Inspection on 17/05/05 for Kilkee Lodge Residential Home

This inspection was carried out on 17th May 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

Kilkee Lodge Residential Home 25/09/08

Kilkee Lodge Residential Home 10/10/06

Kilkee Lodge Residential Home 13/12/05

Kilkee Lodge Residential Home 21/09/04

Kilkee Lodge Residential Home 19/03/04

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 Kilkee Lodge Residential Home 297 Coggeshall Road Braintree Essex CM7 9ED Lead Inspector Kay Mehrtens Draft Unannounced 17th May 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. Kilkee Lodge Residential Home Version 1.10 Page 3 SERVICE INFORMATION Name of service Kilkee Lodge Residential Home Address 297 Coggeshall Road, Braintree, Essex CM7 9ED 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) 01376 342455 01376 342466 Kilkee Lodge Care Homes Limited Mrs Paula Jean Winestein Care Home 80 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (80) of places Kilkee Lodge Residential Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: The home may accommodate 80 persons, of either sex, who fall within the category of Old Age. It is also registered to care for 2 named people, with dementia, over 65 years of age. Date of last inspection 7th March 2005 Brief Description of the Service: Kilkee Lodge is a purpose built home for older people. All rooms are single with en-suite facilities. The home is buit on two floors with a lift. It is able to meet the needs of people that require assistance with personal care and mobility. The home comprises of several lounges, dining and conservatory areas. There is a large, secure courtyard, which is decorated with tubs and provides seating for residents. The home is situated near to Braintree town centre, local amenities, shops and GP surgery. Kilkee Lodge Residential Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 17th May 2005, lasting 5 hours. The inspection process included: discussions with the manager and deputy, four staff, thirteen residents and eight relatives. The premises were inspected, including the grounds. Samples of records and residents care plans were inspected. The outcomes of complaints received by the commission and the home are included in the report. The inspection covered twenty standards. One additional requirement was made to those not addressed from the last inspection. The home was clean and well maintained. The staff were caring and had a positive approach to the training opportunities provided. The manager approached the inspection in a positive and cooperative manner that was focused on achieving best practice to meet the needs of the residents. What the service does well: What has improved since the last inspection? The manager has built up a senior staff team that has helped her delegate tasks and responsibilities. Positive steps have been made in addressing the need for more staff supervision and support. The employment of a regular Kilkee Lodge Residential Home Version 1.10 Page 6 group of overseas agency staff has meant a more consistent staff group for residents to get to know and rely on. The home is currently being redecorated in colours that will help more confused residents find their way around the home. The garden and courtyard have benefited from a better programme of maintenance and care. The home has worked well with health care agencies to improve the response time in meeting the health difficulties of residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kilkee Lodge Residential Home Version 1.10 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 Kilkee Lodge Residential Home Version 1.10 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) 2 and 3. Standard 6 is not applicable. Residents are now provided with information regarding their fees and funding arrangments and are made aware of what is covered by the fees and the additional charges. Assessments did not provide sufficient detail and information. EVIDENCE: Since the last inspection, the manager and owner have linked with the placing authorities and produced information, linked to the home’s contract, that details the individual fees and funding arrangements for residents. This is now in place for all residents whose placements are supported by social services. The home has a good admission procedure that includes visits to the home by prospective residents and their families. Pre-admission assessments are undertaken by the manager and, more recently, by delegated senior staff. There is a format for assessments that covers the required areas. A recently completed pre-admission paper was sampled, as well as the admission Kilkee Lodge Residential Home Version 1.10 Page 9 documents of some recently admitted residents. These did not cover all the areas necessary to produce a clear picture of the residents’ personal care and health needs. There were gaps in history and insufficient detail with regard to both physical and mental health needs. Some assessment lacked information with regard to religious and social needs. One record was not signed or dated by the staff member completing the document. The assessments also included “body maps” indicating pressure areas and previous injuries. However, some of those sampled did not reflect other information gathered prior to and on admission or subsequent changes in residents skin condition. Kilkee Lodge Residential Home Version 1.10 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) 8,9,10 and 11. The system for residents consultation with regard to care plans needs to improve. The health care needs of residents were well met and improvements had been made with regard to medication. The manager and staff are caring and positive in their contact with residents. EVIDENCE: Four care files were inspected, one with the resident concerned. The overall standard of the care plans was generally good. However, there were some areas that required more