Inspection on 28/02/06 for Hythe Nursing Home

This inspection was carried out on 28th February 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

Hythe Nursing Home 29/09/08

Hythe Nursing Home 14/11/06

Hythe Nursing Home 24/08/05

Hythe Nursing Home 19/10/04

Hythe Nursing Home 22/07/04

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 Hythe Nursing Home 91 North Road Hythe Kent CT21 5ET Lead Inspector Lisbeth Scoones Announced Inspection 28th February 2006 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 Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hythe Nursing Home Address 91 North Road Hythe Kent CT21 5ET 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) 01303 265441 01303 230329 Premium Healthcare Limited Mrs Linda Barbara Hazrati Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users with palliative care needs to be restricted to three (3) at any one time. Service users under the age of 65 years old are restricted to one (1) whose DOB is 08/05/1943. Service users admitted for intermediate care can be aged 55 years old and over and are restricted to two (2) in number. 24th August 2005 Date of last inspection Brief Description of the Service: Hythe Nursing Home is a large converted detached two-storey house situated on the outskirts of the town of Hythe. Rooms at the rear of the home have panoramic views of the town and the English Channel. There is a bus stop nearby and the railway station is ¾ mile away. There is a large patio area which overlooks the sloping rear garden and most residents would need supervision when accessing this area. There are parking spaces in front of the home as well as opportunities for off street parking. Mrs Linda Hazrati has been the manager since July 2002 and continues to show a commitment to the development of her staff in order to provide the residents with a quality service. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 7.5 hours and comprised discussions with the Directors, the manager, deputy manager, newly appointed care worker, the chef and other staff, several residents and a visiting relative. A tour of the building was undertaken and care and other records examined. Prior to the inspection, 4 residents and 7 relatives completed a comment card. The great majority of comments made were very positive and some of these are incorporated in the report. The manager completed a pre-inspection questionnaire. Information thus received informed the inspection process. What the service does well: What has improved since the last inspection? A deputy manager has been appointed thus allowing the manager the supernumerary time and support needed to address staff training issues and commence a formal staff supervision programme. The manager and deputy share the responsibility for staff training. The deputy manager said she is enjoying taking new members of staff through the induction training. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 6 The manager has nearly completed the NVQ 4 in management and said she had enjoyed and benefited from the experience. It is now her intention to undertake the NVQ assessor’s course. Following comments made by relatives, the home has upgraded its telephone system thus ensuring that all calls are answered without delay. A furniture replacement programme has been carried out and resulted in the decorating of all communal areas, new dining room furniture and new curtains in the bedrooms. Attractive, colourful pictures have been hung on dining room walls and a big clock provided in the same area. A formal staff-training programme has been introduced providing staff with opportunities for specialist training. A formal staff supervision programme has been introduced. What they could do better: From comments received it is ascertained that not every residents has access to the service user guide or the inspection report. It was recommended that a system be introduced that ensures access. It was also recommended that the service user guide include residents’ views. Whilst care plans examined are comprehensive and reviewed, for those residents with mental health and palliative care needs more information needs to be included. Whilst good medication administration systems are in place, it was recommended that a protocol for “as required” medication be devised. It was recommended that staff be vigilant in the television programmes they chose on behalf of the residents. Whilst it is evident that the manager deals with every complaint, one complaint had not been logged thereby not providing evidence that the complaint was investigated or satisfactorily resolved. Whilst the home provides a clean environment, two recommendations were made in respect of an odour in a sluice room and the provision of wallmounted soap dispensers in residents’ bedrooms. The home currently has not achieved that 50 of the care staff are NVQ trained. The manager is well aware of this and is trying to address the issue. One recommendation was made in respect of safety. Please contact the provider for advice of actions taken in response to this Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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 Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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, 3, 4, 5, 6 Whilst prospective residents are provided with some information, not all residents have access to the service user guide nor the inspection report. Residents are only admitted to the home following a comprehensive assessment of need. Residents and their relatives are offered opportunities to visit the home before they make a decision whether the home can meet their needs. Residents assessed as needing intermediate care are provided with a programme to maximise their independence. EVIDENCE: The directors said that the service user guide and statement of purpose are regularly reviewed. Prospective residents are provided with an information pack, which refers to the service user guide and the recent inspection reports being available at reception. However, not all residents are aware of either the guide or the report. It was recommended that systems be developed to allow for easier access to the guide and the inspection report. The manager showed Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 10 the inspector letters of thanks and gratitude. It was recommended that at the next review, residents’ views are included. From discussions with residents and documentation seen, it is ascertained that a pre-admission assessment is undertaken prior to the decision being made that the home can meet the resident’s needs. From discussions with staff and training records seen, it is ascertained that staff individually and collectively have the skills and experience to deliver the planned care. It is the home’s philosophy, as confirmed by a visiting relative, that visitors are welcomed at any time. Since the previous inspection, the home became registered to care for two residents with intermediate care needs over the age of 55. The manager said that the service is working well. Dedicated accommodation has been provided and staff are supported by the rehabilitation team. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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, 9, 10, 11 The care planning system is clear but for those residents with mental health or palliative care needs further detail of planned care needs to be incorporated in the care plans. Residents’ health care needs are fully met. The systems for medication administration are good and records well maintained but a protocol needs to be devised regarding “as required” administration of medication. Residents are treated with dignity and respect for their privacy. Residents with palliative care needs and their relatives are treated with care, sensitivity and respect. EVIDENCE: The manager and her trained staff regularly review the care plans. A sample of these was examined and this contained information about a range of assessed care needs and planned nursing intervention including safety, Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 12 personal hygiene, mobilisation, communication and activities. Good clinical risk assessments are used to inform the care plan. However, for those residents with mental health and palliative care needs, additional information needs to be provided to evidence that their assessed needs can be met. See also standards 12 and 14 in respect of suitable activities and choice. Assessments to determine risks of developing pressure ulcers are undertaken and acted upon and district nurses would be consulted to provide wound care advice. The home has a range of pressure relieving equipment, and specialist chairs. Nutritional assessments are undertaken and residents weighed regularly. Residents have access to hearing and sight tests, chiropody, speech therapy and dental care. The services of a continence advisor are sought when necessary and there was evidence of regular visits by GP’s, other health professionals and psychiatric referral. The deputy manager showed the inspector the clinical room, which was tidy and clean. Whilst, in general, medication charts viewed were well maintained, for one resident, the instruction for the application of a prescribed ointment was missing on the MAR chart. In respect of “as required” medication, it was recommended that a protocol be devised. Good systems are in place for the safe disposal of unwanted and out of date medication. The home is served by two GP surgeries. A GP visits the home weekly. It was observed that staff communicate with the residents in a dignified and respectful manner. Residents are well dressed in clothes of their choice. The home is registered to care for people with palliative care needs. The deputy manager said how much she had enjoyed the recent palliative care training undertaken at the local hospice. She said it is her intention to train the care staff. The inspector provided the deputy manager with information of how to access the Liverpool Pathway to care of the dying. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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, 14, 15 Residents’ social and recreational needs are met and contact with family/friends and the local community is encouraged. Residents are helped to exercise choice and control over their lives but in respect of choice of television programmes staff must be vigilant that this meet the residents’ needs. Residents receive a varied, wholesome and balanced diet. EVIDENCE: The provision of activities to cater for residents’ social care needs was not discussed in great detail on this occion. During the afternoon of this inspection, a “keep fit” lady was entertaining the residents in the lounge. A resident who preferred to stay in her room was offered the same service. Two residents said they enjoy visits from the local vicar and the carol singing sessions at Christmas. A resident was watching his favourite film on DVD in his room. A resident said that the home had recently provided her with a new TV. It was noted that staff enable residents to make choices in respect of what they would like to wear, where and what they would like to eat and what they would like to do. Some residents are very dependent and are either nursed in Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 14 bed or stay in their room. A discussion ensued about the need for staff to be sensitive to residents’ needs in respect of whether they wish the television to be on or off and the type of programme they like to watch. In a shared room, both occupants were asleep while the television was on loud presenting a “talking” programme. Relatives are encouraged to visit and are made welcome at any time. The inspector met with the chef in a clean and tidy kitchen. She has a good knowledge of the residents’ individual nutritional needs, preferences, likes and dislikes and speaks to them on a regular basis to ascertain their views. Residents said that the food was good and varied. It was noted that a choice of biscuits were offered at coffee time. Meals, including soft foods are well presented and diets catered for. It was observed that a choice of meals is available. Cakes and scones are made every day. Fresh fruit, local vegetables and fresh fish are provided. Evening meals are varied and include sandwiches, soup and jacket potatoes with various fillings. Residents either have their lunch in the dining room or in their bedrooms if they prefer. The chef said that the replacement of the kitchen units is part of the home’s development plan. The Environmental Health Officer recently inspected the kitchen. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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, 18 Residents are confident that their complaints and concerns are taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: Whilst it is evident from talking to the residents that they are encouraged to air their views and express any concerns to the manager and staff, one complaint had not been entered into the log thereby not providing evidence that the issues had been satisfactorily dealt with. The complaints procedure is included in the Service User Guide. The Home has an adult protection policy and staff demonstrated their awareness of the action to take if this was ever witnessed or suspected. They are first introduced to adult protection issues at induction and during NVQ training. The manager is the adult protection trainer. She acknowledged that adult protection training has been delayed but is now due in March 2006. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 25, 26 Residents live in a safe well-maintained, clean and pleasant environment. However, one sluice facility is not adequate to ensure infection control. EVIDENCE: The Home is located in a quiet, residential area in Hythe. It occupies high ground with some rooms having an attractive view of the sea. It provides a pleasant and well-maintained environment. There was evidence of a continued maintenance and renewal programme and bedrooms are redecorated and refurbished when they are vacated. The company employs a full time maintenance person and a gardener. A patio area is accessible to residents and their visitors, although they would need to be accompanied by staff when going into the garden. As already referred to, the communal areas have recently been redecorated, picture provided and dining room furniture replaced. Two residents’ bedrooms visited were very sunny and it was recommended that, for residents’ comfort, the provision of shading be considered. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 17 Apart from a carpet stain in a shared bedroom and a malodorous sluice room, the standard of cleanliness is good and staff are trained in infection control issues. It was recommended that the effectiveness of the sluice machine be investigated and replacement considered. It was further recommended that the availability of liquid soap dispensers be reviewed. Some of the wallmounted dispensers were empty and bottles of liquid soap provided instead. Infection control specialists recommend the use of wall-mounted liquid soap dispensers. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29,30 Residents’ needs are met by the number and skill mix of the staff who are well trained. However, the 2005 target of 50 NVQ trained care staff has not been achieved. The home’s recruitment process is sound. EVIDENCE: As confirmed on the duty rota, in addition to the manager and the deputy, there was a trained nurse and 5 care staff on duty. Two trained staff are on duty most mornings with 5 carers. In addition to the care staff, the home employs domestic, catering and maintenance staff as well as two administrative staff who deal with contracts, recruitment and all financial issues. The home operates a key worker system. Some key workers have recently changed and one resident said she was unaware who her key worker was. The manager said this would be addressed. Since the appointment of a deputy, the manager’s supernumerary hours have been reinstated. This has allowed her the time to audit care and other records, concentrate on staff training and commence formal supervision. Staffing levels have been stable and many staff have worked in the home for a number of years. Currently there is a vacancy for a part-time night carer. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 19 A recently employed care worker described the details of her recent recruitment. From this discussion and dodumnatataion seen, it is ascertained that the home’s recruitment process is sound. Two written references, POVA and enhanced CRB checks are undertaken prior to offering employment. Statutory, induction and NVQ training is provided. The deputy manager said she enjoys providing induction training. This has recently been reviewed in order to comply the Skills for Care criteria. The manager said it is her intention to undertake NVQ assessor’s training and to explore ways of enabling as many staff as possible to undertake NVQ training. The target of 50 NVQ trained staff is currently not achieved. It was evident from the training calendar seen in the manager’s office and from discussions with staff that the home provides many training opportunities. Recent and planned training include: Adult Protection, Dementia Care, Intermediate care, Parkinson’s Disease, Ageing skin and moving and handling. The deputy manager has recently undertaken palliative care training. All staff are provided with individual staff training files. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38 Residents live in a home, which is well managed by a manager who leads by example and creates an open and inclusive atmosphere. Good monitoring systems are in place, which includes residents’ views on the service provided. Good systems are in place to safeguard residents’ monies. Staff are appropriately supervised and a formal system has been introduced. Apart from one safety issue identified, residents’ health, safety and welfare are promoted and protected. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 21 EVIDENCE: Mrs L Hazrati, has been the home manager for a number of years, is a first level nurse and has many years of experience in managing care homes. Her management approach is one that encourages an open atmosphere in which staff and residents can raise issues and express their views. There are frequent informal and regular formal staff meetings. She has nearly completed the NVQ level 4 in management. The Directors Mr A Barnes and Mr P Barker support Mrs Hazrati and they praised her for her many achievements. Mrs Hazrati has 50 supernumerary hours and attends management meetings. Residents’/relatives’ views are sought on a daily basis and through six monthly quality questionnaires. The Directors visit the home very regularly and a monthly report in accordance with Regulation 26 is written and a copy sent to the CSCI. The home looks after the personal allowance monies for one resident. Good records of financial transactions made on behalf of the resident were seen including receipts and audit. Since the employment of a deputy manager, the formal process of staff supervision has been commenced. She and other senior staff provide staff supervision. A newly appointed care worker said she was well supported and supervised during the induction period. Staff spoken to confirmed that they had received statutory training, including moving and handling. A member of staff in the company’s other home is the moving and handling trainer. The maintenance man undertakes environmental risk assessments and checks the fire alarms and fire fighting equipment. In-house fire safety awareness training takes place twice a year. A recent fire risk assessment has been carried out. The manager demonstrated that residents’ health and safety and practices in the home are protected through training, appropriate policies and risk assessments. However, in one resident’s room it was noted that a window was without a restrictor. This was discussed with the manager who said it would be rectified immediately. Accident records were well maintained. The manager advises the CSCI of any event reportable under Regulation 37. Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 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 2 x 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 3 x x x x 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 2 Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 4 5 6 7 8 Refer to Standard OP1 OP7 OP9 OP14 OP16 OP26 OP28 OP38 Good Practice Recommendations That the service user guide and inspection report are freely available and that the service user guide includes residents’ views That care plans include mental health and palliative care needs That a protocol for “as required” medication is devised That staff are sensitive to residents’ perceived wishes and choices That every complaint is logged and investigated That the cause of the malodour in the sluice room be investigated and an audit undertaken in respect of the provision of wall-mounted liquid soap dispensers That the target of 50 NVQ trained staff be achieved That a window restrictor be provided Hythe Nursing Home DS0000026101.V275991.R01.S.doc Version 5.1 Page 24 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. 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