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Inspection on 31/01/08 for Kingsclear Nursing And Residential Home

Also see our care home review for Kingsclear Nursing And Residential Home for more information

This inspection was carried out on 31st January 2008.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides an excellent needs assessment process ensuring that they only admit residents whose needs they can meet. This is also supported by good information to residents and relatives about all aspects of life in the home. Care needs are well documented providing staff with appropriate information enabling them to undertake care efficiently. The home promotes and encourages contact with family and friends and the local community. The activity arrangements in the home are excellent and meet the individual and collective of the residents. Activities are planned monthly and are overseen by three activities coordinators.The standard of the environment is excellent providing residents with ample communal and individual accommodation, which is well maintained, comfortable and homely. Staff recruitment and training is good providing staff with the required skills to maintain good quality care. The home is well managed by an experienced manager in the best interests of the residents. The health, welfare and safety of the residents and the staff are promoted.

What has improved since the last inspection?

The requirements made at the last inspection have been met. Medication procedures now denote reasons for non- administration of medication. There is an ongoing schedule of maintenance and repair, and the requirements made in relation to the environment have been undertaken. Staff NVQ training is ongoing and management are working towards maintaining 50% target. CRB (criminal Records Bureau) Disclosures are in place.

What the care home could do better:

The service continues to meet the National Minimum Standards providing residents with good outcomes of care. There are no requirements as an outcome of this inspection.