information to reflect residents’ wishes and changes in their health and personal care needs. Residents spoken to were not aware of the existence of their care plans. The inspector sat with a group of residents explaining the content and need for these plans. They recognised the need for a plan but re-stated that they had not been consulted. Examination of the plans supported their statements, as none had been signed by residents. The manager joined the inspector and residents to discuss care plans and this proved to be a useful discussion group. It gave these residents an opportunity to express their individual wishes regard to the changes and content of their own plans. It became clear that some residents felt unable to express their wishes. The manager recognised the need to increase residents’ involvement in Kilkee Lodge Residential Home Version 1.10 Page 11 the process so that they can develop a care plan, with staff, that meets their needs and ensures that all staff act accordingly. Comments from relatives and residents highlighted inconsistencies between staff in dealing with residents’ care. They felt that some staff did not always know about them. Residents were pleased with the health care provided at the home. They informed the inspector that they see visiting doctors and district nurses in private. They were pleased that staff escorts are provided for hospital appointments, if needed. The inspector had the opportunity to speak to one of the doctors, attached to the home, prior to the inspection. They were positive regarding the care provided at the home and felt that they were well informed when referrals are made to the surgery. The home has made positive links with the local health “Rapid Assessment Unit”(RAU). They have worked with the unit and referrals to hospital have reduced. They are shortly to be involved in a 2-week pilot project with the RAU with the purpose of further reducing hospital referrals. This will involve daily contact with the units’ staff who will review residents’ health and facilitate early assessment and intervention. This is a very interesting and preventative project that the manager recognises as a clear benefit for the residents. The storage and audit of medication had improved since the last inspection. The deputy manager had worked well in addressing the shortfalls highlighted at the last inspection. Senior staff have received training with regard to medication administration. The medication records were not fully inspected but staff were observed to follow the correct procedures during the inspection. Residents stated that they are provided with lockable facilities in their rooms should they choose to hold their own medication. Relatives were impressed with the way in which staff administered medication, ensuring that residents’ wishes and dignity were respected. Residents informed the inspector that their wishes with regard to care from male or female staff are respected. They felt that their dignity was maintained when they were hoisted and they appreciated the privacy provided for doctor visits and nurse treatments. The manager has yet to fully address the standard with regard to death and dying. Evidence from care files showed that not all staff were asking residents about their wishes, faith and requests with regard to death and dying. The manager recognised the need for staff to receive training in this area to ensure that this information is gathered in a respectful and sympathetic manner. This has been raised at previous inspections and must be addressed by the manager before the next inspection. Kilkee Lodge Residential Home Version 1.10 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 and 15. Residents’ choice is respected in many aspects of their life in the home. Positive steps are taken to ensure that residents and their visitors are made welcome. Mealtimes are relaxed and pleasant occasions. EVIDENCE: Residents were generally very positive about the variety of activities provided at the home. They certainly enjoyed the entertainer that sang for them during the afternoon. They felt that their wishes were respected. They enjoyed trips out and the regular entertainment provided, as well as church services. Though some residents did tell the inspector that they would like some activities at the weekends and different times in the week. Regular resident and relative meetings are held in the home. Relatives and residents were very complementary regarding the hospitality offered whenever they visit. There are several small lounges for residents to use to entertain visitors in private. Some residents expressed a wish to have a key to their room. The admission record does refer to residents being given a key “on request”. The inspector Kilkee Lodge Residential Home Version 1.10 Page 13 suggested to the manager that this be changed to include a need for staff to ask if residents want a key, rather than leave it to them to request one at a time when life can be very confusing and unsure for them. Residents were extremely complementary regarding the meals at the home. They particularly liked the home baked cakes and the offer of a cooked breakfast everyday. The menu is displayed in both dining rooms and offers a good choice of healthy meals. Residents were clear that alternatives are available whenever they want, as are additional snacks. The mealtime on the day of the inspection was a very pleasant and sociable time. Residents were chatting with each other and with staff. Staff were seen to be very gentle and respectful when helping residents that needed assistance. Meal times are flexible for those residents that choose to eat in their room or come later to the dining area. Teatime was a relaxed affair used by several relatives as a positive time to visit and chat with their relative and other residents. Relatives enjoyed the experience as much as the residents. Kilkee Lodge Residential Home Version 