Inspection on 03/01/06 for West View

This inspection was carried out on 3rd January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

West View 20/02/08

West View 27/07/06

West View 19/07/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE West View Plummers Lane Tenterden Kent Lead Inspector Lisbeth Scoones Unannounced Inspection 3rd January 2006 10:20 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service West View Address Plummers Lane Tenterden Kent 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) 01843 860000 Kent County Council Mrs Caroline Jane Heffernan Care Home 60 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (44) of places West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 30 of occupied beds can be used at any one time for service users who are under the age of 65 years old but are over the age of 55 years. Additional service users with a diagnosis of DE(E) are restricted to two (2) whose DOBs are 22/05/1918 and 24/08/1913. 19th July 2005 Date of last inspection Brief Description of the Service: West View is an innovative service, registered in April 2005, and aims to provide a range of services to meet both the health and social care needs of 60 male and female residents aged 55 and over. Accomodation is on two floors each providing care for 30 residents. Nursing care and recuperative care is provided in the 15 bedded Benenden East and 15 bedded Benenden West units on the first floor accessed by two passenger lifts. The ground floor comprises two units: The Lindens and Wittersham. Long term residential care for 15 residents and up to 2 of places for short stay respite care is provided in the Lindens. Wittersham provides long term dementia care for 15 residents and up to 2 of these may be used for short term respite care. West View Integrated Care Centre is newly built and situated in Plummer Lane. It offers magnificent views of rural countryside and provides ample car parking. There is a secure garden as well as other gardens, walkways and a pond to the front of the building. The market town of Tenterden with bus services, railway station and other amenities is nearby. The town of Ashford is approximately 15 miles away. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken by Lisbeth Scoones, regulatory inspector and Norma Lawson, regulation manager and took place over 7 hours. The inspection comprised discussions with the manager and deputy manager and visits to one nursing unit and the dementia care unit. The inspectors toured these, spoke with the senior sister, team leaders and other staff; had conversations with residents, examined medication records and discussed practices and examined care and other records. The kitchen was also visited and the inspectors met with catering staff. At the time of the inspection occupancy comprised 26 permanent and 2 respite residents on the ground floor; 26 residents in the intermediate/recuperative and nursing care units. What the service does well: What has improved since the last inspection? At the previous inspection, a number of requirements and recommendations were made. Many of these have been fully acted upon. Some recommendations are in the process of completion. Following an action plan regarding medication issues to be addressed, a number of improvements have been made. The arrangement for the trained nurse’s hours on night duty has been reviewed. A training matrix is now in place ensuring adequate training of all staff at all times. The home now keeps a record of visitors and accident records are maintained in accordance with the Data Protection Act 1998. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 6 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. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6 The home’s statement of purpose and service user guide provide residents with the information they need to make an informed decision about the services the home provides. Some minor changes are needed to accurately reflect the current service All residents move into the home having had their needs assessed and been assured that these needs will be met. Residents assessed and referred as requiring intermediate (recuperative) care are assisted to maximise their independence and return home. EVIDENCE: The Statement of purpose and Service User Guide dated April 2005, meet the standard and provide residents with the information they need to make an informed choice of the services provided. Both documents should be regularly reviewed to reflect any changes as they occur. Following analysis of quality assurance questionnaires, it was agreed that the outcome be referred to in the service user guide as per standard 1.2. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 9 The centre has procedures for admission covering the various types of care on offer. For intermediate care, a flow chart identifies the process. For those residents requiring long term residential or dementia care, the process would include an assessment by the care manager and preadmission assessment by the manager of the centre. For those residents requiring nursing care, admission criteria would be determined through a joint assessment process. The centre has dedicated rehabilitation facilities, which include equipment for therapy and treatment. Specialist services from relevant professions including physiotherapists and occupational therapists are provided to meet the assessed need of those residents admitted for rehabilitation. