Inspection on 19/01/06 for Highland House Retirement Home

This inspection was carried out on 19th January 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

Highland House Retirement Home 25/04/07

Highland House Retirement Home 29/06/06

Highland House Retirement Home 04/10/05

Highland House Retirement Home 24/01/05

Highland House Retirement Home 27/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Highland House Retirement Home Littlebourne Road Canterbury Kent CT3 4AE Lead Inspector Mark Hemmings Unannounced Inspection 09:40 19 January 2006 th 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 Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 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. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Highland House Retirement Home Address Littlebourne Road Canterbury Kent CT3 4AE 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) 01227 462921 Mrs Marian Walsh Vacant Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 Brief Description of the Service: The premises are a two storey older property, to which purpose built extensions have more recently been added. Most of the bedrooms are located on the ground floor and most of them are for single occupancy. All of the bedrooms have a private wash hand basin and toilet. Four of the bedrooms also have a private shower. There is a stair-lift which gives step free access to all parts of the accommodation used by service users. The premises are fitted with a call bell system which is designed to assist service users to summon help from staff should it be needed. The property is set back a little from one of the main roads into Canterbury. There are no shops within easy walking distance. To the rear of the premises there is a large enclosed garden. The day to day operation of the Home is overseen by the Registered Provider and by the Head of Care. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and it took about three hours to complete. During this time, the Inspector spoke with or spent time with five service users. He spoke with the Registered Provider and with the Head of Care. Also, he spoke with two of the care workers, with one of the housekeepers and with the cook. The Inspector looked at various parts of the accommodation. This included (by invitation) two of the service users’ bedrooms. The Home continues to provide the service users in residence with the support and assistance they need within a comfortable setting. There are no Required Developments at the end of this Inspection Report. The Inspector did not examine all of the Standards on this occasion. The reader is asked to read this Inspection Report in conjunction with the previous Inspection Report in order to obtain a comprehensive account of the Inspector’s current evaluation of the facilities and services available in Highland House. What the service does well: The Home provides service users with a pleasant and comfortable setting within which to make their home. The assistance each service user receives is provided in consultation with them and takes place within a prudent assessment of potential risks to health and safety. The Home’s catering service is well organised and service users consider the food served to be enjoyable and sufficient. In general, suitable arrangements are operated in the Home to help safeguard the health and safety of the service users. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The dining room can become rather cluttered. This is because it is used to accommodate various administrative functions in addition to meeting its main purpose. As a result there often are various items of (non-confidential) paperwork on left out on desks. Also, the amount of space available to service users in more limited than might be the case otherwise. The Registered Provider said that she recognises the problem and that she intends to relocate all of the administrative functions out of the dining room once a space has been established elsewhere in the Home to enable this to be achieved. The Inspector is pleased to note that the Registered Provider intends to resolve this matter during the course of 2006. There is an area of wallpaper in one of the lounges which has become damaged and which now looks unsightly. The Registered Provider informed the Inspector that this defect will be addressed within the timescale which is indicated later in this Report. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 7 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. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 8 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 Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 9 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 and 5. Prospective service users are given the information they need to make an informed decision about living in the Home. Each service user receives a written statement of the terms and conditions of their residency. Service users’ needs for assistance are assessed before admission. Service users are confident that their needs for personal care will be met when they enter the Home. Prospective service users and their representatives are encouraged to visit the Home before a decision is made about moving in. EVIDENCE: There is a Service Users’ Guide. This is a brochure which prospective service users are given and which outlines the facilities and services provided in the Home. In addition to this, the Registered Provider and the Head of Care speak with prospective service users in order to answer any remaining questions they may have. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 10 Each service user receives a written statement of the terms and conditions in accordance with which the Registered Provider delivers accommodation and personal care services in the Home. The document is suitably detailed and it is clearly laid out. Previously, the Inspector has been informed that all new service users and their representatives are given an opportunity to talk through the document with someone senior. This is done so that any necessary clarification can be given. On this occasion, the Inspector did not have the opportunity to speak with any of the service users about their experience of having move into Highland House. However when he last did so, people said that she that they had been confident at the point of admission to the Home, that their needs for support could be met reliably and consistently. The Registered Provider is aware of the responsibility placed upon her to ensure that only people whose needs for assistance can be met reliably, are admitted to the Home. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 11 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, 8 and 10. Service users are confident that their present and future needs for personal care will be met in a reliable and consistent manner. They are suitably consulted about the assistance they receive. Service users’ health care needs are met fully. Generally, suitable arrangements are in place with respect to the administration of service users’ medication. Service users consider that members of staff are respectful and that they appreciate their needs for privacy. EVIDENCE: There is a service user plan for each service user. These documents should reflect a clear understanding between service users and care workers about the personal care support to be provided. The Inspector sample checked one section of one of the documents in this system. He found it to be detailed suitably. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 12 Service users say or indicate that they are consulted about the personal care they receive. This is done in order to make sure that it acknowledges their preferences. Service users consider that they receive all the assistance they need. The Inspector observed examples of care workers assisting service users in a manner consistent with that described in the Registered Provider’s assessment of their individual needs. Service users say or indicate that care workers assist them to maintain their health. There is evidence which shows that service users’ doctors and other medical personnel are called promptly when there is a concern about someone’s health. The Commission has not received from any of the members of the local primary health care team, any expressions of concern about their working relationships with the Home. The Head of Care said that when appropriate service users are assisted to administer their own medication. The Inspector understands that suitable arrangements are in place to support this practice. Also noted, were the generally appropriate systems used by the Head of Care to administer and to dispense the other service users’ medicines. The Head of Care is now going to strengthen a particular aspect of these arrangements. This will entail her maintaining a written record of the system she uses to check both the receipt of medicines into the Home and of any items which are returned to the pharmacist. Service users say or indicate that care workers are cordial in their manner towards them, while at the same time being respectful of their individual preferences. The Inspector noted several occasions on which care workers varied their approach according to what they know to be service users’ different expectations of them. For example, some people wanted to retire to the privacy of their bedroom, while others wanted to enjoy the company of others in the main lounge. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Service users have access to a suitably varied range of social activities. Service users are assisted to maintain normal contacts with family and friends. Service users are enabled to exercise suitable choice in their everyday lives. Service users are offered a suitably healthy diet. EVIDENCE: Various social activities are convened in the Home. The small number of service users who commented upon the matter, said that they are occupied suitably. Previously, service users have said that they are assisted to maintain contacts with members of their families and with friends who do not live in the Home. The Inspector has not received any expressions of concern about this matter from members of service users’ families. Service users say or indicate that the pace of daily life in the Home is relaxed and unhurried. There is evidence of service users exercising choice. For example, people observed that they decide for themselves when to get up and Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 14 when to go to bed and how to spend their day. One person told the Inspector that she likes to get up very early in the morning because this has been her practice throughout adult life. The Inspector was pleased to hear that the night time care workers appreciate the need to support her in this and that they always welcome her downstairs with a (very early) morning cup of tea. Service users say that they receive good quality meals and they always have enough to eat. On this occasion, the Inspector did not have the opportunity to join service users for a meal. However when he last did so, he noted the food to have been well prepared and that the portions were of an adequate size. Also noted previously, was the written menu which indicated that service users are offered a normally balanced diet. The cook said that always there are sufficient provisions in the Home to enable all the meals listed on the menu to be prepared. Several service users told the Inspector that they like the way in which the cook takes the time to speak with them about the meals served and about any alterations to the menu which they might like to see introduced. Naturally, this is an important example of good care practice. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18. Service users consider that their views are listened to and that as necessary they are acted upon. Arrangements are in place which are designed to protect service users from abuse, neglect and self harm. EVIDENCE: There is a complaints procedure which explains how service users and other stakeholders can make a complaint about any aspect of the facilities and services provided in the Home. Previously, service users have said or have indicated, that they are confident that any matter they raise will receive serious attention and if possible will be addressed. Previously, the Inspector has established that the care workers have a sound understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances which might jeopardise the wellbeing of a service user. Also, that they are aware of the various agencies external to the Home to which reference can be made should they become concerned about a service user’s wellbeing. Service users say or indicate that they feel safe living in Highland House. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 16 Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 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 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 and 26. Service users are provided with a homely environment. There is an adequate provision of shared use facilities. Suitable provision has been made to assist service users who experience a measure of reduced mobility. Service users’ bedrooms are suitably equipped and have been personalised by their occupants. Service users live in comfortable surroundings. There is an omission in what generally is a suitably safe environment. The accommodation is presented to a normal domestic standard of cleanliness. EVIDENCE: Service users say or indicate that they are comfortable living in Highland House. They consider the accommodation to be homely and welcoming. Having said this, the Inspector notes that the dining room can often appear to be rather cluttered. This is because various desks are located on one side of the room. These are used by care workers and administrative members of staff Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 18 during the course of their duties. Inevitably this results in various (nonconfidential) papers and files being left out. Consequently, this area sometimes can feel like being an office as well as a dining room. Also, the desks quite significantly reduce the amount of space available for some of the service users when they are seated at their dining tables. The Registered Provider said that she intends to relocate the desks to another part of the Home, hopefully during the course of 2006. There is an adequate provision of shared use facilities such as lounges, bathrooms and toilets. The Inspector noted there to be an area of damaged wallpaper in the front lounge. The Registered Provider said that this had only occurred recently when an unused radiator was removed from the area. She informed the Inspector that the damage will be repaired by 1 February 2006. Service users say that they have all the facilities they need in their bedrooms in order to make them into bed-sitting areas. Also, they say that members of staff have encouraged them to make them into their own private spaces. The Inspector saw evidence of this when he had the opportunity to see two of the bedrooms. He noted that the service users concerned had elected to display various ornaments and pictures in