Inspection on 05/06/06 for St Marys Nursing Home

This inspection was carried out on 5th June 2006.

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

Other inspections for this house

St Marys Nursing Home 03/03/09

St Marys Nursing Home 15/04/08

St Marys Nursing Home 09/08/07

St Marys Nursing Home 10/11/05

St Marys Nursing Home 18/04/05

St Marys Nursing Home 26/10/04

St Marys Nursing Home 26/05/04

St Marys Nursing Home 07/05/04

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 Marys Nursing Home 327 Main Rd Sidcup London DA14 6QG Lead Inspector Ms Pauline Lambe Unannounced Inspection 5th June 2006 09:25 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 St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 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. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Marys Nursing Home Address 327 Main Rd Sidcup London DA14 6QG 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) 020 8302 7289 020 8460 7393 St Mary`s Care Home Ltd Mrs Giantee Lallchand Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10th November 2005 Brief Description of the Service: St Marys Nursing Home is registered with the Commission for Social Care Inspection to provide nursing care for 20 Older People. The home is situated on a main road in a residential area of Sidcup close to local shops and bus routes. The detached two-storey house was not purpose built. It has five double and one single bedroom on the ground floor and nine single bedrooms on the first floor. One of the bedrooms has en suite facilities the remainder have washbasins with hot and cold water. Communal areas include a lounge, separate dining room, kitchen and laundry area. Adequate bathing, toilet and sluicing facilities are provided. At the rear of the building there is a garden for residents’ use, which is wheelchair accessible. Visitors can park on the front drive or in the side roads. The fees in the home at the time of this inspection ranged from £526.00 £600.00. Residents paid privately for personal items, hairdressing and chiropody care. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this unannounced inspection was completed on 5th June 2006 over 7 hours. A second brief visit was made to the home on 31st July 2006 to clarify issues in relation to social care plans. The manager and staff assisted with the inspection. Seventeen residents were in home, one resident was in hospital and there were two vacancies. The registered provider was in the home for a short period and spent time talking to the inspector during the inspection. The service was last inspected on the 10th November 2005 and a separate medicine inspection was undertaken on 16th January 2006. A report of this inspection was sent to the registered person. The inspection included a review of information held on the service file, a tour of the premises, and inspection of records, talking to residents, staff and the manager and reviewing compliance with previous requirements. Following the site visit contact was made with relatives and other interested parties to get their views of the service. Feedback on the service was generally positive. What the service does well: What has improved since the last inspection? What they could do better: A risk assessment must be completed for all residents prior to fitting bedrails. Further improvements were needed to medicine management. The registered provider was in the process of addressing the redecoration work to the environment. Carpets must be kept clean and the home well maintained. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 6 Efforts must be made to verify the authenticity of references received for prospective employees. A copy of the collated quality assurance survey must be sent to the Commission. The hot water temperatures must be maintained as close to 43C degrees as possible. 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 Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 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 the following standard(s): 2 and 3. Standard 6 did not apply to the service. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Systems were in place to assess resident needs prior to admission. EVIDENCE: Care records seen included copies of pre-admission assessments and some care manager assessments. Residents received written confirmation that based on assessment the home was suited to meeting their needs. Residents were provided with contracts for service and copies of these were seen. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 and 10. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Care plans seen showed how resident needs were to be met and that their health care needs were met. Improvements had been made to medicine management and the new systems were assessed as safe for residents. EVIDENCE: Care plans were prepared and those seen included risk assessments, reflected the needs of the residents and were kept under review. No risk assessments were seen to show why bedrails were fitted to resident beds. Care plans seen included evidence that care plans had been discussed with residents or relatives. Also the manager did undertake audits of care records. Some records seen had entries corrected using correction fluid. Relatives seen during the inspection said they were satisfied with the quality of care provided. Feedback from relatives was positive about the care provided. Records showed residents were registered with a G.P and had been seen routinely by a dentist, chiropodist and optician. Other specialist health services such as dietician and tissue viability nurse services were accessed through referral. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 10 The Commission pharmacist did an inspection of medicine management on 13th January 2006. This was done following the introduction of a new medicine system. This showed that the new system had greatly improved medicine management. Policies and procedures had been updated, medicines were safely stored, and records were kept for medicines received, administered and disposed with. Medicines were supplied in blister packs and a medicine trolley was provided to use when administering medicines. The new system enabled an audit trail to be completed for medicines brought into the home. On the day of this inspection a new cycle of medicines had started therefore the administration charts for the previous month were viewed. These showed some gaps and two members of staff had not signed hand written entries on administration charts. There was evidence to show that the manager had undertaken medicine audits. Residents who spoke to the inspector indicated staff treated them with respect. Relatives seen during the inspection were satisfied with the way residents were cared for. Shared bedrooms had screening provided to ensure privacy for the occupants. During the inspection staff were observed interacting appropriately with residents, knocking on door before entering bedrooms and being responsive to resident’s requests for assistance. Requirements 1 and 2. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 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 the following standard(s): 12 – 15. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Residents who could comment were satisfied with their lifestyle. Visitors were welcome to visit at any time. Menus showed a varied diet was provided and residents did not raise any concerns about their meals. EVIDENCE: Details of the activities provided were displayed in the lounge and staff said they organised activities in the afternoons. A number of residents said they preferred to spend their time in their bedrooms and did not like to sit in the lounge or take part in organised activities. A number of other residents were quite frail and not keen or able to participate with activities. A designated activity organiser was not employed and care staff organised activities as part of their role. A system was in place to record the activities provided and who took part. Records seen showed that the following had been provided for residents, ball games, sing-a-longs, one–to-one time and watching television and videos. Social care plans were for residents but records must reflect the implementation of these particularly for those residents assessed by staff as needing one to one activity time. The manager had also registered some residents with ‘dial-a-ride’ to enable them to go on outings. Religious services were provided fortnightly. Most of the residents seen in the lounge on the day St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 12 of the inspection could not comment on their satisfaction with the activities provided and residents seen in their rooms said they did not want to take part. The home had an open visiting policy and again residents who could comment were happy to see their visitors in their bedroom or the communal lounge. One relative commented that ‘the carers and all the staff are very pleasant and welcoming’. Feedback from relatives indicated they were made feel welcome when visiting the home. Staff and management said they encouraged residents to make decisions about their lives and efforts were made to record resident or relative involvement in care planning. Residents who were able to voice their opinions said they were satisfied with the way care was delivered. The kitchen was clean and tidy. Adequate supplies of fresh and frozen foods were seen. A cleaning schedule was in place and records kept of fridge, freezer and food temperatures. Menus were prepared by the manager on a four weekly cycle and changed three monthly. Those seen indicated a varied diet was provided and a choice of meal offered to residents. During lunch staff were observed being attentive to residents and assisting them sensitively as needed. Some meals were served and left uncovered in front of residents before the staff were ready to give them the help they needed to have their meal. A number of residents required assistance with feeding and had pureed meals. Some residents said they enjoyed their meal and others indicated this by eating all the meal. A full and a part time cook were employed to provide daily and evening cover seven days a week. Requirements 3. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Policies, procedures and records were in place to ensure complaints and adult protection issues were managed appropriately. Residents indicated they knew who to talk to if they had a concern. Relati EVIDENCE: A complaints policy and procedure was provided and displayed in the entrance hall. Residents and relatives were very clear that if they had a problem they would talk to the manager. Records were kept of complaints made. Since the last inspection one complaint had been recorded and records seen showed this had been managed appropriately. Residents who spoke to the inspector indicated they knew who to talk to if they had a concern. No complaints had been referred to the Commission. Feedback from relatives indicated they knew about the home’s complaint procedure. Allegations or suspicions of abuse would be referred to Bexley Social Services for investigation. Copies of the Bexley Adult Protection Procedures and ‘alerter’s’ guide and a copy of the DOH document ‘No Secrets’ were provided. Staff who spoke to the inspector displayed an understanding of adult protection and how they would manage such an incident. Since the last inspection staff had access to training on adult protection. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 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 the following standard(s): 19, 21, 22, 24 and 26. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. The environment was showing signs of wear and tear and the registered person had plans in place to address this. Residents seen did not raise concerns about the environment. The home was generally clean. EVIDENCE: From a tour of the premises and maintenance records seen the home was safely maintained. However communal areas were showing signs of wear and tear. The corridor on the first floor needed repainting both to walls and woodwork. A decorator was working on the ground floor at the time of this inspection and the registered person said that plans were in place to redecorate the home over the Summer months. The registered person said that the programme to redecorate was being done slowly to avoid disruption to residents and he agreed to send a maintenance programme to the Commission to show how the work, and other refurbishment will progress and the planned timescale. The rear garden was neat and tidy and accessible to wheelchair users. The exterior of the home was satisfactorily maintained. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 15 Bathrooms and toilets were clean and tidy. Bathrooms could be improved by the decorating them in a more homely way. Hot water checked in the first floor bathroom was 47C degrees, other hot water outlets checked were within safe limits. Records seen for in-house hot water temperature checks showed these were maintained normally within safe limits. The registered person said he was reviewing bathing facilities and was thinking about changing one bathroom to a wheel in shower room if this was considered more suited to meeting the needs of the residents. Up to date service records were seen for the hoists, lift and assisted baths. A number of bedrooms were viewed and many of these required redecoration and repair, please refer to comments above re the decoration programme. The following issues were noted in bedrooms: in bedroom 4 the wall by the bed head was damaged, in bedroom 7 the wall under the window was damaged or had possible signs of damp, in bedroom 9 the carpet was stained and in bedroom 17 the ceiling was stained. A number of bedrooms looked cluttered and untidy due to storage of large boxes of pads. The manager was addressing this issue and said there had been an ‘over supplying’ of pads from the PCT and arrangements were in place to have some boxes returned. Screening was provided in shared bedrooms for additional privacy. As mentioned a number of residents could not comment on how satisfied they were with the environment while others did not raise any issues about the environment The home was generally clean and free of offensive odours. Hand washing facilities were available where waste was handled and staff had access to protective clothing. Requirements 4 and 5 and recommendation 1. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 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 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 – 30. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Records showed staffing levels were adhered to, 50 of care staff had achieved NVQ 2 or above and staff had access to relevant training. Improvements were needed to one area of employee recruitment. EVIDENCE: The staff team comprised of a registered manager, registered nurses, care assistants and domestic staff who worked together to meet the needs of the residents. Staff rotas seen showed the home adhered to staffing levels agreed with the previous regulatory body. Staffing on the day of inspection complied with the home’s staffing notice. Comments made by residents and relatives included ‘the staff are extremely kind and I could not wish for my resident to be happier’, ‘the home is extremely well run, kept clean and staff are pleasant and welcoming’. Feedback from relatives indicated that in their opinion there was enough staff on duty. Thirteen care assistants were in employment and seven of these had achieved NVQ level 2 training or above. Four employee files were viewed. These showed that staff had been recruited in line with regulatory requirements. A system was in place to check that nurses employed were registered with the Nursing & Midwifery Council. The manager was advised of the need to verify the authenticity of references St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 17 received for employees for example those received without an organisation stamp, compliment slip or on headed paper. Staff who spoke to the inspector indicated they received the training they needed to fulfil their roles. Since the last inspection staff had access to the following training: fire safety, moving & handling, infection control and adult protection. Tissue viability training was planned for staff in June 2006. Requirement 6. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 18 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, 33, 35 and 38. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Efforts were being made to obtain relative and resident feedback on the service. Safety records were well maintained and showed attention was given to providing a safe environment for residents and others. EVIDENCE: The manager was registered with the Commission and assessed as having the qualifications, skills and experience needed to manage the service. Resident and relative meetings were not held but the manager said she communicated with relatives on a one-to-one basis. A number of residents would not be able to voice their views at a residents meeting but others had this ability. Regulation 26 reports were sent to Commission as required by regulation. At the time of this inspection the manager was in the process of sending a satisfaction questionnaire to residents and relatives. Once this was St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 19 completed and collated a copy of the report and any improvement plan made based on the findings must be sent to the Commission. Nobody in the home acted as an appointee for a resident. The home looked after personal allowances for three residents. This money was provided by relatives and used for resident personal needs. Personal finance records were made available to relatives and residents as needed. Adequate recording systems were in place at the last inspection and the manager confirmed that these remained unchanged. From the information provided in the pre-inspection questionnaire and records seen during the inspection attention was given to providing a safe environment for residents and others. Safety systems such as servicing of the fire alarm, hoists, assisted baths, gas and electricity were up to date. Maintenance records showed that hot water temperatures were maintained within safe limits. However on the day on the inspection the hot water temperature in the bathroom on the first floor was recorded at 47C degrees. This was bought to the attention of the manager to address. Requirements 7 and 8. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X 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 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 3 X 2 X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 2 X 3 X X 2 St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13 Requirement Timescale for action 14/07/06 2. OP9 13 3. OP15 16 4. OP24 23 The registered person must ensure risk assessments are completed for the use of bedrails. Corrections on care records must not be made using correction fluid. 14/07/06 The registered person must ensure safe systems are in place to manage medications safely. • Staff must sign administration charts at the time of administering medicines. • Two members of staff must sign to verify information transcribed and hand written on the administration charts is correct. The registered person must 14/07/06 ensure meals are covered when being served to residents and are only served when the resident is ready to eat or be assisted to eat. The registered person must 14/07/06 ensure the premises are kept in a good state of repair DS0000006772.V290722.R01.S.doc Version 5.1 St Marys Nursing Home Page 22 5. OP19 23 6. 7. OP26 OP29 23 19 8. OP33 24 9. OP38 13 An audit of the premises must be completed and repairs and redecoration issues identified. • A redecoration, repair and refurbishment programme must then be prepared giving dates for start and completion of work. A copy of this programme must be sent to the Commission in response to this report. • Environmental repairs identified must be completed. The registered person must ensure the premises are kept clean including bedroom carpets. The registered person must verify the authenticity of references received for employees. The registered person must provide a copy of the quality assurance report to the Commission once this has been completed. The registered person must ensure risks to the health and safety of residents are identified and as far as possible eliminated. Hot water temperatures must be maintained as close to 43C degrees as possible at all times. • 14/07/06 14/07/06 14/07/06 14/07/06 07/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 23 1. OP24 The registered person should review the decoration of the bathrooms and where possible make these more homely and inviting for residents. St Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Marys Nursing Home DS0000006772.V290722.R01.S.doc Version 5.1 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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