Inspection on 20/12/05 for Mount Ephraim House

This inspection was carried out on 20th December 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Mount Ephraim House 20/01/09

Mount Ephraim House 28/01/08

Mount Ephraim House 26/07/06

Mount Ephraim House 21/06/05

Mount Ephraim House 08/02/05

Mount Ephraim House 02/11/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Mount Ephraim House Mount Ephraim Tunbridge Wells Kent TN4 8BU Lead Inspector Debbie Sullivan Announced Inspection 20th December 2005 09:30 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 Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 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. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mount Ephraim House Address Mount Ephraim Tunbridge Wells Kent TN4 8BU 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) 01892 520316 01892 523180 mountephraim_house@tiscali.co.uk Greensleeves Homes Trust Mrs Julia Main Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2005 Brief Description of the Service: Mount Ephraim House provides residential care for a maximum of 38 older people. Greensleeves Trust, which is a charitable organisation, owns the home. The property is an attractive period house located in a residential area of Tunbridge Wells close to the town centre. There are large well-kept and secluded gardens and a small parking area at the front and side of the house. Accommodation currently consists of 37 rooms for single occupancy, six of which are equipped with a shower and en suite facilities. Bedrooms are located in the original part of the building and an annexe; thirteen bedrooms are located on the ground floor. A bedroom is available for guests who may wish to stay overnight. There are two shaft lifts in the main building and a stair lift in the annexe. Each bedroom is equipped with a television point and there is a staff call system. The home employs a manager, deputy manager, two assistant managers, carers, administrative, catering, maintenance and housekeeping staff. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over seven and a quarter hours. The visit included a tour of the premises, time spent with the manager and individually with four members of the care staff, the cook, seven residents and a visitor. Documentation was read and the residents were joined at lunchtime. The pre inspection questionnaire completed by the home and a small number of comment cards received also provided information. At the time of the inspection the home was fully staffed, one resident was in hospital and there were two vacant bedrooms. Throughout the day staff were friendly and helpful and ready to provide any information requested. Comments received during the inspection included, From residents, “I like being here very much” “They do look after you” “Meals are pretty good” “Lovely old home” “This home is 100 ” From staff, “I am very happy here” “There was a nice feeling when I came to get an application form” “Very impressed, everyone is very friendly here” “ They were really good about my NVQ, it started quickly”. “Very clean home” What the service does well: The home provides a clean, homely and welcoming environment. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 6 The routines are flexible and residents enjoy being able to be as independent as possible. Needs are thoroughly assessed pre admission, if the home is no longer able to meet needs reassessment is requested involving relevant other professionals. Staff enjoy working at the home and feel well supported, training opportunities are good and more staff are undertaking NVQ courses. The home is well managed, with the new management structure proving successful in sharing responsibilities to ensure the home runs smoothly. What has improved since the last inspection? What they could do better: Work is taking place to ensure that all staff receive regular supervision, this needs to be consolidated. Proposed plans for renovation, possible extension and improvement to the home need to be formalised, and in the meantime repair and refurbishment necessary to any area in the home needs to be undertaken, especially where woodwork around windows in residents’ rooms has become cracked and in need of repainting. An area of the laundry floor must be made impermeable. A new drugs fridge will ensure medication is kept at the correct temperature. Progress is being made and needs to continue in the number of care staff NVQ trained. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 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. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 8 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 Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5. Prospective residents are able to access information about the home to help them make an informed choice. Assessment takes place prior to admission and residents are only admitted if needs can be met. EVIDENCE: The home has a statement of purpose and service user’s guide, both of which have very recently been updated and are presented in an attractive format in a folder, an accommodation and service agreement are provided for each resident. Assessment of needs takes place prior to admission by two members of the management team, or a manager and carer, assessment forms are included on care plans and help to inform more in depth recording of needs. Prospective residents and their relatives are able to visit the home to view the service and trial stays can be arranged. During the inspection a manager received a telephone enquiry about vacancies and suggested a visit take place. A resident spoken with said their daughter had viewed the home on their behalf. Following admission a six-week trial period takes place. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 10 The home does not offer intermediate care, although does provide respite and an example was given of a resident admitted for respite who chose to remain at the home permanently. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. Care plans contain comprehensive information regarding residents’ needs and are regularly reviewed. Medication policies and procedures are in place; storage of refrigerated medication needs to be improved upon. Carers treat residents in a dignified manner and privacy is maintained. The needs and wishes of residents near the end of their lives are respected. EVIDENCE: Each resident has a care plan recorded in an indexed folder, information was east to find and recording, especially in relation to keeping reviews up to date, had improved since the last inspection. Several care plans were read including one of a fairly recently admitted resident and one including an example of involvement from medical professionals where there was concern that needs could no longer be met by the home. Care plans also included risk assessments, agreement to self medicating where applicable, weight charts, daily log sheets and sheets for recording contact from GP’s and other professionals such as District Nurses or