list. A brief transcript of questions asked and answers given by candidates is kept to demonstrate equal opportunities. The manager has set up a training company, which is used by several London borough social services departments, staff have access to all the relevant Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 19 training run by the company. Staff spoken with were up to date with food hygiene, fire, moving and handling, medication, 1st aid training etc. Hale Place has achieved the Investors in People award. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is competent and runs the home in the best interests of the residents. The health safety and welfare of service users and staff is protected. EVIDENCE: The manager has owned and run the home for approximately 18 years, and has attained the registered managers award. The manager undertakes periodic training to up date his skills, and there are clear lines of accountability. The home has several quality assurance systems in place in that the views of residents are regularly sought by annual questionnaires, (as well as informally) reviews of care, staff members audit medication and check record keeping. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 21 As the manager also owns the home they do not undertake reports under regulation 26. a discussion took place about how best to meet the amended regulations for quality assurance. The home does not generally hold money on behalf of residents, but where this is needed clear and accurate records are kept. The call bell system is not working at present, and the manager said he has no immediate plans to fix it, as it has not been used in many years. The manager said the current clients do not know how to use it, due to their dementia. The high levels of staff, and working practices have compensated for the residents not knowing how to use their bells, with frequent checks being undertaken, etc. The manager agreed to review the provision of the call bell system as new residents are admitted and will look into other equipment which may be helpful to the staff, i.e. pressure mats, etc. The pre inspection questionnaire indicates that the manager fulfils his duty regarding health and safety checks, servicing of equipment, safe storage of hazardous substances etc. Accidents and injuries are recorded, and reported when necessary. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP9 Regulation 13 (2) Requirement The manager must ensure the medication practices are appropriate and comply with legislation regulation and good practice, in that The storage of some medication and the medication fridge must be reviewed. Timescale for action 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP33 OP38 OP38 Good Practice Recommendations The care plan for one resident displaying challenging behaviour must be updated detailing management strategies. The quality assurance systems should be enhanced to comply with the amended regulations (regulation 24) The environmental risk assessment should include the pond area. The provision of call bells or other related equipment should be regularly reviewed as agreed to ensure the DS0000066586.V321399.R01.S.doc Version 5.2 Page 24 Hale Place Farmhouse Residential Hotel for the Elderly needs of residents continue to be met, and safety of resident is maintained. Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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 Hale Place Farmhouse Residential Hotel for the Elderly DS0000066586.V321399.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!