1.10 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) 16,17 and 18. The home has a clear complaints procedure that is actioned in a positive manner by the manager. The same approach is taken with regard to residents’ rights and protection. EVIDENCE: The home has received some complaints since the last inspection. The Commission for Social Care Inspection investigated one complaint. Only one element of the complaint was upheld with regard to the failure to provide adequate personal care for a resident prior to hospital admission. The manager has dealt with, and upheld, a recent complaint regarding a failure by staff to adequately attend to the personal care needs of a residents’ whilst in their room. The manager addressed this complaint in a positive manner, meeting with the family and responding to the issues raised. Records evidenced a positive approach and balanced response. Several residents were assisted in accessing the polling station during the recent election. However, the manager informed the inspector that she was concerned about the postal process, as the voting papers arrived too late for some residents to exercise their rights. She has complained to the local authority. Residents are provided with information regarding access to a local advocacy service. Indeed, two residents informed the inspector that they use this service and find it very helpful. Kilkee Lodge Residential Home Version 1.10 Page 15 A recent POVA investigation has been well managed by the manager. All relevant information was gathered and shared with the appropriate agencies. The decision at the required strategy meeting was for the commission to undertake the investigation into the POVA enquiry. The outcome and any relevant findings will be reported in the next inspection report. The home has clear policies and procedures with regard to the protection of vulnerable adults and staff have received training in this area. Kilkee Lodge Residential Home Version 1.10 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. Residents are provided with a safe, well maintained and pleasant home. EVIDENCE: Kilkee Lodge is a large home on two floors. Each floor provides the residents with a choice of lounge areas in which to meet their friend and family, as well as join in with communal activities such as regular in-house entertainment and mealtimes. The electrics and lighting were in the process of being upgraded during the inspection. The corridors were also being redecorated. The manager had arranged for each corridor to be coloured to reflect the names chosen by the residents and to help them feel less confused when finding their way around the home. The gardens and courtyard looked much better. The manager informed the inspector that they had a new gardener who was keen to improve the gardens and allow better access to flower beds for the residents. The standard of cleanliness was generally good. Residents and relatives were pleased with the décor and cleanliness of the home. The home was bright and there was no evidence of any bad odours. However, the hoists were still in Kilkee Lodge Residential Home Version 1.10 Page 17 need of a thorough cleaning. This was highlighted at the last inspection. One bathroom was found to contain disused wheelchairs cushions and cot side bumpers. These were dirty, dusty and stored in the wrong place. These matters were brought to the attention of the manager. Continence pads were being kept in general bathrooms and on trolleys and hoists. The manager was aware that this was not the correct practice as it meant that staff were using allocated pads for general use and possible shortage or incorrect uses may have occurred. She informed the inspector that a senior member of staff had been recently delegated to link with the continence nurse to address training and other issues and that this would be brought to their attention. Kilkee Lodge Residential Home Version 1.10 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 and 30. Staffing levels and training ensure that the needs of the residents are well met. EVIDENCE: Examination of the staff rota and observation during the inspection indicated that the staffing levels are significantly higher for the morning shift. The manager has ensured that the busiest times are well managed. The home has two floors. The staff levels for the morning are 13. This provides 6 staff for each floor with an additional staff member to escort residents to health appointments or assist where needed. The afternoon shift reduces to 9 staff. in addition to care staff there is one “supervising senior” on duty from 9 till 5pm and 2 activity workers from 9 till 5 pm. The manager also has a deputy. The manager has learnt to delegate more tasks, since the last inspection. The introduction of the role of “supervising seniors” has meant that staff supervision has developed and other delegated tasks have enabled the manager and deputy to focus on staff training, admissions and other management tasks. The inspector spoke to one of the new supervising seniors. They were positive about their role, recognised the need for support and training and enjoyed the opportunity to develop new skills and link with other agencies, as part of their delegated workload. Residents and relatives had noticed the improvement in access to a senior member of staff. Regular staff meetings and senior staff meetings are now taking place. The manager recognised the improvement in staff morale and support since these had been developed. The role of the two new “supervising seniors” is to attend Kilkee Lodge Residential Home Version 1.10 Page 19 all staff handover meetings. This has helped to ensure that information regarding residents and training is effectively shared. The commitment to staff training is good. The deputy manager has developed a training programme that covers different aspects of residents’ needs and statutory training requirements. This