Inspection on 09/06/05 for Kathryn`s House

This inspection was carried out on 9th 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`s House 24/09/07

Kathryn`s House 04/05/06

Kathryn`s House 06/10/05

Kathryn`s House 13/12/04

Kathryn`s House 17/06/04

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

CARE HOMES FOR OLDER PEOPLE Kathryns House 43-47 Farnham Road Guildford Surrey GU2 5JN Lead Inspector Helen Dickens Unannounced 09 June 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. Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kathryns House Address 43-47 Farnham Road Guildford Surrey GU2 5JN 01483 560070 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) Mrs Z Z Merali 9 Braemar Close, Godalming, Surrey, GU7 1SA Acting Manager - Ms. Denise Hoare Care Home (CRH) 29 Category(ies) of Old age, not falling within any other category registration, with number (OP) 29 of places Dementia - over 65 years of age (DE(E)) 10 Physical disability over 65 years of age (PD(E)) 1 Sensory impairment (SI) 2 Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Of the 29 residents accommodated, up to DE(E). 2 Of the 29 residents accommodated, up to PD(E) 3 Of the 29 residents accommodated, up to SI(E), as registered partially sighted. 4 The age range of Service Users will be 65 10 may fall within the category 1 may fall within the category 2 may fall within the category Years and over. Date of last inspection 13 December 2004 Brief Description of the Service: Kathryns House is a large terraced house in the town centre of Guildford. The service provides care and accommodation for up to 29 older people, ten of whom may have dementia. The accommodation is on four floors.with a lift to access the upper floors of the home. The lower ground floor is accessible only by a staircase and would therefore prove unsuitable for those with physical disabilities and mobility problems. The home does not have a garden. There is a small area at the rear of the home for residents to sit. Also at the rear, there is an area set aside for parking. Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7 hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. The inspection was carried out by Helen Dickens, Lead Inspector for the service. Ms. Denise Hoare (acting manager) and Mrs.Z. Merali represented the establishment. A tour of the premises took place. 7 residents were spoken to and two staff were interviewed. Records were examined and comment cards left at the service for distribution to some residents, relatives, and health and social care professionals. This was a positive inspection. The inspector would like to thank Mrs. Merali, Ms. Hoare, and the staff and residents of Kathryn’s House for their time, assistance and hospitality during this inspection. What the service does well: The service has a committed staff team, some of whom have been there for over ten years. They try hard to create a homely environment for residents. The atmosphere was open and honest and all suggestions made by the inspector were positively received by staff and management. Those residents who spoke with the inspector were complimentary about the staff and management of the home, and comments such as “I like it here very much” were typical. Another resident gave the thumbs up sign and said “I’ve got no complaints at all.” The food, though not inspected on this occasion, was also reputed to be very good. One resident said she would agree to be interviewed by the inspector only if it was well before lunch as “the meals here are so good, I would hate to miss one.” There is an ongoing programme of decoration and the decorators were in the home on the day of the inspection. One resident commented that “they were always having the place done up.” The radiator covers purchased following the last inspection are of high quality and looked very good in resident’s bedrooms. Kathryns House H58 S13687 Kathryns House V219190 090605 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. Kathryns House H58 S13687 Kathryns House V219190 090605 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 Kathryns House H58 S13687 Kathryns House V219190 090605 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 The system for admitting new residents needs to be strengthened so that prospective residents and their families can be assured that residents needs can be met. EVIDENCE: The file of one resident who had recently been admitted contained a copy of the community care assessment generated as part of the care management process. It was detailed and well written but over one year old and therefore would not necessarily have provided an accurate assessment of needs on admission. The resident was well known to the staff as previous respite care had been arranged, but there was as yet no written care plan from which staff could work. The acting manager said staff had been given verbal instructions, based on the assessment, and a care plan was about to be drawn up. The system needs to be reviewed to comply fully with Standard 3 and Standard 5.3. Kathryns House H58 S13687 Kathryns House V219190 090605 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 and 10 The care planning system in place gives staff a good overview of needs to enable them to provide appropriate support to residents. The home tries hard to protect