Inspection on 25/07/08 for Kitnocks House Nursing Home

This inspection was carried out on 25th July 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kitnocks House Nursing Home 24/07/07

Kitnocks House Nursing Home 22/11/06

Kitnocks House Nursing Home 13/01/06

Kitnocks House Nursing Home 21/07/05

Kitnocks House Nursing Home 18/01/05

Kitnocks House Nursing Home 07/07/04

Kitnocks House Nursing Home 08/01/04

Kitnocks House Nursing Home 22/07/03

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Kitnocks House Nursing Home Wickham Road Curdridge Hampshire SO32 2HG Lead Inspector Kathryn Emmons Unannounced Inspection 25th July 2008 09:00 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 Kitnocks House Nursing Home DS0000012130.V367545.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. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kitnocks House Nursing Home Address Wickham Road Curdridge Hampshire SO32 2HG 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) 01489 798244 01489 799411 kitnocks@zoom.co.uk Kitnocks House Limited Mr Anthony Nicholas Murdoch Care Home 62 Category(ies) of Dementia (62), Dementia - over 65 years of age registration, with number (62), Mental disorder, excluding learning of places disability or dementia (62), Mental Disorder, excluding learning disability or dementia - over 65 years of age (62) Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Dispensation has been given to 4 named service users in the LD category to remain accommodated in the home. 24th July 2007 Date of last inspection Brief Description of the Service: Kitnocks House is a care home providing nursing and accommodation for 62 persons with mental health difficulties, from the age of 18. It is situated in the rural area of Curdridge, between the local villages of Botley, Wickham, and Bishops Waltham. The registered provider is Kitnocks House Ltd. Kitnocks is a converted Edwardian building, originally refurbished and opened as a 32-bed nursing home in 1993. It was further extended in 1994 and in 2007 an extra 13 beds and communal areas were added. All bedrooms are single with the exception of 6 double bedrooms. There is a passenger lift. The home is set in large grounds. Flexi paving is provided so that the grounds may be accessed and enjoyed with minimal risks to service users. Residents must meet the National Health Service clinical eligibility criteria for continuing care before they can be admitted. The home’s weekly fees range from £750 per week to £1930. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. A visit to the service took place on July 25th 2008. This visit was unannounced and took place over 5.5 hours. Care received by three residents was looked at in detail. This is a method called case tracking. This included looking at their personal records, a range of general home records and staff detail records. Staff were spoken with and the care they provided was observed. One relative completed one of the comment cards we had sent out before the visit. We also received a completed self-audit document completed by the manager, to provide information before we did a site visit. We also looked at how the provider makes information about their service, including CSCI reports available to prospective service users. What the service does well: There was evidence that information about residents have been obtained before they went to live at the home. This means that staff can have an understanding of residents needs to ensure these can be met before an offer of admission is made. Excellent access to a multi disciplinary heath care team means that resident’s holistic needs are met and responded to promptly. Residents are offered a comprehensive activities programme. This means that residents have opportunities to engage in worthwhile activities. Residents have a good choice of food available and they are consulted regarding the choice of food. This means that residents are able to express their opinions and are provided with a varied diet. Staff receive training and are engaged in a National Vocational Qualification training programme and ongoing training for keeping their Nurse registration up to date. This means that they have more knowledge and skills to provide care for residents. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Through pre admission assessment, undertaken by knowledgeable healthcare professionals, residents can be confident that their assessed needs can be met when they are admitted to the home. Up to date information enables residents to make an informed choice regarding living at the service. EVIDENCE: From looking at three resident files we could see that information regarding residents needs had been obtained before they had been admitted to the home. There were assessments undertaken by the manager of the service and information obtained from other health care professionals such as psychiatrists and the resident’s hospital doctors and social workers. The manager told us that normally any assessment would be undertaken by the manager and the Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 9 consultant psychiatrist to ensure that all of the prospective residents needs can be met by the service. Two documents are in place called the service user guide and the statement of purpose. These two documents are available to residents and their relatives and inform them of the services they can expect if they live at the home. Details also include who the staff are and what jobs they do, what the environment is like and what to do if they have any concerns. We saw that contracts were in place, which had been signed by the resident or their relative. We saw on file a letter from the manager to the resident confirming that they needs could be met at the home. This enables residents to have confidence that they are going to live in a home where staff can meet their individual needs. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive care plans and risk assessments enable residents to be confident that their needs will be met. Medication systems and relevant training enable residents to be confident of receiving their medication correctly. Comprehensive access to heath care professionals enable residents to have their heath care needs met. Resident’s dignity and privacy is maintained. EVIDENCE: Through case tracking we looked at three residents care files. In each file we saw similar documents. These included care plans for daily personal care needs such as washing and dressing and taking meals and medication through to mental heath needs and social recreational needs. Where possible the resident or their relative had signed the care plans. We could see that these were reviewed monthly and regular updates were seen in the welfare and progress Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 11 notes. There is an annual review where all relevant people are invited including the key worker for the resident or senior nurse. We spoke with staff and saw staff delivering care and it was clear that they knew each individual need of each resident. This means that residents are able to have their care needs met even if they are unable to communicate