has included first aid, manual handling, fire training, dementia care, Parkinson’s and diabetes. The manager and deputy have recently completed manual handling trainer courses. Twenty of the homes fifty permanent staff have National Vocational Qualification level 2 or equivalent. One member of staff is a qualified NVQ assessor. The home now employs five regular agency staff that are currently undertaking NVQ training and attending other courses offered by the home. The manager informed the inspector that more staff have begun or are ready to start their NVQ training so that the standard will be met before the end of the year. This will continue to be monitored. The staff were positive about the training provided. The staff were observed to be polite and pleasant when in the company of the residents. The inspector observed many occasions when the staff sat and chatted with the residents, responding to requests for assistance in a discreet and appropriate manner. However, some residents did say that some staff are “short and lack patience” when they ring for help, especially if this is done accidentally. Otherwise, the residents and their relatives were pleased with the care provided by the staff in the home. One resident was especially pleased that staff found time to sit and chat with them and help them with small activities and tasks. The staff on duty impressed the inspector. They were seen to be very gentle and caring with the residents, especially those that needed help with personal care. The residents clearly enjoyed their company and the atmosphere was relaxed and pleasant throughout the day. Kilkee Lodge Residential Home Version 1.10 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31,36 and 38. The management style is very much focussed on the best interests and needs of the residents. Records were generally well maintained though better monitoring of accidents remains a requirement. EVIDENCE: The manager has learnt to delegate more tasks, since the last inspection. She has recognised the benefits of meeting regularly with staff and using senior staff more effectively. The manager and her deputy have worked well together in building staff training and morale. The manager has a good understanding and awareness of the needs of the residents. She is well known to them and their families. Both residents and relatives spoke very highly of her. They felt that she listened and responded to comments in a positive and caring manner. The manager is undertaking NVQ level 4 and hopes to complete before the end of the year. Kilkee Lodge Residential Home Version 1.10 Page 21 Supervising seniors are now undertaking some staff supervision, with support from the deputy manager. There is a programme for supervision sessions in place and this will be monitored at the next inspection Not all aspects of standard 38 were inspected. The previous requirement, regarding the need to monitor accidents and cross reference information, still lacked a consistent approach from staff and will be monitored at the next inspection. Kilkee Lodge Residential Home Version 1.10 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x x x x 2 x 2 Kilkee Lodge Residential Home Version 1.10 Page 23 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 Regulation 12 Requirement The registered person must ensure that detailed assessments are completed on service users proir to and on admission to the home. The registered person must ensure that service users, where possible, or their relatives are involved in their care plan and that care plans are kept under regular review. This is a repeat requirement. The registered person must ensure all staff communicate with service users in a respectful and patient manner. The registered person must consult with service users regarding activities and ensure that a meaningful programme is provided at appropriate times. This is a repeat requirement. The registered person must ensure that lifting hoists are cleaned regularly. This is a repeat requirement. The registered person must also ensure bathrooms are kept clean and free from potentially Version 1.10 Timescale for action 19.06.05 2. OP7 15 19.06.05 3. OP10 16 19.06.05 4. OP12 16 19.06.05 5. OP26 16 19.06.05 Kilkee Lodge Residential Home Page 24 hazardous objects. 6. OP36 18 The registered person must 19.06.05 ensure that staff receive supervision at least six times per year. This is a repeat requirement. The manager had made a start to address this standard, progress will be monitored at the next inspection. The registered person must 19.06.05 ensure that accident records are cross-referenced with daily recording and monitored by staff. This is a repeat requirement. 7. OP38 17 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP10 OP11 Good Practice Recommendations The registered person should consider replacing the plastic disposable cups currently used by residents in the lounges. The registered person should ensure that service users wishes regarding dying and death are recorded and that staff receive training in this subject. This is a second repeat recommendation. The registered person should develop staff training further with regard to the provision of NVQ level 2 in care in order to achieve the 50 standard. The registered person should consider the use of a checklist for staff files to improve organisation of the system. The registered peson should develop the quality assurance system further, as outlined in Standard 33. This is a repeat recommendation but this standard was not inspected and will be monitored at the next inspection. 3. 4. 5. OP28 OP29 OP33 Kilkee Lodge Residential Home Version 1.10 Page 25 Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex c01 1RJ 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 Kilkee Lodge Residential Home Version 1.10 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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