Inspection on 23/08/06 for Kingsley

This inspection was carried out on 23rd August 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingsley 05/08/08

Kingsley 17/02/06

Kingsley 24/11/05

Kingsley 07/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Kingsley 28 Downs Park Herne Bay Kent CT6 6BZ Lead Inspector Kim Rogers Unannounced Inspection 23rd August 2006 08:55 Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 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 Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 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 Adults 18-65. 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. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kingsley Address 28 Downs Park Herne Bay Kent CT6 6BZ 01227 363395 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) Dyzack Limited Rhonda Diana Grant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th February 2006 Brief Description of the Service: Kingsley Homes (the Home) is registered to provide accommodation and personal care for nine younger adults (service users) who have a learning disability. The premises are an older detached property which has two storeys. The ground and the first floor are used to provide accommodation for the service users. The second floor houses various offices and related functions. Each of the service users has their own bedroom. All of the bedrooms have a private bathroom. The Home is located on a quiet residential street and it is within walking normal walking distance from Herne Bay’s shopping centre. The Registered Provider is a private limited company. Mr Z Hasmat Ali is one of the Directors of the Company. He is the Responsible Individual. This means that he is responsible for overseeing the work of the Registered Manager. In turn, the Registered Manager administers the Home on a day-to-day basis. The fee for this home is £1,200 a week. For more information please contact the Provider. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows a number of evidence gathering exercises including a visit to the home. A pre inspection questionnaire was completed by the manager and submitted to the Commission. The Inspector met with and spoke to staff, the manager and service users during a visit to the home. The inspector made observations, sampled records and had a look around the home. There are currently eight service users living at Kingsley. The manager had about 24 hours notice of this visit. Service user said or indicated that they are happy at the home and get on with staff and other service users. Service users said they are happy with their bedrooms. Staff said they work as a team and enjoy working at Kingsley. Staff said ‘My manager is supportive and approachable’ The manager demonstrated how the home has improved since the last inspection. Some areas of good practice were noted and are included in this report. What the service does well: Information about the home including the contract of terms and conditions has been presented in a format suitable for service users. Assessments are based on the principles of person centred planning. This is recognised as good practice. Key workers review service user plans in detail every month. Risks are managed and supported in a positive way as part of an independent lifestyle. Behaviours are supported in a positive effective way. This has lead to decreases in challenging behaviours, which in turn has lead to increased independence and increased community participation and presence. This is a strength of this home. Service users have opportunity to access a range of community leisure and educational facilities and services. Relationships are supported. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 6 The environment is homelike and clean. Staff are longstanding and competent in supporting service users needs. Staff communicate effectively with service users enabling choice. The home is well run by a competent effective manager. The manager and Provider are committed to constantly improving the service. The staff team is stable and longstanding. What has improved since the last inspection? What they could do better: Some medications systems require review and improvement. The quality assurance system should be developed to include an action plan on how the home plans to improve following comments from returned questionnaires and service users views. The manager agreed to include how competency is assessed for new staff on the induction booklet and plans to introduce a LDAF accredited induction. The manager agreed to address these issues. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 7 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. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Service users have the information they need about what the home has to offer which is produced in an accessible format. Service users know their needs and aspirations will be assessed. Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a Statement of Purpose and Service User Guide. These documents include information about the home, staff and the service provided. The Service User Guide has some photos and pictures making it more accessible to service users. This enables prospective and current service users to have the information they need in a suitable format to make a decision about this home. The manager said that the aim of this home is to support service users to develop independent skills. Service users files were sampled. The home has developed a contract of terms and conditions of residency. The manager said contracts have been explained to each service user. The contract details the roles and responsibilities of service users and has been produced in an accessible format. This is an improvement since the last inspection. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 10 Assessments carried out by the home were seen in service user plans sampled. The manager said that she and the provider carry out assessments and compatibility with existing service users is discussed and supported. The home is using the ‘Listen to me’ assessment as well as a more formal assessment, which is recognised by the standards as good practice. Assessments have been completed with service users and some hopes and dreams for the future identified. These assessments should form the basis of the service user plan. The manager should now action plan towards these hopes and dreams with service users. This will ensure service users have the support they need to achieve their goals. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Service users know their changing needs and goals will be supported. Service users are supported to make choices and decisions. Service users are supported to take risks as part of an independant lifestyle. Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector sampled service user plans. Records are organised and easy to follow. A person’s needs are assessed and a plan developed stating how staff are to support these needs. Plans are detailed and reviewed each month by a key worker. These monthly reviews are detailed and include an evaluation of individual goals. Service users and their families attend more formal reviews. A person centred assessment is being used and this should continue to develop to ensure that when aspirations and dreams are identified they are supported and reviewed by staff. Communication guidelines are included in plans detailing any special communication needs. This is important as some service users use alternative Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 12 forms of communication. These guidelines for staff ensure that service users are supported to make choices and decisions. Behaviour management guidelines are developed and are based on positive approaches. These too are kept under monthly review. This consistent positive support has lead to increased participation and inclusion in the local community. Family members commented in letters that they felt certain challenging behaviours have decreased since their relative moved to the home. Risks are assessed and strategies devised to support these risks. This means service users are not restricted but supported to take risks as part of an independent lifestyle. Service users attend reviews when family and care manages are invited. The manager spoke with knowledge and understanding of service users needs and strategies to support those needs. The manager works alongside staff to coach mentor and observe. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Service users take part in a range of activities and are supported to access the community. Service users relationships with friends and family are supported. Service users rights and responsibilities are respected by staff. Service users are offered a balanced diet. Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user has an individual activity planner. The manager agreed to add weekends to this planner. Service users have the opportunity to take part in a range of activities. Service uses indicated that they are happy with these opportunities. Service users access local amenities and facilities, including shops and leisure centres. The manager spoke with knowledge about the importance of service users being part of their local community. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 14 On the day of the visit some service users were attending various college courses including further education and independent living skills training. One service user showed the inspector an information booklet he has edited I his role at a local club. This has been recognised and celebrated by staff. When at home service users enjoy playing pool and watching films etc. There was evidence that service users have been supported to develop their independent living skills. Some service users are supported to attend church and places of worship. Family and friends details are recorded in service user plans. Records are kept of contact with family and friends. Some service users visit friends who live locally and this is supported by staff. Staff support service users to keep in contact with their family as some live a distance away. Service uses said they use the phone in private to speak to their friends and family. Service users told the inspector about holidays they have enjoyed with their families. The manager said all service users will have the opportunity for a holiday this year. The manager said that service users are encouraged to take part in household tasks for example cleaning their rooms and laundry. Some service users take part by doing a part of the task. This leads to more independence and control. Staff were observed interacting with service users in an appropriate respectful manner. The atmosphere was relaxed with service users indicating by their behaviours that they are happy with the pace of life. The kitchen is spacious and was clean on the day of the visit. There was a bowl of fruit available and the inspector saw some fresh vegetables. The kitchen is suitable for service users to take part in cooking tasks. The home keeps a record of meals taken, which the manager said are usually planned on a daily basis. Service users said they are happy with the food provided at the home. Service users said ‘Sami is a good cook’ ‘I like curry’. Some service users are supported to make their own packed lunches and plan and prepare meals. Staff used picture cards on the day of the visits to support choice making. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Service users personal care needs and health needs are met. Medication practices are safe but could be improved. Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal care needs are recorded in individual plans, which are kept under review. This ensures that service users are supported in the way they prefer. Service users indicated that their personal care needs are met. Each service user is registered with a GP. The inspector noted that detailed records are kept of health appointments and outcomes. This included chiropody and dieticians. It was evident that service users are assisted to access a range of health advice and support. Health needs are monitored by staff and advice sought when necessary. Health needs are assessed and where necessary a care plan or risk assessment developed. Since the last inspection the manager has some information about health action plans. These health action plans are in the process of being developed with individuals. This is an improvement since the last inspection. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 16 Staff support service users with their medication as no service user has elected to maintain their own medication. There are systems in place for ordering and receiving medication into the home. A record is kept of medication entering the home. The inspector examined the medication administration records (MAR). There were no gaps and initials are used as required. Since the last inspection the manager has introduced a system for auditing the MAR and medication practice, which is good practice. The manager agreed to add allergies to MAR. Medication is currently stored in a locked filing cabinet. This is not in line with the standard and the manager has ordered a suitable medication cupboard. In the meantime the storage has been improved while the home await receipt of the suitable cupboard. Internal and external medication has been separated. Each service user plan has a current list of service users medication with information about side effects. Guidelines are in place for the use of ‘when required’ medication. The manager said that staff attend a training course and are mentored before they administer medication to service users. However certificates in files were of attendance not of competence. The inspector discussed the need to carry out regular competency appraisals with staff to ensure they maintain their competency. The manager agreed to develop a system to check staff competency regularly. A requirement was made regarding this. The medication policy and procedures has been updated since the last inspection. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users views are listened to and acted on. Service users are protected from abuse. Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure. This procedure is included in the service user guide and is also produced in ‘widget’ format, which consists of symbols. The manager said that individual meetings with staff enable service users to air their views. Service user meetings are also held, which staff facilitate. Opportunity is also given at review meetings to make complaints or raise issues. Neither the home nor the Commission have received any complaint about the service since the last inspection. The home has an adult protection policy as well as the local authority multi agency protection policy. Staff attend training in recognising and responding to abuse. There have no adult protection alerts since the last inspection. When interviewed the manager was able to show knowledge and understanding of adult protection procedures. Service users are supported to control their personal allowance. Individual records are kept of expenditure, which is receipted. The process of ensuring that the manager is not appointee to any service user is in hand. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 18 Aggression and self-harm is understood and supported. Guidelines are clear and based on positive approaches, which is good practice. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,30 The home is safe, clean and homely. Service users rooms are individual and suit their needs Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users appeared relaxed and happy in their home. Furniture and fittings are of good quality and domestic in nature. There is a large lounge, kitchen/ diner with separate laundry on the ground floor. Rooms are spacious. There is a garden to the rear, which is not overlooked and has seating. Service users said they have barbeques in the garden. The house has a homelike feel. All bedrooms for service users are single and all have en suite facilities. There is also a separate bathroom. All of the bedrooms are individual with service users own possessions such as photos and pictures. Service users have keys to their bedrooms. The home was clean on the day of the visit. The manager said that service users are supported to carry out the cleaning and laundry etc. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 20 Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Staff are trained to do their job although competency should be checked regularly. Recruitment checks are robust which protects service users. Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector sampled some staff files. At present staff complete an induction, which is generic and not specifically tailored to learning disabilities. The induction in staff files showed dates and signatures next to topics. There was no record to show how staff have been assessed as competent. Recently the provider has researched a new induction accredited to the Learning Disability Awards framework (Certificate in Working with People with a Learning Disability). The manager agreed to implement this to improve the induction of any new staff. The inspector noted that staff complete a range of training as certificates were present in staff files. The inspector discussed with the manager the need to ensure staff transfer this learning into practice by regular competency appraisals or assessments. There was evidence that thorough checks are carried out to ensure that staff are suitable to work with vulnerable people. The required information in relation to each staff member was available to the inspector and in order. This Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 22 is a development since the last inspection. Staff were observed supporting service users in a positive consistent manner. Service users were at ease joking and interacting with staff and the manager, however staff are aware of maintaining the boundaries necessary for effective support. The staff team is longstanding with good retention rates. This leads to consistency in care and support, which benefits service users. Service users said they get on with staff. Three staff have completed an NVQ qualification. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 This is a well run home. Service users know their health and safety will be protected. Quality assurance systems are in place but should be further developed to ensure that service users views underpin the development of the service. Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager spoke with knowledge and understanding of service users needs and has a good understanding of the day-to-day operation of the home. The manager has been in post since the home opened about two years ago. The manager has several years experience in working with people with a learning disability and has completed the required qualification of the National Minimum Standards. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 24 The manager said that regular staff meetings and regular supervision sessions with staff enable her to monitor practice and ensure effective communication. The manager also works alongside staff. It was evident that the manager is approachable to staff and service users and has a caring and supportive style. There are monitoring and audit systems in place to ensure good practice is maintained. There is a quality assurance system in place. Questionnaires are sent out to relatives and social care and health professionals for feedback. Views of service users are also sought. A summary statement has been produced. The inspector discussed the need for an action plan to be produced from the results. This will ensure that the service develops and improves underpinned by these views. Records are well organised, up to date and held securely. The home is safe, well maintained and free from hazards. The inspector noted that staff attend various health and safety related training courses regularly. Cleaning products are stored appropriately. Accidents and incidents are recorded and included in formal reviews. These are also audited and reported to the health and safety officer for monitoring. Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 26 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 YA20 Regulation 13(2) 18 Requirement Staff must be competent for the job they are to perform. This includes medication practices. The Registered Manager must ensure that staff competency is checked and recorded on a regular basis. Timescale for action 30/10/06 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 YA35 Good Practice Recommendations How competency is assessed should be included in the induction and competency appraisals for staff carried out regularly. The home should use a Learning Disability accredited induction. The quality assurance system should include an action plan to ensure that the review and development of the home is based on service users and stakeholders views. 2 YA39 Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Kingsley DS0000047949.V294763.R01.S.doc Version 5.1 Page 28 - 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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