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 The care planning system, though improved, does not adequately provide staff with the information they need to satisfactorily meet the residents’ needs. Residents’ health care needs are well met with evidence of good multidisciplinary working. The medication audit needs to be more robust to ensure it meets the standard. EVIDENCE: The inspectors viewed a sample of care plans in both units. Whilst these contained much useful information, the following issues were identified for action. In the recuperative units: • Not all care plans had been signed or dated by the resident. • Some care plans were dated but not signed by the carer completing the record • A care plan identified that a blood pressure should be recorded weekly, but there was no evidence that this had been carried out. • No moving and handling assessment for a resident with a fracture of the leg. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 11 • • A month delay in the recording of a resident’s skin integrity risk assessment. A summary sheet not signed or dated. The inspector viewed a sample of care plans for residents assessed as requiring dementia care and an improvement was noted. However: • For a resident who recently had a number of falls, there was no fall risk assessment in place that contained instructions for staff how to minimise the risk. • A risk assessment summary was dated 24/12/02. • A bowel chart had not been completed. • For a resident a “nutritional framework” document was left blank. The Core Intermediate Care Team ( amalgamation of CART and Adult Rapid Response Team) comprises physiotherapists, occupational therapists and community district nurse and provides care and support to those residents admitted for recuperative care. The centre employs its own physiotherapist. All staff are trained to treat and prevent the development of pressure ulcers and to promote continence. Residents have access to dental and chiropody services. Both inspectors spent time examining medication records and discussing practices. Both clinical rooms were tidy and well ordered. In the recuperative units the following issues were identified: • For some residents who self-administer, there was no recorded authorisation. • Self-administration assessment forms lacked a review date. • The medication audit does not include a CD check. • A completed course of antibiotics was not signed off on the medication chart. • Some medication, following resident’s death, had not been returned to pharmacy. • Some hand written transcriptions had not been countersigned. • Fridge temperatures had not been recorded on 7 occasions in one month. • Sharps boxes were not dated indicating the first day of use. In the residential units the main issue identified was the tray of prescribed creams and lotions kept collectively in the clinical room. The practice of making this available to staff by placing it in the sluice is not acceptable and these should be kept in a suitable lockable place in residents’ rooms. It was noted in residents’ records, that staff sign when the creams have been applied. In both clinical rooms, a number of buckets were noted for the safe collection of medications to be returned for incineration. In both units, the buckets were sealed and inadequate provision was made for the further storage of such waste. It is acknowledged that the centre had only recently been successful in setting up the system now required and that the delay in the collection was on West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 12 the part of the contractor. However, whilst the centre’s medication audit includes this issue of disposal, this particular problem had not been highlighted. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 15 Residents are provided with choices in relation to their chosen lifestyle. Residents receive a wholesome, balanced and varied diet. EVIDENCE: Those residents admitted for recuperative care said that they have a choice in relation to leisure and social activities, food and routines of daily living. Leisure facilities for those residents receiving long-term care are developing and currently include bingo, daily newspapers, word games, beauty therapy and the shop. A reminiscence room has been set up in 1930’s style, the contents of which many residents and their relatives have contributed to. The inspectors were shown a fully operational sensory room with a variety of “snoezelen” equipment. The latter has been purchased with monies raised through charity fundraising. A “well-being” chart has been introduced to monitor residents’ response to the relaxation offered. The manager said that the next project to be developed would be a sensory garden. Shaw Health Care provides the catering arrangements at West View and the kitchen is well equipped and staffed. Residents complete menu cards and choose what they wish to eat. Residents said that they enjoy the meals. Three meals a day are provided as well as a snack meal in the evening if required. Nutritional assessments are undertaken and diets catered for. The inspectors West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 14 met with the chef who said that menus have recently been reviewed and that residents had been consulted in the process. Residents had made a request for “more cake” and this is being looked into. Meals served looked appetising and were well presented. The requirements made by the environmental health officer have been acted upon but for one recommendation regarding catering staff to wear adequate protective clothing, which remains outstanding. The issue was discussed with the chef and Shaw Health Care’s manager and will be acted upon. The inspectors were surprised that not all members of the catering staff were aware of the contents of the EHO report. Every unit has a kitchen from which the meals are served. Additional kitchens are available to be used by residents and their relatives. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Residents know that their complaints will be listened to. Staff are trained in adult protection issues thus ensuring that residents are protected from abuse. EVIDENCE: There is a complaint procedure, which is included in the Service user Guide. To date, the Commission has been made aware of one complaint, which, following investigation by the centre, was substantiated. Staff are provided with in-house adult protection training. The deputy manager, who is the centre’s trainer, acknowledged that for some members of staff, the training was overdue. See also standard 30 in respect of a training matrix. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The centre provides a safe and well-maintained environment. The home is clean, pleasant and hygienic but some soap dispensers in communal toilets were empty and the sluice is in need of additional storage space for miscellaneous items. EVIDENCE: Shaw Health care is responsible for maintaining the building both in respect of routine maintenance and renewal of fabric and decoration. The grounds and gardens are attractive and accessible to residents. The responsibility of the domestic and laundry provision is with Shaw Health Care. The centre was clean with no unpleasant odours. An infection control policy and procedures are in place and staff training provided. However, it was noted that in three communal toilets the soap dispensers were empty. In order to provide an environment that can easily be kept clean, additional storage space must be made available in one sluice room. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30 Staff are provided in sufficient numbers and skills mix to meet the needs of the residents but some staff feel that staffing levels are not adequate during the morning shift at Wittersham. Residents are in safe hands at all times and cared for by staff who are trained and competent to do their job. EVIDENCE: The centre offers day care and is registered to provide residential, dementia and nursing care. In respect of nursing care, registered nurses and health care workers are employed on a secondment basis. As quoted from the Statement of Purpose, “A secondment of service agreement exists which forms the protocols adopted by the employing authority and the area PCT to enable the provision of nursing care within West View.” The centre has been accredited to provide placements for first year student nurses. A community nurse (as part of the intermediate team) oversees the nursing needs of “residential” residents receiving recuperative care. It was said that nurses employed at the centre would undertake a delegated role for residential clients on occasions. As identified at the previous inspection, staff working at the Wittersham unit expressed concerns regarding the level of staffing. Both Wittersham and the Lindens are each staffed by three carers, with a senior carer also on duty across the two. The issue was discussed with the manager who said that West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 18 staffing numbers might fluctuate according to dependency. Staff at the recuperative units said that they were very busy and that, at times, there is only one nurse on duty. Following recent staff departures, there are currently two vacancies for part time nurses and until staff has been recruited, the centre uses its own and other agency staff. On the day of the inspection, the inspector met with two agency staff on the nursing unit. Duty rotas examined would indicate that for each shift, sufficient senior and unit staff is provided. The issue of the night registered nurse’s contracting hours has been addressed. Recruitment procedures were not discussed or staff files examined. Following a previous recommendation, the deputy manager has reviewed some job descriptions but has still to review those pertaining to nursing staff. Some staff’s role (including those of the deputy manager and the senior sister) has been changed and the resulting responsibilities must be reflected in their job description. See also standard 36 in respect of staff supervision. The deputy manager is in charge of induction and other training. The induction programme was discussed in detail and samples of ongoing and completed induction programme were seen. At the previous inspection, it was agreed that the induction-training programme did not contain sufficient detail or timescales to evidence that this was delivered according to TOPSS standard. Due to a new set of Common Induction Standards (CIS) being introduced, the deputy manager is in the process of reviewing the programme. This will be looked at in greater depth at the next inspection. Planned and undertaken training is now reflected on a training matrix. The matrix is monitored every two weeks. The deputy manager said she has requested each member of staff to produce a training profile and will then compile an individual training and development assessment programme for each member of staff. This would include all statutory training. (Standard 30.4) See also standard 38. The centre also provides opportunities for specialist training as e.g. dementia care either in work time or time is given back if out of working hours. The provision of such specialist training will be looked at in detail at the next inspection when the staff training development programmes and profiles are available. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38 The manager is supported by senior staff in providing leadership throughout the home. Residents live in a home that provides an open and positive management approach. Monitoring systems ensure that residents’ views are included in establishing whether the home meets its aims and objectives and Statement of Purpose. A number of audit tools have been introduced to ensure consistent and compliant practices and record keeping. Staff are appropriately supervised. Residents’ health, safety and welfare are promoted and protected except for an outstanding recommendation of the environmental health officer. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 20 EVIDENCE: Mrs Caroline Heffernan, a registered nurse, is the registered manager and has 5 years experience in managing care homes. She has a management qualification and is supported by a Head of Service, Operational Manager and a Business Officer. The deputy manager is a registered nurse, responsible for training, recruitment and audit. A senior sister heads the nursing units and senior team leader the residential and dementia units. All staff have been provided with recently reviewed job descriptions relevant to their role and responsibility except for the nursing staff. In respect of quality monitoring, through staff and residents meetings, the manager ensures involvement from staff and feedback from residents and their relatives. The centre has introduced a number of audits to ensure consistency and compliance as e.g. in respect of care plans, medication, moving and handling and the servicing of equipment. As already referred to, the audits may need to be reviewed in order to meet the desired outcome. Formal monthly monitoring visits are made and comprehensive reports written. A copy is submitted to the CSCI. These visits include discussions with residents and staff and details of staff training. The inspectors discussed the centre’s arrangements for dealing with residents’ personal finances. Some residents make use of the centre’s Personal Property Accounts (PPA’s), which feeds into and out of a KCC account set up with a major bank. As this system appears to contradict the standard, the inspectors said they would take further advice on the matter and refrain from making a judgment on this occasion. All staff have formal supervision as confirmed by staff spoken to. Records pertaining to supervision sessions were not requested on this occasion. Arrangements are in place for clinical supervision for nurses and health care staff. As already discussed in standard 30, all staff are provided with statutory training identified in a training matrix. Fire training is provided monthly and during every shift, a nominated Fire Officer and First Aider are on duty. The centre has three moving and handling trainers. At previous inspections, the signage on bedrooms doors stating that these should be kept shut while according to the Fire Officer, these do not have to be kept shut, was reported. There has been no change to this situation. It was not ascertained whether the centre has obtained a copy of the Fire Risk assessment. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 21 One recommendation made by the EHO remains outstanding in respect of adequate protective clothing for catering staff. Accident records are well maintained and stored in accordance with the Data Protection legislation. West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 2 STAFFING Standard No Score 27 2 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 x 2 West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) Requirement That the registered person shall prepare a plan as to how the service users needs in respect of health and welfare are to be met. That the medication audit be reviewed to include signatures, CD checks, disposal and administration of prescribed creams and ointments and assessments of selfadministration Timescale for action 07/02/06 2 OP9 13 (2) 07/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP1 OP18 OP26 OP27 Good Practice Recommendations That the Statement of Purpose and Service User Guide be kept under review and include residents’ views That all members of staff receive adult protection training That the sluice room be provided with additional storage and the all communal toilets be supplied with liquid soap That all staff have a job description reflecting their role DS0000063680.V275113.R01.S.doc Version 5.1 Page 24 West View 5 6 OP30 OP38 and responsibility. That staff numbers are adequate to meet the residents’ needs That the induction programme be reviewed to comply with current standards and that every member of staff has an individual training and development and profile. That the centre complies with the EHO recommendation for adequate protective clothing for catering staff West View DS0000063680.V275113.R01.S.doc Version 5.1 Page 25 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 West View DS0000063680.V275113.R01.S.doc Version 5.1 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. 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