chiropodists. On the day of the inspection the health and behaviour of one resident was causing concern, action was taken to contact the GP who arranged hospital admission, to Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 12 contact a relative and make sure a carer frequently monitored the resident and stayed with them for much of the time. A key worker system is in place with each member of the care staff having special responsibility for up to four residents. The home has a secure medication room; the temperature of the drugs fridge had been erratic and was occasionally too high, the home will need to purchase a new fridge to ensure the safekeeping of refrigerated medication. MAR sheets were correctly completed and included a photograph of the resident and a list of the condition each medication was used for. Carers receive medication training and observation of the lunchtime drugs round showed that it was undertaken correctly. Residents spoken with were happy with their care, throughout the inspection care staff were seen to be attentive towards them, treat them with dignity and respect privacy. Residents near the end of their lives are able to remain at the home as long as needs can continue to be met, preferences for terminal care and funeral arrangements can be recorded on the care plan if wished. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Residents are able to exercise choice and control over their lives and the routines of the home are as flexible as possible. Meals are well cooked with daily choice available. EVIDENCE: One of the deputy managers is responsible for organising activities, regular activities include a reading session, keep fit, quizzes and bingo, beauty sessions, craft and visits by entertainers, a Christmas party had taken place the previous week. Religious services are held at the home on a monthly basis. Hairdressing is available weekly. The routines of the home are flexible, residents are able to go out independently or with relatives, carers sometimes take them out if time allows. One carer spoke of taking residents shopping, a resident was going out to lunch with a relative and another was taking a walk around the garden after lunch, which they choose to do even in cold weather. Visitors arrived during the inspection and were made welcome. Throughout the home several tea and coffee making areas are available and residents have access to fridges to store their own food. Several comfortable areas to access in the daytime are available, and residents are able to choose when to get up and go to bed, breakfast can be taken in bedrooms. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 14 Individual bedrooms seen all included varying amounts of personal items brought from previous accommodation, rooms can be decorated to individual taste when a resident moves in. Meals are served in an attractive dining room, a small number of comment cards received from residents stated that they did not always find the food satisfactory. Residents spoken with were mainly satisfied with the choice of meals provided, with one resident commenting that if they did not like what was offered they could request an alternative. Two choices of main meal and supper are available daily, alternatives provided are recorded. Meals are freshly cooked, fresh fruit and vegetables are delivered each weekday. The menu is displayed in the dining room and residents are asked daily for their choice. Residents were joined at lunchtime and were served portions appropriate to appetite. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Residents can feel confident that any concerns or complaints will be listened to and acted upon. Residents are protected by the homes’ adult protection procedures and recruitment practices. EVIDENCE: The home has an established complaints procedure, the complaints and suggestions leaflets were displayed near the main entrance. No formal complaints had been recorded for over a year, the manager said that residents do verbally complain but are reluctant for complaints to be written down. Matters brought to the attention of the management team are usually resolved quickly. A resident spoken with had once complained about a matter in relation to their personal care, which had been promptly dealt with. There had been one adult protection raised by the home since the last inspection that was fully investigated with the knowledge of the resident concerned and closed, it was not in relation to the care or any other service offered by the home. Staff receive adult protection training and carers spoken with were aware of the homes’ adult protection procedures. CRB and POVA checks are taken up on all staff employed at the home. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26. The home provides a well-maintained, clean, safe and homely environment. Opportunities for independence and access would be increased by renovation to some parts of the home. EVIDENCE: The home occupies a period building with an annexe, accommodation is on three floors with access via stair or shaft lifts. Due to the nature of the building a number of bedrooms also need to be accessed via a step or a few extra stairs, in the annexe the stair lift does not reach the top few stairs, therefore residents on that upper level need to be fully ambulant to be totally independent, if they begin to experience mobility problems a ground floor room is offered when one is available. One resident spoke of recently moving downstairs due to reduced mobility and being much more independent as a result, another was waiting to move. Planned renovation and improvement to the home would increase opportunities for access to some areas. Equipment to aid independence was seen throughout the home, a bath hoist was being fitted in one bathroom during the inspection. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 17 All areas seen were clean, well decorated and homely; a lot of work had gone into decorating for Christmas. The maintenance man undertakes minor repairs and the manager said that whilst major work on the home is awaited minor refurbishment such as fitting of new carpets in some areas would take place. Individual bedrooms were all well decorated and comfortable and included personal items and furniture. In the older part of the building some window frames in bedrooms and other woodwork had become cracked and needed repainting. Communal areas comprise of a large and small lounge, dining room, games room and library. The garden is very attractive and well maintained, and includes a patio area; residents spoke of enjoying accessing it in good weather. There are bathrooms on each floor, one bathroom on the upper floor of the old part of the home is unusable as it is too small, it could be extended into an adjoining storage room and this should be strongly considered to allow more independence for those on that floor. A small area of the laundry floor needs to be recovered, as it is permeable. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. A well-trained and competent staff group meets the needs of residents, further training would enhance skills. The homes’ recruitment procedures serve to protect residents. EVIDENCE: The home was fully staffed, recent recruitment having been successful, one new carer had started work the day before the inspection and was shadowing whilst on induction. Four carers are on duty in the mornings, three in the afternoons and two waking carers are on duty at night. When new staff are shadowing they are in addition to the usual staff compliment. Maintenance, catering, housekeeping and administrative staff are also employed. Some staff files were read including that of a new employee and ancillary staff, all contained proof of identity, CRB checks and references. New staff spoken with all said they had found the recruitment process thorough and professional. Staff receive induction and mandatory training such as manual handling, first aid and fire safety as well as training on specific topics of interest for example, diabetes and dementia. Topics can be requested and training on emphysema had been provided by a local hospital at the request of staff caring for a resident with the condition. Staff felt that training opportunities were good and new carers were complimentary regarding their induction and the patience shown by new colleagues whilst they gained confidence. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 19 The home has not reached the target of 50 care staff being NVQ trained in 2005,some staff with the qualification had left although others are on a course and new staff will be signed up to courses. New staff are expected to show a commitment to the training. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 and 38. The home is well run in the best interests of residents and staff. Residents can feel confident that their health, safety and welfare are protected by the homes, policies and procedures. EVIDENCE: The manager is well established at the home, there are also a deputy manager and two assistant managers. The deputy and one assistant manager have recently joined the home and started the NVQ 3 course, the manager is currently undertaking the Registered Managers’ Award. The new management team is working well together and some aspects that required attention are being addressed, such as regular supervision for all staff. Not all staff had previously had regular supervision meetings, now this is being shared by the management team, established staff spoken with stated that they did have supervision. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 21 The atmosphere in the home is open and welcoming, staff were seen to relate in a friendly and professional manner with residents and to work well as a team. New staff commented on how welcome they were made on arrival. Residents and relatives are sent a six monthly questionnaire so that they can comment on aspects of the running of the home and regular resident and staff meetings are held. The home does not manage residents’ finances, but gives options for the safe storage of funds, residents can either lock money in their rooms or use the homes’ safe in which case all transactions are recorded and doubly signed for. Records are kept safely and securely in the office area and residents can access their personal information on request. The home has organisational policies and procedures in place, a sample of which were inspected, as were some maintenance records. Regular fire practices take place and alarms are tested weekly, the home has a valid insurance certificate and records seen in respect of other safe working practices such as testing of food and fridge temperatures in the kitchen were up to date. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 2 3 3 2 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 4 3 3 3 2 3 3 Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 23 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 OP9 Regulation 13(2) Requirement Timescale for action 20/02/06 2 OP19 23(2)(a) 3 OP22 23(2) “ The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home”. In that a new drugs fridge needs to be purchased to ensure that refrigerated medicines are kept at the correct temperature. “The registered person shall 20/02/06 ensure that the premises are suitable for achieving the aims and objectives set out in the statement of purpose” In that plans developed for the renovation and improvement of the property need to be drawn up and made available to CSCI at the earliest opportunity, with a proposed timescale for work to commence. The manager stated that plans are in the process of refinement. This requirement is repeated from several previous inspections. “The registered person shall 20/02/06 ensure that the physical design and layout of the premises DS0000023986.V263806.R01.S.doc Version 5.0 Mount Ephraim House Page 24 4 OP21 23(2)(j) 5 OP26 13(3) 6 OP28 18(c) 7 OP31 9((i) meets the needs of service users”. In that proposed improvement to the premises include action to provide unrestricted access to and from the upper level of the annexe for residents. “ The registered person shall ensure that there are provided in the premises sufficient numbers of lavatories, and of wash basins, baths and showers.” In that within plans for renovation consideration must be given to extending the upper floor bathroom in the older part of the building to allow residents on that floor maximum independence. If renovation is delayed this work should be considered independently. “The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home.” In that the laundry floor must be made completely impermeable. “ The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform.” In that work to achieve 50 NVQ trained care staff must be progressed. “A person shall not manage a care home unless he has the skills qualifications and experience necessary for managing the care home”. In that the registered manager needs to complete the DS0000023986.V263806.R01.S.doc 20/02/06 20/02/06 20/02/06 20/02/06 Mount Ephraim House Version 5.0 Page 25 Registered Managers’ Award. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP16 OP18 OP19 OP36 OP38 Good Practice Recommendations It is recommended that all complaints be recorded in the complaints book, residents making a complaint should be advised it is good practice to record concerns in writing. It is recommended that CRB checks be renewed every three years. It is recommended that window frames and surrounds in bedrooms be repaired where they are cracked and needing repainting. It is strongly recommended that the planned programme of regular supervision for all staff be fully implemented as soon as possible. It is recommended that all parts of the premises be surveyed in relation to the location of smoke detectors and where necessary additional detectors be fitted. Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Mount Ephraim House DS0000023986.V263806.R01.S.doc Version 5.0 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. 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