Inspection on 18/07/05 for St Margaret`s Ltd

This inspection was carried out on 18th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

St Margaret`s Ltd 05/05/09

St Margaret`s Ltd 08/05/08

St Margaret`s Ltd 30/05/07

St Margaret`s Ltd 10/11/06

St Margaret`s Ltd 19/06/06

St Margaret`s Ltd 26/01/06

St Margaret`s Ltd 09/12/04

St Margaret`s Ltd 23/06/04

St Margaret`s Ltd 05/01/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE St Margarets Ltd 3 - 5 Priestlands Park Road Sidcup Kent DA15 7HR Lead Inspector Pauline Lambe Announced 18 July 2005 09:20 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 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. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Margarets Ltd Address 3 -5 Priestlands Park Road Sidcup Kent DA15 7HR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 300 2745 Mr A Hudda Linda Masher CRH 22 Category(ies) of OP 22 registration, with number of places St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 22 male or female Date of last inspection 9 December 2004 Brief Description of the Service: St. Margaret’s is privately owned by Mr and Mrs Hudda and has been registered since 1971. The home is registered to provide care and accommodation for 22 older people. The Home is a large detached two-storey property, which includes a purpose built extension. A lift is available for the residents. St Margaret’s is located in a residential area close to transport and shops. There are three double and sixteen single bedrooms, fourteen of which have en suite facilities. There are two bathrooms with WC’s and three further WC’s. A small lounge is situated at the front of the building. In addition there is a large lounge/dining room, which looks onto the attractive garden at the rear of the property. Residents have access to health care services via the local GP practice. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 7.5 hours by one regulation and one pharmacy inspector from the Commission. The service was last inspected on 9th December 20004, a separate pharmacy inspection was undertaken on 13th December 2004 and an additional visit was made on 11th February 2005. The additional visit was done to review compliance with requirements particularly in relation to medication management and the development of care plans. This inspection process included reviewing the service file, speaking to residents, relatives, staff and management. Inspecting records required by regulation and undertaking a tour of the premises. Compliance with requirements and recommendations made at the last inspections and the additional visit were reviewed. The Commission received twenty two completed comment cards. These were from residents, relatives and visiting professionals. Comments made were positive and showed a general satisfaction with the service provided. What the service does well: What has improved since the last inspection? Improvements had been made to medication management however further improvements were needed to ensure systems in place did not pose a risk to residents. Staff had worked to develop individual care plans for residents and again further work was needed to ensure risk assessments were completed and supported by relevant care plans. This specifically applied to the prevention of pressure sores and safe moving and handling of residents. Management and staff were receptive to the advice offered by the inspectors and indicated a willingness to work with the Commission to ensure standards improved and regulations were met. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 and 5. Standard 6 did not apply to the service. The home had introduced a pre-admission assessment format. This must include an assessment of needs as detailed in Standard 3.3 for self-funding residents to ensure the home can meet their needs in respect of health and welfare. Arrangements were made for residents and their representatives to visit the home prior to admission. EVIDENCE: The manager had introduced a format to record pre-admission assessments. The forms seen were scantily completed and should include more detail to provide a full picture of the prospective resident, their needs and social background and to reflect that the home could meet their assessed needs prior to admission. Since the last inspection the manager had introduced a system to confirm in writing to residents that the home could meet their needs based on the outcome of the pre-admission and care manager assessments. Residents and their representatives were welcome to visit the home prior to admission. Some of the residents who spoke to the inspector confirmed they had viewed the home before making the decision to accept a place. Recommendation 1. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 9 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 standard(s) 7,8,9 and 10. Improvements had been made to care planning but further work was needed to the ensure risk assessments were completed where a need was identified. Residents felt staff respected their privacy and dignity and involved them when providing care. EVIDENCE: Care plans had been developed since the last inspection. Long term assessments’ of need were seen. Three care plans were viewed and contained details on how care was to be delivered. These required further improvements in some areas to reflect how all identified care needs would to be met. For example no risk assessments had been completed to reflect the care plans prepared for residents in relation to moving and handling, continence management and prevention of pressure sores. There was no evidence to show that residents or relatives were involved with care planning. Care plans were due for review at varying times and not always monthly as stated in standard 7. Daily evaluation records did not reflect the implementation of care plans and a tick list system, with a key code was in place in relation to the delivery of personal hygiene and activities. The full pharmacy inspector’s report will be sent to the registered person but the requirements made will be included in this report. Overall there had been St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 10 improvements made to the management of medication however further improvements were needed to ensure there was no risk to residents. Residents who spoke to the inspector said staff treated them with respect and involved them in decisions about their care at the time of receiving care. This level of involvement was not reflected in some of the care plans seen. However some care plans did say to ‘offer the resident..’ Residents had access to NHS services through G.P referral. Staff were observed interacting with residents in a friendly and positive manner and being attentive to their needs. Requirements 1,2,3 and 4. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 11 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 standard(s) 12, 13, 14 and 15. Services used said they were satisfied with their lifestyle and meals provided and relatives supported this comment. The home has an open visiting policy to facilitate contact with family and friends. Residents said they were involved with decisions affecting their lives though this was not always evident in records. EVIDENCE: Records in relation to resident’s social history, hobbies and interests varied. Some records seen had very little information on which to base suitable social and activity care plans. No activity care plans were seen but a tick list was kept to show the residents’ involvement with organised activities. Residents said they had enough activities provided and that staff arranged for entertainers to visit the home. Several residents were reading the daily paper and said they liked to ‘keep up with the news’. A day trip to the seaside was planned to take place later in the summer. Residents and relatives confirmed they had no difficulty visiting the home and were made feel welcome by staff. Residents said they made decisions as to how they spent their day, how they liked to dress and present. However this level of involvement in care planning was not evident in all care plans seen. The kitchen was clean and tidy. Cleaning schedules were in place for the kitchen but no records were kept to show that these were put into practice. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 12 Food was stored appropriately. Menus were prepared on a four weekly cycle and those seen showed a varied diet was provided. Residents who spoke to the inspector said they were satisfied with the quality and choice of meals provided. Lunch was observed and the meal was taken in a calm and pleasant setting with tables properly laid. Staff assisted residents as needed and it was evident that a choice of meal was provided. At the last inspection a recommendation was made in relation to fitting a fly screen to the kitchen window. As the kitchen had a ‘scavenger’ fitted the inspector got advice from environmental health who said a fly screen was not required. The inspector also confirmed with environmental health that it was acceptable for staff that undertook the preparation and cooking of meals to have basic food hygiene safety as a minimum training. Requirements 1and 5 and recommendation 2. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 13 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 standard(s) 17. The home did not have its own policy and procedure in relation to adult protection. A copy of the local Social Services Procedures was provided. EVIDENCE: The complaints standard was not reviewed on this occasion. However there were no complaints made about the service to the Commission or to the home since the last inspection. Residents who spoke to the inspector said they would feel comfortable raising concerns they had with one of the staff. Staff who spoke to the inspector indicated an awareness of adult protection and how they would handle a suspicion or allegation of abuse. The home did not have its own policy and procedure in relation to adult protection and this may cause delay or confusion for staff if they had to deal with an allegation or suspicion of abuse. The need to have a local policy relevant to the service was discussed with the manager. A whistle blowing policy was provided but required updating. Requirement 6. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 14 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 standard(s) 19 t0 26. Communal areas and resident bedrooms were clean, tidy, well ventilated and homely in appearance. Bathing and toilet facilities were suited to meeting the residents’ needs. A service/commissioning certificate was not seen for the new assisted bath. Suitable equipment was provided to meet resident needs but an up to date service certificate was not seen for the portable hoist. EVIDENCE: The home was generally clean, tidy and adequately maintained. Two bedrooms were assessed against the standard and were found to comply. Residents said they were satisfied with their personal and the communal space. Resident comments included ‘I’ve got a lovely room’, ‘The room suits me, I like it because I have my own toilet and wash basin’ and ‘they keep my room lovely and clean’. Bedrooms were nicely personalised with resident’s own belongings. Bathrooms, toilets and en-suite areas were clean and tidy with hand-washing facilities provided. A number of paper towel holders were empty which meant staff could not readily wash and dry their hands. An up to date service/commissioning certificate was not seen for the new assisted bath. The home had one portable hoist, which was overdue a service. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 15 The manager agreed to arrange to have this done as a matter of urgency and an immediate requirement was left for the registered person to address these issues. At the time of writing this report the manager confirmed verbally to the Commission that the bath and hoist had been serviced. The home had a well maintained mature garden. Several residents commented on how much they enjoyed sitting in the garden or just viewing it from the lounge window. Recommendations 3 and 4. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 and 30. Staff presented as a supportive team who worked together to meet the needs of the residents. Adequate staffing levels were maintained and residents did not raise concerns about staffing levels. Standard 29 could not be assessed, as staff personal files were not kept in the home. EVIDENCE: The staff team comprised of a full time manager, deputy manager, senior officers, care assistants and domestics. The home has had a consistently stable staff team, which residents liked, as staff knew them and knew how to meet their needs. Staff personal files were not kept in the home so could not be inspected. CRB checks were seen for the majority of the staff. There was no evidence to show how an issue raised on a CRB check had been handled and the manager told the inspector verbally how this had been done. Staff files must be inspected at the next inspection. Staff who spoke to the inspector said they received support and training relevant to their role. They displayed an understanding of residents’ needs and what it must be like to be admitted to a care home. Staff commented positively on the induction programme provided. The manager organised relevant staff training to be carried out in the home. Records seen showed that since the last inspection a number of staff had received training in basic first aid and moving & handling. None of the care staff had obtained NVQ2 qualifications, however the manager said that five staff were currently undertaking the course. Requirement 7. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,35,37 and 38. The home had a registered manager who had been in post for some time. There were some concerns identified in relation to servicing of some equipment, the need to have restricted openings on the upstairs windows and the electrical installation. EVIDENCE: The manager had been in post for some time and was registered with the Commission. From the evidence provided the current residents’ were having their needs met. However work was required to ensure systems and procedures in place for the running of the service complied with current legislation and the national minimum standards. For example in relation to the provision of up to date policies and procedures, involving residents and relatives with care planning, providing safe medication management and having a quality monitoring system in place to review and improve the service. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 18 The home took no active role in the management of resident’s personal finances. The home did not hold any money or valuables belonging to residents. A policy in relation to this was not seen. Record keeping had improved since the last inspection, however the home’s policies and procedures required a full review to ensure they were up to date, to reflect current and local practice and support how the home meets the National Minimum Standards and complies Regulations. The inspectors offered advice on how best to do this and the pharmacy inspector offered to view and comment on medication policies and procedures as they were being developed. A selection of safety records were checked. There was no electrical safety certificate seen for the premises. The manager agreed to arrange to have this done as a matter of urgency and an immediate requirement was left for the registered person to address the issue. At the time of writing this report the manager confirmed verbally to the Commission that estimates had been obtained to have the electricity supply checked. The home did not have a fire risk assessment of the building or an evacuation policy. Other relevant safety systems were in place. At the last inspection it was recommended that a risk assessment be completed on the window openings above the ground floor as these opened very wide and could pose a risk to residents. This had not been done and the recommendation has been repeated in this report. Requirement 8 and recommendations 5 and 6. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION 2 3 3 2 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 x x x 3 x 3 2 St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 20 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 7 Regulation 15 Requirement The Registered Person must prepare a written care plan, in consultation with the service user or their representative, as to how a service user’s needs are to be met in respect of their health and welfare. (Timesclae of 6th May 2005 was not met) The Registered Person must ensure risks to the health and welfare of residents are identified and as far as practicable eliminated. For example residents identified as being at risk of deveoping pressure sores, requiring assistance with moving & handling and being at risk of falls must have risk assessments completed and care plans in place to show how the risk will be managed. Daily evaluation records must reflect the implementation of care plans. The Registered Person must produce policies and procedures for ordering, receiving, storing, administering and returning medicines, self administration of medicines, supply of medicines G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Timescale for action 30th September 2005 2. 7 13 30th September 2005 3. 9 13 30th September 2005 St Margarets Ltd Page 21 4. 9 13 5. 12 16 for day leave and drug errors. Ensure permanent records of receipt are kept which do not use adhesive labels.The home must keep a complete list of all currently prescribed medication for each service user, including names of creams / ointments and vitamin injections. The home should use computer generated administration and receipt records produced by the pharmacy to ensure accuracy. When service users take medicines out of the home, a record must be kept of the amount taken out and the amount returned. Ensure all medicines including creams and ointments have full directions.Labels must not be altered by staff.Sufficient medicines cups must be available for each resident receiving medication. A lockable medicine refrigerator must be used to store medicines for refrigerationThe temperature of the refrigerator must be monitored and recorded daily using a minimum and maximum thermometer. The oxygen mask must be covered to protect from dust. The Registered Person must ensure staff receive updated training on medicines handling and management. Staff must receive training on administration of oxygen. Ensure staff are audited on their adherence to policies and procedures relating to medicines. The Registered Person must ensure residents are consulted about their social interests and are consulted about the programme of activities arranged G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 28th October 2005 28th October 2005 St Margarets Ltd Page 22 6. 18 13 7. 29 19 8. 38 13 by or on behalf of the care home. The Registered Person must make arrangements to prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse. Staff must have access to clear policies and procedures as to the action they must take if they become aware of or suspect incidents of adult abuse. The Registered Person must not employ staff to work in the home unless the person is fit to work in the home and the information required in schedule 2 has been obtained. The records listed in schedule 2 in realtion to staff must be kept in the care home and available for inspection. The Registered Person was left an immedicate requirement to obtain an electrial safety certificate for the building, to service the assisted bath and the portable hoist. 30th September 2005 30th September 2005 22nd July 2005 for the baths and hoits. 29th July 2005 for the electrical certificate. 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. Refer to Standard 3 15 19 Good Practice Recommendations The Registered Person should carry out and record a needs assessment for residents who are self-funding covering the arears included in standard 3.3. The Registered Person should ensure the cleaning schedule for the kitchen is followed by recording the dates for completion of the tasks. The Registered Person should ensure a programme of G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 23 St Margarets Ltd 4. 5. 26 38 6. 38 routine renewal of the fabric and decoration of the premises is produced and implemented. The Registered Person should ensure paper towels are provided for staff at all times to ensure they ave access to hand-washing and to prevent the spread of infection. The Registered Person should undertake a risk assessment in relation to the windows above the ground floor. These open at the top only but did not have restricted openings. The risk assessment should address any risk these pose to service users and reflect any remedial action taken. The Registered Person should ensure a fire risk assessment is done on the building and the home has an evacuation policy and procedure in place in the event of a fire. St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 24 Commission for Social Care Inspection Riverhouse 1 Maidstone Road Sidcup Kent DA16 3BU 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 St Margarets Ltd G51G01s6785StMargaretsv211705.7.7.2005stage4.doc Version 1.30 Page 25 - 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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