Inspection on 13/07/05 for Kent Farm

This inspection was carried out on 13th July 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

Kent Farm 25/01/07

Kent Farm 30/11/05

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Kent Farm Mill Street Uffculme Cullompton EX15 3AR Lead Inspector Louise Delacroix Announced 13 July 2005 10:00hrs 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. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kent Farm Address Mill Street Uffculme Cullompton Devon EX15 3AR 01884 840144 01884 841486 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) Ms Pauleen Rachel Maitrise Care Home 15 Category(ies) of OP Old age (15) registration, with number PD(E) Physical dis over 65 (15) of places Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2 February 2005 Brief Description of the Service: Kent Farm is a residential care home, which provides a home for fifteen older people, who may have a physical disability. It is situated in the village of Uffculme and is close to the village square. It offers fifteen single rooms, ten of which have en-suite toilets. Fourteen of these rooms are situated on the first floor, and are accessed by a shaft lift. There is a homely lounge with a selection of armchairs and a bright dining room, with three tables. A visitors’ car park is available and rooms are styled to encourage the entertainment of visitors. The home is built on three sides of a courtyard, and residents and visitors use this in the summer.In May 2005, there was a change of ownership. The new owner has already made many positive changes. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over eight hours and was announced. Fifteen people were living at the home on the day of the inspection. Everybody living at the home contributed to the inspection, apart from one person who was unwell. Five members of staff were spoken to individually and time was spent talking with the new manager/owner about their plans to develop the service offered at the home. Two visitors also gave positive feedback about the home. In the morning, an outside entertainer led the singing of popular songs, which a number of residents joined in with, while others spent time in other areas of the home. In the afternoon, a member of the care staff team supported some of the residents with looking at items linked to the past, including magazines and cooking items, which led to a lively discussion. Other people spent time in their rooms, sat out in the courtyard or went out for the day. A tour of the building took place and all bedrooms and bathrooms were inspected. Records, including the pre-inspection questionnaire, care plans, some policies, accident sheets, staff files and fire records were also looked at as part of the inspection. Thirteen comment cards, which have been completed by people living at the home and by people visiting the home, have also been incorporated into the report. All were positive, one said the care ‘is excellent (both physical and emotional)’ and that their relative is ‘very, very happy’. What the service does well: The new owner/manager has worked hard to share her aims for the home and to gather views from those involved in the home about strengths and weaknesses. Staff, visitors and residents recognised improvements to the service and said they felt involved in the changes taking place. People described the new owner/ manager as being ‘on the ball’, as a person who gets things done, and another said she had ‘shaken things up’ for the good of Kent Farm. The home is building strong connections with health services, which is appreciated by residents. There is a growing range of activities and people living at the home are encouraged to contribute their ideas about what they would like to do. The home is well maintained and decorated in an attractive style. Residents’ bedrooms have an individual style and many have been personalised with the residents’ own pictures and furniture. There is a garden and attractive courtyard with garden furniture and a gazebo. There is a friendly atmosphere. A relative commented, ‘ this home was selected in the expectation of ‘family’ Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 6 and intimate comfort and ambience. Repeated visits have confirmed our decision’. Training is being promoted and staff spoke positively about being encouraged to think about their training needs and the support they have received to complete their NVQs. Good communication through staff meetings, residents’ meetings, supervision and improved records of care all help to promote an open management style with clear leadership. 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. Kent Farm D54- D06 63659 kentfarm 230255 130705 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 Kent Farm D54- D06 63659 kentfarm 230255 130705 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) 3,4,6 The staff have a wide range of experience and skills that are being developed further by the owner. Prospective residents are assessed holistically before moving to the home to ensure the home can meet their needs. EVIDENCE: Only one person has moved to the home since the new owner/manager bought the home. A detailed pre-assessment was on file that was holistic and covered a range of needs, including weight, likes and dislikes with food, emotional and social needs. Two other care files were inspected, each of which included a ‘pen picture’ of the resident written with their consent. The owner explained that this was to help staff recognise residents as a whole person rather than just concentrating on the support they needed. Generally members of staff spoke positively about increasing their involvement in care files. The staff team has a good range of experience and skills. This was shown through discussion, observation and staff files. The owner has taken a ‘hands on’ approach so that she can recognise the skills and training needs of staff, Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 9 with the aim of staff having greater clarity about their roles and responsibilities. The home does not provide intermediate care. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 10 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) 7,8,11 The current style of care planning is being reviewed. However, already the emphasis on professional recording to ensure good communication between staff has created better outcomes for residents, although one area of risk assessment needs developing. Strong links with health services and an emphasis of advocating for residents means people living at the home receive the health support they are entitled to. Key members of staff possess the practical skills to meet the needs of residents who are dying, and with support are learning to recognise the stages of bereavement. EVIDENCE: Three care plans were inspected, which have been reviewed on a monthly basis. Care plans reflected the changing needs of residents and clear guidance was seen to meet the care needs of a frail resident. Work is beginning to document the social and emotional needs of residents and further work is planned to review the current style of the care plans. Daily records and a communication book contained appropriate wording. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 11 Risk assessments were seen and are in the process of being reviewed. However, these do not cover the use of bed rails. The owner has been proactive in contacting health services to review the needs of the residents and has advocated for residents to receive specialist support. This was shown from discussion with staff, who praised the owner’s direct approach, and discussion with residents, who expressed their appreciation. A visitor commented, ‘There is a welcome increase in visits from the doctor – it certainly seems that everything is being done which can be’. Records also showed letters from and contact with health professionals, including a consultant geriatrician. Weights are regularly recorded and advice sought, if necessary. Recently gentle exercise has been introduced. Records show that both the physical and psychological needs of residents are recognised and addressed. A visiting health professional wrote that they felt welcomed by staff, that they were kept informed about residents and that they could see them in private. Discussion took place with the owner about the skills of staff to meet the needs of residents who are dying. She has observed their skills and discussed approaches with senior staff with the emphasis on recognising the psychological needs of residents, both in approaching their own deaths, and the losses they have experienced in their lives. Staff spoke about the impact of bereavement on the wellbeing of residents and guidance received from the owner. The owner was also clear when to seek advice to ensure that the home can meet the needs of a resident who is dying. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 12 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) 12,13,14,15 The range of activities is improving and is varied in style to meet the different interests of residents. This home encourages visitors and the owner promotes the ethos of residents taking more control over their lives. The meals are good, offering both choice and variety, and catering for special dietary needs. EVIDENCE: Residents spoke positively about increased activities and the planned trips, which include an outing to Teignmouth. People were also seen pursuing their own interests, such as reading or embroidering. Care plans showed that residents were being encouraged to take up previous interests with the support of staff. Notes from residents’ meetings show that people living in the home are consulted about activities and trips. A member of staff, who is training in occupational therapy, was seen using reminiscence materials, which participating residents responded well to and enjoyed discussing. Six residents, through comment cards, said the home provided suitable activities and another said ‘sometimes’. Staff, the owner and residents through discussion said that activities were still being developed and reviewed. Records are kept of who has been involved and what has taken place. Five visitors to the home, who completed comment cards, said that they were made to feel welcome and that they could see their friend/relative in private. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 13 Residents confirmed that they were able to have visitors and that they had maintained links with the local community. On completing the buying of the home, the owner sent out letters to visitors and relatives inviting them to a buffet, which she said was well attended. Throughout the inspection, residents showed that they were well informed about the changes taking place within the home and appeared to feel part of these changes. A resident said in a comment card that they ‘were fed very well’ and other people echoed this. One person said they were pleased that the teatimes meal was being reviewed, as they had become repetitive which was discussed at a residents’ meeting. On the day of the inspection, the main meal was roast pork, which was very tender, and vegetables. The meal was well presented and the tables attractively set. Residents were observed being given alternatives in line with their recorded personal preferences. A chart was seen for a frail resident to record their food and fluid intake, which contained up to date information. The cook demonstrated their knowledge of the individual likes and dislikes of residents and how they catered for specialist diets. Staff were seen encouraging residents to have drinks throughout the day and jugs of drink were seen in residents’ rooms. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 14 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 People living and visiting the home know who to contact if they have a concern. EVIDENCE: No complaints have been received by the new owner or by CSCI. Generally visitors knew about the home’s complaints procedure and residents who were asked knew who to speak to if they had a concern. Kent Farm D54- D06 63659 kentfarm 230255 130705 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) 19,20,21,22,23,24,25,26 This is a well cared for home, which provides residents with an attractive, clean and homely place to live. The owner ensures residents are provided with equipment suitable to meet their individual physical health needs. EVIDENCE: The owner explained how they had employed a gardener and had bought a gazebo and garden furniture to encourage residents to use all areas of the home. The owner said that other garden furniture had recently been painted. The courtyard was well cared for and attractively set out, and residents were seen using it later in the day when it was cooler. The grounds are easily accessible. There is a small porch with seating for smokers, which one resident said they appreciated. After buying the home, the owner has been pro-active in requesting the fire service to visit and has agreed a rolling programme with them. A record was seen of maintenance work, which is completed by care staff and acted upon by the owner. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 16 The communal areas of the home are attractively decorated and homely in appearance with a range of suitable lighting and armchairs arranged in small groups. There is a clearly marked accessible toilet close to the lounge and the dining room. The sluice is located separately from service users’ toilet and bathing facilities. The home has two bathrooms with assisted baths and two bedrooms with en-suite bathrooms. Eight other single rooms have en-suite toilets. The home has a four-person shaft lift between the two floors. There are grab rails throughout the building. The courtyard is accessible to all service users, including those people in wheelchairs. Hoists and assisted baths are installed. Portable call systems are available in every room. Equipment is well stored. A service user, who uses a wheelchair, can access their en-suite toilet using a ceiling track hoist. All bedrooms have a ceiling track for use with a hoist. A resident said that they appreciated the owner arranging for a safer and more comfortable sling for their hoist. Care records showed that the owner has requested and obtained pressure-relieving equipment for residents, who have been assessed as at risk of pressure sores. Bedrooms are well decorated and personalised to reflect individual taste. All rooms are carpeted and contain the recommended furnishings. For example, they have two comfortable seats, bedside lighting and a wash-hand basin. Residents are offered the choice of having a lock as documented in care plans. Some rooms have lockable storage space. The owner discussed her ideas for how other rooms could be provided with this facility. One resident spoken to on this subject said they had decided not to have lockable storage. Rooms are naturally ventilated and centrally heated. The owner had begun a rolling programme for radiator covers to be fitted with the next radiators identified as high risk being fitted with covers in August 2005. Risk assessments showed this would also occur for radiators identified as a medium risk. Records were seen for water temperatures, which are within the recommended guidelines. The home was clean and free from odours, which a resident and visitor said was always the case. A member of staff explained that care staff carry out daily cleaning duties. Residents’ rooms are fitted with paper towel dispensers. Liquid soap is provided and stocks of disposable gloves and aprons were seen around the home. Staff have also been recommended in the communication book to carry hand-washing gel around with them to try and prevent cross infection. This was seen around the home. Kent Farm D54- D06 63659 kentfarm 230255 130705 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) 27,28,29,30 Staffing levels and training provide a good staff team to care and support the residents. The recruitment process at the home offers protection to residents. EVIDENCE: A resident said that the staff are good and kind. Other residents repeated this sentiment when they were spoken to individually. A visitor wrote in a comment card, ‘ a great deal of care and concern has been taken with my friend’. Feedback from quality assurance cards from visitors contained comments such as ‘100 happy’, staff very caring’ and ‘pleasant and helpful staff’. A staff member who had come on duty was heard talking with and spending