Care Home: Dorley House

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What the care home does well The atmosphere of the home remains relaxed and staff continue to be friendly and welcoming. The home is well managed with comprehensive staff training programmes in place in addition to a quality monitoring system in place which is an on-going process. People living in the home are encouraged to be independent and all aspects of their health, leisure and welfare are identified and planned for. Record keeping is good and there is an on-going programme of refurbishment and repair to ensure all parts of the environment remain pleasant and comfortable. Complaints are handled well with people living in Dorley saying they felt listened to and that action is taken to address any concerns. A wide range of activities are provided in-house as are outings to local attractions which are chosen by people living in the home. What has improved since the last inspection? All of the four shortfalls identified at the last inspection have been met in respect of clear recording of medication administration, staff practice to reduce infection, informing the CSCI of any adverse events and a fire risk assessments being carried out. In addition to these there have been a number of additional improvements including the provision of two walk in showers, redecoration of the communal areas and individual bedrooms and new soft furnishings in individual bedrooms each of which enhance the general attractiveness of the home. The good practice recommendations regarding obtaining references from overseas employers and implementing the induction programme have also been addressed. What the care home could do better: No shortfalls were identified at this visit. CARE HOMES FOR OLDER PEOPLE Dorley House 19/20 Bedfordwell Road Eastbourne East Sussex BN21 2BG Lead Inspector Gwyneth Bryant Unannounced Inspection 7th April 2008 07:00 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 Dorley House DS0000067684.V361259.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. Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dorley House Address 19/20 Bedfordwell Road Eastbourne East Sussex BN21 2BG 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) 01323 729545 01323 648893 dorley @stmichaelscare.com St Michaels Care Homes Limited Mrs Norma Wood Care Home 33 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (33) of places Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only-(PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE/E) up to twenty-four The maximum number of service users to be accommodated is thirtythree (33). 1st May 2007 2. Date of last inspection Brief Description of the Service: Dorley House is a large detached three-storey house with large secluded rear gardens close to Eastbourne town centre with all its amenities and approximately two miles from the seafront and promenade. All floors are accessible via the provision of a passenger lift and stair lifts, however there are also some internal steps so those accommodated in these areas need to be mobile. The home has a dining room and two lounges, one of which is located on the top floor. There are twenty-five single rooms and four doubles, of which twelve single rooms have en-suite toilet facilities. All rooms have at least a wash hand basin. Grab and hand rails are provided throughout the home. There are communal bathrooms on each floor except the attic floor and bath hoists are provided in all bathrooms. Two bathrooms also have walk in showers. As part of the pre-admission process people are provided with an information pack that includes a copy of the service users guide, the statement of purpose and a brochure. Copies of inspection reports are made available if requested. Fees charged as from 1 April 2007 range from £395 to £525, which includes toiletries. Additional charges are made for hairdressing, chiropody, newspapers and outside activities such as visits to the theatre. Intermediate care is not provided. Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced site visit and took just under six hours and its purpose was to check compliance with both key standards and other minimum standards. There were twenty-four people in residence on the day of which six were spoken with. Discussion also took place with one carer, the registered provider and the Registered Manager. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. All of the people spoken with spoke highly of the care given and the kindness of staff and food was another area singled out for special mention as being very good. The Registered Provider makes monthly visits and the subsequent reports are available in the home for inspection. Prior to the site visit we asked the Registered Providers to complete an Annual Quality Assurance Assessment (AQAA) in June 2007. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. This was provided and the information included in this report as necessary. Seven staff surveys and eight user surveys were returned and responses showed that overall both people living in Dorley House and staff are happy and feel supported and valued. Comments in surveys included: • • • • • • A string of ‘always’ since most issues are temporary and resolved quickly. I am lucky there is somewhere like this to come to. They go the extra mile to ensure my comfort and well being. I feel very lucky to have found a home at Dorley. I am very happy here; I have all my friends here. Very pleasant staff. What the service does well: The atmosphere of the home remains relaxed and staff continue to be friendly and welcoming. The home is well managed with comprehensive staff training programmes in place in addition to a quality monitoring system in place which is an on-going process. People living in the home are encouraged to be Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 6 independent and all aspects of their health, leisure and welfare are identified and planned for. Record keeping is good and there is an on-going programme of refurbishment and repair to ensure all parts of the environment remain pleasant and comfortable. Complaints are handled well with people living in Dorley saying they felt listened to and that action is taken to address any concerns. A wide range of activities are provided in-house as are outings to local attractions which are chosen by people living in the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 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 Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 4 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 moving into the home benefit from an admission process that ensures their individual needs and wishes are comprehensively assessed and identified as being able to be met prior to moving into the home. EVIDENCE: As part of the care planning process all people moving into Dorley have a detailed assessment of their needs which is used as a basis for their individual plans of care. The admission assessments for three individuals were viewed and it was evident that a thorough assessment process had been undertaken prior to all three people coming to live at the home. Information is gathered from a variety of sources including social care professionals, in addition to input from family and friends. Information in the AQAA demonstrated that all people moving into the home are provided with a Statement of Purpose and service users guide prior to admission and this was confirmed both by people spoken with and in returned surveys. A copy of the service users guide is in each individual’s bedroom as a point of reference. Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 9 Comments in surveys included: • • A good clear efficient person came to assess me. Gave me all the information I needed to make a choice. (contract) it was explained to me when I was assessed before admission. Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8,9 and 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. The care planning systems ensure that the health, medical and personal needs of those living in the home are identified and planned for in a consistent and comprehensive manner. EVIDENCE: Five care plans were viewed and it is clear that they have been developed from the information in the pre-admission assessments. The plans were satisfactory in that they included clear information on the care needs of people living in the home and the necessary action to be taken to meet those needs. Care plans also indicate preferred times for getting up and going to bed and identify what the individual is able to do independently and which tasks they need help with. Records of these daily care needs are maintained with staff signing to demonstrate that care has been delivered in line with the care plan. People living in the home are encouraged to remain independent within a riskassessed framework. Risk assessments had been carried out and they clearly identified the hazards and included sufficient detail for the management of Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 11 risks. Daily notes were sufficiently detailed to inform the care plan review process and ensure changing needs are quickly identified and met. Care plans include detailed information on meeting healthcare needs such as chiropody, hospital appointments, dentists and opticians. Each room has a poster with a photograph of the individuals’ key worker and an explanation of the key worker role which enables people to have a named person to discuss any issues. Some people living in the home hold and administer their own medication and satisfactory risk assessments have been carried out to ensure they are not at risk. There are policies and procedures on respecting service users dignity and privacy and all service users are offered keys to their bedrooms and staff were seen to knock on doors before entering. Throughout the site visit staff were seen to treat individuals with care and respect and it was evident that comfortable working relationships had been developed. Medication Administration Records were viewed and found to be clear, accurate and up to date ensuring that it is clear whether or not medication has been given. One shortfall in the administration procedure was identified and the manager agreed to discuss the matter with the individual concerned. Comments in surveys were mostly positive with people indicating that they are satisfied with all aspects of the care given. People spoken were highly complementary of staff with comments such as: • • • • the young girls are excellent. Everything is just marvellous I cant fault them. Staff are very kind and (name) is particularly good. Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 12 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 and 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 in the home have the opportunity to experience a lifestyle that matches their expectations, choice and preferences in respect of leisure activities and meals. EVIDENCE: People living in the home are offered a comprehensive range of activities, based on their preferences. There is a daily activity programme displayed on the notice board and people are encouraged to both participate and make suggestions for additional activities. Some activities are themed such as a ‘race day’ during which individuals are randomly given a horse name for the Grand National with a prize for the holder of the winning horse. Regular outings are arranged to local attractions or to the shops after consultation with people living in the home. Care plans included the individual preferences of people living in the home and both the Registered Provider and the Manager confirmed that every effort is made to ensure they have a good quality of life. One person spoken with said that the Registered Provider allows them to use the homes laptop computer to Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 13 view and print digital photographs which indicates every effort is made to meet the needs of individuals’ hobbies. Those people spoken with confirmed that they go out into the community and that visitors are made welcome at all times. Monthly religious services are provided in the home and arrangements are made for who wish to follow their own religion with transport arranged to local churches if necessary. Each of the people spoken with said how much they enjoyed the activities and comments in surveys included: • • • • • • • I am given the choice of what activities we have available and always asked if I would like to take part. We can suggest at residents meetings what we would like to do and this is then put into action. Very happy with food etc Food very good. Residents friends and family are made very welcome. Much effort is made to make their visit as pleasant as possible. We are told when people call how the atmosphere is upbeat and good. The meals are excellent – too much food at times. I chose not to join in all the activities. The weekly menu is displayed on the notice board and a choice is given for each meal. The menu showed that meals are varied, well balanced and nutritious. On the day people were seen to be enjoying a lunchtime meal of their choice and staff were seen to discreetly assist as required. At the start of the site visit it was pleasing to note that people were observed to be getting up at a time of their choosing and to have a breakfast meal of their choice either in their rooms or in the dining room. One person spoken with said that her morning tea and porridge was not hot when it arrived and this was discussed with her key worker who agreed to deal with the matter. Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 14 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 and 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. The home has a satisfactory complaints procedure with evidence that those living in the home feel that their views are listened to and acted upon. People living in the home are further protected by satisfactory adult protection systems. EVIDENCE: The home has policies and procedures on complaints and no formal complaints have been received by the CSCI and surveys indicated that people living in Dorley know who to speak to if they had a complaint and that they are aware of the complaints procedure. One person spoken with mentioned an issue and although they were not fully satisfied with the outcome, it was evident that the home followed the correct complaints procedure and ensured the outcome was in line with equal opportunities procedures. A concern was raised with the CSCI, however there was no evidence to demonstrate that anything untoward had taken place in the home. Comments in surveys included: • • • prompt action, always listen and give good advice and explanation – very professional. (complaints) someone is always available if I have a problem. (complaints process) it was explained to me on admission. DS0000067684.V361259.R01.S.doc Version 5.2 Page 15 Dorley House There are detailed policies and procedures on Protection of Vulnerable Adults and all staff have received appropriate training so are aware of the procedure in the event of an allegation. There is an on-going staff training programme to ensure all staff remain up to date on the latest guidance and this issue is also included in the induction process. All staff surveys indicated that they knew where to access an independent advocate for individuals if necessary. Dorley House DS0000067684.V361259.