Inspection on 20/06/08 for The Vines

This inspection was carried out on 20th June 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 The Vines Innhams Wood Crowborough East Sussex TN6 1TE Lead Inspector Caroline Johnson Unannounced Inspection 20th June 2008 10:00 DS0000071600.V366531.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 DS0000071600.V366531.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. DS0000071600.V366531.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Vines Address Innhams Wood Crowborough East Sussex TN6 1TE 01892 610414 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) Priory RS Ltd Mrs Jo-Ann Davis Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (0) of places DS0000071600.V366531.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either M/F whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia (MD) 2. The maximum number of service users to be accommodated is twelve (12). N/A Date of last inspection Brief Description of the Service: The Vines is a specialist residential care home that is registered to offer longterm care and rehabilitation to twelve adults with an acquired brain injury. The home aims to provide service users with a safe and supportive environment whilst enabling those accommodated to participate in and access local community resources. The Vines is situated in a quiet residential area of Crowborough within walking distance of the main high street. The Vines is one of two residential care homes in East Sussex owned by Priory Rehabilitation Services limited. Since the last inspection the home re-registered under a new charity number. The home is therefore classed as a new service. The current fee is £1433 per week. A copy of the home’s inspection report is available at the home for viewing. Additional charges are made for toiletries, magazines and haircuts. DS0000071600.V366531.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 stars. This means that the people who use this service experience good quality outcomes. For the purpose of this report the people living at the Vines will be referred to as ‘residents’. As part of this inspection process a site visit was carried out on 20 June 2008. The inspection lasted from 10.00am until 4.20pm. During the inspection there were opportunities to spend time with the Operations manager and with three staff members in private. The registered manager was on leave at the time of inspection. Time was also spent in the lounge area observing and speaking with a number of the residents. With the exception of one bedroom all areas of the home were seen during the inspection. A wide range of documentation was seen including pre admission documentation for one resident admitted since the last inspection. Three care plans were also seen. In addition records were seen in relation to staff recruitment, training, staff and residents’ meetings, medication, menus and health and safety. In advance of the inspection the manager completed an AQAA (annual quality assurance assessment) and information from that document has also been included in this report. What the service does well: The home is well maintained and the continual programme for redecoration ensures that the standard of the décor remains good. The home’s procedure in relation to assessment of prospective residents is very good and as part of this process prospective residents are invited for a three-day assessment in the home. This provides the home with an opportunity to carry out an indepth assessment but also gives the prospective residents a taste of what living in the home would be like. A wide range of training opportunities are made available to staff and this insures that they are equipped to meet the complex needs of the residents accommodated. Staff spoken with felt well supported and valued the regular supervision provided. Residents spoken with stated that they like living at the Vines. DS0000071600.V366531.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. DS0000071600.V366531.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 DS0000071600.V366531.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): 1,2,3,4 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of prospective residents are fully assessed prior to the home making a decision about whether to provide accommodation. EVIDENCE: There is a detailed statement of purpose in place and a service user guide. The statement of purpose has been reviewed in recent months. One resident was admitted to the home since the last inspection. Records showed that the home carried out an assessment of the resident’s needs and abilities prior to making a decision about accommodation. Several health assessments and a social care assessment were also obtained. The home’s policy, where funding permits, is to invite prospective residents for a three-day assessment. This gives the home time to carry out a detailed assessment and also gives the prospective resident time to make up their mind about accommodation. DS0000071600.V366531.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): 6,7,8,9 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care of residents should be enhanced further when the plans to make improvements to the care planning system are in place. EVIDENCE: Three care plans were examined on this occasion. In each care plan there was a detailed assessment of the needs and abilities of the residents. Reviews are held regularly and during this process a number of goals are identified. Where appropriate residents sign their agreement with the goals in place. Some of the goals identified are then listed on the shift plan so that staff can complete showing if they have been achieved. In addition there are daily records detailing the activities that the residents have been involved in over the course of their day. DS0000071600.V366531.R01.S.doc Version 5.2 Page 10 In each of the files seen there were a number of goals identified. Most of the goals seen were broad and as a result it was not easy to measure the progress achieved. For example one goal identified for two of the residents was to ‘identify activities and interests outside of the Vines’. There were no records in place showing progress with this goal. Another goal was to ensure a resident ‘receives a healthy, balanced diet’. Although there is a menu plan there were very limited records in place of the actual meals served. The shift plan includes a tick system stating if an activity has taken place. The majority of the shift plans seen had been completed but had not been signed by staff. The daily record provides more detail about the activity that has been carried out but in the record seen the information provided was not sufficiently detailed. In each file there are a range of risk assessments in place, which assist in minimising the risk of accidents or incidents occurring. The psychologist spoken with stated that he had identified the need to improve goal planning and will be working with staff to identify clear goals that are more specific in terms of what it is hoped will be achieved. This should ensure that staff would be able to record more clearly the work carried out to address goals and progress can then be measured more easily. A member of staff advised that they have just taken over the role of coordinating residents’ meetings. A meeting was held the day prior to the inspection and hand written minutes were available detailing the outcome. The minutes provide limited information and discussion was had about how these could be improved to demonstrate more clearly the choices given, how decisions are reached and how residents are kept informed of house issues. There were very few records in place in relation to previous meetings. However, it was confirmed following the inspection that a number of meetings have been held but that either minutes were not taken or they were miss filed. Meetings are now to be held monthly. DS0000071600.V366531.