Inspection on 31/05/07 for St Michaels Nursing Home

This inspection was carried out on 31st May 2007.

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 Michaels Nursing Home 07/10/08

St Michaels Nursing Home 10/04/08

St Michaels Nursing Home 10/10/07

St Michaels Nursing Home 19/02/07

St Michaels Nursing Home 11/05/06

St Michaels Nursing Home 28/11/05

St Michaels Nursing Home 18/05/05

St Michaels Nursing Home 08/02/05

St Michaels Nursing Home 05/05/04

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

CARE HOMES FOR OLDER PEOPLE St Michaels Nursing Home Elm Grove Westgate-on-Sea Kent CT8 8LH Lead Inspector June Davies Key Unannounced Inspection 31st May 2007 9:40am 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 Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Michaels Nursing Home Address Elm Grove Westgate-on-Sea Kent CT8 8LH 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) 01843 835709 01843 832905 Charing Healthcare Julie Elizabeth Watson Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2007 Brief Description of the Service: St Michaels Nursing Home is a large attractive three storey detached home with small garden areas. It is situated close to the sea and is a short journey to the local amenities. The home is registered for the provision of nursing care for people with Dementia, and has recently added a new extension to provide dementia residential care for 32 service users. Although the Home is registered for 45 nursing dementia care service users, it currently does not use all of these places. The Home employs a Manager and a team of Registered Nurses and care staff. There are waking night staff employed. There is a shaft lift to access all floors and a call bell system; equipment is also available to ensure that service users can be moved safely. The new extension provides a shaft lift giving access to the first floor, and corridors are wide enough to cope with wheelchair users. Bathrooms in the new extension are supplied with lifting equipment, to ensure that service users can be bathed safely. The scale of charges at the home are £396.54 - £580.00, per week. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over a period of 7.5 hours, during this time the inspector viewed documentation relating to standards inspected, spoke with the registered manager, deputy manager and a member of staff, two service users and a professional visitor to the home. The inspector also toured the new extension but did not carry out a tour of the old home which is due for refurbishment in the next few weeks. Present service users will be moving into the new extension in the coming week while the old home is refurbished. What the service does well: What has improved since the last inspection? The majority of staff have now completed protection of vulnerable adults training and have a good knowledge of what constitutes abuse. The new extension to the rear of the home has now been completed; this provides light and airy accommodation with wide corridors for those service users who need to use a wheelchair. The whole extension is domestically furnished and all fittings are of a high quality, offering service users a pleasant domestic environment in which to live. While bathrooms in this new extension offer the specialised equipment required by some service users they are bright and domestic in style. All new health care staff complete a Skills for Care induction programme. Mandatory training of existing staff has improved since the last inspection but must remain ongoing to ensure that all staff receive this training. Health and safety within the home has improved and is generally well monitored. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3 Quality in this outcome area is good. The homes Statement of Purpose and Service User Guide needs be slightly amended to give service users accurate information. Sufficient information is gained prior to a Service User moving into the home to ensure their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service User guide should have an organisational structure included and reviews dates should be included. Pre-admission assessments are gained from Care Managers and the home carries out its own pre-admission assessment which consists of a tick list relating to the physical, personal and social needs of the service users, St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 9 information gained via these two pre-admissions assessments give sufficient information on which to base a care plan. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is poor. Care plans still fail to identify all aspects of service users health needs. There was evidence of good multi-disciplinary working taking place on a regular basis. The systems for medication administration are poor and potentially place service users at risk. Staff make sure that all service users have their dignity and privacy is respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were viewed, while generally giving sufficient information in some cases there was evidence that information from pre-admission St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 11 assessments were missing. There was no evidence that the service users or relatives are involved in the drawing up of these care plans. Risk assessments were available in each care plan and did give some guidelines to staff as to how risk could be kept to minimum. Each care plan contained a falls chart but there was evidence within the daily reports where falls had taken place, but no evidence was available of these falls on the falls chart. There was evidence in each care plan viewed that regular monthly reviewing takes place. Daily report sheets were very repetitive, but did not clearly indicate fluid intake, especially in cases where service users needed assistance. Personal hygiene care was not clearly reflected in daily reports, for instance whether dental or denture care had been given, whether pressure areas had been checked regularly, hair washing had not been recorded. There was some evidence on daily report sheets that a service user had a dressing applied to a wound, but no follow up, as to how the wound was progressing or whether the dressing had been replaced. Evidence was available that assessments are requested from continence nurse, that nutritional screening takes place monthly and that service users receive regular visits from their general practitioner. Care plans also stated when visits had been made from dentists, chiropodists and other health care professionals. An audit carried out of the administration of medication in the home showed that administration is correctly signed in onto the MAR sheet. There was evidence of a generic letter from a G.P. practice regarding the covert administration of medications; this letter goes against the recommendation of the Royal Pharmaceutical