Inspection on 21/07/08 for The Hawthorns

This inspection was carried out on 21st July 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Hawthorns 08/08/07

The Hawthorns 10/01/07

The Hawthorns 30/12/05

The Hawthorns 06/09/04

The Hawthorns 21/04/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOME ADULTS 18-65 Hawthorns (The) The Hawthorns Coulsdon Road Caterham Surrey CR3 5YA Lead Inspector Ruth Burnham Unannounced Inspection 21st July 2008 09:30 Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 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 Hawthorns (The) DS0000013667.V368557.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 Adults 18-65. 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. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hawthorns (The) Address The Hawthorns Coulsdon Road Caterham Surrey CR3 5YA 01883 383713 01883 383714 john.rhodes@sabp.nhs.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) Surrey and Borders Partnership NHS Trust Manager post vacant Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2007 Brief Description of the Service: The Hawthorns is on the main site of Surrey and Boarders NHS Trust Headquarters. It is a self-contained building set within a group of homes. All service users have their own single bedroom. There is ample garden space to the rear of the property, which has a patio area; the rest of the garden is laid to lawn. The building is a modern bungalow style property providing accommodation for service users on the ground floor only, however there are some steps within the building. There are local shops and pubs within walking distance of the home, other community facilities, such as the library and swimming pool are reached by using the home’s own transport or local bus services. Many day care facilities are provided for service users on the Trust’s Headquarters’ site. A few service users attend activities within community facilities, such as local education services. The service users have a complex range of needs; including challenging behaviour The fees start from £1,410.68 per week. Items that are not covered by the fees include: hairdressing, toiletries, and meals out, nail manicures, some activities and holidays. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 08:30 and was in the Service for five and a half hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Service’s owner or manager and any information that CSCI has received about the Service since the last inspection. We spoke to the area manager, 1 staff member and people who live in the home. We observed interaction and care practices and looked at records and documents, including 2 people’s care plans. Surveys were sent to residents, health and social care professionals and staff as part of the inspection. No responses had been received at the time of writing this report. The area manager completed the Annual Quality Assurance Audit for the Commission; information provided in this document is also included within the report. There are six Required Developments at the end of this Report. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The Commission for Social Care Inspection would like to thank the residents, the area manager and staff for their hospitality, assistance and co-operation with this inspection. What the service does well: People who may consider moving into the home would be provided with helpful information about what life is like there. Thorough assessment and admission procedures mean people who may consider moving into the home in the future can be confident their needs will be understood and can be met. People who live in the home enjoy opportunities to take part in a range of social and leisure activities. Their personal and healthcare needs are met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for handling medication. They are listened to and protected from abuse. People benefit from the support of the committed, and competent staff team. Effective quality assurance systems promote year on year improvement in the service. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People who use the service experience good outcomes in this area. Should people consider moving into the home in the future they would be provided with helpful information to assist them to decide if the home would be suitable for them. There are clear admission and assessment procedures to ensure people’s needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People currently living in the home have all lived there for a number of years. Any new residents entering the home would have a detailed assessment carried out of their needs to ensure the home will be suitable for them. There are clear admission procedures and criteria to reflect the principles of admission and assessment appropriate to the home. It is not envisaged that anyone else will be admitted to the home in the near future. Current residents are being reassessed at this time to ensure their needs can continue to be met. One resident said they are hoping to move into more independent living accommodation in the near future. Helpful information about what life is like in the home is available in the service users guide, copies of this document are available to people who live in the home and their relatives where appropriate. This document was displayed in the home and is updated each year. The home does not offer intermediate care. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6-9 People who use the service experience adequate outcomes in this area. People are involved as far as possible in planning their own care according to their individual abilities. Staff do not always have access to the most up to date information about peoples’ care needs. People are not always protected form harm where risk management processes are ineffective. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home have detailed plans of care. Two peoples’ care plans were examined, these showed that their care needs are assessed and reviewed regularly. Daily care notes are also recorded. One person who was spoken with was aware of the contents of their care plan and confirmed that they were involved in setting up the plan of care, they said they had recently attended a meeting to update the care plan. Not all care records were dated and the Person Centred Plans were not up to date. Staff do not therefore have access to the most up to date information about people’s needs and may not be aware of any agreed changes to the plan. Care planning documentation for each individual contains a great deal of information, however this is not always Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 10 up to date or user friendly to provide clear guidance for staff on how to meet changing needs. Risk assessments are recorded and reviewed but are not being used and developed as working documents leading to action to ensure people continue to be protected from harm as their needs change. It was of particular concern that one person has had an increased number of falls recently in the home, evidenced by severe facial