these to staff. Residents who spoke to us and through surveys we received back from staff and relatives we could see that residents had access to Doctors, mental heath professionals such as Community Psychiatric nurses (CPN’s) and Consultant Psychiatrists and Consultants in the Care of older people. Some residents living at the home have needs, which fall under the Mental Health Act 1983 so they also receive reviews as part of this. We could see from files that opticians and dentists visit when needed. During the visit we met with the local doctor who has all of the residents on their caseload. The doctor told us that they did a twice weekly surgery at the service and would also see residents outside of these times if needed. Some residents had nursing needs in respect of Catheters, tracheotomy and PEG’s (percutaneous endoscopic gastrostomy) )all of these procedures are carried out by the trained nursing staff. The manager confirmed and we could see from training certificates that all staff received training and regular updates to evidence that they were competent and understood current safe practice. Medication records were seen for two areas of the service and those residents case tracked. Records had been competed correctly and we could see what medication was ordered and when it was returned back to the pharmacy. All of the residents living at the service receive nursing care so a trained nurse on each shift is responsible for administering medication. The doctor told us that residents medication was regularly reviewed to ensure that residents were not on medication they did not need. A relative told us that their relative who lived at the service was always treated with respect. Three of the residents we spoke with indicated they were happy with how they were supported. One resident said “I get a lot of help and they come and sit with me” Interactions were seen by us that were valuing and appropriate. Examples were when a resident had wanted to speak with the manager and did not understand they had to wait as the manager was speaking to someone else. Staff were seen assisting a resident into the lounge and the resident did not understand where they were going and another resident who was anxious about locating her laundry. It was clear that staff understand that many of the residents have mental health conditions as well as being older people. The support in using the toilet and moving around the service was given in a discreet way and staff were seen to knock on the doors to bedrooms and bathrooms before entering. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with appropriate activities and are supported to access the local community. Staff have an awareness of residents spiritual and emotional needs. Residents have control over who visits them. Dietary needs and preferences are catered for. EVIDENCE: Care plans contained residents choices regarding activities . Since the last inspection more activities have been provided and during our visit we could see that all residents were engaged is some form of activity. There is an activities coordinator who visits the home from 1 – 7pm five days a week. A female care assistant visits twice weekly to engage female residents in activities such as nail care and hair care. Another activity person visits for 2 afternoons per week. External entertainers also visit the home an example of this is a singer who will do music and singing afternoons. We saw residents during the visit engaging in playing football, doing a jigsaw and watching television. Currently 9 of the residents attend local community activities such as working an Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 13 allotment, going to Lee-on-Solent and visiting places of local interest. One of the residents also goes to a local support group. There are links with local churches and residents spiritual needs are acknowledged and respected. Residents living at the service have varying levels of ability and varying disabilities. There is a working knowledge of equalities and diversity .The manager and staff work hard to try and enable residents to be as independent as possible whilst remaining safe. Examples give to us were people attending various religious services and being able to dress how they chose. Residents we saw indicated they had enjoyed their lunch on the day of the visit to the service. Comment cards received from relatives also indicated that the food provided was “always” good. The administrator is responsible for liaising with residents to produce a menu. This was seen and was varied. We could see that residents had choice and were able to have snacks and drinks when they wanted. Those residents who had dietary requirements such as diabetes and vegetarian diet were catered for. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints policy enables people to know how to make a complaint. Daily contact from the manager to the residents enables any concerns to be raised quickly. A Safeguarding adults policy provides staff with a working awareness of what constitutes abusive practice. EVIDENCE: Prior to the visit pre inspection self audit information was sent to the commission. This recorded that there had been one complaint and one safeguarding incident since the last inspection in July 2007 . we had information at our office which made refernce to another safeguarding adult incident and another two concerns regarding a residnets rights not being upheld and residents not being safe when they went to bed due to their beds not having correct bedrails fitted. All of these incidents were dicsussed in depth with manager. It was confirmed that all incidents had been referred appropriately investigated and concluded. The only issue which was upheld was regarding bedrails being fitted to a bed, which had been carried out. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 15 A complaints file is in place and residents are able to speak to the manager on a daily basis. We could see that one resident wrote letters every day to the manager raising issues and these were always responded to. A comment card we received from a relative indicated that they were “always” satisfied with the process for raising issues if they had any. A safe guarding adults policy is in place. Three staff when asked said they knew about the policy and where to find a copy of this. We could see from training files of three staff that safeguarding training had been delivered. Two staff we spoke with were given safeguarding adult scenarios and they answered these appropriately. Additionally the manager has written to one of the consultants used by the service to arrange more training in the area of managing challenging behaviour and abuse awareness. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and pleasant service, which they have control over. Décor and furnishings are residents choice and specialised equipment enables them to be as independent as possible. EVIDENCE: Since the last inspection work has started on a new wing being built onto the side of the home. This will be ready for registration by November 2008 and will provide additional bedrooms and communal areas. An ongoing refurbishment programme is in place with communal areas and bedrooms being redecorated. We saw specialized equipment such as hoists and assisted baths in place. We saw a few bedrooms and these had been personalised by the resident living in the room. We could see that there were Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 17 specialised beds and matting in one of the rooms to enable the resident to be safe. There were various seating facilities including lounge chairs, which enable the resident to sit in a chair without slipping out. There are soft paving areas in the courtyard . This enables residents to be as safe as possible when undertaking outside activity. The gardens are landscaped and have garden furniture so residents can sit outside in a comfortable environment. The home was clean and tidy and fresh throughout and residents indicated to us that they were satisfied with their rooms and the general lay out of the home. One resident told us they couldn’t find their laundry but a care assistant was able to show us the location of the resident’s laundry. Residents clothing looked to be in good repair and well ironed. Bed linen and towels were in good supply. This all contributes to residents living in comfortable surroundings. Residents we spoke with told us they were satisfied with their bedrooms. We saw that call bells were in place and we used one in a bedroom and this was answered very promptly. A resident told us “I call my bell sometimes and they are here straight away”. An infection control policy is in place and staff were seen wearing gloves and aprons and using correct disposal bags when dealing with dirty laundry. Training files also showed that infection control training had taken place. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An enthusiastic and trained care team cares for residents. The services recruitment procedures ensure residents are cared for by safely recruited staff. Staff are employed in sufficient numbers and skill mix to meet assessed needs of residents. EVIDENCE: Residents spoken with and comment cards received indicated that residents are satisfied with the way in which they are cared for by the staff team.One resident said “I like them all they are good to me and will help me” another resident when asked if they liked the way they were helped by staff they said “Yes, I do a lot,they nice”. Most of the judgements we made about staff skills have been made by observing how staff supported residents. We saw interactions which showed that staff were patient with residents and tried to engage with them to seek out the residents choices and preferences. We saw staff laugh and chat with residents and they had time to sit and talk with the residents about issues such as a film that was on television, where a resident was going on a forthcoming trip and general chat about the weather and what was happening in the service such as activities. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 19 The atmosphere in the service was very relaxed and there were staff in all areas on the service ready to provide support and companionship to residents. One staff member said the atmosphere and relationship between residents and staff was “like a big family” We could see from the pre inspection information we were sent and from what staff told us that there were at least three trained nurses on a shift and they were supported by at least 7 care staff. Staff told us about their induction process and how they would participate in the induction of other staff. It was evident that staff would not work by themselves until they were assessed as being competent and they also themselves felt confident to care for residents. Staff told us that they had received training in first aid, abuse awareness and moving and handling. Pre inspection information showed that staff have been trained in National Vocation Qualifications and that 60 had NVQ 2 or above. A couple of trained staff told us they were supported to keep up with their ongoing training to ensure they carried out up to date research based practices. Three recruitment files were looked at. A recruitment policy is in place and all files seen contained the correct checks such as references, completed application form and Criminal Record Bureau checks and identification. This means that staff have been recruited safely and residents can be confident that they are cared for by people who have the necessary skills and attitude to care for them. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A Manager who has a good rapport with residents, health and social care professionals and visitors manages the service. Residents are protected by the services health and safety polices and procedures. Financial management systems keep residents monies safe. Quality assurance systems show how the service is run in the best interests of the service users. EVIDENCE: The manager of the service is Dr Nicholas Murdoch. Dr Murdoch has been the registered manager for several years and has many years experience in caring for residents with mental heath conditions and physical disabilities. Staff said they had a “very good professional relationship” with the manager and made Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 21 comments such as “You can go to Nick for anything he is so supportive” and “He is always there for you and is very happy to teach you as much as you want to know”. A comment card we received back said that the manager is “always available to speak to and approachable”. We were told by a health care professional that the manager “knows the residents needs very well and provides them with many opportunities to do as much as they can for them selves”. Residents were seen interacting with the manager. We could see the manager was positive and responsive to residents. A quality assurance system is in place so residents and visitors to the home can see how the providers intend to improve the service and action any points residents raise. Residents and relatives are given a questionnaire to complete annually and the registered providers of the service carry an audit visit out every month. These reports are discussed with the manager and copies are kept in the home. We discussed with the administrator how residents finances were managed. We saw records which indicated that monies were held in a safe way and a clear audit trial was in place to ensure resident’s money was safeguarded. Pre inspection information evidenced that polices and procedures are maintained. Records are in place at the home, which show that servicing of equipment and systems such as the fire safety system and heating system are up to date. Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 x x 4 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 4 x x 3 x x 4 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 4 x 3 x 3 x x 3 Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no 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 Kitnocks House Nursing Home DS0000012130.V367545.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone 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. 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