Inspection on 19/02/08 for White Lodge

This inspection was carried out on 19th February 2008.

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

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

White Lodge 22/03/07

White Lodge 19/12/05

White Lodge 02/08/05

White Lodge 11/03/05

White Lodge 11/05/04

White Lodge 05/02/04

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 White Lodge White Lodge 44-46 Madeira Road Cliftonville Margate Kent CT9 2QQ Lead Inspector Mrs Sally Gill Unannounced Inspection 09:40a 19 & 22 February 2008 th nd 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 White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service White Lodge Address White Lodge 44-46 Madeira Road Cliftonville Margate Kent CT9 2QQ 01843 225956 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) michaeljtopping@aol.com Mr Michael Joseph Topping Mrs Christine Salms Topping Care Home 23 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (22) of places White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residential care for people with a learning disability is restricted to 1 person whose DOB is 13/08/37 22nd March 2007 Date of last inspection Brief Description of the Service: White Lodge is registered to provide accommodation for up to 23 older people and admits low to medium dependencies. Mrs and Mrs Topping own the home and also have day-to-day control. The premise was originally two semi detached properties and are now joined as one. Accommodation for people is on three floors, the basement, ground and first floor. The home has a passenger lift and is therefore suitable for wheelchair users. There are 20 bedrooms. Two doubles and 18 single rooms. Nine rooms have ensuite toilet and wash hand basin. All other bedrooms have a wash hand basin. People have the use of two bathrooms, one of which is assisted and a shower room. There is a dining room and three lounges, one of which is used as a smoking room. There is a reasonable sized garden, which is well maintained with lawn, established borders and shrubs and seating areas with table and chairs. The garden is suitable for wheelchairs users. Each room has a call bell for people to call for assistance should it be needed. All rooms have a television point. The home is set in a residential street in Cliftonville. There is car parking in the street to the front of the home. Within short walking distance there is a selection shops, local amenities and bus stop. The staff compliment consists of the owners, senior carers and carers. In support are a cook and domestic staff and a gardener. Staff work a rota that includes a minimum of three care staff on duty in the morning, two in the afternoon and two at night. The current fees range from £320 to £380 per week. There are additional charges for hairdressing, magazines and newspapers, chiropody, telephone and personal toiletries. A copy of the latest inspection report can be viewed at the home or down loaded from www.csci.org.uk. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over a period of time and concluded with an unannounced visit to the home on 19th February between 09.40am and 1.25pm and an announced visit on 22nd February between 9.25am and 11.05am. Senior staff assisted throughout day one in the absence of the owners. The owners assisted on the return visit. People that live at White Lodge, relatives and staff were spoken to. Observations included interactions between those that live at White Lodge and staff. Twenty-one people were living at the home at the time of the visit with one vacancy. Surveys were sent to the owners to distribute to those living at the home and relatives. Feedback received was all positive. The care of three people was tracked to help gain evidence as to what its like to live at White Lodge. Various records were viewed during the inspection and parts of the home were toured. The home returned the annual quality assurance assessment (AQAA) when we asked. This was clear and contained most of the information asked for and has been used to inform this report. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. What the service does well: People living at White Lodge feel it is a real family home and you can have a laugh with the staff. Relatives feel that as soon as you walk in you can tell what a wonderful home this is by the smiles on peoples faces, their chatter and laughter. A thorough assessment of people needs and wishes is undertaken before admission to ensure the home can meet people’s needs. People are encouraged to visit the home prior to admission to look at their room and meet everyone. People feel their health care needs are met. If there are any issues these are dealt with quickly. Monitoring of any concerns and referrals are well documented in care plans. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 6 People feel there are opportunities for a variety of activities, which meet their expectations. One said, “Activities keep eyes and brain active in a relaxed and friendly atmosphere. Happy with social contact”. People said they are happy with their own rooms, the food and company and the home is always clean and tidy. One said, “Very well balanced diet. Varied and appetising, fresh fruit available most days”. Everyone spoke well of the staff and owners. Staff feel well supported and feel they have a good team. What has improved since the last inspection? What they could do better: Improved recruitment processes must be adopted to protect people living at White Lodge. Development of a formal quality assurance tool would allow everyone involved in the home to give anonymous feedback. Systems in place to promote safe self-administration of medication should be recorded. Please contact the provider for advice of actions taken in response to this White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 7 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. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 8 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 White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5 & 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Literature about the home and its services could better inform people before making a decision to move in. People who use the home can be confident their needs will be met based on an assessment. EVIDENCE: The homes statement of purpose and service user guide is not displayed within home. Staff could not lay their hands on either document at the time of the unannounced visit. One relative said they felt they did not receive sufficient information about the home prior to moving in but most felt they did. The owners acknowledge this is an area that could be improved. People said they chose the home because it was recommended and they would have no hesitation in recommending it themselves. One said you could see White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 10 and feel what it’s like as soon as you come in, people have a smile on their faces and there’s plenty of chat and laughter. Copies of local authority assessments are obtained. The home undertakes their own thorough assessment in the person’s own environment. These assessments are used to develop the care plan. People confirmed that they or their families had been and looked round the home prior to moving in. They were able to see the room, which would be theirs and meet other people. The home does not offer intermediate care but subject to room availability can offer respite care. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Some areas of the medication system need minor improvement to fully safeguard people. EVIDENCE: Peoples are asked about their care needs and wishes, which are documented in a care plan. Records are organised, easy to follow and had been recently reviewed. Staff advised that care plans had improved, although they felt there is always room for further improvement. One contained a life history but others did not. Care plans contain risk assessments including falls and manual handling. Tissue viability risk assessments were not always undertaken. The owner agreed to undertaken these and make a record. People confirmed that support and help is given in a way they prefer. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 12 People’s health care needs are clearly met. People spoke of attending out patients, district nurse visits and confirmed a doctor is called as soon as there is a problem. Detailed reports are in place and confirm any health issues are monitored closely. A chiropodist visits the home every six weeks. Equipment is in place to aid independence. People confirmed that regular opportunities are available to do armchair exercises, which are enjoyed. Most people are weighed regularly and this is recorded in the care plan. The home only has bathroom scales and the owner stated that where people cannot be weighed they are monitored and should there be any cause for concern action would be taken. Generally people are protected by the homes medication systems. The temperature reading of the room used to store the medication was 26 degrees. The home was advised to monitor the temperature of the room to ensure that it is below 25 degrees. Some good practice recommendations were made in relation to medication. Internal and external medications should be stored separately, medication should always be stored in the box where this contains the prescription label, and the cupboard should only be used to store medicines. Prescription medication such as paracetamol for one person must not be used for any other. Good practice would record the return medication when it is stored in the returns box. The owner advised all these had been implemented by the second visit. Medication Administration Record (MAR) charts was examined and shows appropriate use of signatures and codes. Not all handwritten entries were signed, dated or witnessed and again this had been addressed by the second visit. The administration process was observed, which was safe and followed good practice. Staff advised that all staff that administers medication have received training. Staff who administer medication have their competency regularly reviewed by the owner who is a trained assessor. People are encouraged to manage their own medication where possible. The risk assessment clearly records people’s abilities to do this safely. However the safe system put in place to assist self-administration needs to be better detailed, for example where is the safe storage and the handover of medicines so there is a clear audit trail. This is a recommendation. People feel their independence is encouraged and their privacy and dignity is respected. Staff were observed to always knocked on doors before entering peoples rooms. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use services are able to make choices about their life style. Social and recreational activities meet individual’s expectations. EVIDENCE: People have access to varied activities including dominoes, bingo, armchair exercises, reading, television and music. An entertainer comes in to play music. One person said “I enjoy taking pat in all the activities”. A relative confirmed that planning has begun to celebrate a special birthday for one person. People obviously enjoy each others company and one person talked of a friendship that had developed with their neighbour down the hallway. Outings are an area where the home plans to develop opportunities. A relative confirmed that people do go to the pantomime and also some are off to the Theatre Royal in March. One person is able to go out into the community and also uses public transport. Others said their families take them out or the owners. A hairdresser visits the home regularly. Staff advised that two clergymen regularly come into the home to see different people. One person White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 14 attends a local church every week. Relatives said they are made to feel welcome and always offered refreshments. Those spoken to are entirely satisfied with the care provided and felt they are always kept informed. A meeting has been held to allow people to voice their views and allow choices to be discussed. It is hoped this will be a regular occurrence. People are able to choose to spend time alone in their own room if they wish which is respected. People comments about the food ranged from satisfactory to excellent. One said “I find the meals here are 1st class and can always have something different if I would like”. Special diets are catered for. Breakfast is a choice of cereals or toast usually taken in people’s own rooms. The main meal is at lunchtime although there is no choice alternatives are always available. One said we have three or four vegetables on offer. One person talked about recent changes to the menus. The cook has been discussing choices and new dishes with people and then trying them out. This has resulted in several new dishes being tried and tested, which people have enjoyed. Tea is a light meal or sandwiches. People confirmed there is always plenty of fresh fruit available. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People feel confident to speak out about any concerns and are sure that action would be taken. People are protected from abuse and feel safe living in the home. EVIDENCE: Everyone spoken to felt any concern would be resolved not that they had any. The complaints procedure is displayed within the home. One relative said the owners are so easy to talk to. Two complaints have been received by the home, which were upheld. A record of all complaints is maintained together with any investigation and outcomes. A grumbles book may benefit the home rather than logging grumbles as formal complaints. People feel safe living in the home. Staff have received training in safeguarding adults. Policies are in place to protect people including a whistleblowing policy. Staff said they would be confident to speak out if they were unhappy with others care practices. Staff demonstrated they had the knowledge of routes to report abuse both inside and outside of the home. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25 & 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a homely, comfortable and clean environment. EVIDENCE: People live in a safe environment. The home is homely and domestic in character. Some parts of the home are nicer than others although there is an ongoing refurbishment and redecoration plan in place. All communal areas and some corridors have recently been re-carpeted. All radiators are now fitted with low temperature surfaces. Two bedrooms have recently been redecorated and some corridors. People confirmed the gardens are used in the summer weather and fetes are also held outside. The gardens are safe, attractive and assessable to those with mobility problems. They consist of lawn areas, borders with established White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 17 shrubs and seating areas with table and chairs. There are three lounges one of which is a smoking room. Most people chose to sit in the sun lounge at the rear of the home, which also is home to a budgie and tropical fish tank. People confirmed that they are happy with their rooms and were able to bring in any personal possessions. People said the home is always warm, clean and tidy. One said, “Bright and cheerful cleaners who clean daily”. There were no unpleasant odours. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff support people who use the service. Staff induction training needs improvement to ensure staff-supporting people is competent. Recruitment processes leave people at risk. EVIDENCE: People benefit from a stable staff team. Each shift has a senior carer on duty. People felt there are sufficient staffs on duty. One said they are on hand to assist when you call 99 of the time. All comments about the staff were good. People felt they were kind and hard working. One said, “The staff consistently strive to make it a homely atmosphere”. Staff said they felt well supported by the owners and felt there is a good team in place. More than 68 of staff have obtained a National Vocational Qualification (NVQ) level 2 or above. People are at risk from recruitment processes. Three staff files were examined. The application form only asks for the last three employers and must ask for a full employment history. One employee only had one written reference although two telephone references were in place. Some files did not contain all documentation as per schedule 2 for example evidence of White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 19 qualifications and a recent photograph. Files did not contain Criminal Record Bureau (CRB) checks or Protection of Vulnerable Adults (POVA) checks and the owner advised these were not in place. An immediate requirement was issued. The owner advised that this is also the case for other staff working although a full check on staff files has not yet taken place. Action has been taken to address the shortfalls in the highlighted staff. A check must be undertaken for all staff and any shortfalls addressed to protect people living in the home. A robust recruitment process must be followed. Requirements have been previously made twice previously regarding recruitment but wording has been changed to be more specific. People are not supported by staff that has undertaken an induction programme to Skills for Care specification. Induction training for new staff would include shadowing a senior carer as well as undertaking the homes induction, which at present is not to Skills for Care specification. The home has recently subscribed to a Distance Learning programme, which will enable them to address shortcomings identified. Mrs Topping is scheduled to become a Manual Handling Instructor. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. Not all areas of management are effective. Development of quality assurance systems would ensure that people’s views underpin the development of the home. EVIDENCE: People felt the owners are approachable and will resolve any issues that arise. Mr Topping has completed a Registered Manager Award (RMA) at National Vocational Qualification (NVQ) level 4 in care. Mrs Topping is a Level 1 Registered General Nurse (RGN) and an NVQ assessor. Both have considerable years experience in residential care. All feedback regarding the White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 21 owners was very positive. Shortfalls in recruitment processes are unacceptable. Although not all areas of the home are well managed or fully protect people, action is now being taken to address this. White Lodge has a very homely and friendly atmosphere. People feel that the owners offer a personal touch to make White Lodge a happy place to reside. A residents meeting has taken place. It is hoped these will continue to give people a forum to air their views and feedback on the home. Feedback and comments have already been taken on board and improvements made such as dining arrangements and menu choices. A formal quality assurance system is yet to be developed which is recommended. This should include gaining feedback from other stakeholders such as professionals and relatives, which have contact with the home. The owners plan to implement a self-assessment quality audit shortly, which is based on the National Minimum Standards. Staff feel well supported. Senior staff meetings are held regularly and a full staff meeting held annually. Supervision is mainly informal. Details of staff statutory training were not available at inspection. Details are to be sent to the Commission. Accident reports were detailed and did not give cause for concern. The home holds a small amount of monies for one person with records maintained. Information received showed the servicing of equipment was within recommended timescales. White Lodge DS0000023623.V358727.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 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 3 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 X 3 X X 3 White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP29 Regulation 19 & schedule 2 Requirement The home must operate a robust recruitment procedure. In particular Application forms must contain a full work history Two written references to be in place prior to the employee starting work CRB/POVA checks are in place prior to the employee starting work All staff files must contain all documentation listed in schedule 2 Immediate requirement made Timescale for action 22/02/08 White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 24 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 Refer to Standard OP9 OP33 Good Practice Recommendations Expand the risk assessments for self-administration of medication to include details of safe storage and hand over and audit systems for medicines. Develop a quality assurance system, which will allow anonymous feedback from people that live in White Lodge and others involved in the home. White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI White Lodge DS0000023623.V358727.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!