CARE HOMES FOR OLDER PEOPLE Kingsclear Nursing And Residential Home Park Road Camberley Surrey GU15 2LN Lead Inspector Mary Williamson Key Unannounced Inspection 31st January 2008 10:00 X10015.doc Version 1.40 Page 1 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 Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 2 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. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsclear Nursing And Residential Home Address Park Road Camberley Surrey GU15 2LN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01206 828290 01276 691228 admin@caringhomes.org Kingsclear House Limited Susan Mary Allen Care Home 72 Category(ies) of Dementia - over 65 years of age (10), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (72), Physical disability over 65 years of age (5), Sensory Impairment over 65 years of age (5) Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 52 beds providing nursing care for elderly people from the age of 60 years The number of persons for whom residential accommodation with both board and personal care is provided at any one time shall not exceed twenty (20) 14th June 2006 Date of last inspection Brief Description of the Service: Kingsclear Nursing and Residential Home is a care home providing nursing and personal care for older people from the age of 60 years. Service provision includes permanent, convalescence and respite care. The home is part of a group of seven care homes in Surrey operated by Caring Homes Limited. These homes are part of a wider network of care homes, specialist centres and independent hospitals in England and Scotland operated by the same organisation. The home is located in a quiet residential area convenient for Camberley town and all community facilities. The building is a large, detached Edwardian house that has been extended over the years. The original architectural features of the main house have been tastefully combined with the modern, purpose built facilities. The home is set in 4 acres of landscaped grounds and has ample car parking facilities. Bedroom and communal facilities are on three floors, accessible by stairs and passenger lifts. For operational purposes the home is divided into five living units though service users have choice of where they sit during the day. Most bedrooms are single occupancy and ten have en-suite facilities. There are five lounges also a large dining room on the ground floor; a number of combined lounge/dining areas are also available on all floors. The accommodation includes a spacious conservatory, also an activities room and hair dressing/therapy room. All areas of the home are wheelchair accessible and provision includes suitable assisted toilet and bathing facilities. A full time registered nurse-manager is responsible for the day-to-day management of the home. Weekly fee charges ranged between £609 and £772 for personal care placements and £730 and £825 for nursing placements as of January 2008. Additional charges applied for private physiotherapy, hairdressing, chiropody, dental and ophthalmic services and beauty treatments. Also for newspapers, staff escorts, outgoing telephone calls, dry cleaning, outings and transport. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 5 Prospective service users and their representatives are informed about the services and facilities of Kingsclear in literature available at the home. A copy of the home’s latest inspection report is publicly displayed in the home and available from the Commission for Social Care Inspection (CSCI). Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star rating. This means that the residents who use this service experience good quality outcomes. This was the first site visit of a key inspection and was unannounced. Mary Williamson regulation inspector undertook the inspection. The registered manager Mrs Susan Allen represented the home during the inspection, and the regional manager was also present. A tour of the premises was undertaken and records relating to the care of the residents and the management of the staff were examined. Discussions were held with residents, relatives, the manager, regional manager, and various staff during the visit. The diverse needs of residents were included in individual care plans. The complaints procedure was seen and the management of the one complaint received since the last inspection was satisfactory. The majority of the residents were keen to talk about their experiences of living in the home. Visitors also contributed comments regarding the home. CSCI would like to thank the residents, manager and the staff team for their cooperation and hospitality during the inspection. What the service does well: The home provides an excellent needs assessment process ensuring that they only admit residents whose needs they can meet. This is also supported by good information to residents and relatives about all aspects of life in the home. Care needs are well documented providing staff with appropriate information enabling them to undertake care efficiently. The home promotes and encourages contact with family and friends and the local community. The activity arrangements in the home are excellent and meet the individual and collective of the residents. Activities are planned monthly and are overseen by three activities coordinators. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 7 The standard of the environment is excellent providing residents with ample communal and individual accommodation, which is well maintained, comfortable and homely. Staff recruitment and training is good providing staff with the required skills to maintain good quality care. The home is well managed by an experienced manager in the best interests of the residents. The health, welfare and safety of the residents and the staff are promoted. 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. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 8 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 9 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 Outcomes Statutory Requirements Identified During the Inspection Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, and 6 People who use the service experience an excellent quality outcome in this area. This judgement has been made using available evidence including a visit to this service. The information available to residents and relatives provides them with quality information to help them to make an informed choice regarding the home. Excellent pre admission needs assessments determine the suitability of the home to meet resident’s needs. This service does not provide intermediate care. EVIDENCE: The statement of purpose and service user guide is available to all residents and their relatives in order to provide them with enough information regarding the home. There is a copy of these in individual bedrooms for easy access. The residents guide is informative and contains relevant information, for example what colour uniforms staff wear, when it is difficult to read name badges. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 11 All residents have a needs assessment undertaken prior to being admitted to the home. The manager undertakes these. Six needs assessments were sampled and are very detailed and informative providing the home with a good understanding of the care to be provided. The home does not provide intermediate care. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. Residents who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individual care plans outline in detail how care is undertaken, which promotes privacy and dignity. There are satisfactory arrangements in place to meet specific health care needs. The medication administration policy protects the residents living in the home. EVIDENCE: Individual care plans are in place. These are written with input from the resident and their family, information obtained from the pre admission needs assessment, and any other relevant information from health care professionals. Care plans were seen for six residents and are well maintained and reviewed every month. A resident stated that she is consulted about her care and another resident stated, “ They always ask me what I like”. The care plans are located at appropriate nurse stations and are updated daily by care staff. At various stages throughout the inspection staff were spoken to, who demonstrated a sound knowledge of residents needs. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 13 All the residents are registered with a GP from various surgeries locally. Some GP’s visit weekly and others when required. Specialist treatment for example physiotherapy, tissue viability, dietician, and consultant input are accessed on referral by the GP. The chiropodist, dentist, and optician all visit the home frequently. Some residents make their own arrangements to see their dentist and optician. The home has a medication administration policy in place. Medication practice was observed on two units. All staff that administer medication are familiar with this policy and also observe the NMC (Nursing and Midwifery Council) Code of Professional Conduct. The medication recording charts are well maintained and accurate recording was noted. Medication is supplied by a local chemist, who also undertake audits of medication. Currently the home is supporting a resident to self medicate in order to preserve their independence. A risk assessment has been written for this. The above arrangements protect residents living in the home. Privacy and dignity is promoted, and staff were seen to knock on residents bedroom doors prior to entry. Locks are provided on individual bedrooms. Staff were observed to address residents in a polite and professional manner. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. Residents who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The activities programme is excellent and meets the resident’s expectations. Family and community links are maintained and resident’s nutritional needs are met. EVIDENCE: The home employs three activities coordinators who between them provide an excellent programme of social and recreational activities in the home. A weekly timetable is produced outlining events for example chair aerobics, quizzes, book club, library, bongo, aromatherapy and hand massage, film club, board games, mobile shop, reminiscence, and sing along. One to one time is also available to resident who choose not to join group sessions. Residents were observed reading their newspapers, and chatting in groups over coffee. Residents commented that “there is plenty to do if you want it”, and another resident stated that she “enjoyed the quiz sessions very much”. Family links are maintained and visitors are welcome in the home at any reasonable time. Relatives visiting during the inspection stated that they can Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 15 always talk to the manager and are kept up to date with changes to care and events in the home. Spiritual needs are observes and the activities coordinator stated that the local Parish Vicar will visit when he can and the Roman Catholic Priest attends with Holy Communion regularly. Residents attend songs of praise in the local church. The catering arrangements in the home are satisfactory. Menus are planned by the chef over a four- week period and are seasonal. Residents are encouraged to contribute towards menu planning during meetings and during regular audits within the home. Menus are displayed on the dining room tables daily so that residents have a choice of meals. Lunch was observed being served in the main dining room and the food offered was appetising and nutritious. Staff were supporting residents who required help with feeding. The kitchen was clean and orderly. There was an agency chef on duty who had a sound knowledge of the nutritional needs of the residents, and their likes and dislikes. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, and 18. Residents who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The complaints procedure and safeguarding awareness procedure protect residents living in the home. EVIDENCE: The home has a complaints procedure in place and all residents and their relatives have access to a copy of this, which is located in individual bedrooms. A complaints log is maintained and there has been one complaint since the last inspection. Residents and relatives are confident that if they had a complaint that this would be taken seriously and managed efficently. The home also has a safeguarding awareness policy in place and all staff undertake safeguarding awareness training during induction training. There is also a copy of the local authorities policies and procedures on safeguarding vulnerable adults in place and some senior staff members have attended training in these procedures, which has been cascaded throughout the staff team. Staff spoken to during the inspection had a sound understanding of these procedures and felt confident that if an incident of abuse arose it would be managed appropriately. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, and 26. Residents who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is suitable for its stated purpose. Residents live in a comfortable, well maintained, homely, and safe environment. EVIDENCE: The standard of accommodation offered to the residents living in the home is excellent. The home is divided into five units and each unit has its own lounge, which also included a dining area. There is a large lounge located on the ground floor, which is also used for group activities. The home also provides a quite lounge leading a conservatory. There is a large communal dining room also situated on the ground floor. Ramp access is provided to the well-maintained gardens, and there is a roof garden on the first floor. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 18 Resident’s accommodation is provided in single bedrooms, ten of which have en-suite facilities. There is also one double room available. Bedrooms have been tastefully furnished and personalised to reflect individual personalities. The home is clean and hygienic. The housekeeping team maintain a high standard of cleanliness and when spoken to all had a good understanding of the infection control policy and the COSHH procedures. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 19 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30. Residents who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s needs are being met by the number and skill mix of staff employed. The recruitment procedure is robust and the training arrangements satisfactory ensuring that residents are protected. EVIDENCE: The staff duty rotas were examined and indicated that staff are employed in adequate numbers to meet the assessed needs of the current residents in the home. The registered manager and regional manager explained that the number of staff varies according to occupancy levels, and staff are deployed to various units according to need. Residents comments include “ staff are very kind, ” “staff are very busy”, “staff always come when I ring my bell”, a relative stated that “ there appears to be a shortage of staff every time I visit”. The home also employs a large team of ancillary staff including chefs, kitchen assistants, cleaners, receptionists, activities coordinators, laundry staff, maintenance staff, and an administrator. The recruitment procedures in the home are robust and protect the residents living there. Four staff employment files were examined. They included all the required documentation for the protection of the residents and in accordance with employment legislation, including written application form, two written Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 20 references, an employment history, and a CRB (Criminal records bureau) disclosure. A training company known as Training in Care is part of the organisation and provides all the training within the organisation. All staff undertake induction training and a week of supervised practice in line with Skills for Care. Following foundation training staff are enrolled to undertake NVQ awards in care. This training is ongoing with staff at various levels of achievement. Qualified nurses are also given to opportunity for professional development and career advancement. Staff spoken to felt satisfied with the amount of training available to them and the level of support they receive to undertake their roles. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 21 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. Residents who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well manager in the best interest of the residents. The health safety and welfare of the residents and the staff are promoted. EVIDENCE: The home is well managed by a registered manager with several years experience in the provision of care to older people. She is also a qualified nurse. She has the support of a lead nurse and a team of qualified nurses who oversees the day- to- day management of individual units. Overall the general opinion of residents and relatives was that of satisfaction with the management structure within the home. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 22 There are systems in place to monitor quality assurance and customer satisfaction. On the day of the inspection the regional manager was undertaking a regulation 26 visit in the home and these reports are retained in the home for information. Customer survey questionnaires are distributed to residents or their relatives for comment and feedback. Results are published in a report available to all concerned. Care plan audits, medication audits, financial audits, clinical audits, meal audits, health and safety audits, and staff questionnaires are also used to monitor quality assurance. A small amount of personal money is kept in the office and managed on behalf of some residents. This is used to pay for hairdressing and chiropody. There is no staff in the home that act as appointee for the residents. This practice protects residents and staff alike. The health, safety and welfare of the residents and staff are promoted and risk assessments are in place for all identified risks and safe working practice. All staff undertake health and safety training. Fire safety regulations are observed. All staff attend mandatory fire safety training and systems are in place for the maintenance of fire fighting equipment and emergency lighting. Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X X X 4 X 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 3 X 3 X 3 X X 3 Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement 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. Refer to Standard Good Practice Recommendations Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Kent ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Kingsclear Nursing And Residential Home DS0000017620.V356061.R01.S.doc Version 5.2 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. 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