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): 12,13,14,15,16,17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities to participate in some interesting and stimulating activities. EVIDENCE: Two days prior to the inspection the majority of the residents went to Port Lymne for a day trip. All the residents spoken with confirmed that they enjoyed their day out. Each of the residents has a weekly programme of the activities that they are involved in included in their care plan. Weekly activities include cinema, bowling, music therapy, an arts and craft session at Ringmer and regular trips to cafes and restaurants. Staff also support the majority of the residents to DS0000071600.V366531.R01.S.doc Version 5.2 Page 12 take a daily walk. The arts and crafts session will be replaced next term with line dancing. One resident is assessed as able to use local amenities on their own for short periods. One resident attends a day centre one day a week and staff advised that the resident has built up a good network of friends there. An aroma-therapist also visits the home regularly. After lunch, time was spent in the lounge with the residents. Nine of the residents were present. One was playing scrabble, one was playing a game of patience, two were sleeping and the remainder were watching television. Residents were generally very positive about the care and support they receive. The home has a seven seated car and staff advised that at any time they can take up to five residents out with two staff as long as there are three staff remaining in the home. Visitors are welcome to the home at any reasonable time. Keyworkers assist residents to maintain contact with relatives. Although there are some activities that are planned in advance, a number of activities are arranged spontaneously. Whilst it is recognised that there needs to be a balance between having too many structured activities and too many spontaneous activities, more time should be given to planning activities in terms of the purpose of the activity and what can be achieved linked to care plans. There is a four-week menu in place, which includes two choices for the main meals. Staff spoken with confirmed that they ask residents which choice of meal they would prefer each day. The main meal is served at lunchtime with a lighter meal provided in the evening. Recently the home has introduced a change whereby one evening a week all the residents choose and prepare their own evening meal with support. They take it in turn to use the kitchen, which is next to the main kitchen area, and so far this has worked well. Records seen of meals served were not detailed and were not dated. However, following the inspection it was reported that the record book held by the cook in relation to meals served was not the book seen at the time of inspection. This will be followed up at the next inspection. In relation to one resident who has been unwell there were detailed records of their dietary intake. DS0000071600.V366531.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): 18,19,20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems in place ensure that residents’ healthcare needs are met. This could be enhanced further, by ensuring that as needs change, consideration is given to whether a risk assessment is needed. EVIDENCE: Since the last inspection the company have appointed a consultant psychologist and two assistant psychologists to work in the home. The consultant psychologist works in the home a minimum of one day a week. Both of the assistants work a minimum of two days a week which means that four days a week there is an assistant psychologist in the home. One of the small lounge areas is used for one-to-one consultations with residents. The arrangements in place for the storage and handling of medication were in order. However, it was noted that one resident was prescribed medication for epilepsy, on an as required basis, and that the majority of the staff team are DS0000071600.V366531.R01.S.doc Version 5.2 Page 14 not trained to administer this. Staff spoken with confirmed that this medication has never been required and that if this situation occurred they would just call an ambulance. It was agreed that this issue would be discussed with the resident’s gp. However, following the inspection it was confirmed that the medication is for use by paramedics only, in the case of an emergency. All staff must be reminded that this is the case. The sample sheet showing staff signatures was not in the medication cupboard. A returns book is kept showing information about all medication returned to the local pharmacy. One resident has been unwell recently and it was noted that the home had taken appropriate action in ensuring that a range of medical appointments were carried out to try to identify the problem. The residents’ dietary intake was being monitored. For a period of time there was a concern that the resident might have epilepsy. Records did not show that there had been a risk assessment in place in relation to this at that time. There were however guidelines in place for managing stair climbing. Staff seen in the course of their duties were courteous and treated residents with respect. They support residents to attend a range of healthcare appointments. Records showed that residents receive regular chiropody, dental and opticians appointments. Each of the resident’s weights is monitored monthly. DS0000071600.V366531.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 quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems in place ensure that any complaints, and any suspicion or allegation of abuse would be dealt with appropriately. EVIDENCE: Records showed that there have been no complaints recorded since the last inspection of the home. There is a detailed complaint procedure in place and a simplified version is also included in the service user guide. No complaints have been made to the Commission about this service. The staff training matrix shows that all staff have had training on the subject of adult protection and prevention of abuse. A staff member spoken with was clear about what should happen if abuse were suspected. There is a detailed policy and procedure in place on the subject and the home has a copy of Sussex multi-agency policy and procedure for safeguarding vulnerable adults. DS0000071600.V366531.