Inspection on 14/01/08 for Surrey Hills Nursing Home

This inspection was carried out on 14th January 2008.

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

Surrey Hills Nursing Home 13/02/07

Surrey Hills Nursing Home 13/12/05

Surrey Hills Nursing Home 23/08/04

Surrey Hills Nursing Home 21/05/04

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

CARE HOMES FOR OLDER PEOPLE Surrey Hills Nursing Home Brook Road Wormley Godalming Surrey GU8 5UA Lead Inspector Mary Williamson Unannounced Inspection 14th January 2008 10:20 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 Surrey Hills Nursing Home DS0000017646.V357287.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. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Surrey Hills Nursing Home Address Brook Road Wormley Godalming Surrey GU8 5UA 01428 682346 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) G.JOHN@CAREHOMESOFDISTINCTION.CO.UK Mr L K Hasham Mrs N Hasham Mrs Patricia A Grimwood Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. In respect of this home, service users may be admitted from the age of 60 YEARS. Accommodation may be provided for one (1) named service user under the age of 60 years. 13th February 2007 Date of last inspection Brief Description of the Service: Surrey Hills is a registered care home, one of a group of similar services run by Care Homes of Distinction, in the area. The home is a large detached premises situated in the village of Wormley. There are twenty-nine single bedrooms, two of which have full en-suite facilities, and eight double bedrooms. There are a number of bathrooms and toilets situated on each floor. Nursing care is provided on two floors served by passenger lift and stairs for forty-five older service users with dementia. There are road and train links to the village and the home provides car-parking facilities. Catering is in-house. There is a staff team with nurses and carers who are supported by a wider network of health care professionals offering holistic care. Fees at this home are in the range of £685 to £735 per week, information provided on 14/01/2008. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality ratings. This was the first site visit of a key inspection and was unannounced. Mary Williamson Regulation Inspector undertook the inspection. The registered manager Mrs Patricia Grimwood represented the organisation and was present for the duration of the inspection. A tour of the premises was undertaken and records relating to the care of the residents and the management of the home were examined. Discussions were held with staff individually and in groups. It was also possible to talk with residents who were able to engage in conversation. Time was also spent observing residents and their interaction with staff. The manager completed an AQAA (Annual Quality Assurance Assessment) and the inspector was provided with a copy of this during the inspection. Equality and diversity is observed and diverse needs of residents are recorded in individual care plans. The home has a complaints procedure in place and available in the residents guide. There have been no complaints since the last inspection. The Commission for Social Care Inspection would like to thank the residents, staff and management team for their help and hospitality during the inspection process. What the service does well: The home is well managed in the best interest of the residents. The home provides residents and their families with appropriate information in order for them to make a decision about living in the home. No resident is Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 6 admitted to the home without a needs assessment to determine if specific needs can be met. Care plans are good and involve residents, family and other health care professionals. These are a working tool and are updated daily. Activity arrangements meet individual and collective needs. The standard of the environment provides residents with comfortable, and well - maintained home to live in. Recruitment practice is safe and staff are employed in sufficient numbers to meet the needs of the current residents. The home is committed to the training and development of staff. What has improved since the last inspection? What they could do better: The service must support resident with their choice of meals. Visual aids and prompts should be considered in helping residents choose food of their choice. More organisation is required in the dining room and lounge areas at lunch time, to ensure that residents are getting the help and support they require. Currently food is placed in front of residents and allowed to go cold before staff get the opportunity to help them. Only one course should be served at a time, as residents get confused and eat both their main meal and desert together. Residents should Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 7 be supervised when they wonder away from the table during meal times and records kept of food intake. Staff must be supported with the continued development of their English communication skills. 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. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate information is available to prospective residents and their relatives prior to admission. Individual needs assessments and contracts of occupancy are in place. The home does not provide intermediate care. EVIDENCE: The home has a statement of purpose and resident’s guide in place. All prospective residents and their families have access to a copy of this prior to admission to help them make an informed choice about living in the home. The manager stated that on several occasions it is the family that will choose the home on behalf of the resident. Individual contracts of occupancy are in place. Contracts sampled outlined the care provided, the type of accommodation occupied, the fees payable, and the method and frequency of payment. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 10 All prospective residents have a needs assessment undertaken prior to being admitted to the home. The manager or a senior member of staff with the experience necessary to do so undertakes this assessment. Needs assessments are carried out in hospital, or in residents own homes with input from the resident and their families. Needs assessments are discussed within the senior staff team to establish if specific needs can be met prior to a placement being offered. Four needs assessments were seen and were detailed and informative. The home does not provide intermediate care. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care plans outline how personal, and health care needs are met with privacy and respect. The medication administration procedures protect the residents living in the home. EVIDENCE: Each resident has a care plan in place, which has been written with his or her input as much as possible. Relatives, and reports from health care professionals are also included in the care planning process. Four care plans were sampled. These are well written and outline how individual care needs and goals are met. These are reviewed monthly by the care team and key workers, and amended and updated when necessary. Risk assessments are in place for manual handling, the use of bed rails, and skin care assessments. Some residents were being nursed in bed and care staff were able to explain how pressure relieving equipment for example profile bed, air mattresses, and cushions were provide to prevent pressure sores. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 12 The arrangements in place to meet the health care needs of the residents are satisfactory. All the residents are registered with a local GP who visits the home every week, or more frequently if required. The home has a treatment room where the GP can see residents in private. Two residents stated that they liked the doctor. The chiropodist visits four to six weekly, dental treatment is available from the NHS, and an optician service visits the home regularly. Specialist input can be accessed on referral by the GP. The district nursing team are also available when required. The home has a medication policy in place and all staff who administer medication in the home are familiar with this policy. All medication is stored in a locked medication room, which can also accommodate the medication trolleys. Lloyds the chemist supplies all the medication to the home mainly in blister pack format. They also undertake audits of medication and written reports. The home has a contract in place with PHS Group for the disposal of medication (hazardous waste). The medication recording charts (MAR) were seen and are well maintained. All medication is signed for and no errors or gaps were observed. The GP reviews resident’s individual medication at regular intervals. Currently there are no residents in the home who self medicate. Privacy and dignity are respected and staff were seen to knock on residents doors prior to entering. Locks are also available on bedroom doors if residents require this facility. Staff address residents in a polite manner, and screens are provided in shared rooms. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activity arrangements in place meet individual and collective needs. Family and community links are maintained. Food served to some residents on the day of the inspection was cold, as it had been left to stand too long. EVIDENCE: The home has an activities programme in place which includes karaoke, reminiscence, art and craft, music and movement, and table -top activities. One to one activities for example aromatherapy, reading, and manicures also take place. The home organises special themed events and social gatherings, and recently hosted a 102 nd birthday party for one of the residents. He stated that he had a visit from the Mayor and Mayoress and “felt important”. The home made most of their Christmas decorations and won first prize in the organisation. Family and community links are maintained and visitors are welcome in the home at any reasonable time. Some relatives were visiting at the time of the inspection and were all satisfied with the care provided. The manager stated that students from the local school visit the home regularly. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 14 The spiritual needs of the residents are supported. The local Church of England minister organises a short service every two weeks when resident can attend. The Roman Catholic Priest visits the home to administer Holy Communion, and visits from clergy of other denominations are arranged on request. The staff stated that residents are given the choice when they wish to get up and go to bed. They are encouraged to choose what they want to wear and what activities they wish to participate in. The kitchen was visited and found to be clean and organised. The chef on duty demonstrated the menus in place. These are planned on a four- week cycle and are seasonal. The lunch meal was planned as Spaghetti Bolognaise, but liver and bacon casserole was actually offered. The chef stated that the supplies had not been delivered in time. During the morning several staff and residents were asked by the inspector what was for lunch but nobody was aware of the menu. There were no menus displayed in the home and none of the residents were given a choice of food prior to it being served. Lunch was served to residents in various locations. Some residents sat in the newly refurbished dining room, some sat in both lounges and others in the conservatory. This system was disorganised and residents were not supervised properly. One resident in the dining room wandered off and her lunch was left on the table for thirty minutes until it was brought to the attention of a staff member. Another resident in the dining played with the food on her plate. Eleven resident sat in the larger lounge with food in front of them for thirty minutes, before any assistance was offered. Some of these residents ate their desert first and poured their fruit juice in their dinner while waiting to be fed. The same situation occurred in the small lounge and conservatory. The arrangements at mealtimes must be reviewed to enable residents to be given the high level of assistance they require. The food is leaving the kitchen hot therefore arrangements must be made to feed it to the residents at the same temperature. It was observed that some residents are confused with more than one course at a time and therefore this must be managed accordingly. It is recommended that the fourteen liquidised diets be served in a way, which looks appealing and can be distinguished in terms of texture and flavour. Residents who were able to comment stated that the food was good. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure and the abuse awareness procedure in the home protect the residents living there. EVIDENCE: The home has a complaints procedure in place, which is included in the resident’s guide. All residents and their relatives have access to a copy of this on admission to the home. Most of the residents in the home would have to rely on relatives or friends to make a complaint in their behalf. The manager stated that residents and relatives are encouraged to voice their opinions, views, and concerns at any time and these are taken seriously. There is a complaints and compliment “thank you” log in place. There have been no complaints since the last inspection. Several letters of appreciation have been received. There is an abuse awareness policy in place and all staff undertake training in abuse awareness during their induction training. This is also updated yearly. Staff confirmed this during discussion. The home also has a copy of Surrey’s Multi Agency Policies and Procedures on Safeguarding Vulnerable Adults in place. The manager and senior staff have attended training in these procedures and this has been cascaded throughout the staff team. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe wellmaintained environment, which is suitable for its stated purpose. The standard of cleanliness is good. EVIDENCE: The home is well maintained, comfortable and decorated to a satisfactory standard. The accommodation provided meets the individual and collective needs of the residents. There is ample communal space, which included a recently refurbished dining room overlooking scenic views of the countryside. Two lounges and a conservatory provide varied lounge space according to peoples preference. The home has been adapted to meet the mobility needs of the residents. There is a lift access to the first floor, assisted bathrooms and toilets, hoists, Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 17 grab rails, and a ramp access to the gardens. There is also a call bell system throughout the home. Individual accommodation is provided in single and double rooms. These are comfortably furnished and have been personalised to reflect individual personalities. The standard of cleanliness and hygiene in the home is good. Staff are aware of the infection control policy in place. The laundry is located on the ground floor and is fitted with one industrial washing machine and one industrial dryer. A discussion took place between the manager, laundry assistant, and the inspector regarding the quantity of equipment in place for the requirements and size of the home. The manager was confident, that this was sufficient and stated that laundry could be sent to the other homes in the group, in an emergency. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are being met by the number and skill mix of staff. Recruitment procedures are safe. Staff are trained to do their jobs. EVIDENCE: The staff duty rota was seen and the number and skill mix of staff on duty was sufficient to meet the assessed needs of the current residents. Staff numbers vary according to needs and occupancy levels. The home also employs two chefs, a kitchen assistant, two housekeepers, an administrator, two maintenance staff, and contract gardeners. Consideration must be given to the way staff are deployed at meat times to ensure adequate supervision in the dining areas, and the effective monitoring of residents nutritional needs. The recruitment procedures in the home are safe. All staff have an interview, complete an application form, provide two written references, an employment history, and a Criminal Records Bureau (CRB) disclosure. Four staff employment files were randomly sampled and contained all the documentation required for employment legislation. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 19 The organisation has a training coordinator in post who oversees all the training in the home. The manager stated that all new staff undertake five days induction training in accordance with Skills for Care and continue with foundation training. All staff have a workbook they complete. The home is an accredited training centre and is linked with Surrey University to provided placements for student nurses. The home also provides adaptation training for overseas students. NVQ training is ongoing and currently 35 of staff have achieved an NVQ at level 2 or above. The home currently employs staff with various levels of spoken and written English. During discussion with some staff it was evident that communication was difficult and staff were unable to make themselves understood. The AQAA indicated that staff attend English classes to improve their communication skille. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed in the best interests of the residents. The health, safety and welfare of the residents and staff are promoted. EVIDENCE: The home is well managed by a registered manager with several years experience in the provision of care to older people with dementia. She has an NVQ level 4 in management. She has the support of a deputy manager who is a qualified nurse and also holds an NVQ Level 4 in management. The manager’s office is located near the main communal areas of the home providing easy access to residents and visitors. She operates an open and inclusive style of management. Staff stated that they felt supported by the Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 21 management arrangements in place. The support backup in place for senior management cover is good with a twenty- four on call system in place. Quality assurance is monitored and acted upon. Questionnaires are sent to relatives, and various health care professionals with an interest in the home yearly. Feedback and information received is analysed and a written report published for information. The most recent report is available in the home with the statement of purpose. Weekly audits are carried out by the manager and submitted to head office for comment. Regular house staff meetings take place and minutes taken. Health and safety audits, medication audits, and reviews of care all contribute to the quality assurance process. Surrey University also undertake audits for training purposes. Resident’s finances are not managed by the home. The organisation will engage a solicitor to act on behalf of a resident if relatives are unable or unwilling to manage their financial affairs. The home has a wide range of health and safety policies and procedures in place, some of which were seen throughout the day. All staff undertake health and safety training during their induction, including first aid, manual handling, food hygiene, infection control, and fire safety. COSHH procedures are observed. Risk assessments are in pace for all identified risks and safe working practice. A risk assessment should be developed for meal times and the supervision of residents with regard to the risk of choking. Fire safety regulations are followed and fire alarms are tested weekly. There is a contract in place for the maintenance of fire fighting equipment and emergency lighting. All staff undertake fire safety training annually. Information provided in the AQAA indicated that appropriate safety certificates are in place. Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 23 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 OP14 Regulation 12(2) Requirement Timescale for action 13/02/08 2 OP15 OP38 16(2)(i) The registered person shall as far as practicable possible enable residents to make decisions regarding the care they receive including their choice of food. The registered person shall 13/02/08 ensure that meals are served to residents hot, and adequate supervision is provided in dining areas at meal times to oversee this. The registered person must also ensure that liquidised food is presented in a way, which is appealing in terms of textures, flavours and appearance. A risk assessment must be developed around meal times for the risk of choking. 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 Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 24 Surrey Hills Nursing Home DS0000017646.V357287.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone, Kent 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. 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