Inspection on 26/09/06 for Tristford

This inspection was carried out on 26th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tristford 12/02/09

Tristford 03/10/05

Tristford 31/05/05

Tristford 09/12/04

Tristford 09/06/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

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

CARE HOME ADULTS 18-65 Tristford 7 Radnor Park West Folkestone Kent CT19 5HJ Lead Inspector Wendy Mills Unannounced Inspection 26 September 2006 09:30 th Tristford DS0000023615.V299319.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 Tristford DS0000023615.V299319.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. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tristford Address 7 Radnor Park West Folkestone Kent CT19 5HJ 01303 241720 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) MNP Complete Care Group Mrs Lorraine Celia Harrington Care Home 12 Category(ies) of Physical disability (12) registration, with number of places Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residential care for older people with a physical disability is restricted to 2 residents whose d.o.bs are 09/11/30 and 11/01/41. Residents over the age of 65 are restricted to one (1) whose DOB is 22/07/1939 3rd October 2005 Date of last inspection Brief Description of the Service: Tristford is part of the MNP Complete Care Group. It is a residential home providing care and support for up to twelve people with physical disabilities. It is a large, well-maintained, late Victorian, three story, detached house that overlooks a local park. It is close to all local amenities in Folkestone. The accommodation for residents is arranged on two floors, the upper floor being accessed by a spacious lift. There are twelve single bedrooms that are comfortably furnished, light and airy. The communal space is large and well decorated. There is easy access to a safe, well-maintained and enclosed garden. On the third floor there is a large administrative office and a training room for staff. The MNP Group are the registered providers for the home. The registered manager is Mrs Lorraine Harrington. Mrs Harrington is a registered nurse and has many years experience in care. She has managed the home for over two years now. The fees for this home range between £749 and £1425 per week and are based on the individual needs of each resident. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit began at 9.30am and lasted five hours. During the course of the visit the views of eleven residents, one relative and four members of staff were sought. Four of the residents gave their views in the privacy of their own rooms and all staff were interviewed in privacy of the main office. Telephone contact was made with visiting health and social care professionals to obtain their views. In-depth discussion was held with both the registered manager and the deputy manager. The contents of pre-inspection questionnaires were considered and documentation kept within the home was examined. A tour of the home and ground was made. The home continues to maintain and improve upon the good standards of care noted at previous inspections. The requirements and recommendations from the previous inspection have all been met. Both residents and relatives expressed their satisfaction with the care given and commented upon the commitment and kindness of the staff. Staff, residents and supporters praised the way the home is managed and said that the registered managed maintains good communication within the home, with visitors and with visiting health and social care professionals. The residents, registered manager and staff are thanked for the warm welcome they gave, and for their assistance throughout this visit. What the service does well: The home cares for the health and well being of the residents very well indeed. Nutrition in the home is well managed and well balanced and appetising meals are provided. All residents were in very good health and spirits on the day of inspection. The home listens to the wishes and aspirations of the residents and supports them to achieve their goals. The home promotes the independence of the residents and ensures that they lead fulfilling and interesting lives. There is a large amount of specialist equipment needed to support the high dependency needs of the residents. This is maintained in very good order and the home and residents constantly seek out new devices such as communication aids to help improve independence. The environment of the home is good. It is spacious, well furnished and tastefully decorated. There is a very relaxed, welcoming and friendly atmosphere. Relatives, health and social care professionals and supporters say that they are always made welcome and that they are kept appropriately informed of the progress of the residents. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 6 The home and the registered providers provide a very good level and quality of induction, mandatory and specialist training for staff. Staff said that they are well supported and feel that there is good communication within the home. The home is well managed. Both staff and residents praised the registered manager and her deputy for their diligence and professionalism. 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. Tristford DS0000023615.V299319.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 Tristford DS0000023615.V299319.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, 3, 4 & 5 The quality in this outcome area is good. This judgement is based on available evidence gathered both before and during this visit. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home Appropriate pre-admission assessments are made. This ensures that only those residents who are suited to the home and whose needs can be met are offered a permanent place in the home. EVIDENCE: The home has a service user guide and statement of purpose that meet the required standards. All residents have contracts in place and, in as far as possible, understand their rights and responsibilities whilst living in the home. There are clear pre-admission policies and procedures. Inspection of the care plans and pre-admission documentation for the two new service users showed that these policies and procedures have been correctly followed. No resident is offered a permanent place in the home until they have completed a satisfactory trial period. The views of the other residents are appropriately sought in respect of new admissions. Tristford DS0000023615.V299319.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The residents know that the home will respect their confidentiality and value their views. They are able to make decisions about their lives and participate in the decision-making process about the home. There is a clear and consistent care planning process that the residents and their supporters understand. Records and maintained securely. EVIDENCE: Residents’ meetings are held regularly. Residents said that the staff are kind and that they listen to their views. Examination of care plans confirmed that aspirations and choices are recorded. Risk assessments are in place. Indirect observation confirmed that the residents are discretely offered the appropriate level of assistance to carry out the activities they wish. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 10 Records are stored securely. Residents said that staff respect their confidentiality. Staff were very clear about their responsibilities in respect of confidentiality. One member said that she was pleased that the manager actively discouraged any form of gossip within the home. Tristford DS0000023615.V299319.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 The quality in this outcome area is excellent. This judgement is based on evidence gathered both before and during this visit. The home supports the residents to lead fulfilling lives and works to maximise their independence and minimise their disabilities. Nutrition is well managed in the home and the residents enjoy varied and appetising meals. Special diets are also provided when indicated. EVIDENCE: Goals and aspirations are recorded in the care plans. Since the last inspection one resident is preparing to move on to supported living. She said she is very excited about the prospect of being more in control of her own life but, at the same time, is feeling a bit apprehensive. Two other residents now have college placements and spoke enthusiastically about their college work and what they would like to do next. Other residents said that they had enjoyed the good summer weather, which meant they were able to get out more. They had visited numerous places of interest, including Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 12 the Spitfire Museum, a bird park, Howlett’s Zoo, the Chinese Circus and the Monkey rain forest. The home is very good at helping the residents to maintain family contact. A wide variety of communication methods are used from texting and e-mail to telephone contact. Relatives said that they are made very welcome to the home and can visit at any reasonable time. Many of the residents have severe communication difficulties but staff at the home were observed to be very good at establishing the wishes of the residents. The home is very good at finding out about communication aids and working with the local HNS speech and language therapist. The home employs a physiotherapy assistant. This member of staff works under the direction of the local NHS physiotherapist who draws up physiotherapy programmes. The assistant then carries these programmes out routinely with the residents. This helps to maintain their mobility, circulation and general well-being. Nutrition at the home is good. Most food is purchased locally. Resident assist with the shopping if they wish. They are consulted about the types of things they like to eat and there is always a choice. The main meal is taken at lunchtime. On the day of inspection there were plenty of fresh vegetables and a choice of a fish or meat dish. Vegetarian meals are prepared, if required, and special diets are catered for. Lunchtime on the day of inspection provided a good opportunity to sit and talk with the residents and to sample the meal. The food was well presented and tasty. The dining area is pleasant and calm. Staff were indirectly observed to give assistance with meals in a discreet and unobtrusive way. Tristford DS0000023615.V299319.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 The quality in this outcome area is excellent. This judgement is based on evidence gathered both before and during this visit. The home promotes excellence in care practice. It meets the diverse and very complex health needs of the residents very well indeed. EVIDENCE: Care plans list clearly the personal support needs of the residents. There is an excellent level of staff training in the specialist health needs of the residents. The residents say that personal support is given in a gentle and discreet manner. Indirect observation confirmed this. Staff spoken to were all very aware of the need to respect the dignity of the residents. Written policies and procedures for the management of medicines in the home are clear and comprehensive. Staff training in the administration is up-to date. Since the last inspection further infection control training has taken place and the staff are now more careful when administering medicines. In addition, the registered manager has carried out an audit of PRM medication and devised a form to ensure the PRN medication stored in the home is well managed. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The home has sound policies and procedures of the handling of concerns and complaints, and for the protection of vulnerable adults. The staff are well aware of these and this protects the residents from harm. EVIDENCE: Residents said that they know they can talk to the staff or the manager if they have any concerns. No one has had cause to make a formal complaint since the last inspection. Some residents said that they did not think that they would ever have to make a formal complaint as day-to-day concerns are dealt with as they arise. There is a rolling, structured induction programme for all staff within the MNP group. This includes a module on the Protection of Vulnerable Adults. There are further training sessions to update staff. All staff, including the housekeeping and maintenance staff, have attended at least one session of adult protection training. The staff interviewed during this visit were all clear about their responsibilities to report any concerns and said that they would not hesitate to do so. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The standard of the environment in the home is very good. It provides the residents with an attractive and homely place to live. The layout and specialised equipment promotes the independence of the residents. EVIDENCE: A tour of the home was undertaken. The home is tastefully decorated and since the last inspection there has been further redecoration. The large lounge/dining room and wide hallways allow for good wheelchair access. There is a large shaft lift and there are ramps to both the front and rear gardens. The bathroom and shower room have both been decorated in bright colours and the use of stencils and pictures has made these areas much more attractive. Residents say they now enjoy using the shower room more. The rear garden is flat and safe with some raised flowerbeds. Unoccupied rooms are redecorated prior to the admission of a new resident. One of the new residents was proud to show off her room and said that she Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 16 had chosen the colours and the stencil pattern. All rooms have individual colour and décor styles. The residents said that they choose their own soft furnishings and colour schemes and decide how to arrange their furniture. All rooms are tasteful and well furnished. Since the last inspection a staff training room has been provided on the top floor of the home. The main administrative office is also on this floor. This office would now benefit from refurbishment to bring it in line with the very high standard of décor throughout the other two floors of the home. Due to the high dependency needs of the residents a significant amount of specialist, enabling equipment such as electric mobility scooters and wheelchairs, specialist communication equipment, continence aids and bracing appliances such as neck collars and head pointers, is needed. All equipment is very well maintained and specialist firms visit regularly to service much of the equipment. Despite the considerable amount of specialist equipment, it is arranged well and storage is discrete. This means that the home maintains a comfortable and spacious feel. All areas of the home were very clean, tidy and free from offensive odours on the day of inspection. However, the laundry room is quite small and difficult for staff to work in. The registered manager said that they are currently thinking of ways in which they can improve this area to safeguard infection control and make it easier to sort the laundry. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. There is well-trained and enthusiastic workforce that positively promotes improvement in the quality of life of the residents. EVIDENCE: Staff said they are clear about their roles and responsibilities. They spoke enthusiastically about their work in the home and about the way they support the residents to achieve their goals. There is an excellent training matrix and a high level of staff training is undertaken. Staff said that they appreciate the amount of training. In addition to all mandatory training, the home achieves a very good level of specialist training. It accesses a number of organisations to provide this training as well as using in-house expertise. The recent list of specialist training includes; Loss and Bereavement (KCTA training); Stroke awareness (Stroke Association); Catheter awareness (MNP); Medication (Judith East, pharmacist; Continence management (Continence adviser); and Dysphasia (Belinda Walker, Speech and language therapist). The home is commended for providing such a good level of specialist training. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 18 The home already has achieved a good level of staff holding level II and III NVQs and three more members of staff have just embarked on NVQ III. Staff said that there are regular staff meetings and that they have both annual appraisals and regular one-to-one supervision. Since the last inspection a training room has been provided on the top floor of the home. This has made it easier to arrange regular training sessions and to invite specialist trainers. The home is centrally situated and staff from other homes in the group come to these sessions. This gives all staff in the group a chance to meet up with each other and exchange ideas. It also means that it is viable to run a rolling induction programme. An induction session is held every Tuesday afternoon. The registered managers in the group take it in turn to lead these sessions and one was in progress on the day of inspection. There is a very stable workforce and no agency staff has been needed as staff work together to cover annual leave. Sickness levels and staff turnover are low and staff moral is high. Examination of a sample of staff files showed that all appropriate preemployment checks have been made. Since the last inspection the company has completely revised its recruitment policies and procedures. The company has now centralised its recruitment procedures. This means that there is greater consistency throughout the homes in the group and that there are greater safeguards in place. An administrator carries out the initial checks. She ensures that the application form is completed correctly, makes requests for references and CRB checks and checks the references against information given on the application form. She then ensures that the candidate is available to work the required shifts. Once these initial checks are complete, the complete application pack is forwarded to the manager of the home. The manager then makes a decision about whether to interview the candidate and whether to offer employment. This means that the manager is freed from routine paperwork and can concentrate fully on the suitability of the candidate for the post. The final decision to appoint rests with manager or registered person. The home is commended for this excellent recruitment practice that protects the residents from unsuitable staff. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home is well managed and the views of the residents are taken into consideration when decisions are made about the running of the home. This means that residents can be confident that the home is run in their best interests. EVIDENCE: Mrs Harrington, the registered manger has many years experience in working at all levels in care homes. She has managed the home for over two years. Prior to he appointment as manager she was deputy in the home for eight years. This means that she knows the home and the residents very well indeed. She holds the NVQ IV in Management and Care and has retained her registration with the NMC and maintains her continuing professional development. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 20 In depth discussion about the management of the home took place with the manager, Mrs Lorraine Harrington and her deputy, Mrs Elizabeth Rowe. Both have good experience in care, a good understanding of best care practice and have maintained their development portfolios. Conversation with Lorraine showed that she has extensive knowledge of the specialist needs of the residents. She relates well to the residents, their supporters and her. She holds a budget for the home and said that this is sufficient to be able to purchase for day-to-day needs and general maintenance. Staff said that they like working at the home and respect Lorraine for her fairness and ability as manager of the home. Staff were very positive in expressing their views about both Lorraine and Liz. They said that they valued their leadership and felt that the home is well organised. They feel that their views are listened to and acted upon when appropriate. The registered providers submit regular reports about the running of the home to the CSCI, in accordance with regulation 26 of the Care Standards Act. They are commended for the high standard of these reports. Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 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 4 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 3 3 3 3 3 3 3 X Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 YA30 Good Practice Recommendations The home should continue to try and find a solution to make the laundry room more ergonomic. This would help maintain good infection control and make it easier to sort clothes Tristford DS0000023615.V299319.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 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 Tristford DS0000023615.V299319.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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