Inspection on 13/06/05 for Kathryn Court

This inspection was carried out on 13th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kathryn Court 26/06/07

Kathryn Court 29/09/06

Kathryn Court 17/11/05

Kathryn Court 21/01/05

Kathryn Court 13/09/04

Kathryn Court 27/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Kathryn Court 84 Ness Road Shoeburyness Essex SS3 9DG Lead Inspector Ann Davey Vicky Dutton Unannounced 13th June 2005 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. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kathryn Court Address 84 Ness Road Shoeburyness Essex SS3 9DG 01702 292800 01702 292383 kathryncourt@runwoodhomes.co.uk Runwood Homes plc 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) Manager post vacant Care home 52 Category(ies) of OP Old age - 52 registration, with number DE(E) Dementia - over 65 - 52 of places Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Dementia - over 65 years of age (52), Old age, not falling within any other catergory (52) Date of last inspection 21st January 2005 Brief Description of the Service: Kathryn Court is a purpose built establishment accomodating 52 older people. The registration catergory permits the home to provide care for older people including those with dementia. Kathryn Court has easy access to shops and local amenities. There are good public transport links to the area. Overall the accomodation and facilities within the home conforms with the minimum standards for existing homes (prior to the national minimum standards) which includes 48 single and 2 double bedrooms, all of which have ensuite fcailities. The garden/patio area for residents is very limited. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of 7.30 hours. As there were two inspectors, this equated to 15 hours input. The inspection focused mainly on the progress the home had made since the last inspection, although a number of other standards were also considered. A partial tour of the home took place. Staff, residents and a visitor were spoken with. Records were selected at random and inspected. A notice was displayed in the main entrance area throughout the day advising all visitors to home that an inspection was taking place with an open invitation to speak with an inspector. The acting manager had been in post for only 1 week and was on the premises throughout the inspection. The inspectors gave a full and detailed ‘feedback’ to the acting manager with opportunity for clarification and/or further discussion. Assurances were given that the most serious shortfalls would be addressed locally were possible, but a full and detailed response will be required from Runwood plc in due course. Kathryn Court has been without a registered manager since February 2005. Since then, Lorraine Smith, Operations Manager for Runwood plc, has undertaken the overall management of the home. What the service does well: The home was bright, welcoming and friendly. The acting manager who had been in post for only 1 week dealt with the inspection well. Individual members of staff and in particular the care team manager, who was covering a double shift on the day, were very helpful and cooperative. The home has been without consistent management for a number of months and has done well to remain so positive. Residents’ bedrooms were very personalised and homely and the main entrance area in particular is attractive. Residents looked clean and tidy and it was nice to see that attention had been given to little details such many ladies were wearing various items of their jewellery. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 6 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. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 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 Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 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) 3 & 5 Care staff are suitably trained to meet the general needs of current residents and where appropriate, visits prior to an admission taking place are arranged. EVIDENCE: The admission assessment selected at random was appropriate in detail and content. From discussion with the acting manager, opportunity is made were possible for relatives and/or residents to visit the home before admission takes place. The home does not provide intermediate care. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 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 & 10 Staff are not following the homes policies and procedures concerning all medication practices which could potentially put service users at risk. Care plan documentation has improved, but training and development work is required to enable staff to have a greater understanding and awareness of individual residents current care needs. Other identified care practices require a full review to further promote the dignity, privacy and wellbeing of residents. EVIDENCE: A random selection of care plan documentation and other associated records were inspected. It was encouraging to note that the standard of recording had improved since the last inspection. However, considerable development work still remains as care needs were not always identified on care plans, care plans reviews were sometimes out of date, risks assessments were out of date, entries of significance were not always seen to be ‘followed through’ and daily observational recorded were noted on care plans. Recording systems particularly on the 1st floor were disordered. Full details were given to the acting manager with opportunity for clarification and further discussion. Residents’ confidential and personal documentation was left throughout the Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 10 day in the main entrance area. Entries with the communal logbook were appropriate. Residents were wearing white plastic aprons at lunchtime, many female residents did not have any leg coverings and one dining area is close to a busy main road whereby members of the general public in parked cars or walking by have full visual access to residents eating and receiving personal care. These practices must be addressed in order that the dignity, privacy and wellbeing of residents is enhanced further. Staff spoken with were familiar with residents needs and staff were observed to care for residents with a caring and sensitive attitude. Rapport between residents and staff was friendly and appropriate. Residents and the relative spoken with were positive about the care provided by the home, but were unhappy about the number of agency staff used. Apart from many female residents not wearing any form of leg coverings, residents were dressed in a respectful, dignified manner. A random selection of medication records identified some errors within the recoding system. These were made know to the acting manager as they could potentially put residents at risk. They were concerning the manual transcribing of medication issues not always having a double initial/signature and a change in an administration dosage time not being initialled/signed. PRN (as/when required) protocols were in place. Records demonstrate that residents have full and appropriate access to all health care professional as/when required. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 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) 13,14 & 15 Family and friends are able to visit the home at any reasonable time. Consultation needs to take place with residents concerning menus planning and times of meals to ensure satisfaction and reasonable choice. EVIDENCE: The aspect of social activities was not inspected on this occasion. There were a large number of visitors to the home during the day. Residents spoke positively about this. The home has an attractive reception area that can be used for waiting purposes and a larger room on the first floor if residents wish to see their visitors in a private surroundings other than a bedroom. Within the reception area, there is a good section of information and literature about the home and the wider community. The home should consult residents about the choice and variety of food especially at lunch, tea and suppertime. In addition, the timing of ‘tea’ needs to be reviewed. Staff reported significant wastage of food and residents felt that the food was ‘alright’, but wish to be more involved in the choice available. The choice at 4.30/4.45pm tea is normally sandwiches/soup, chicken nuggets and chips/sandwiches or fish cakes and chips/sandwiches. Staff said that further refreshments are available later in the evening, but residents were unsure about this. The home must ensure that the provision of food is acceptable to residents and provided at times convenient to them. In addition, Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 12 the home should give attention to the presentation of food. Food at lunchtime was not presented well and dessert portions in particular were not proportionate to appetites. The home maintains good food provision records. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 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 & 18 Staff had an acceptable knowledge base and understanding of Adult Protection issues. Runwood plc’s complaints policy was not being followed which leaves any complaint unsure about the way the home deals with complaint issues. EVIDENCE: Since the last inspection, the home has received four complaints. Only 2 had been properly recorded. One complaint was concerning the front door being left open that would give dependant residents access to a busy main road. On 2 separate occasions during the inspection, relatives were overheard to inform staff that the door was left open again. This is dangerous practice. Residents said that they would be happy to raise any matter of concern with staff on duty or ask their family to deal with any issue. Staff spoke of their Adult Protection training and were familiar with the correct procedures should abuse be suspected and/or whistle blowing. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 14 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) 19,20,21,23,24,25 & 26 The general standard of furnishings, décor and fitments within the home were satisfactory, although some areas require a programme of decoration. Some ‘housekeeping’ issues require attention to promote the safety and health of residents EVIDENCE: Residents’ bedrooms were appropriately decorated, furnished and equipped. The majority were very personalised, creating a warm homely atmosphere. The main reception area within the home is particularly pleasant with good seating arrangements and a wide selection of literature and information. Although the day of inspection was very warm, the home was well ventilated and the air temperature comfortable for residents. However, the conservatory area was most uncomfortable for residents, it was very hot and the air circulation was inadequate. In addition the ‘sun glare’ coming in from the room area was causing discomfort to residents using the facility. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 15 A number of issues require attention, these include; the call bell and fire alarm system was faulty as lights repeatedly flashed and/or would not disable, a large number of lids were missing off waste bins, colour caps were missing off taps, grab rails in corridors had not been painted, ‘hospital’ logo blankets were being used, latex gloves/plastic aprons were left in easy reach of dependant residents, there was broken/old pieces of furniture left outside a fire escape and there was a general lack of small tables for residents to place hot drinks on in communal areas. The homes outside grounds remain inadequate in size for the number of residents accommodated. The outside area used by residents only has a ‘waist high’ security fence to prevent residents having direct access to an adjacent busy main road. The home is registered to provide care for residents with dementia and could be dangerous if residents are left unsupervised or ‘wander’ into this area. Call bell response time when tested was good. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 16 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, 29 & 30 Care staffing levels are adequate to meet the physical needs of residents. The homes recruitment process is inadequate and puts residents at risk. The home is reliant on agency staff to maintain minimum staffing levels. This provides inconsistent care for residents. Staff rotas did not provide an accurate picture of which staff had on duty. EVIDENCE: Since the last inspection, morale amongst staff was noted to be better. It was reported that sickness levels had also improved. Staff were helpful and cooperative throughout the inspection and residents spoke positively about individual members of staff. The home has not had a registered manager since February 2005. The acting manager left in May 2005 and the home now has another acting manager. The current acting manager had been in post for 1 week only but dealt with the inspection in a competent manner. The home has been through a long period of instability. Since February 2005, Lorraine Smith Operations Manager for Runwood plc has overseen the management of the home. The home is totally reliant on agency staff to maintain minimum staff levels. At weekends there are as many as 5 agency care staff on duty per shift. This provides lack of continuity for residents. Residents are not happy about the current situation. The acting manager said that there has recently been a recruitment drive that should reduce the vacancies. There is no domestic cover in the afternoon/evening period. This is not acceptable as the home is large Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 17 and parts of the home were noted to be in need of housekeeping attention late afternoon. Staff recruitment records showed that some staff in post did not have the required number of references, a Criminal Records Bureau check had not been requested and there was a lack of induction records. The acting manager located a folder containing various items of loose documentation in relation to agency staff. The folder was in a state of poor state of disorder. These inadequate practices place residents at risk. The staff rota for the previous week was not accurate in detail and content. Other staff rotas seen were not dated. One senior member of staff is designated as the full time ‘deputy manager’; however, in reality only one shift per week given to these responsibilities as the rest of the time this person is fulfilling a care team manager’s post. Staff spoke of good training opportunities but records were not viewed on this occasion. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 18 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) 31,32,33,37 & 38 Since the last inspection, management within the home has not been consistent or stable. The registered provider must address this and ensure that the home has sound leadership/management and that practices and procedures are in place to safeguard residents and promote good care. EVIDENCE: Since the registered manager left the home in February 2005, Lorraine Smith, Operations Manager for Runwood plc, has overseen the management of Kathryn Court. The current acting manager had been in post for 1 week prior to the inspection. Shortfalls identified at this inspection occurred before this period and should have been identified and addressed by Registered Provider prior to the inspection. The Registered Provider must therefore fully review its Regulation 26 (visits by the registered person) visits, as they are not effective Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 19 in identifying addressing and monitoring issues. There must be adequate support given to the new acting manager in order to raise standards. The appointment of the acting manager has had a positive influence on the home. Staff and residents are happy about the appointment. Having only been in post for a week, the acting manager is still ‘finding her way’, but said she is committed to raising standards. It was disappointing to note that the registered provider had not provided the new acting manager with the last inspection report. The acting manager demonstrated competence throughout the inspection and had a positive outlook. The registered provider must give careful consideration to the content of this report and provide every assistance and support to the home to address the shortfalls and raise standards to ensure that residents’ welfare, safety and wellbeing are upheld and promoted. Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 20 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 2 15 2 COMPLAINTS AND PROTECTION 2 2 3 x 3 3 2 2 STAFFING Standard No Score 27 1 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 3 2 2 2 x x x 1 1 Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 21 yes 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 15 Requirement The registered person must ensure that all residents have a plan of care and current risk assessments which contain all relevant detail and information. All documentation within the care plan system must be reviewed on a regular basis. (The previous timescale of 21/2/05 has not been met. This is a 4th repeat requirement) 2. 9 13 The registered person must ensure that all medication practices within the home are in accordance with laid down guidance. (The previous timescale of 21/2/05 has not been met. This is a 2nd repeat requirement) 3. 10,14 & 15 16 The registered person must ensure that the dignity, privacy and choice of residents is upheld at all times. This is with reference to residents wearing leag coverings of their choice, wearing appropiate protective covering in the dining room, I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Timescale for action 13/7/05 13/7/05 13/7/05 Kathryn Court Version 1.30 Page 22 being afforded privacy in the dining room and being consulted about menus and times of mealtimes. 4. 16 22 The registered person must ensure that the home operates within and complies with the companys agreed complaint procedures in accordance with regulation. 13/7/05 5. 19,20,25 & 26 23 The registered person must carry 13/7/05 out a full premesis audit to ensure that the home is in a good state of repair and decoration, has adequate storage space for old/ unwanted furniture, appropiate furniture for residents to place hot drinks on, is suitably ventilated within the conservatory area, call & fire alarm systems are in good working order, the home is free from hazards and the outside grounds are safe. This is for the safety, comfort and wellbeing of residents. A full audit must be sent to the Commission. (The previous timescale of 21/2/05 has not been met concerning storage facilities, ensuring there is appropiate privacy at windows and providing safe, secure outside grounds. These are 2nd & 4th repeat requirements) 6. 27,28 & 29 18 & 19 The registered person must ensure at robust recruitment procedures are in place, adequate records are held on agency staff working in the home, staff rotas are accurate, adequate domestic staff are employed to keep the home in good order, provided consistent 13/7/05 Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 23 management within the home, staff responsiblities are reviewed in accordance with their designated titles and agency staff are reduced. This is for the protection and wellbeing of residents. (The previous timescale of 21/2/05 to ensure that adequate senior and domestic are provided has not been met in full. This is a 3rd repeat requirement) The previous timescale of 21/2/05 to ensure that robust recruitment procedures are in place has not been met. This is a 4th repeat requirement) 7. 32,37 & 38 18,19 & 26 The registered person must review the manner in which the Regulation 26 visits are undertaken and reported on. This is with particular reference to the issue that the home has been without a registered manager for 4 months but was overseen by an Operations Manager during this period. The Commission would have expected the majority of the identified regulatory shortfalls to have been identified and addressed prior to this inspection. Full details of these shortfalls are contained within the body of this report. Some are also referenced within this agenda for action. 13/7/04 Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 24 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 31 Good Practice Recommendations The registered person should ensure that an application for the registration of a manager is made to the Commission with minimal delay. The registered person should ensure that the daily routines and practices within the home are in the best interests of residents. This is with reference to mealtimes. 2. 33 Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Kathryn Court I56 I06 S15442 Kathryn Court V230318 140605 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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