order to make the spaces their own preserve. There are various items of equipment in place to support care workers when assisting those service users who experience a measure of reduced mobility. These include two mobile hoists and other smaller aids, such as assistance poles near to the toilets. Care workers told the Inspector that they have sufficient resources to hand to enable them to undertake safely and reliable this aspect of their work. A range of practical steps have been taken to help ensure the safety of the service users. This includes common sense but very important facilities such as the fitment of banister rails along all of the corridors. The Registered Provider continues to take suitable precautions to reduce the risk that a service user might accidentally scalded. This has been achieved by the installation of special valves to which are designed to control the temperature of the hot water service. However, the Registered Provider has not yet completed fully a programme of work which will see guards fitted to the radiators which are located in parts of the accommodation which routinely are occupied by the service users. The Inspector understands that this work will now be completed by 1 February 2006. Service users say that the accommodation is kept clean and orderly without being fussy. The Inspector’s assessment was consistent with this view. The Registered Provider said that the kitchen continues to comply with the principal requirements of the local Department of Environmental Health. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 19 Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 20 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 and 30. There is an adequate number of staff on duty to ensure service users’ needs for assistance are met. Appropriate steps are taken to ensure that only suitable people work in the Home. Care workers have the competencies they need in order to work effectively. EVIDENCE: There are at least three care workers on duty from early in the morning until the mid evening period. At this point, the two waking night care workers come on duty. During the day, there are also other people on duty who do most of the catering or most of the housework. All of the staff posts in the Home are filled. The care workers consider the Home to be staffed adequately. There are various arrangements in place which are designed to ensure that care workers coordinate their activities. These include handover meetings at the beginning and end of each shift which are organised by either the Head of Care or by one of the Senior Care Workers. Also, diary records are completed so that each service user’s changing needs can be identified and met. Service users say or indicate that they receive all the assistance they need from care workers and that this is provided in a timely manner. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 21 The Registered Provider completes a number of security-related checks. These are designed to ensure that all members of staff employed in the Home are suitable to be entrusted with access to service users who may be vulnerable. The Registered Provider is responsible for ensuring that all care workers have the competencies they need in order to enable them to reliably respond to each service user’s needs for assistance. To help discharge this responsibility, the Registered Provider ensures that all new care workers receive introductory training. In addition to this, existing care workers undertake a number of training courses which are designed to enhance their capacity to deliver care. The Inspector observed care workers when they were assisting the service users. He noted this help to be delivered in an appropriate manner in that the care workers demonstrated that they were competent to respond effectively and reliably to the requests for assistance in question. Also noted, was the fact that the care workers were kind and considerate in their approach. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 22 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, 36 and 38. There is a suitable management system in place to support the delivery of care and accommodation services in the Home. Service users’ preferences and wishes are reflected in the operation of the Home. The work completed by members of staff is supervised. Suitable arrangements are in place to promote the health and safety of the service users and of members of staff. EVIDENCE: There is an established management team in the Home. This comprises the Registered Provider, the Head of Care and several senior are workers. All of these people have a detailed knowledge both of the people in residence and of Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 23 the systems used to operate the Home. There is always someone senior on the premises or who can be called upon for advice and assistance. Regular staff meetings are convened in the Home to help ensure that good team working is promoted. Staff say that Highland House in general is a happy place in which to work and they consider that this is noticed by the service users. Some of the service users told the Inspector that they have indeed noticed this and that they find it be reassuring to know that staff get on well together. Service users say that the Home is run without there being any intrusive rules or routines. This means that they can continue to experience a normal home life of their choosing. The Registered Provider operates a system by means of which service users are invited to comment about their Home. Previously, the Inspector has noted that the results of this annual consultation exercise are summarised in a Quality Report. This has indicated there to be a high level of satisfaction with the facilities and services provided in the Home. Each person who works in the Home reports to a senior member of staff. This means that their work is monitored in order to ensure that it meets service users’ needs and that it contributes to the orderly running of the Home. The Registered Provider said that all items of equipment in use in the Home remain in good working order and that they have been serviced in accordance with the manufacturers’ instructions. The Registered Provider said that the premises continue to comply with the principal requirements of the Kent Fire and Rescue Service. The Inspector examined the programme of the periodic checks which have to be completed in order to ensure that the Home’s fire safety equipment remains operational. Things were found to be order. Previously, the Registered Provider has said that she has completed a review of the premises in order to identify any potential hazards which might compromise the health and safety of both the service users and members of staff. She has reported that no such hazards were found. The Inspector examined various parts of the premises during the course of the present inspection visit and he did not notice any obvious hazards which required attention. Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 24 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 3 3 3 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X 3 Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 25 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. Refer to Standard Good Practice Recommendations Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 Page 26 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 Highland House Retirement Home DS0000023450.V272782.R01.S.doc Version 5.0 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. 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!