Guidelines and the Mental Capacity Act. In another instance, insulin prescribed for one service user, where insulin units could be adjusted according to G.P. instructions, units had been changed just above date line, instead of being cancelled out and new directions legibly written on a new line on the MAR sheet, this should also have been dated or signed by the G.P. or other prescriber, with a witness signature. Controlled drugs are used in this home, and were appropriately entered into the controlled drugs register with double signatures, and controlled drugs corresponded with the register. In one case where eye drops had been prescribed there was no opening date on the bottle, and the eye drops were out of the 28-day life cycle. The RGN’s responsible for the administration of medication had been appropriately trained and there was an up to date list of staff. The home does have a policy and procedure on the administration of medication but this was in need of review. Staff do respect the privacy and dignity of the service users, by knocking on doors prior to entering bedrooms, bathing and washing are carried out behind closed doors. Service users are able to have visitors in the privacy of their own bedrooms. Service users wear their own clothes; most clothes are purchased on their behalf by relatives. During the key inspection the inspector observed that staff speak respectfully to the service users. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is adequate. Activities and social events are on offer but more could be done to enrich the social lives of the service users. Visitors are welcomed into the home, and service users are able to see their visitors in the privacy of their own rooms. . The meals in this home are good offering both choice and variety and catering for special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was evidence to show that a varied activities programme is offered to the service users, and the home employs two activities facilitators. More could be done to provide activities that are more suitable for these dementia care service users and to provide one to one social stimulation to those service users confined to their bedrooms. Knowledge of this could be better attained St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 13 through in depth dementia care training for all staff. Care plans do not always record the interests of the service users. Visitors are welcomed into the home and are able to visit service users in the privacy of their own bedrooms. There are no restrictions of visiting within the home. Relatives support the homes fund raising activities. Local community groups do not visit the home. Relatives of service users are involved in the management of their financial affairs this is due to the level of dementia for all the service users. There was no information available in the home informing relatives how they could contact local advocacy groups. Two bedrooms showed that service users are encouraged to personalise their own bedrooms with small items of furniture, pictures, photographs and ornaments. The inspector was present during the serving of a lunchtime meal; this showed that service users are offered a choice of menu. The mealtime in the dining room was unhurried. Some of the service users choose to eat in their own bedrooms. Any liquidised meals are presented in an appealing and attractive way. The home operates a four-week rotating menu, and this shows choices offered to the service users, and that meals are well balanced varied and nutritious. One service user said that they thoroughly enjoyed the food in the home. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. The home has a satisfactory complaints system with evidence that service users feel that their views are listened to and acted on. Staff have a knowledge and understanding of adult protection issues, which protects the service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a recently reviewed complaints procedure, this is clearly written with a statement of the time in which the complaint will be responded to. There have been two complaints to the home since the last inspection. Both complaints were appropriately recorded and investigated and reply of outcome were given within the 28 day period as stated in the complaints policy and procedure. There is a clear policy and procedure for the protection of vulnerable adults, and whistle blowing, but these are due for review. No adult protection issues have occurred since the last inspection and 77 of staff including RGN’s have received POVA training. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a recently completed extension, which is registered to offer 32 bedrooms for residential dementia care. To date this new extension has not been used, and it is envisaged that service users receiving nursing care will move into this new extension within the next seven days, while the old building is undergoing extensive refurbishment. Due to this impending move the inspector did not undertake a tour of the old building, but did visit the new wing. The new wing has been built to a high standard, and offers each service user a bedroom of good size, with en suite facilities and adjustable bed. Furniture and fixtures are of a high quality and domestic in style. The new extension has a ground floor and first floor; on the ground floor there is a large dining area and a separate large communal sitting room, with views onto a patio and garden areas. It was noted however that garden area around the new build needs to be cultivated and a secure outside area is required to St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 16 enable service users access to a secure outdoor space. No notification in the form of an action plan specifying dates has been given to CSCI local office regarding this move or the refurbishment of the old building. On the day of this key inspection the home was very hot, and this was due to the old boilers not operating properly, this problem is due to be remedied with the provision of new boilers during the refurbishment programme. The laundry room provides washing machines that have sluicing and disinfecting programmes, and the laundry room floor is impermeable to water. The home has policies and procedures relating to infection control, and dealing with clinical waste, but these are in need of review. All staff are provided with protective clothing in the form of disposable gloves and plastic aprons. Clinical waste is disposed of into the appropriate yellow bags in a lidded clinical bin in the sluice room; the home has a contract with a clinical waste contractor. The outside clinical waste bin has a lock in situ. All communal hand-washing facilities are provided with liquid soap and paper hand towels. Staff have a good knowledge of infection control and 93 have completed infection control training. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is adequate. Recruitment of domestic staff must improve to ensure that service users are living in a clean environment. The manager needs to make sure that sufficient staff are qualified and all staff have mandatory training to safely meet the assessed needs of the service users. Recruitment practices have improved ensuring that service users are not placed at risk. Induction process now meets the guidelines of Skills for Care induction. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the present time the home has 29 service users, staff rotas indicated that there are a sufficient number of staff on duty, both RGN’s and health care assistants to meet the needs of the service users. The home also has three adaptation nurses who are supernumerary to rota on their training days. The home still does not employ a Registered Mental Health Nurse. At the time of the inspection the manager was using a health care assistant for cleaning due St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 18 to sickness of one domestic, and another two domestic had left their employment. The manager stated that she was in process of recruiting more domestic assistants. Only 24 of healthcare assistants have a NVQ qualification, and one health care assistant is in the process of gaining her NVQ qualification this still leaves the home well below the 50 of qualified staff as required by this standard. The inspector viewed two staff files and found them to be in order – application forms giving full employment history, CRB check, work permits, three items of identification including a photograph, two written references, statements of term and conditions. All new staff receive initial induction together with Skills for Care induction package when taking up employment in the home. The inspector was able to view part of a completed induction for one member of staff. The inspector did note that not all health care assistants have completed mandatory training as required. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38. Quality in this outcome area is good. The manager has a good understanding of the areas in which the home needs to improve. Service user views are sought, but the home needs to develop it quality assurance system to include the views of stakeholders to ensure that service users receive a high standard of care. Attention to health and safety issues are satisfactory ensuring the service users and staff live and work in a safe environment. This judgement has been made using available evidence including a visit to this service. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 20 EVIDENCE: The registered manager is a qualified nurse, with many other qualifications, and has spent many years as a registered manager in St Michael’s Nursing Home. She has a good understanding of her role in the home and the improvements needed in the home to provide a better quality of care and environment for the service users. While the registered manager has a quality assurance system this needs to be developed further, and views of stakeholders on the quality of care in the home should be sought. Where service users personal allowances are handled by the home they were well managed with clear accounts being used for each service user and receipts kept for all expenditure. Health and safety elements of staff training are ongoing, and not all staff have completed their mandatory training, especially first aid and food hygiene. Up to date maintenance certificates were seen for all appliances used in the home. Fire risk assessments and health and safety assessments have been carried out. The registered manager must make sure that weekly testing of the fire system is carried out weekly as there were some gaps on previous months. Service users must been given access to a safe and secure garden area. All windows in the new extension have been fitted with window opening restrictors. The home has a HSE accident book, and accidents are clearly recorded and kept in accordance of the Data Protection Act 1998. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 21 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 Schedule 1 15 Requirement Timescale for action 27/08/07 2. OP7 Small amendments to be made to the Statement of Purpose Previous requirements have been made under this standard 31/08/06 A service user plan of care 30/06/07 generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered Accurately detail individual assessed needs and ensure that these needs are met Wound Care Plans, fluid intake, documentation to be improved Previous requirements have been made under this standard: 31/07/04, 31/07/05,31/03/06, 11/05/06, 28/02/07 The administration of medication 16/07/07 must be conducted in line with the Royal Pharmaceutical Guidelines and Mental Capacity Act. DS0000050429.V337777.R01.S.doc Version 5.2 3. OP9 13(2) 17(1)(a) Schedule 3 (3)(i) St Michaels Nursing Home Page 23 Medication should not be administered covertly, without written permissions for each individual service user from a multi-professional team and should include relatives, and the service user. Any changes in dosage of medication should be written accurately onto a new line on the MAR sheet, and appropriately signed. All medication with an opening life of 28 days should be dated on bottle on the day of opening. The grounds are suitable for use by service users and are secure for service users with dementia To provide the CSCI with a written action plan that includes timescales for the ongoing refurbishment both internally and externally of the home. Previous timescales 31/08/04, 31/05/05, 31/07/05, 31/03/06, 30/06/06 Domestic staff must be employed in sufficient numbers to ensure that the home is maintained in a clean and hygienic state. 50 of the care staff must achieve NVQ level 2 in care Previous requirement The current timescale was given at the inspection visit dated 28/11/06 and 30/09/06 All staff must complete the mandatory training. This requirement has been partly met as most staff have now undertaken training. St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 24 4. 5. OP19 OP24 23 (2)(o)(n) 12,13,23, 14,16 27/07/07 27/07/07 6. OP27 18(1)(a) 27/07/07 7. OP28 18 30/09/07 8. OP30 12,13,18 17/08/07 9. OP33 12(1)(a) 24(1)(a) (b) (2)(3) The current timescale was given at the inspection visit dated 28/11/06 and 31/07/06 The quality assurance system must be developed further to obtain the views of external stakeholders. 27/08/07 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 Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local 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 St Michaels Nursing Home DS0000050429.V337777.R01.S.doc Version 5.2 Page 26 - 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. 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