cuts and bruises. The risk assessment in this person’s file had been regularly reviewed however no changes had been made as a result of recent falls and no referral had been made to relevant health care professionals for an environmental assessment. A physiotherapist has been involved in the provision of a walker which the person is now being encouraged to use around the home although this is of no help where stairs must be negotiated. One resident who was spoken to explained that everyone has a designated member of staff as their keyworker, they said they liked this arrangement. Keyworkers are trained to offer one to one support; they know people well and understand peoples’ needs. The majority of people who live in the home have limited verbal communication skills. Staff have the necessary skills and experience to support people to make decisions and choices. Holidays, menu planning and outings are planned mainly with the support of staff who generally know the residents well. Information is provided in formats appropriate to peoples’ individual needs to help them to make decisions. During the visit it was noted that staff are respectful, kind and supportive of people who live in the home. There is a friendly atmosphere and good rapport between staff and the people who live there. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 17 People who use the service experience adequate outcomes in this area. People are encouraged and supported to access a variety of activities. Activity programmes do not always support peoples’ aspirations for increased independence. Blanket policies restricting access to key areas of the home undermine independence and give the home an institutional feel. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are supported to make choices in their everyday lives as far as they are able. There are six people living in the home all of whom attend various activities; for example, bowling, shopping, trampolining, swimming and visiting local pubs. Some people attend the on site day centre. Holidays are planned with the support of staff in line with the assessed needs, abilities and wishes of each person. The home has its own vehicle which is Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 12 used for outings. One person said they enjoyed going shopping with staff and walking around the grounds. Most people have contact with family members. One of the residents was looking forward to a birthday outing with their family. They also said they enjoyed going to church and attending art and music classes and other sessions at the day centre. This person is hoping to move into more independent living accommodation in the future. It was surprising therefore that activities were not being programmed to support this person to improve their independent living skills. This was discussed with the service manger who agreed to look into this. The dining room has been refurbished and provides a pleasant space for people to enjoy meals. There is also a small courtyard where 2 people were enjoying breakfast outside on the morning of the visit. Staff are trained in basic food hygiene. It was noted that the kitchen is kept locked which restricts freedom and independence for everyone who lives in the home. The front door and other doors are also kept locked which means people who are more independent always have to ask to go outside. These blanket policies give an institutional feel to the home and individual care plans do not appear to support these practices. The service manager agreed to ensure all blanket policies are reviewed to assess their relevance and ensure people who would benefit from unrestricted access to areas of the home to promote their independence will be actively supported and encouraged to achieve this. People who live in the home are encouraged and supported to plan the menu. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 – 20 People who use the service experience good outcomes in this area. People who live in the home can be confident their personal and healthcare needs will be met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for handling medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home can be confident their personal and healthcare needs will be met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. People who were spoken to said they could choose when to go to bed and when to get up and are supported to choose their own clothes, hairstyles and other aspects of personal grooming. One person was very pleased with their recent manicure and enjoyed the make up sessions at the day centre. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 14 Peoples’ health is promoted through regular visits to the local G.P and they all have an annual health check. People are supported to access other health care professionals including psychiatric services, physiotherapists, dentists, chiropodists and opticians when required. Each person has a detailed health action plan. Those seen had not been dated, it was therefore unclear if information in them was current. The service manager agreed to ensure all documentation is dated and signed. People are protected from harm through safe systems for handling medication. Staff who handle medication are trained to do so. The Medication Administration Record (MAR) sheets were seen, these were well maintained and up to date. Any medicines that are only given periodically ‘as required’ are entered on the MAR sheet. None of the people who live in the home are able to take responsibility for their own medications. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good outcomes in this area. People who live in the home are listened to. They are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home are listened to and encouraged to offer comment or complaint. The complaints procedure is in pictorial form to make it easy for people to understand. One person said they would always tell staff if they were unhappy about anything. During the visit staff were observed to offer sensitive support when people were anxious and needed reassurance. Complaints are recorded and dealt with appropriately within reasonable timescales. The Commission for Social Care Inspection (CSCI) have not received any complaints about the service since the last inspection. The home referred one issue to the Safeguarding Adults team for investigation. This was dealt with appropriately by the home. The service manager and staff have undertaken training in the protection of vulnerable adults and staff are aware of the whistle blowing policy. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 – 28 & 30 People who use the service experience adequate outcomes in this area. People who live in the home are benefiting from recent improvements to the environment. There is still risk of harm where toilet and bathroom areas need refurbishment to ensure effective standards of hygiene can be maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the Trust has worked hard to improve the environment for people who live in the home. Communal areas are clean and well presented. The dining room has been refurbished and the kitchen has been replaced. Flooring in corridors and on the stairs has also been replaced. People are supported to personalise their bedrooms and a number have been redecorated. A choice of outside space is a real bonus in this home, however, lawned areas need to be mowed and weeds need to be removed to make these areas more inviting for the people who live in the home. People may be at risk of harm where work is still needed to bring toilets and bathroom areas up to a reasonable standard and ensure these areas can be Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 17 cleaned effectively. The service manager agreed to ensure that damaged surfaces are repaired or replaced and the shower area is thoroughly cleaned. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 – 36 People who use the service experience good outcomes in this area. People who live in the home benefit from the commitment of the staff team to providing good quality care. Robust recruitment procedures protect people from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the commitment of the staff team to provide good quality care. There are sufficient numbers of staff on duty to meet the needs of people who live there. There is a core team of bank and agency who cover any shortfalls in shifts at the home, a number of them have worked at Hawthorns for many years, which helps to ensure continuity of care and support offered to individuals. People are protected through robust recruitment and selection procedures. Staff files seen contained all the required information and were well maintained and up to date. It was pleasing to hear that residents are involved in the selection process, one resident who was spoken to explained how they had recently been involved in interviewing applicants for the deputy manager post. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 19 There have been some problems accessing staff training recently. The service manager said this is now being addressed and additional training is being sourced to ensure all staff have the opportunity to attend relevant courses such as caring for people with autism and other specialist training to help staff understand the specialist needs of people who live in the home. All new staff attend the Trust’s induction course where all mandatory training is covered. Supervision takes place 4 – 6 weekly for all the staff team. Appraisals are carried out annually. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use the service experience adequate outcomes in this area. Suitable interim management arrangements are being put in place to insure the service is operated in a way that promotes the health and wellbeing of people who live in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Circumstances beyond the control of the Trust mean there is not currently a registered manager in the home. This has had some negative impact on the running of the home where there has been no one in overall day to day control to ensure the service to people there is proactive and responds quickly to their changing needs. The area manager confirmed that efforts are being made to Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 21 recruit a suitable manager. It was clear during the inspection that the area manager has a good relationship with people who live in the home and knows them well. The slippage in management standards in recent months is now being addressed. The Commission considers the interim management arrangements now being put into place to be satisfactory in that a suitably qualified deputy manager has now been recruited to manage the day to day running of the home. Until a manager is appointed the area manager will continue to oversee the service. The area manager completed the Annual Quality Assurance Audit for the Commission. This showed that there is a quality assurance system in operation in the home. Monthly Regulation 26 visits are undertaken; these are unannounced and provide feedback to the home on good practice as well as area’s for development. Follow up visits ensure that actions identified have been carried out. Not all records required to evidence that a safe environment is being maintained for the people who live in the home were available. The service manager agreed to forward copies of the current electrical and Gas safety certificates and ensure that all portable electrical appliances have had safety checks. The home is working with the Environment al Health Officer to ensure that all the recommendations from their recent inspection have been complied with. People may be at risk of infection where communal mats are being used in bathroom and shower rooms, this was drawn to the attention of the service manager during the visit who agreed to ensure all staff have a clear understanding of infection control issues. Staff have received training in safe working practices including basic food hygiene, first aid, fire safety, health and safety and moving and handling. Hawthorns (The) DS0000013667.V368557.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 Adults 18-65 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 3 2 3 3 X 4 X 5 N/A INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 3 29 x 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 X 3 X X 2 x Hawthorns (The) DS0000013667.V368557.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 YA6 Regulation 15(2) Requirement Care records must be kept up to date to ensure staff always have access to the most up to date information about peoples’ care needs. People must be protected form harm through effective care planning and risk management processes. Activity programmes should support peoples’ aspirations for increased independence. Peoples, independence should not be undermined by blanket policies that restrict access to key areas of the home giving the home an institutional feel. bathrooms and toilets must be upgraded to ensure that satisfactory standards of hygiene can be maintained and risk of infection is eliminated. Timescale for action 30/08/08 2 YA9 13(4) 30/08/08 3 YA16 12 30/09/08 4 YA27 13(4) 30/09/08 5 YA37 9(2) The RI must ensure that a suitable manager is recruited and they make an application to be registered by the Commission DS0000013667.V368557.R01.S.doc 30/10/08 Hawthorns (The) Version 5.2 Page 24 as soon as possible. 6 YA42 13(4) Records evidencing the safety and regular maintenance of electrical and gas installations, equipment and portable appliances should be available for inspection. Communal bathmats should not be used. 30/09/08 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 Refer to Standard YA24 Good Practice Recommendations Lawned areas need to be mowed and weeds need to be removed to make outside areas more inviting for the people who live in the home. Hawthorns (The) DS0000013667.V368557.R01.S.doc Version 5.2 Page 25 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 Hawthorns (The) DS0000013667.V368557.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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