Inspection on 06/10/05 for Iden Manor Care Home

This inspection was carried out on 6th October 2005.

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

Iden Manor Care Home 14/10/08

Iden Manor Care Home 19/12/06

Iden Manor Care Home 24/05/05

Iden Manor Care Home 31/01/05

Iden Manor Care Home 11/10/04

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 Iden Manor Care Home Iden manor, Cranbrook Road Staplehurst Tonbridge Kent TN12 0ER Lead Inspector Gary Bartlett Announced 6th October 2005 09:30 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 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. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Iden Manor Care Home Address Iden Manor Cranbrook Road Staplehurst Tonbridge Kent. TN12 0ER 01580 891261 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Whitepost Health Care Centre CRH Care Home 45 Category(ies) of Dementia (20) registration, with number Old age (25) of places Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users between 55 and 65 years of age that have physical and mental conditions usually associated with older persons may be admitted. 2. The following rooms have been identified for service users experiencing difficulties with memory loss or diagnosis of dementia. Rooms 32, 33, 34, 35, 36, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, and 51. 3. It has been agreed that room numbers 36 and 50 can be shared by married couples or siblings who request the facility. Date of last inspection 24 May 2005 Brief Description of the Service: Iden Manor Care Home is owned and operated by Whitepost Health Care Centre. It is a Victorian Manor House situated in fifteen acres of land on the edge of Staplehurst. Staplehurst offers the usual facilities of a small town and has a mainline railway station. Currently, the Home provides 25 beds for low dependency service users and 20 beds for dementia care. The Home is being developed in four phases, the intention being to eventually provide a total of 51 nursing care beds. A shaft lift and stair lift provides access to the first floor. There is car parking to the front. The Home employs care staff that work a roster that gives 24-hour cover. The Home also employs other staff for catering, domestic and maintenance tasks. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Iden Manor from 9.30 a.m. until 6.00 pm. During that time the Inspector spoke with some residents, a visitor and some staff. Parts of the Home and some records were inspected. Due to the nature of the service provided by the Good Shepherd Wing it is difficult to reliably incorporate accurate reflections of residents’ reflections of that service in the report. A large number of comment cards were received prior to the inspection. Residents and their relatives generally responded that they liked the home and staff. Responses from health professionals also indicated good standards of care and good communication. Statements on comment cards included: • “Staff are very kind and gentle” • “..is loved and well cared for” • “…I’m very satisfied with the care…” • “I am very pleased with the standard of care provided by Iden Manor..” • “Iden Manor is exemplary in every respect.” • “Iden Manor should be used as a role model for all other homes.” • “Excellent care and atmosphere..” The last year has been very unsettled at the Home, in that there were unforeseen absences within the management team and more recently a further change in manager. The person-in-charge had been in this post since 4 July 2005 and was still to be registered as the Manager. For the purpose of this report she will be referred to as the Manager. The Manager and staff gave their full co-operation throughout the inspection. What the service does well: Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 6 Iden Manor provided a comfortable environment that was clean bright and airy. The Home had an open and friendly atmosphere with good interaction between residents, staff and visitors. Personal health care needs were generally well supported and residents’ individual preferences were catered for where practicable. There was a good standard of hygiene and cleanliness in the Home. Staff were well supported in their NVQ training. 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. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 4 The Home’s Statement of Purpose and Residents’ Guide provided service users and prospective service users the information they need to make a decision about moving into the Home. EVIDENCE: The Manager said the Statement of Purpose was accurately descriptive of the aims, objectives, philosophy of care, services and facilities and terms and conditions of Iden Manor and copies of the Service Users Guide were provided for each service users or their representative. These were not inspected in detail on this occasion. Records seen indicated prospective residents, their families, advocates, and relevant health care professionals were involved in the assessment process. Specialist advice was sought from external sources where required, for example psycho-geriatric guidance for the Good Shepherd Wing. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8, 9 and 10 Residents’ health and welfare would be better promoted by care plans being more consistently maintained and risk assessment being recorded when necessary. Staff adhered to the procedures for the, storage, administration and disposal of medicines. Residents were able to take responsibility for their own medication if they wished and when it was safe to do so Residents’ health needs were met with good liaison with relevant health care professionals. Staff treated residents with respect and maintained their privacy and dignity. EVIDENCE: Each resident had a care plan. Four care plans, two from each unit, were inspected in detail. They had not all been completed and some were not reflective of the resident’s current needs. Daily records were not consistently detailed or informative. It was not always apparent that necessary follow-up action had been taken. It was evident that appropriate health care professionals had been involved in decision-making but this information had Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 10 not always been recorded or transposed to the relevant parts of the care plans. Risk assessments had not been reviewed or recorded as a result of recent incidents. It was important for necessary and current information to be recorded and readily available to staff for them to be able to meet residents’ needs. The Manager understood this and was aware that the care plans were not consistently of the standard required. They explained that the recent shortage of senior staff and qualified nurses had contributed to this shortfall. The clinical preparation rooms were inspected and medications were seen to be stored in accordance with their instructions. Records were available to indicate that all staff administering medications had been trained and signed off as being competent to do so. The Medication Record Administration Record (MAR) sheets that were inspected had been completed appropriately. Medications were seen being administered in compliance with current guidelines. The Home continued to have a good working relationship with the specialist and local health care professionals. This greatly assisted in supporting residents in their health care needs. From observation and discussion with residents it was clear that staff treated residents with respect and promoted their privacy and dignity. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12, 14 and 15 Residents had some choices about their daily lives, were able to have visitors at any reasonable time and enjoyed continued links with the local community where this was their preference. Social activities were well organised and creative. Residents would benefit from greater availability of activities. Dietary needs of resident were well catered for with a balanced and varied selection of food that met their tastes and choices. EVIDENCE: Residents spoken with were happy with the flexibility the Home offered in regard to meeting personal preferences where practicable, for example what time they got up, went to bed etc. The Activities Co-ordinator was seen to be continuing to work very hard and residents appreciated their efforts. Some residents mentioned they would like more activities and outings. This was also referred to in some comment cards returned to the Commission. The Manager explained that it was intended to employ further activities staff when the Home increased its registered numbers. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 12 Residents spoke favourably of the meals, said they had plenty to eat and enjoyed the choices available to them. This was also reflected in the minutes of a residents meeting that had been held on 16 September 2005. The meals were well presented and looked appealing. Lunch was taken in a relaxed atmosphere and staff were seen to offer assistance in a discreet and sensitive manner. The menus seen were varied and alternatives were offered. Residents said they were offered drinks and snacks during the evenings. One resident said “you are never hungry here.” Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16, 17 and 18 Residents and their relatives knew their complaints would be listened to and acted on. Residents’ legal rights were protected and there were systems to ensure residents were protected from abuse. EVIDENCE: Residents benefited from the complaints procedure being readily available. A visitor described how they knew of the complaints procedure but had not had cause to use it. Comment cards received prior to the inspection included the statements: • “..if I have commented on something not quite right it is dealt with.” • “Complaints have been made verbally and have been dealt with” The Manager said that records of complaints were kept and these included details of investigation and action taken and were be used to inform future practice. The Manager described how all permanent residents admitted to Iden Manor were enabled to be on the electoral role. Postal votes were mostly used although residents would be taken to a polling station should they request it. The Manager confirmed that where residents lacked capacity they were facilitated access to advocacy services. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 14 There were procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The Manager and other staff spoken with demonstrated a sound understanding of adult protection procedures and stated that any allegation of abuse would be referred to the concerned agencies without delay. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 The standard of the environment within the Home was very good providing residents with an attractive, homely and safe place to live. EVIDENCE: Residents said they were happy with their rooms. The bedrooms seen had been personalised with the occupants’ personal effects and reflected their individual tastes and interests. Work was being done to equip more bedrooms with en-suite facilities. A resident who had moved to another part of the Home as a temporary measure said they were comfortable with the interim arrangements. Residents said they had access to all parts of the Home and facilities they needed. The Manager described how plans for an alternative arrangement of the dining/communal living area in the Good Shepherd Wing to afford the residents more spacious accommodation had been submitted to Whitepost. The need for this was reflected in 2 comment cards sent to the Commission by resident’s relatives. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 16 The hot water pressure in a first floor bathroom had been improved since the last inspection and the hot water tested at several outlets was at a safe temperature. The Manager said further improvements to the water supply should be made as the building works progressed. Ramping from the lounge to the garden and hard surfacing outside The Good Shepherd Unit had enhanced residents’ access to these areas. The parts of the Home inspected were clean and free from unpleasant odours. Staff were seen to effectively maintain infection control to promote residents’ health. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Residents’ needs would be better met if the senior team had its full complement of staff with the necessary skills mix. Recruitment processes were robust and offered protection to people living at the Home. The Home was addressing the training of staff so they had the skills to meet the needs of the residents. EVIDENCE: Residents spoke very highly of staff and thought they worked hard. Comment cards received prior to the inspection included the statements: • “The staff are always pleasant and will always find time to talk to you. I find the Home very friendly”…” • “The staff are helpful, courteous and very kind.” • “Not only are the staff wonderfully kind and caring .. they make me feel part of the family..” • “..the staff have been most caring and supportive to us all. • “Pressing the emergency bell…produced an immediate and very satisfactory response, and very professional and caring response.” Recent changes in the senior staff group had resulted in there not being a deputy manager and only two qualified nurses working on permanent Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 18 contracts. There were some qualified nurses that worked as “bank staff” but their availability could not be