Inspection on 01/06/07 for Kingston Residential Care Home

This inspection was carried out on 1st June 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingston Residential Care Home 19/09/06

Kingston Residential Care Home 08/11/05

Kingston Residential Care Home 18/07/05

Kingston Residential Care Home 25/09/04

Kingston Residential Care Home 19/04/04

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 Kingston Residential Care Home 27-31 Westbrook Road Margate Kent CT9 5AU Lead Inspector Brenda Pears Key Unannounced Inspection 1st June 2007 10:00 Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 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 Kingston Residential Care Home DS0000023485.V337525.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 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. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingston Residential Care Home Address 27-31 Westbrook Road Margate Kent CT9 5AU 01843 292412 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) kingston.house@craegmoor.co.uk info@craegmoor.co.uk Parkcare Homes Limited Mrs Joanne Jeavons Care Home 21 Category(ies) of Learning disability (21), Physical disability (7) registration, with number of places Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th September 2006 Brief Description of the Service: Kingston provides residential accommodation and care for adults with differing degrees of learning disability. The service users may have an additional physical disability. The Home, owned by a large Company, is a Victorian terraced property on three floors. It is situated in a residential area of the seaside town of Margate and is within walking distance of all local amenities, including the seafront and local shops. There is on road parking to the front of the property. The Home provides 24-hour staff cover, including staff on wake-duty at night. There is always a senior member of staff on duty or on call, to deal with any queries or emergencies. The health care needs of the residents are met by the local primary health care professionals. The fee levels are set according to the needs of the individual and dependent on the staffing hours required to provide this support. An approximate guide to fee levels would be from around £767.13 to £1,364.44 per week. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken on the 24th May 2007 and started at 10.30am. The focus of this inspection was on the previous requirements, on the core minimum standards and the well being of service users. The methods used to complete this inspection consisted of reviewing records, discussions were undertaken with the deputy manager, two service users and members of staff. A tour of the building was carried out plus observations and previous findings all inform the outcomes in this report. The inspector also observed interactions between staff and service users at this time. Four service user questionnaires were received and one family member. All feed back was positive with one service user stating they were pleased ‘how problems are listened to and dealt with’. What the service does well: What has improved since the last inspection? The home was found to be clean and benefiting from some redecoration and refurbishment throughout the building. Picture signs support the safety of service users and these are displayed by fire doors and fire extinquishers. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 7 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 Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are pre admission assessments on record that support the needs of new service users entering the home. EVIDENCE: Prior to any admission being undertaken, the manager carries out a full pre admission assessment. These are contained on care plans along with copies of signed terms and conditions. Five questionnaires received also confirm that full information was available prior to admission to the home. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are reviewed and service users make decisions about their daily life, supporting independence and appropriate care. EVIDENCE: Individual care plans are clearly recorded and completed after discussions with each individual living in the home. Care plans contained up to date information on likes and dislikes, meals eaten, liquids taken, activities undertaken, what members of staff assisted with personal care and how much assistance was given regarding making the bed and tidying the individual’s room. Files seen at this time were orderly, up to date and well maintained. Reviews now contain how the service user has agreed with any decision and how the key worker has involved each service user. There is a mini version of Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 10 the individual’s care plan in each room to ensure all up to date information is readily available when needed. Care plans have been further developed and now contain questions of what a person would like if they were on a desert island. Staff explained that this often highlights things that are important and key workers undertake a record of a ‘Pathway to Independence’. Activities are chosen by each service user and supported by appropriate staffing numbers. A board outside the main lounge area shows what activities are planned and those that have been undertaken. Observations at this time confirm that due consideration is given for independence, privacy and choice. Service users are supported to take reasonable risks to allow them to participate in chosen activities. All risk assessments are kept under review and service user’s personal information is stored securely. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Choices are encouraged and supported, service users engage in appropriate leisure activities in the local community and enjoy a varied diet. EVIDENCE: Outings and activities are chosen by the service user and appropriately supported by staff. Photographs and records of activities and outings enjoyed by service users confirm service users use local amenities and keep contact with family and friends. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 12 Money is now allocated by the organisation to ensure service users are able to enjoy a holiday. Service users have a choice of where to take holidays and recent holidays enjoyed were at Centre Parks and Butlins Holiday Camp. Staff explained how one a service user is supported to maintain a relationship with a person in another home. This relationship has strengthened and is fully supported by regular contact that is facilitated by the home. There is a choice of meal and the chef has a record of meals offered and special diets/preferences are catered for. Service users eat where they would like to and an alternative table is available if anyone wishes to eat quietly away from the dining room. The menu of the day was displayed on the menu board and pictures are currently being developed to support this information. Temperatures of food are taken as food is served and records were seen that show the temperatures of fridges and freezers, a record of the choices of meals offered, why a person has not eaten (for example, if they are at college) and notes if a person is not always eating the meal provided. Clear information was also on file for cleaning products used in the kitchen and paper towels and pump soap were also available in the kitchen area. The meal being cooked at this time was locally purchased meat and vegetables with milk and bread being bought on a daily basis. Meals are home made and a brunch meal is enjoyed at weekends to support those wishing to stay in be a little longer. There is a communication board that identifies activities such as the music man, exercise, nail-care and beauty therapy. One activity that the home has developed is passing items around and for service users to develop a story or describe their memories. This is a sensory experience and most service users take part. Service user meetings are undertaken to inform everyone of activities and any special events that are being planned. Observations at this time confirm that service users choose their own activities and daily routines. Service users in the home at this times were fully included and appeared relaxed and confident when taking part in the inspection. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff do ensure healthcare needs are met, consider the dignity of service users and treat individuals with respect. Medication is administered and stored appropriately. EVIDENCE: The new medical room was seen and this room provides an orderly, bright and well appointed room for dealing with medication. Records clearly state healthcare appointments made and outcomes of all health support that is given. Full reviews are undertaken and the home has good support from the local doctor and the learning disability team. Medication is securely and appropriately stored with all record sheets being found to be up to date and clearly completed. Temperatures of the fridge are monitored and due to some erratic temperatures, the medication fridge was not being used until this was Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 14 repaired. New lighting has been installed to provide the best possible environment for handling and recording medication. The home is currently in the process of producing new pictures of service users for medical records. There are currently no controlled drugs being dealt with in the home. Full information is contained on files regarding conditions, what they are, what medication is taken for, what side effects to recognise and to observe behaviours when new medication is prescribed. The local pharmacy continues to support the home and provides any information that is required. All healthcare needs are assessed and are presented in a section of each care plan along with all areas of health indicators that are recorded and assessed. Staff have a purpose built container for administering medication around the home. Internal and external medication is stored in separate cupboards in the medication room. All medication seen at this time was in date, stores were in acceptable amounts and stock checks are carried out regularly. Staff have worked hard to ensure all requirements in this area are fully met. Service users health needs are fully met and service users are protected by the homes procedure for managing their personal care and medication. Families are kept fully informed of any incidents that affect service users. This was confirmed on one family questionnaire received. Medication is stored securely and keys are also stored in a double secure manner. Only medication is dealt with in the medication room and two staff members administer medication at all times. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines and practices in the home do support and protect service users. EVIDENCE: There is an open and transparent working environment within the home. All money for service users is securely stored and no staff members are appointed to deal with individual finances. Small amounts of cash are stored for day to day expenses and all transactions are supported by two staff signatures. An ongoing breakdown of all transactions is produced on computer and audited regularly. Staff explained that formal service user meetings were causing some anxiety and an alternative approach has been developed to support service users. Staff have a key worker system in place and key workers undertake ‘Key worker meetings’. These meetings are more informal, allow one to one time and provide an opportunity for the individual to express any concerns, worries or develop goals and future plans. Some family members work closely with staff to support service users, ensuring continuity and appropriate support is agreed. Staff have regular contact with families by telephone and through reviews where any changes to care plans are agreed with the service user. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 16 A copy of the complaints procedure is on display in the moan entrance hall as are comment cards for anyone to take and complete along with a copy of the last inspection report. The code of practise, current insurance certificate and philosophy of care for the organisation are also on display. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users benefit from a relaxed, spacious and clean home, although some areas still require upgrading. However, a room set aside for visitors to speak in private with family/friends would be beneficial. EVIDENCE: The registration certificate must reflect the correct number of rooms being offered in the home. Due to the adjustment of double rooms now being used as single rooms, in line with current standards, the registration certificate is inaccurate. The manager has addressed this problem from the home but as this variation application has to be formalised through the organisation, the registration has not been amended and is currently not meeting regulations. Service user rooms are individual, personalised and contain comfortable furnishings. Those who are able, following assessments, have locks and keys Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 18 for their own rooms. One room has magnetic door closures that are connected to the fire alarm. This supports one person who cannot sleep unless the door is open and ensures their safety at all times. Bathrooms seen at this time were bright, well equipped with pump soap, paper towels and appropriate containers for linen and other disposal containers. Hallways are due to be redecorated and carpets replaced. Many door frames have been chipped by wheel chairs and also require repair and decorating. There is a small kitchen area available for service users to use and develop independent skills. Although this area was found to be clean and in good order, the temperature in this room was too hot at this time. It was an overcast day, no sun was shining into this room, yet the temperature was still unacceptable. The heat made it impossible for anyone to use for any length of time. While the laundry was found to be orderly, this area is in urgent need of attention. This very poor condition and damaged flooring is not ensuring the control of infection. This was also highlighted at the last inspection and is in urgent need of upgrading. One questionnaire received from a family member highlighted the fact that visitors do not have a quiet room to sit and talk with service users. This would support visitors and also provide an area where service users could talk privately that was away from their own bedrooms. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff undertake appropriate training, are competent and qualified to work in the home. The homes recruitment policy and practices protect service users. EVIDENCE: The inspector was informed that there is a low staff turnover in the home. No agency staff are used as the current staff fill any gaps in the rota. This supports service users and ensures continuity of care. Each key worker is responsible for maintaining care plans, reviews and records. The staff team on duty at this time consisted of the deputy manager, one senior carer, one acting senior, three care staff, on domestic, one carer undertaking one to one support, on maintenance persons and one chef. Discussions with staff at this time evidenced a good knowledge of service user needs and routines. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 20 A new domestic person has been appointed and domestic work is undertaken Monday to Friday, care staff cover these duties during the weekend period. There is a kitchen assistant who carries out the cooking at weekends as the chef works Monday to Friday. Two staff currently have NVQ level three qualifications, four staff are currently undertaking NVQ level two training and six more are awaiting the start of new NVQ level two courses. The manager has her registered managers award and the deputy manager has NVQ level three and is booked on NVQ level four training. Other training undertaken includes care of ageing skin, pressure sore care and use of creams, behaviour management and training regarding people with learning disabilities. A training matrix was available at this time. Discussions were undertaken regarding the knowledge of dealing with a visually impaired person. Staff were given contact details for support and information to enable staff to fully support any person with a degree of sight loss. This will include ensuring the environment and person rooms are adequately equipped. Staff files were locked and files seen at this time were indexed and found in an orderly format. The organisation deals with all references, CRB checks are obtained before any new member of staff starts work. An induction programme is in place and new staff are seen as being additional on shift when first starting work in the home. Throughout this programme, discussions are undertaken and questionnaires completed by staff to ensure they fully understand the induction process. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff and routines in the home do, in the main, protect service users and promote their safety and well being at all times. EVIDENCE: The home is managed in an inclusive way that ensures everyone, both service users and staff, are aware of what is happening in the home. Observations and discussions with staff confirm that staff are able to discuss any matters with the manager. Service users appeared comfortable and confident during this inspection. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 22 The well being and safety of service users is ensured through recruitment and training. Health and well being is ensured through support from appropriate healthcare professionals and up to date training. Staff are trained in core skills that support service users needs and well being. Life skills and goals are developed and the routines in the home are dictated by the needs and wishes of service users. Service contracts and certificates were seen and were all up to date including those for the shaft lift, electrical testing, boiler and gas checks and also for the emergency alarm system. Kingston Residential Care Home DS0000023485.V337525.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 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 X 2 3 3 X 4 X 5 x 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 2 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 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 3 12 X 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 3 X Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 YA41 Regulation 23 Requirement The registration certificate to accurately reflect the bed numbers in the home to meet requirements and ensure the full safety of service users. Brought forward from previous inspection. 2. 3. YA24 YA28 12 13 23 23 The laundry & linen room must be made fit for purpose. The service user kitchen to be maintained at an acceptable temperature for the well being of service users and staff. That staff are appropriately trained and have knowledge to support the changing needs of service users. (Specifically regarding such needs as sensory loss) 30/09/07 31/07/07 Timescale for action 31/08/07 4. YA35 YA33 12 18 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 25 No. 1. 2. Refer to Standard YA20 YA5 Good Practice Recommendations To ensure pictures continue to be added to files until all medical files are complete. The service user contract to include details of what services are provided for the fees paid. (Requirement from last inspection, but unable to confirm completion at this time. Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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 Kingston Residential Care Home DS0000023485.V337525.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!