time listening to a resident’s own life experience showing a good rapport. On the day of the inspection, there was three care staff on duty and the cook. In the afternoon, there were two care staff and a member of staff leading activities. At the end of the inspection at 6pm, there was two care staff on duty. Throughout this time, the owner, who is also the manager, was available. None of the residents or visitors who contributed to the inspection raised staffing levels as a concern. The staff rota reflected the staff on duty. Three staff files contained all the required documentation. For three new staff, CRBs had been applied for but had not been received. However, all three had been given clearance from the POVA list and completed a full application form with a full employment history. Two written references and correct forms of ID were also on file. Staff have written that they have been provided with information about General Social Care Council. The manager said they were supervised. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 18 Staff explained how they had received recent training in Moving and Handling and First Aid. The pre-inspection questionnaire and staff meeting minutes state that the home’s staff are on a waiting list for Protection of Vulnerable Adult training and that food hygiene training is booked for September. Staff also spoke about being supported to complete their NVQs and to look at further training i.e. a certificate in the administration of medicines. Currently approximately a third of the staff have a NVQ 2 or above. The manager also has plans to provide internal training to look at recording/care planning and is hoping to help enhance staff’s ability to promote activities. Kent Farm D54- D06 63659 kentfarm 230255 130705 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) 31,32,33,36,37,38 The systems for consultation with residents are good with a variety of evidence that indicates that residents’ views are both sought and acted upon. EVIDENCE: The owner/manager has many years of experience in working in residential settings, which was apparent in her Fit Person’s interview. She has shown a commitment to making positive changes to the service. Using her own practice to act as a role model, whilst also recognising that some changes have to be introduced over time in order to gain peoples’ confidence. A resident commented about the manager saying, ‘If something needs doing, she’ll do it’. Another said the owner had ‘got on top of things’. Staff talked about an open style of management and several residents said they felt the new owner/manager was approachable and many felt she was acting in their best interest, which has also been commented on by relatives. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 20 Staff commented positively about the introduction of staff meetings and supervision. Minutes from the staff meetings were seen and evidence that staff are encouraged to express their views and ideas. The introduction of a communication book and recording of nighttime care helps improve communication between staff. Staff starting a new shift were seen updating themselves by reading what had happened on previous shifts. The owner was also heard sharing appropriate information with staff about the health needs of residents and talking to residents about planned visits by health professionals. A visitor wrote that, ‘I find the communication between owner/staff and my self and family extremely good’. Another visitor confirmed this. According to residents and minutes from residents’ meetings, the owner has promoted the role of CSCI and ensured that everyone is aware of the purpose of inspections, as well as having a right to read the home’s inspection report. A resident said they appreciated this involvement. The owner is beginning to introduce a quality assurance system, which has included resident and staff meetings. Supervision sessions for staff have also recently started and in discussion it was clear that the manager is building a picture of the skills of her staff team and where they would benefit from further support and training. Record keeping is clear, up to date and kept securely. These document maintenance safety checks, which have resulted in the purchase of a new boiler and cooker. Residents and staff were aware of improvements, especially those made to the fire alarm system. Maintenance records show that portable electrical appliances have been checked, as has the gas supply and the lift. Fire records are up to date and show that individual staff training has commenced. Staff names are documented and the owner explained that an external company would be brought in by August 2005 to train all staff. The names of whom will be sent to CSCI. Kent Farm D54- D06 63659 kentfarm 230255 130705 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 x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x 3 3 3 Kent Farm D54- D06 63659 kentfarm 230255 130705 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 Regulation Requirement No requirements made. Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 7 Good Practice Recommendations It is recommended that risk assessments be written for the use of bed rails, which includes a procedure for checking that they are correctly positioned. Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Kent Farm D54- D06 63659 kentfarm 230255 130705 stage 4.doc Version 1.40 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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