the privacy and dignity of residents. EVIDENCE: The care plans examined were complete and up to date and had a good level of detail about residents needs. They were signed by either the resident or their family and this showed they had been involved at some point. However, the care plans were not in a format accessible to residents and there was little in the way of leisure or interests mentioned. The contents page of one care plan listed an item called ‘goals’ but this information was missing from the care plans sampled. The health needs of residents were well recorded and the fluctuating mental health of one resident was carefully noted, together with changes in treatment and support needed from staff. The home has provided tasteful curtains and curtain rails for those residents who share rooms. Beds have been placed to allow maximum privacy. However, one shared room had a hand basin that was not screened off from Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 10 the door where the other resident would need to have come in and out, accompanied by staff. The acting manager said staff always knock before they enter a residents room. Rooms did not have key locks but were fitted with two-way catches. This enabled residents to ‘lock’ themselves in, but staff could gain access with permission or in emergencies. The suitability of clothing needs to be reviewed as the privacy and dignity of some residents with dementia was being compromised. Staff were observed to be gentle and patient with residents throughout the inspection. The home needs to review the appropriateness of hairdressing arrangements. The owner and acting manager suggested that each resident could have their hair done in the privacy of their own rooms from now on. Kathryns House H58 S13687 Kathryns House V219190 090605 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) 12 Social and leisure activities are limited for residents at Kathryn’s House and arrangements will need to be strengthened to enable the home to meet this standard. EVIDENCE: There is no regular activity plan for the home though a few residents go out either to day care or into town with taxi transport. There is a designated care worker who is given some time to do activities but this is irregular and usually involves only a few of residents. The group activities included knitting and colouring. During the afternoon a large group of residents were observed to be in a lounge area with the TV on in the background which no-one was watching. Most residents were either asleep or dozing. One resident did her own artwork and was pleased to describe her hobby to the inspector. Staff encouraged this interest. One staff member told the inspector she had made a ‘catch ball’; this enabled some residents with limited mobility to enjoy chair-based exercise. There are obviously parties and communal entertainments from time to time as there are large collages on the walls made up of photographs from past events. There are two boat trips arranged this summer for residents. Details of any interests/hobbies need to be properly recorded on resident’s Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 12 plans together with any therapeutic opportunities which are being explored. Consideration needs to be given to residents with dementia and specialist advice sought. The owner and acting manager were very keen to pursue this. Kathryns House H58 S13687 Kathryns House V219190 090605 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 and 18 The home has a satisfactory complaints procedure and the system for the protection of vulnerable adults should protect residents from abuse. EVIDENCE: The home’s complaints procedure is framed and hangs in the entrance hall; it is also available in the policies and procedures book. It sets out the timescales and stages very clearly. However, the procedure is not in a format which would be accessible to many of the residents and advice should be sought on this matter. A record of all complaints needs to be kept in a log, and details of any investigation and action taken should be recorded. There have been no complaints since the last inspection. The latest version of the Surrey multi-agency procedures for the protection of vulnerable adults is available to staff in the office. An alleged incident was dealt with promptly according to these procedures. Social Services determined, after initial enquiries, that there was no need for a fuller investigation. CSCI were notified as per the procedure. Some staff have had training in the protection of vulnerable adults but the remainder of the staff have not. The inspector recommended that the home contact Surrey County Council to enquire about training opportunities for staff. The home’s own vulnerable adults procedure, detailed in the staff handbook, is well done and comprehensive. The vulnerable adults policy in the general policies and procedures book needs to be replaced and this was discussed with the owner. Kathryns House H58 S13687 Kathryns House V219190 090605 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) 19,21,22,23,24,25 and 26. Recent decorative work continues to improve the appearance of the home making a more comfortable environment for residents to enjoy. However, a number of areas need review in order to maintain and improve the quality of life of residents. EVIDENCE: The layout of the home poses some challenges for staff and residents but there is also a homely feel to the property. There is a programme of decoration and maintenance and the work done in each room is clearly documented. The new radiator covers are of good quality and look really nice in resident’s rooms. A programme for replacing these covers has been given to CSCI. On the day of the inspection the decorators were working in the home. One of the hoists was on a landing and the home should review this with a view to finding a more suitable storage area. Until then, a risk assessment should be carried out with advice from the fire officer. Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 15 Resident’s rooms are personalised and the acting manager said residents are given a choice of colours when rooms are redecorated. There are some shared rooms in this property and the home has fitted tasteful dividing curtains to protect resident’s privacy. One resident who used to share a room but was unhappy doing so, was given the option of a single room when one became available. Though the new room is rather dark, the resident stated that this was a positive choice and that “it’s the best room for me.” There are still some radiators needing covers but these are the low risk ones and will be completed during the summer. One shared room had only one armchair between two residents and this was discussed with the acting manager. The home appeared clean on the day of the inspection, but in several parts of the home, there were offensive odours. The acting manager said that carpets were shampooed as necessary and the carpet cleaner was about to be used in one of the bedrooms during the inspection. However, despite these measures the premises are not free from offensive odours and this needs to be dealt with urgently for the comfort of residents, staff and visitors. Water temperatures in areas accessible to residents need to be controlled and this is discussed in more detail in the final section of this report. Kathryns House H58 S13687 Kathryns House V219190 090605 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) 28 The staff have a good understanding of resident’s support needs and there was a positive attitude from management about staff training.. EVIDENCE: The owner said that of the 10 care staff, five have nearly finished NVQ2 and two others are starting NVQ3. The home is therefore likely to meet the target of 50 of care staff having NVQ2 or above by the end of 2005. Agency staff would be included in the 50 ratio but the acting manager confirmed that Kathryn’s House does not use agency staff. One of the staff commented on the owner’s attitude to training, saying “They do keep their finger on the button….they definitely encourage training for staff.” Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 17 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) 33,36, and 38 Systems for resident’s consultation need to be strengthened to improve the way residents are able to influence the day to day life of the home. Staff supervision must to be formalised and offer regular opportunities for staff support. Policies and practices need to be reviewed to ensure so far as reasonably practicable the health, safety and welfare of residents and staff. EVIDENCE: There were a some examples of resident’s involvement in decision making. The acting manager said that residents are given a choice of colours when rooms are decorated and some of the rooms inspected were clearly personalised by residents. There had been some residents meetings. Though the notes from these meetings said residents ‘commented favourably’, they showed little in the way of choices or options being put to residents. There were also a few resident’s questionnaires on file. Kathryn’s House has a really good staff handbook were policies and procedures Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 18 are clearly set out for staff. This would support them in their care roles. Interviews with staff and the acting manager suggested that staff supervision was happening on a day-to-day informal basis. Some formal one-to-one meetings had taken place but were not recorded. In order to meet this Standard, care staff need to have at least 6 formal supervision sessions per year. The staff handbook at Kathryn’s House confirms this position. On the day of the inspection there were some health and safety matters requiring attention and Immediate Requirements were made on the following; 1)Water temperatures in areas which are accessible to residents need to be controlled to around 43C and a record should be kept to monitor these. 2)The hazardous substances cupboard was not locked and some substances, which may have been hazardous if ingested, were not contained within the cupboard. 