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 and 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. . The standard of decor and maintenance within the home is good, providing people living in the home a safe, homely and comfortable environment. EVIDENCE: A tour of the premises was carried out and a random selection of rooms inspected. The home continues to provide a safe and comfortable place in which to live. Individuals’ bedrooms were well maintained and pleasingly decorated and it was evident that people are able to bring in their own possessions in order to personalise their bedrooms. The refurbishment programme is underway with two bathrooms being renovated to provide walk in shower facilities which now gives people living in Dorley additional choices over how to be bathed and to ensure that process is easier and safer. A number of bedrooms have been redecorated and new curtains and bedding provided, each of which ensures individual rooms remain attractive and comfortable. Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 17 There are hoists and other equipment provided that fully meet the needs of people living in Dorley. All people living in the home are given a key to their room as a matter of course but may leave it on a hook inside the door if they choose not to use it. The laundry facilities are satisfactory and washing machines are able to wash clothes at temperatures that control the risk of infection. Staff are trained in infection control and were seen to be working in ways that minimised the risk of cross infection. Dorley House DS0000067684.V361259.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 and 30 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. There are sufficient staff with appropriate skills to meet the needs of those people living in the home and the recruitment practice is also sufficiently robust to safeguard those living in the home EVIDENCE: Staff rotas showed that there are four care staff on duty at each daytime shift in addition to the manager. Two night waking staff are employed as are domestic staff and cooks. Staff surveys indicated that additional staff would be better so they can give more time to residents especially providing one-to-one time. Comments were ‘we never have enough hours in the day’; it would be nice to have more time with residents but it is a very busy environment’. Comments in other surveys included: • • • some staff are excellent. (name) is wonderful. I cant fault them (staff). Recruitment records were viewed and it was found that all staff had provided the required information prior to appointment, including Protection of Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 19 Vulnerable Adults and Criminal Record Bureau checks, two written references and a full employment history. There is staff training development programme, which includes both mandatory training and additional training such as dementia care. Of the twelve care staff, eleven have achieved National Vocational Qualification level 2 in care therefore this standard is exceeded. The staff induction programme has been implemented and this was confirmed by staff within the staff surveys. In addition, the induction records for two new staff were viewed and found to include all aspects of the services provided in the home. Dorley House DS0000067684.V361259.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 and 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. People living in the home and staff benefit from clear leadership and direction and all aspects of their health, safety and welfare are protected and promoted. EVIDENCE: The Registered Manager has the skills, qualifications and experience to manage the home and provide clear leadership and direction to staff. Responses in staff surveys indicated that the management approach is open and inclusive and that staff feel appropriately supported. The Registered Manager is due to update her knowledge by undertaking additional training in organising activities and has completed the manual handling assessor course, which enables her to train new staff. The manager convenes meetings for both those living in the home and staff with the minutes of these meetings available. These demonstrate that people Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 21 living in the home are listened to and their suggestions acted upon and that they have a say in how the home is run. Minutes of meetings showed they had been consulted in menus, outings and other activities. The finances of people living in the home are protected by good record keeping and where small amounts of money is held on their behalf appropriate records are maintained. There quality monitoring system has been fully implemented and it covers all aspects of the service and ensures the home is run in the best interests those living there. The Registered Provider makes monthly, unannounced, visits to the home as part of the quality monitoring process and the subsequent reports are available for inspection. Viewing these records showed that the Registered Provider audit all parts of the service as an on-going process to ensure high standards are consistently maintained. Comments in staff surveys included: • • • • • • • • • • Would refer concerns to the manager or person in charge. (information on residents) I would say it is the most detailed from where I have worked before. All in all the home is very good. We are always kept informed of our progress – the recent introduction of the self-appraisal has been a good idea. The manager and provider are both very supportive of our needs. The staff look after the residents well and provide a homely atmosphere. Dorley is always looking into improving things for residents and staff which is great. I do hope the home can operate at full capacity so that we can benefit more from the company (wages). Although I wouldn’t work anywhere else now that I know Dorley. Residents need more and different activities. Staff meetings are necessary. The AQAA showed that regular checks are made on all electrical and gas appliances and systems and these records were checked on the day and found to be up to date. In addition checks are carried out on call bells, water delivery temperatures and emergency fire systems. All staff have been trained in fire safety and a fire safety risk assessment has been carried out for all parts of the premises. These systems ensure the safety of people living in the home in the event of fire. Accident records were viewed and found to be accurate and maintained in line with the Health and Safety Executive guidance. Dorley House DS0000067684.V361259.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 3 X N/a 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X 3 X X 3 Dorley House DS0000067684.V361259.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. 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. Refer to Standard Good Practice Recommendations Dorley House DS0000067684.V361259.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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