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): 24,25,26,27,28,30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home that is well maintained and decorated to a good standard. EVIDENCE: Bedrooms are well decorated and have been personalised to reflect the individual personalities and tastes of the residents. Since the last inspection a number of the windows have been replaced with double glazed windows. New tables and chairs have been provided in the dining area. Staff and residents advised that the seating in the lounge was replaced a year ago. However time was spent in one chair whilst speaking with a resident and it was not a very comfortable chair. Two of the residents spoken with also confirmed that they DS0000071600.V366531.R01.S.doc Version 5.2 Page 17 do not find the seating in the lounge very comfortable. The operations manager confirmed that there are plans to replace the seating in this area. It was noted that towels are provided in the toilet and bathroom areas. It was acknowledged that this is not considered good practice as it could increase cross infection. However, the home are currently trialling a hand drier in one of the bathrooms and if this proves successful similar driers will be provided in all bathroom areas. It was reported that there is a quote in to replace the flooring in one of the bathroom areas. The carpet in the smoking area is old and although cleaned regularly this needs to be replaced. A staff member advised that one of the residents does his own laundry with staff support. A cleaner is employed three mornings a week to clean the communal areas and bathrooms. The washing machine provided has a sluice facility. There is also a contact in place for the removal of any clinical waste. All areas of the home seen were clean. DS0000071600.V366531.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): 31,32,33,34,35,36 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The continuous training available ensures that the staff team remain equipped to meet the needs of the residents accommodated. EVIDENCE: Staff spoken with confirmed that there are generally 4-5 staff on duty throughout the day and the manager works in addition to this. There is one staff member on long-term sickness and permanent staff are currently covering these hours. Where necessary agency staff are used. Two waking night staff are on duty at night. Staff recruitment records were seen in relation to two staff. In both cases the home had carried out thorough checks prior to making an appointment. All new staff complete an in-house induction when they commence working in the home. Following this they complete the Common Induction Standards. Computerised records showed that the majority of staff have attended training in all areas. Pie charts and graphs can be used to highlight when staff are due DS0000071600.V366531.R01.S.doc Version 5.2 Page 19 to receive an update in a particular area and a refresher is then booked. A number of the courses are carried out on-line. In addition to mandatory training there are opportunities in place to attend further training. A staff member spoken with confirmed that in the past year they had completed a course on the provision of supervision and on communication and personal effectiveness. A high percentage of the staff team have completed or are currently in the process of studying for an NVQ at level two or above. One of the senior staff spoken with is currently studying for level three and the second senior is about to complete level three and hopes to start level four as soon as possible. All staff spoken with confirmed that they receive monthly supervision. One of the senior staff spoken with advised that she will be completing a course on the provision of supervision and following this she will take on the responsibility of providing supervision for the staff in her team. DS0000071600.V366531.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): 37,38,39,40,42 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home that is well run and the systems in place ensure that the home is continuously reviewing and improving how they operate. EVIDENCE: It was reported that the registered manager has almost completed the Registered Manager’s Award. The operations manager advised that she visits the home at least once a week and provides a weekly informal supervision and a monthly formal supervision for the manager. She also visits once a month unannounced to carry out a monthly report on the conduct of the home. DS0000071600.V366531.R01.S.doc Version 5.2 Page 21 Records seen showed that a thorough assessment is made to ensure that the home is running smoothly. There is currently no space to sign the form. Monthly reports show evidence that the Operations manager speaks with the residents to hear their views on the care provided, checks audits of the kitchen and health and safety and looks at records of fire safety. One recent audit tracked the home’s progress in relation to the majority of the standards. Annual satisfaction questionnaires are also distributed to residents and to their families and representatives. Staff meetings are held weekly. Every alternative meeting involves a discussion regarding the residents and the psychology team attend these meetings. Staff spoken with confirmed that they value these meetings. As a result staff are working more consistently in ensuring that the needs of the residents are met. The company are currently carrying out a review of all their policies and procedures. Following this a review will then be carried out to standardise the format for all local policies and procedures. Health and safety meetings are also held regularly and minutes were seen of the last two meetings. A range of audits are carried out regularly, some of which include audits of care plans, catering and medication. Since the last inspection the home has reported any incident that has affected the wellbeing of a resident. DS0000071600.V366531.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 3 4 3 5 X 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 3 25 3 26 3 27 3 28 3 29 X 30 2 STAFFING Standard No Score 31 X 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 2 3 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 4 X 3 X DS0000071600.V366531.R01.S.doc Version 5.2 Page 23 N/A 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 YA19 Regulation 13(4c) Requirement The registered person must ensure that when a resident’s health changes an assessment must be carried out to determine if it is necessary to draw up additional risk assessments on a temporary basis. In order to avoid cross infection the practice of using hand towels in the toilet and bathrooms must cease. Timescale for action 15/08/08 2. YA30 13(3) 15/08/08 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. 2. 3. Refer to Standard YA6 YA7 YA12 Good Practice Recommendations The home should continue with their plans to introduce goals that are specific measurable and achievable. Minutes of residents meetings should demonstrate how residents are kept informed of house issues and also how residents are given choices and how decisions are reached. More thought should go into planning activities so that they are linked to meeting the identified needs and wishes DS0000071600.V366531.R01.S.doc Version 5.2 Page 24 of residents as stated in their individual care plans. DS0000071600.V366531.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. 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