Inspection on 26/11/07 for The Crown Nursing Home

This inspection was carried out on 26th November 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

The Crown Nursing Home 03/02/09

The Crown Nursing Home 21/05/08

The Crown Nursing Home 29/06/07

The Crown Nursing Home 27/04/06

The Crown Nursing Home 08/12/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Crown Nursing Home High Street Harwell Didcot Oxfordshire OX11 0EX Lead Inspector Kate Harrison Unannounced Inspection 26th November 2007 10:30 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 The Crown Nursing Home DS0000065924.V349925.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. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Crown Nursing Home Address High Street Harwell Didcot Oxfordshire OX11 0EX 01235 820010 01235 834050 thecrown@schealthcare.co.uk 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) Trinity Care (Crown) Limited Mrs May Sancio Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (0) of places The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing only - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 16. Date of last inspection 29th June 2007 Brief Description of the Service: The Crown Nursing Home is a purpose built home located in the village of Harwell, Oxfordshire, close to local shops and amenities. The home is part of the Southern Cross group of homes. The Crown is home to 16 older people who require nursing care. The accommodation is on two floors and all the rooms have en-suite facilities, but only three have a bath. There is a lift to provide access to the first floor. Twelve of the rooms overlook the garden and some have a small balcony. The garden, which is largely paved, was designed to be easily accessible for wheelchair users. The current scales of charges as at June 2007 are between £580.00 and £778.00 per week. People living at the home pay for hairdressing, chiropody (non diabetic), newspapers, toiletries and taxi fares. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of the service was an unannounced ‘Key Inspection’, and was the second inspection visit this year. We arrived at the service at 10.30 hours and spent 5 hours in the home. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager through the Annual Quality Assurance Assessment, and any information that we had received about the home since the last inspection. We saw most areas of the home and looked at records and documents relating to the care of the residents. There were eleven people living at the home at the time of the visit. We asked the views of some of the people who use the service during our visit, and of relatives and healthcare professionals through our questionnaire. We also discussed care with relatives seen during the inspection visit. We looked at how well the service was meeting the standards set by the government and have in this report made judgements about the standard of the service. The registered manager has recently returned from maternity leave, and was present during the inspection visit. From the evidence seen and from comments received we consider that this home would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Further training is needed for staff before they are competent to help people who need assistance to move. What the service does well: What has improved since the last inspection? The home’s manager has returned from Maternity Leave. A monthly activity programme has been started, and this has improved the quality of life for people living at the home. People particularly like the one to one sessions with a carer. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 6 A nurse call system has been installed in the lounge area, and the courtyard garden has been improved, with the help of a relative. The downstairs communal areas have been redecorated, and new carpets have been fitted. A new dishwasher has been purchased and more adjustable beds are available. More staff have attended training sessions including customer care, communication, fire evacuation, and two members of staff have received training certificates through the Alzheimers Society. Staff members are receiving more supervision sessions, and an improved induction programme has been started. The home has started using VisionCall, to provide optical care for the people living at the home, and to provide training for staff on eye care. 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. The Crown Nursing Home DS0000065924.V349925.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 The Crown Nursing Home DS0000065924.V349925.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): 1, 3 and 6. The home does not provide intermediate care. Quality in this outcome area is good. Pre-admission assessments are carried out to make sure that the home can meet the needs of those admitted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager usually conducts the pre-admission assessment, following referral from a care manager or from family. We saw pre-admission assessments for individuals admitted earlier in the year, and they contained all the necessary information from care managers’ assessments and from hospital discharge forms. The pre-admission assessments also contained all the information needed for the manager to know that the home could meet the needs of the individuals. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People living at the home have their healthcare needs met, but progress needs to be made in consulting people about their care and in improving staff skills in moving people properly. EVIDENCE: All the people living at the home have care plans to meet their needs, and individuals at the home were well groomed and appropriately dressed on the day of our visit. Risk assessments including an appropriate nutritional risk assessment are conducted. We saw care plans showing how the health needs of individuals were monitored and addressed, and noted how staff followed medical advice on particular issues. Visitors told us that their relatives were happy at the home, and that they had no worries about their health care. They made comments about the caring attitude of the staff members, and about their dedication to the people living at the home, though concerns were expressed that they are overworked. We saw staff members treat individuals with respect and kindness, and saw a good rapport between individuals and the staff members. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 10 Although the staff members in general practice a person centred approach to care, there is little evidence that the individuals or their representatives have been consulted about their care, as the care plans seen and other documents such as consent for bed rails, were not signed. We recommend that, in order to show that people living at the home have been consulted, individuals and/or their relatives are given opportunities to sign care plans and other documents. It is not clear that the key worker system works well, as one person living at the home was allocated a key worker who has been on maternity leave, and now works at weekends only. This means that she is available for short periods only to help the individual, and is not able to fulfil the role appropriately. The key worker role should be reviewed, so that all the individuals living at the home have access to their key worker at reasonable times. We observed poor lifting techniques by staff members, when two members of staff moved an individual from one chair to another, and then moved the individual back in the chair using underarm lifting techniques, in view of the home’s manager. This technique is not recommended practice, as it can cause damage to frail older people. We noticed that relatives had brought this issue to the attention of the company’s operations manager at the Relatives’ Meeting in September 2007, and they were assured that practice would be monitored. A relative also mentioned this issue in our survey. The manager explained that she conducts the moving and handling training and said that she spoke to the staff members involved during the inspection visit, so that they would not continue with poor practice. The moving and handling training provided at the home must be reviewed, to make sure that all care staff members know and understand why only appropriate methods of assisting individuals to move must be used. The manager must also review the moving and handling risk assessment process, so that only appropriate methods of moving and handling individuals are detailed on the care plans. The home has policies and procedures to help manage medication safely, and the supplying pharmacy last visited in February 2007 to conduct an audit. We saw how medication is managed and noted that the medication records for two individuals were accurate and complete. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 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. 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. There have been improvements to the quality of daily life for people living at the home, but more needs to be done. EVIDENCE: There is now a monthly activity programme in the home, showing that there is some activity provided most weekday afternoons. On the afternoon of our visit, two staff members provided one to one sessions of activity, such as help with jigsaws or drawing, and it was clear that the individuals helped valued this activity very much. One relative said that the one to one sessions were very useful, as it helped to reduce the loneliness experienced by individuals. A relative commented that since completing a life story document the staff members find it much easier to talk meaningfully with his/her relative, and this has improved the individual’s quality of life. An exercise class is provided one a month, and as people at the home enjoyed it, it needs to be considered as a weekly activity for its social and health benefits. Other activities provided include weekly visits by a ‘Pets as Therapy’ dog, games, films, music and pottery sessions. While we acknowledge that the provision of activities has improved, there are no arrangements in place to make sure that individuals are able to spend time outside the home, and the activities plan does not show that activities continue The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 12 over the weekends. The minibus used by the home has been out of action for several months, and at the September Relatives’ Meeting, it was expected that outings would start again soon. One response to our questionnaire said that physically individuals are well looked after, but that other aspects of their lives are not attended to. The home should consider how to provide more varied activities, including outside activities for people living at the home. Visitors said they were always welcome at the home, and that the revived relatives meetings were very welcome. Those who responded to our survey said that they are ‘always’ kept up to date with important issues about their relatives. We spoke with the cook, and she explained how she learns about the food preferences and needs of newly admitted individuals. Fresh vegetables are available, and people are given a choice about their meals. Individuals said that the food is good, and on the day several said that they enjoyed the day’s lunch. Aids are available to help staff members help individuals to eat, such as angled cutlery and plate guards. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 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. 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. People living at the home are safe from harm, and they and their relatives know how to make a complaint. EVIDENCE: The home’s complaints procedure is displayed in the hall and relatives who responded to our survey said that the home ‘usually’ or ‘always’ responds appropriately to complaints raised. Individuals told us that they would talk about their concerns with a member of staff. There is a regular slot for relatives to see the manager if they have any concerns to discuss. There have been three complaints received since the last inspection visit, and the home responded to these within the timescales in the complaints procedure. We have not received any information concerning complaints since the last inspection visit. Since the last inspection visit additional training in how to help safeguard people in the home from harm has been provided, and now all the staff members have received training. The home has copies of the local codes of practice regarding safeguarding and staff members know what to do in the event of an allegation of abuse. The incident reported during the last inspection visit has been investigated appropriately. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There have been improvements to the home’s environment, but more needs to be done to make sure that the home is clean, safe and comfortable. EVIDENCE: There have been several areas of improvements to the environment since the last inspection visit, and there is a system to manage the day-to-day maintenance. The downstairs communal areas have been renovated and the process of redecorating upstairs is in hand. The assisted bath on the ground floor was not in use, and had a notice saying that it had failed a service in August 07. In the three months since then an engineer had arrived to repair the bath, but did not have the correct part. The manager has contacted the company recently to make sure that the repairs would take place soon, but there has been a long delay when people living at the home have not had the use of the bath. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 15 The home should arrange and make sure that repairs to equipment used by the people living at the home take place in a timely way. The bath had strong lime scale deposits and these should be removed, and the toilet needed general cleaning. The cleaning audit should include the monitoring of routine cleaning of all areas used by the people living at the home, to make sure that the home is kept clean and hygienic. A requirement about keeping the home clean was made at the last inspection visit, and has not been properly met. The home has procedures to help staff members to control the spread of infection in the home, and should implement the Department of Health’s guidance about the use of individual hoist slings to prevent the spread of infection. The care staff members manage the home’s laundry on site, and protective clothing is available when necessary, and the laundry room has easy access to hand washing facilities. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The people at the home are not always safe, as the training and supervision arrangements for care staff is not producing safe workers. EVIDENCE: There is a staff members’ rota showing who is on duty over the twenty-four hours, and a nurse is always available. Relatives and people living in the home praised the care staff, and said that they worked very hard to meet the needs of the individuals. They praised their dedication and kindness, and individuals said they enjoyed the allocated time spent on one to one activities. There were 11 people living at the home and on the morning of the inspection visit there were two carers and a nurse/manager on duty, with the cook, cleaner and the painter also present. Relatives expressed concerns that there were not enough staff members always available, especially in the evenings, when two members of staff are needed to assist individuals to go to bed. Relatives said that this means that there is no carer downstairs to attend to the other individuals, as the nurse is usually upstairs and they are concerned that people are not sufficiently supervised to keep them from harm. This issue was brought to the attention of the home following the last inspection visit, and we understood that arrangements were in place so that people living in the home were not left unsupervised for inappropriate periods. The arrangements about how staff members are allocated should be monitored to make sure that the people The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 17 living at the home are safe at all times. The arrangements should be made clear to relatives, so that their concerns are addressed. The home’s staff rota for the week of the inspection visit showed that there were eight members of the care staff, excluding the nurses, and of these two have National Vocational Qualifications in Care. There are two more carers enrolled on the NVQ programme, and the home will be meeting the national minimum standard of 50 trained staff when they complete the course. The home’s induction programme has recently been improved and is now to the necessary standard. There is a training programme for staff and more opportunities have been provided recently, to meet the requirement from the last inspection visit. However, we witnessed unsafe moving and handling practice by two carers who had received training in how to help people move safely, and this brings into question the quality of the training, and the monitoring of practice. The supervision of care staff must include the monitoring of care practice, to make sure that staff are working in a safe way. The home has recruitment procedures, and all the necessary information was available in the recruitment file we saw. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. It is not clear that the home is run in the best interests of the people living there, as the home’s systems are not robust enough to protect and promote their health and safety. EVIDENCE: The registered manager recently returned from maternity leave and intends to continue with the improvement made since the last inspection visit. Although improvements have been made, the poor moving and handling practice we saw at the home reflects on the management, as the issue has been brought to the management’s attention previously and has not been satisfactorily addressed. Petty cash is kept securely and records are kept of transactions. The home conducted a quality survey in the summer, and is taking action on the results, especially about the provision of activities. A senior manager The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 19 conducts monthly monitoring visits at the home and we saw copies of the reports at the home. Quality audits are conducted on aspects of care and practice, but issues of cleanliness and moving and handling practice were not addressed through this system. The home has a health and safety policy statement and states that it will provide training and equipment for staff to work safely, but the unsafe moving and handling practice of some care staff challenges the implementation of the policy statement. Contracts are in place to maintain equipment but action was not taken in a timely way to make sure that the ground floor assisted bath was repaired quickly. The home’s manager is responsible for fire safety, and has systems in place to make sure that people living at the home will be safe in the event of fire. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 X X 1 The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 13 (4) Requirement Timescale for action 14/12/07 2 OP26 23 3 OP30 18 (1)(a) 4 OP36 18 (2) A review of the moving and handling risk assessment process must be conducted, so that staff members know that only appropriate methods of moving and handling individuals are detailed on the care plans. All areas of the home must be 14/12/07 kept clean, pleasant and hygienic. This requirement remains from the inspection visit of 29th June 2007. The moving and handling 14/12/07 training provided at the home must be reviewed, to make sure that all care staff members know and understand why only appropriate methods of assisting individuals to move must be used. The supervision of care staff 14/12/07 must include the monitoring of care practice, to make sure that staff are working in a safe way. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 8 9 10 Refer to Standard OP7 OP8 OP12 OP12 OP26 OP26 OP26 OP27 OP27 OP37 Good Practice Recommendations Individuals living at the home and/or their relatives should be given opportunities to sign care plans and other documents about their care. The key worker role should be reviewed, so that all the individuals living at the home have access to their key worker at reasonable times. Consideration should be given to providing the monthly exercise class as a weekly activity, for its social and health benefits. The home should consider how to provide more varied activities, including outside activities for people living at the home. The lime scale deposits on the ground floor bath should be removed. The cleaning audit should include the routine cleaning of all areas used by the people living at the home. The home should implement the Department of Health’s guidance about the use of individual hoist slings to prevent the spread of infection. The arrangements about how staff members are allocated in the evenings should be monitored, to make sure that the people living at the home are safe at all times. The arrangements about allocation of staff in the evenings should be made clear to relatives, so that their concerns are addressed. All staff are familiar with the contents of all policies and procedures relevant to the role they undertake in the home. This recommendation remains from the last inspection visit of 29th June 2007. The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Crown Nursing Home DS0000065924.V349925.R01.S.doc Version 5.2 Page 24 - 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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