Inspection on 16/07/08 for Newpark

This inspection was carried out on 16th July 2008.

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

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newpark 31/07/07

Newpark 03/10/06

Newpark 16/11/05

Newpark 18/04/05

Newpark 21/09/04

Newpark 13/08/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

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 28/09/2008.

CARE HOME ADULTS 18-65 Newpark 3 Park Road Southborough Tunbridge Wells Kent TN4 0NU Lead Inspector Gary Bartlett Unannounced Inspection 16th July 2008 09:30 Newpark DS0000041066.V367603.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 Newpark DS0000041066.V367603.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. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newpark Address 3 Park Road Southborough Tunbridge Wells Kent TN4 0NU 01892 537717 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) gem.newpark@tiscali.co.uk Chistlehurst Care Ltd Miss Gemma Lucy Wanstall Care Home 10 Category(ies) of Learning disability (0) registration, with number of places Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 10. Date of last inspection 31st July 2007 Brief Description of the Service: Newpark is a residential care home providing personal care and social support for 10 residents who have a learning disability. It is a large semi detached house in a residential area with accommodation over three floors. The home does not have a shaft lift and all the bedrooms in the main house are located on the first and second floors. Two rooms are located in a ground floor flatlet adjoining the main building. The residents have access to a vehicle for attending day care, outings, shopping and other activities. The nearest shops and other amenities such as church, pub and post office are within walking distance. There is easy access to public transport. There are gardens to the front and rear of the property, which can be used by residents. There is car parking space to the front of the house. The home’s current scale of fees range from £524 to £739 per week. Newpark DS0000041066.V367603.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 1 star. This means the people who use this service experience adequate quality outcomes. This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Newpark on 16th July 2008 from 9:30 am until 1:30 pm. The day was spent talking with service users, the Manager and staff and looking at a sample of records including clients care plans and daily records, staff recruitment and training records, accident and incident records. There was a tour of parts of the building and grounds. Judgments have also been made using observation of practice as a number of service users find it difficult to verbalise their opinion of the service. The two surveys returned from relatives of people living in the service tell us that their experiences of the quality of care their relative receives and the quality of the contacts with the service are positive. Comments made by staff include “This is really and truly a happy home and everyone gets on very well” and “It’s a joy to work here”. The Care Homes Regulations 2001 and the National Minimum Standards for Care Homes for Older People refer to people who use the service as “service users”. People living at Newpark prefer to be referred to as “residents”. Accordingly this shall be done in the text of this report. Although not rostered to be working at the time of inspection, the Manager happened to have called into the home and kindly offered to stay. The Responsible Individual was also present for part of the time. The Inspector would like to thank everyone for their contribution to the inspection. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Care plans are being made available to residents in a format they can more readily understand. Improved facilities for the storage of medicines have been provided. There is substantial redecoration and refurbishment being undertaken of the home. Residents with limited mobility have safer access to the rear garden. The minibus has a new step making it easier for residents to get in and out. Staff allocation and numbers have been reviewed to further promote residents independence. The staff rosters indicate a particular person designated as being in charge of a shift to give clearer lines of responsibility and accountability. The complaint procedure has been revised to show that the Commission can be contacted at any point in the process. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 7 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. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ aspirations and needs are assessed before admission to the home. EVIDENCE: The Manager described how prospective service users are only admitted to the home after a full assessment of needs. These are inclusive of relatives and health care professionals and are the starting point for service users’ individual support plans. The records sampled included assessments of personal support, health care needs, religious and cultural needs and social activities. The Manager confirmed the home offers service users a ‘settling in’ period to ensure the home is the right place for them and they are compatible with people already living at the home. Each resident has a contract. Contracts give good detail of the rights and responsibilities of the organisation and the resident. The contracts have space Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 10 to record personal contract detail such as room and fees and to be signed by the resident or their advocate. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents’ care plans, risk assessments and guidelines need further development to ensure consistent support by staff in meeting residents’ individual health and social care needs. EVIDENCE: Each resident has a folder containing information about care needs, current goals, risk assessments and supplementary information. Three were inspected in detail. These would be easier to use if old information was removed and filed separately. Observation of practice showed that staff have a good understanding of individual care and support needs but important information is not always recorded in the care plans. For example if a resident has a Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 12 particular medical condition for which they need regular support. Nor is it clear from records that staff have had the appropriate training to provide the support. Some records are unsigned. Through discussion with the Manager, reading the care plans and observation, it is evident that residents are given full support and encouragement to maintain personal contact with health and social care professionals. Staff are aware that residents have the right to take responsible risks. Risk assessments are normally carried out in response to individual need and to events which indicate risk management processes are needed. In some recent situations risk assessments should have been updated to reflect incidents. Although staff knew what action to take, it had not been recorded. The home does not act as appointee for residents’ monies. This is done via family members or local authority financial services. Residents have access the home’s petty cash for personal spending and this is invoiced to their appointee for reimbursement each month. The Manager said the monthly visits done by the company now look at the handling of residents’ finances. Interaction between residents and staff was observed to be very good showing genuine respect, friendship and appropriate familiarity with each other. Records seen are kept in a manner that maintains confidentiality and there are facilities for them to be stored securely when not in use. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are given encouragement and support to make choices about a range of local social and recreational interests as far as is practicable. EVIDENCE: Staff described how residents are encouraged to follow hobbies and interests of their choosing. Routine is important for those living here and discussion with residents and staff indicates a steady, though flexible, routine occurs on a dayto-day basis and individuals feel safe with this. The home has its own transport. Residents spoke of leisure outings such as the local pub, (a particular favourite), having ‘lunch out’ particularly birthdays, Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 14 bowling and walks to the park. Other occasional opportunities include trips to theatre, shows; daytrips to the coast. Some residents prefer to watch TV, videos, listen to music, playing board games etc. Personal preferences of getting up and going to bed are observed, with account being taken of planned activities. All residents have at least two planned activity days at places of education or work experience Residents visit their families at weekends and can receive visitors at the home. The home does not have a designated cook, meals are prepared by staff, with assistance from residents. Menus are planned with residents choosing what they like to eat. Residents think the food is good and the lunch served during the site visit was eaten with relish. There is a good awareness of healthy eating. Drinks were being made throughout the site visit. Aids to eating are provided and staff are sensitive when assisting someone to eat. Direct observation showed mealtimes to be at a pace comfortable to the residents. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health, social and personal care needs of those living here are well supported with regular contact with specialists and external professionals. Those living here are treated with respect and dignity by care staff. Residents are protected by staff adhering to good practice guidelines in the administration of medicines. EVIDENCE: Staff are clearly aware as to the type and nature of the support required for individual’s personal and intimate care needs and every effort is made to maintain their privacy and dignity at all times. Through discussion with the Manager and assessing the three care plans, it is evident that residents have ready access to health and social care professionals. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 16 The arrangements for the storage of medicines has been improved by the acquisition of an additional drugs cupboard so internal and external medicines can be stored apart. Although the last report stated the temperature of the area used must be monitored to ensure the medicines are stored at the recommended temperature, there are no records to show this is being done. The Manager said she would keep a record with immediate effect. Records show that all staff administering medications have been trained and signed off as being competent to do so. The Medication Record Administration Record (MAR) sheets inspected had been completed appropriately and medicines were seen to be given in accordance with good practice guidelines. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Systems are in place to enable those living and those visiting the home to raise concerns or complaints with staff and people they trust. Residents would be better able to do this with access to procedures in a format they would more easily understand. Protection from abuse has been promoted through staff training and understanding of the support and actions they may need to take. EVIDENCE: The home has a clear complaint procedure in that is on display in the hallway. Since the last inspection, it has been revised to show that the Commission can be contacted at any point in the process. The procedure is also available in the Widget System for residents. Due to the nature of the service, using this system is limited. It is evident the majority of residents are reliant on a relative/ advocate/staff to identify concerns and raise them on their behalf. Accordingly, to promote independence, the complaints procedure is made available to the residents in a format they can more easily understand. This was raised at the last inspection. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 18 The Annual Quality Assurance Assessment completed by the Manager prior to the inspection states no formal complaints have been received in the last 12 months. The Manager and staff spoken with have a good understanding of procedures to safeguard adults. There are currently no safeguarding alerts in respect of the care at this home. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 and 30 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a clean, comfortable and homely environment. EVIDENCE: There is a currently lot of redecoration and refurbishment of the home, with redecoration and new furniture. New equipment has been bought. Residents say they find the home comfortable. The Manager was advised the two non-operative clocks in the room temporarily being used for dining should be repaired or removed. The home now employs a part-time cleaner and cleanliness around the home is good. Currently, staff and residents do the cleaning. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 20 Bedrooms are adequately furnished and some decorated to the preferences of residents. Personal possessions are displayed reflecting their personalities and lifestyles. One residents’ bedroom has been redecorated in the colours of his favourite football team. Residents enjoy using the garden. Access via the back door has been made safer by some ramping. The Manager said the recent focus had been on the improvements to the hose. Perhaps this is why the garden is looking neglected. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents have motivated, interested and dedicated staff who provide good care and support. EVIDENCE: Throughout the site visit residents appeared relaxed and comfortable with the staff on duty. Staff knew how best to communicate with each resident. There was a good balance between encouraging residents with their day and recognising when they needed time and space to themselves. Conversation and activities were inclusive and gave residents time to express themselves. In speaking with staff they understand they are there to work for the benefit of residents. A planned staff roster that shows which staff are on duty and in what capacity. The staff rosters now indicate a particular person designated as being in charge of a shift to give clearer lines of responsibility and accountability. Staff Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 22 felt they worked hard and were able to carry out the duties they were required to do. The Annual Quality Assurance Assessment completed by the Manager prior to the inspection records that staffing hours provided are below the guidelines set by the Residential Forum. There was no evidence during the site visit that jobs were being neglected due to staffing levels. However discussion with staff indicates it can be difficult to undertake external activities at weekends if not all residents want to go out. Staff referred to training they had undertaken including core training such as moving and handling, health and safety, first aid, infection control and fire safety training. They said they also had training specific to clients needs such as managing challenging behaviour. Some training courses are provided via a DVD with questionnaire to be completed and assessed by the manager, other training was by external attendance or by designated trainers providing in house training. Staff spoke of having handovers between shifts and team meetings. The Annual Quality Assurance Assessment indicates she is aware staff meetings and staff supervision should be conducted more regularly. Recruitment records are maintained for each member of staff. Those files seen contained all required information to support a judgment that staff are properly recruited. Use of these files would be easier if they were better organised. Information provided by the manager indicated that all staff hold Criminal Records Bureau certificates and have had POVA checks. The Manager was advised to obtain guidance from the CRB website about the storage of the certificates. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The people living here have their personal preferences, support and care needs encouraged through the registered Managers open leadership and the promotion of a welcoming home. There should be more robust monitoring and quality assurance systems to check care records are of a required standard and to promote safety. EVIDENCE: Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 24 The Manager has worked at Newpark for a number of years, has a degree in Learning Disabilities and has achieved the Registered Managers Award. The Manager said she is now supernumerary to the rota more often than previously. This should give her more time to monitor the standard of care records, the environment and keep abreast of good practice guidelines. Monitoring health and safety in the home is generally to a good standard and equipment is serviced as required to maintain a safe home and facilities. The environmental risk assesments do not include an assessment of the possibility of residents leaving the home via the ground floor windows or the risk of illegal entry. At the time of inspection COSHH requirements were being complied with. The Manager stated all records of maintenance and safety checks are up to date. These were not inspected on this occasion. Regulations require the provider to arrange monthly visits to the home. The records seen indicate they are not being done to this frequency. The responsible individual said he will make sure they are done monthly. The Manager said there is a residents’ meeting every 2 months and new quality assurance system have been introduced. There was discussion about the quality assurance system being used. It is not evident that it takes account of feedback from relevant health and social care professionals. This should be done so the service can make a comprehensive assessment of its performance. The standard of cleanliness in the kitchen and surrounding area is satisfactory, and food hygiene regulations are being followed. There are records of regular checks of the fire emergency systems and staff spoken with have a sound understanding of emergency procedures. One of the fire door leading to the kitchen is wedged open with a rubber wedge which could place people at risk in the event of a fire. This door should be fitted with an automatic closing device. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 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 2 X Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 26 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 14(2)(b), 15(2), 17 Schedule 3, Schedule 4 Requirement “The registered person shall maintain records as specified in Schedules 3 and 4. The registered person shall keep the service user’s plan under review” in that service users’ individual plans and records must be specific in detail of information required for staff to meet service users’ needs. Whilst it is acknowledged there has been work done towards this, all service users must have an accurate care plan by the given timescale, if not sooner, which is thereafter maintained. Timescale for action 30/11/08 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. Newpark Refer to Standard YA6 YA9 Good Practice Recommendations It is recommended old information is filed separately from the care plans so as to make the plans easier to use. It is recommended that when an incident occurs which DS0000041066.V367603.R01.S.doc Version 5.2 Page 27 3 4 5 YA22 YA24 YA33 6 7 YA36 YA39 8 9 YA42 YA42 indicates that an existing risk assessment needs to be reviewed and updated, the revised risk assessment should be recorded in writing in addition to being verbally discussed. It is again strongly recommended the complaints procedure is made available to the residents in a format they can more easily understand. It is recommended that the garden be better maintained for residents to enjoy using. It is again strongly recommended staff allocation and numbers should be reviewed with regard to residential forum recommendations and to further promote residents independence. It is recommended staff receive more regular supervision. It is strongly recommended the registered person further develop the quality assurance and monitoring systems to take account of feedback from relevant health and social care professionals. It is recommended the environmental risk assesments should include the possibility of exit/entry via the ground floor windows. It is strongly recommended the fire door leading to the kitchen be fitted with an automatic closing device. Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 28 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. Extracts may not be used or reproduced without the express permission of CSCI Newpark DS0000041066.V367603.R01.S.doc Version 5.2 Page 29 - 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!