guaranteed. One result of this was it was harder to monitor the quality of care and of associated records such as care plans. It had also led to the Manager being rostered for the three days prior to the inspection. There was some discussion as to whether this compromised the Manager’s ability to assess and manage the overall twenty-four hour service being offered. The Manager said that the Home was trying to recruit more qualified staff and a Deputy Manager. Reference was again made by some residents or their relatives to perceived low numbers of staff at busy times of the day. The Manager stated they had reviewed stafing levels and considered them adequate. Based on figures provided by the Home, staff hours provided exceeded the guidance recommended by the Residential Forum. There were robust staff recruitment processes to ensure only staff properly vetted worked there. The Manager had identified some instances where Criminal Records Bureau checks had not been received for staff and gave assurances that these were being sought. In the meantime, these staff did not work unsupervised. The Manager had written a training matrix for easy monitoring of staff’ training/update requirements. The Manager described how they had requested training for staff in dementia, care planning, medication and risk assessments and was still waiting for a response from Whitepost. NVQ training was encouraged for care staff and ancillary staff. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35, 36, 37 and 38 The Home benefited from a Manager who was accessible and had high expectations of the service to be delivered. The Home regularly reviewed aspects of its performance through a programme of self-review and consultations, which included the opinions of residents and relatives. Residents’ financial interests were protected. EVIDENCE: Comment cards received prior to the inspection included the statements: • “I am very satisfied with the local management…” • “Iden Manor is a wonderful and organised nursing home..” Throughout the inspection, the Manager demonstrated a commendable honesty and commitment to a high quality service. Staff and residents said Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 20 they considered the Manager to be approachable, understanding and supportive. A comment card noted that the sender would “appreciate the ability to leave a message on an answering machine when staff are busy and cannot answer the phone”. Consideration should certainly be given to an improvement to the current system that minimised the unnecessary and distracting calls that went directly to the Manager’s office. Staff records had been augmented to comply with the Regulations, deficits in staff induction had been addressed and regular staff supervision was being implemented. The Manager described how residents and their representatives or relatives were regularly asked for their views about the service. A residents’ meeting had been held in September and questionnaires were distributed annually. The Home encouraged residents to manage their own financial affairs or to have assistance from their families / representatives. There was a sound system of holding and recording residents’ cash, which facilitated ease of monitoring. The Manager said these were more regularly audited than previously The amounts of monies held that were inspected, balanced with the records Residents’ and relatives did not express any concerns about the Home’s management of monies or valuables held on the residents’ behalf. Records seen indicated that staff had recently undertaken fire safety training. Staff were seen to be diligent in minimising risks to residents by carefully placing equipment to avoid obstruction and in ensuring COSHH requirements were adhered to. Records of maintenance and safety checks were seen to be in order. Building works within the Home were being undertaken in such a way that residents were not at immediate risk. The Manager understood the need to undertake comprehensive environmental risk assessments more regularly and was hoping to be able to have a staff member trained so as to be able to this. It was recommended that policies and procedures are signed and dated to show they were regularly reviewed by a competent individual to ensure they complied with current legislation and good practice advice. Records seen were kept in a manner that preserved confidentiality. Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 3 x 3 2 x 3 3 3 2 Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation Requirement Timescale for action Action plan to be received by CSCI by 11/11/05 2. 7 3. 19 15(2)17Sc “The registered person shall hedules3 maintain records as specified in and 4 Schedules 3 and 4. The registered person shall keep the service user’s plan under review” in that care plans must be accurately reflective of service users current needs. 13(4) The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated in that risk assessments must be recorded in response to incidents and changes in residents welfare. 23(2) “The registered person shall having regard to the number and needs of the service users ensure that the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally” in that the damaged flooring near the kitchen must be made good. Action plan to be received by CSCI by 11/11/05 Action plan to be received by CSCI by 11/11/05 Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 23 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. Refer to Standard 12 Good Practice Recommendations It is recommended a further review be undertaken as to whether service users would benefit from the provision of additional staff hours dedicated to providing activities taking into account the size and layout of the Home. It is recommended the Homes complaints procedure is amended to show that complaints can be made directly to CSCI at any time in the process. It is recommended consideration is given to an alternative arrangement of the dining/communal living area in the Good Shepherd Wing. It is strongly recommended that Whitepost provide the dates for staff training identified as being required. It is recommended that policies and procedures are signed and dated to show they are regularly reviewed by a competent individual to ensure they comply with current legislation and good practice advice It is recommended environmental risk assessments be undertaken more frequently and that staff be trained in this. 2. 3. 4. 5. 16 20 30 33.9 6. 38 Iden Manor Care Home H56-H06 S45153 Iden Manor V243153 061005 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection The Oast, Hermitage court Hermitage Lane Maidstone Kent ME16 9NT 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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