3)Some toiletries had been left in bathrooms which would have been hazardous if ingested. As Kathryn’s House is home to some people with dementia, it is particularly important to assess such risks and take adequate precautions.. In addition, the laundry room key was left in the door and laundry cleaning products could have posed a risk. These products should be locked away or the laundry door should be kept locked. The storage of files in the office needs to be reviewed as the height and arrangement of the shelf poses health and safety risks to staff and visitors. Emergency pull cords should always hang free and not be wrapped around the control boxes. This ensures that they will work properly in an emergency, particularly if someone falls and cannot reach up to the box to summon help. On the day of the inspection some. but not all, of the maintenance certificates were available to the inspector. The owner said that one such certificate was being kept elsewhere. In order to assess if a home complies fully with Standard 38, the relevant certificates and maintenance agreements will need to be available within the home. Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 19 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 x x 2 3 2 1 1 STAFFING Standard No Score 27 x 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 2 x 2 x x 2 x 1 Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 20 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 OP3.1, OP3.4 and OP5.3 OP7.1, OP7.2 and OP7.3 Regulation 14(1)(2) Requirement The system for admission of residents must be reviewed in order to comply fully with Standards OP3 and OP5.3. Care plans need to be in a format accessible to residents, and must fully record social care needs and goals. Screening in a shared room upstairs must be reviewed to protect the privacy of residents. The suitability of clothing for some residents needs to be reviewed to protect privacy and dignity. Hairdressing arrangements must be reviewed as per the discussion during the inspection. Residents interests should be recorded and stimulating opportunities identified. Residents should be consulted and up to date information about available activities must be circulated to residents in formats suited to their capabilities. Formal professional advice should be taken with regard to activities for residents with special needs such as dementia. A complaints record must be Timescale for action 09.08 2005 2. 15(1)(2) 16(2)(m), (n) 09.09.05 3. OP10.1, 16© OP10.7 and 12(4)(a) OP24.8 09.08.05 4. OP12.2 OP12.3 OP12.4 16(2)(m), (n) 09.08.05 5. OP16.1 17(2) 09.08.05 Page 21 Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 OP16.3 6. 7. OP18.1 OP19.1 18(1)(a), (c) 23(2)(b), (d) 8. OP22.7 23(2)(l) 9. OP24.2 16(2)(c 10. OP25.5 and 13(4)(a), OP25.8 (c) 11. OP26.1 16(2)(k) kept, detailing investigations and actions taken in respect of any complaints made. The home should review the format of the complaints procedure with a view to making a more accessible version for residents Staff should all have appropriate training in the protection of vulnerable adults. A number of decorative/maintenance issues need attention including; in one of the bathrooms, replacing the stained floor covering, removing heavy limescale from the bath and fitting a lightshade. The pipe cover in the basement needs attention as does the crack on the wall. Another toilet has peeling wallpaper. The stain on the lounge carpet is outstanding from the last inspection and needs to be replaced. The storage of a hoist on one of the landings needs to be reviewed. A risk assessment should be carried out with advice from the fire inspector until suitable storage.space can be identified. Furnishings provided for residents bedrooms must meet standard 24.2, and in particular shared rooms must have sufficient comfortable seating. There are still some low risk radiators waiting to be covered and this is outstanding from the last inspection. An immediate requirement was made to regulate water temperatures to around 43C where residents have access to hot water. The home must keep the premises free from offensive 09.09.09 09.09.05 09.07.05 09.08.05 09.09.05 Immediate 09.06.05 09.07.05 Page 22 Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 odours throughout. 12. 8(1) The owner must confirm to CSCI CSA in writing the arrangements for a Section 11 new manager. The new manager should apply to CSCI for registration and a CRB check. OP33.1 and 16(2)(n) The home must ensure that OP33.6 24(3) residents views are sought about services provided and that this informs all planning and reviews. OP36.2 18(2)(a) Formal staff supervision,at least 6 times per year, should be put in place for all care staff. These sessions should be recorded in writing. OP38.1 and 13(4)(a), The hazardous substances OP38.3 (c) cupboard must be locked and all hazardous substances secured inside. Toiletries which may pose a swallowing hazard to residents with dementia must be safely stored at all times. The laundry should either be kept locked or laundry cleaning products kept securely. The use of the shelf in the office for files must be reviewed as it raises some health and safety concerns. Emergency pull cords should hang free in order to allow easy access if a resident falls. Maintenance certificates need to be available for inspection in the home. 31 09.08.05 13. 09.09.05 14. 09.08.05 15. Immediate 09.06.05 Immediate 09.06.05 Immediate 09.06.05 09.08.05 09.06.05 09.08.05 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. Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 23 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Kathryns House H58 S13687 Kathryns House V219190 090605 Stage 4.doc Version 1.30 Page 24 - 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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