Care Home: Meadowview Nursing Home

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What the care home does well The location of the home suits people living there, as it is in a village setting and it is easy to go to the local pub and visit the shops. People living in the home are respected as individuals, and the staff members know each person`s needs and wishes. One person described living in the home as `freedom`. People have their healthcare needs met, and can do what they want on a daily basis. They can take part in activities, have social events in the home and they can go out regularly and this means that they can continue to live their lives as they want. The food is generally good and the environment is homely and safe. The gardens are safe and provide different areas for people to use, including a central garden and open countrysidePeople can make their concerns known and know that they will be heard and that action will be taken to sort out their problems. Staff training is good and the staff team is experienced and skilled,and were described by people at the home one individual as `happy`. One individual said the best thing about the home was the `happy people` who looked after everyone. The manager is enthusiastic, confident and capable, and manages the home well. What has improved since the last inspection? The building and decoration work on the new accommodation has been completed. The new extension transforms the building into a rectangular shape with a central garden, and this has been upgraded. The new building includes a new laundry room and the new equipment and space helps to manage the risk of infection better. More adjustable beds, and new equipment to help people be more comfortable in bed has been provided. Redecoration has continued in the older part of the building. More staff have been employed, including a dedicated person to manage the laundry and the development of a new post of deputy manager. Staff training has continued and developed, with a focus on dementia training, palliative care and National Vocational Qualifications training to management level. CARE HOMES FOR OLDER PEOPLE Meadowview Nursing Home 48 Rack End Standlake Witney Oxfordshire OX29 7SB Lead Inspector Kate Harrison Unannounced Inspection 12:15 27th May 2008 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 Meadowview Nursing Home DS0000027163.V364618.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. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadowview Nursing Home Address 48 Rack End Standlake Witney Oxfordshire OX29 7SB 01865 300205 F/P 01865 300205 managercaroline@aol.com farhadpardhan@aol.com Mr Farhad Rajabali Pardhan 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) Mrs Caroline Campbell Schofield Care Home 42 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (42) of places Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. On admission persons should be aged 60 years and over. Admission of one named resident under the age of 60. Date of last inspection 6th July 2006 Brief Description of the Service: Meadowview is a privately owned nursing home located in Standlake, Oxfordshire, and is situated in a residential area of the village. The two-storey building has been extended to provide private rooms and communal areas for residents, and has recently been extended to provide a conservatory. The majority of the private accommodation is provided downstairs with two double rooms provided upstairs. There is a passenger lift and toileting, bathing and showering facilities for all the residents. The proprietor and the registered manager run the home with a team of nurses, care staff and housekeeping staff. The weekly fees range from £567 to £620. The village of Standlake has shops and pubs and has a local bus service. The home is currently being further extended to provide more single rooms and will also provide an enclosed garden when completed. Meadowview Nursing Home DS0000027163.V364618.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 3 star. This means the people who use this service experience excellent quality outcomes. This inspection of the service was an unannounced ‘Key Inspection’ and took place over 6 hours during one day. It was a thorough look at how well the service is doing. It took into account detailed information provided by the home’s manager, through the Annual Quality Assurance Assessment (AQAA), and any information that we received about the home since the last inspection. We saw those areas of the home used by people living there and looked at records and documents relating to their care. We also looked at staff recruitment files and at training records, and we spoke with the registered manager of the home and with other staff members. We asked the views of the people who live in the home, staff members and of relatives we saw during the inspection, and their views are reflected in this report. Several people were not able to communicate their views and we took time to observe how they were treated during the day. It was a thorough look at how well the home is meeting the standards set by the government and in this report we make judgements about the outcomes for the people living in the home. From the evidence we saw throughout the inspection visit and from comments received, we consider that the home would be able to provide a service to meet the needs of individuals of various religious, racial, gender or cultural needs, and with physical disabilities. What the service does well: The location of the home suits people living there, as it is in a village setting and it is easy to go to the local pub and visit the shops. People living in the home are respected as individuals, and the staff members know each person’s needs and wishes. One person described living in the home as ‘freedom’. People have their healthcare needs met, and can do what they want on a daily basis. They can take part in activities, have social events in the home and they can go out regularly and this means that they can continue to live their lives as they want. The food is generally good and the environment is homely and safe. The gardens are safe and provide different areas for people to use, including a central garden and open countryside Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 6 People can make their concerns known and know that they will be heard and that action will be taken to sort out their problems. Staff training is good and the staff team is experienced and skilled,and were described by people at the home one individual as ‘happy’. One individual said the best thing about the home was the ‘happy people’ who looked after everyone. The manager is enthusiastic, confident and capable, and manages the home well. 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. Meadowview Nursing Home DS0000027163.V364618.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 Meadowview Nursing Home DS0000027163.V364618.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): 3 and 6. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of individuals are assessed by a competent person before they move into the home, to make sure that the home can meet their needs EVIDENCE: The home’s manager usually visits people who have expressed an interest in coming to live in the home, to make sure that the home can meet the needs of the individual. We saw the pre-admission assessment information for three people who had been admitted in the past year. Information was available from the funding authority for two individuals, and information following discharge from hospital was available for the other individual. The manager visited two individuals in their home and one in hospital, and completed the home’s pre-admission assessment document for all the individuals. Relatives of the individuals visited the home before admission, and the first month is regarded as a trial period. The three individuals expressed their satisfaction with the home and indicated that their needs were met. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 9 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in the home have their health care needs recognised and met as a right, by a trained, caring and respectful team. EVIDENCE: A deputy has been appointed to the manager, to oversee the planning and delivery of care to the people living in the home, and this has helped to manage the increased numbers in the home well. The home has a charter about the rights of people living in the home, included in the service user guide, and the manager and her deputy see good care practice as one of the rights for people living in the home. The manager is developing a personalised approach to care planning and the care team is implementing the person centred approach to the care plans. We saw that staff members were able to manage difficult situations involving people with dementia skillfully and respectfully, and that they spent time chatting to people when they could. We saw the care plans for three people living in the home. The individual or their representative is asked to sign the home’s form about their involvement Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 10 with the care planning process, and the form also refers to the Mental Capacity Act 2005, where care staff who have to make some choices for individuals need to make them in the best interests of the individuals. This is good practice and serves to remind staff about their responsibility under the Act. Risk assessments about health issues, for example about falling and nutrition, were carried out for all the individuals, and individual needs were recognised. One individual had difficulty in communicating and the home had arranged input from the specialist service, so that a way for the individual to communicate was developed. One relative said that the staff team always tell him/her if the doctor was needed, and said that her relative has ‘thrived’ in the home. Another individual said that the manager was ‘very good’ at sorting matters out for her/him, and that the staff were ‘caring’. We saw evidence that other health professionals are called when necessary, and that their recommendations are implemented. Care plans are reviewed regularly, and the manager is looking to improve the way the review information is recorded. All the people living in the home are registered with a general practitioner, and care staff receive induction and regular further training on care topics. The home receives its medication from a dispensing general practitioners’ surgery, and has policies and procedures to guide staff in managing the medication. Medication is kept securely and the nurses receive regular training updates about medication. We saw the records about medication for three individuals, and these were accurate and were well kept. At present no individual living in the home manages his/her own medication, and the home has historically managed medication on behalf of those living in the home. We recommend that on admission people are asked if they want to manage their own medication, or if they want the home to manage it for them, and that their wishes are recorded and respected. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 11 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The ethos and management style of the home supports people living in the home to keep as much control as possible over their lives, and supports them to remain connected to their families and loved ones. EVIDENCE: The recent extension of the home has enabled the ground floor to be used more effectively by people living in the home, and now people have more room to move around safely as they wish. The home’s gardens are also better used since the extension was completed. The home’s routines, such as for personal care and mealtimes, are flexible and are based on individual choice, though there are also set mealtimes. Individuals have the choice about having a key to their rooms, and staff members know each person’s preferred name. The care plans include the social history of individuals, and this is used to help staff relate better to individuals. One individual said that the home gave him/her ‘freedom’ as he/she was encouraged to do what he/she wanted to. The manager has worked to respect the wishes of a couple living at the home, and has arranged their accommodation so that they can live life as they want to. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 12 People are supported to continue practising their religion while in the home, and as there are Christians in the home services are held regularly for those who want to attend. No other religion is practised by people in the home at present. Information about people’s interests is recorded and this is taken into account when discussing the activities schedule. The activity organiser works five days a week time and has developed a 4 weekly rotating activity schedule around the choices of people living in the home. Three members of staff have completed training about the provision of activities for older people, to make sure that when the activities organiser is not available that people can still continue to take part in some activity they like. The activities are group and individual, with usually one activity each morning and another in the afternoons. Trips out are organised, for small and larger groups and the home makes good use of community transport. Recent trips out have been to a wildlife park and to a farm. One individual told us that he regularly goes to the pub for a meal, sometimes with other people from the home. The home’s menu rotates over four weeks and is changed seasonally. People can have their meals in one of the dining rooms, in the conservatory or in private rooms. Two individuals living in the home told us that the food is good. The home has a policy of welcoming visitors, and one visitor told us that she is always made very welcome. There is a group called Friends of Meadowview who support the home, mainly made up of relatives of people who have lived at the home, or who are living there at present. The regular newsletter produced by the manager keeps people informed of the events at the home. Relatives meetings (Friends of Meadowview) are organised and the manager makes herself available to meet with relatives at their convenience. Staff members have received training about how the Mental Capacity Act 2005 affects their work, and are more aware of the rights of people living in the home. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 13 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are protected from harm by the trained staff team, and they are confident that their complaints will be listened to and taken seriously. EVIDENCE: The home’s complaints procedure is displayed in the entrance hall and each individual has a copy in their copy of the home’s guide. A record of all the complaints is kept, and the manager discussed how she intended to improve recording so that it is easier to see that the home has responded to complaints within the timescales in the complaints procedure. Two complaints have been received and responded to appropriately since the last inspection. People said that the manager is open to hearing about their concerns, and two individuals said that they found the manager and staff’very good’ in addressing complaints. We have not received any information about complaints regarding the home since our last inspection. The home has a policy and procedure to manage any suspicions or allegations about abuse of people living in the home. Although the policy refers to the local council’s position regarding safeguarding arrangements, the home’s procedure does not, and needs to be amended to help staff members know when they need to inform the local council’s safeguarding team. All the staff team have received training about safeguarding vulnerable people, and the manager knows that she can refer individuals for inclusion on the government list of people who are not allowed to work with vulnerable adults. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 14 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from good systems to keep the home safe and clean. EVIDENCE: The home is situated in a residential area and provides a homely place for people to live. Several improvements have been made since the last inspection, including redecoration of communal and private rooms, and new curtains and bedding provided. The new building has been decorated and furnished, and the gardens improved, so that the area is safe for people with dementia to use. The home has two people responsible for maintenance issues and there is a reliable system for managing day to day repairs so that the home remains safe. Paper towel dispensers and an appropriate waste bin have been ordered for the new bathrooms and laundry, so that the risk of infection is minimised. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 15 At the last inspection a recommendation was made that the future use of the two double rooms upstairs be considered and the manager has since then changed the use of the rooms for the benefit of two people living in the home. A new laundry room has been provided, with two new industrial washing machines and a new dryer. All staff members have had recent infection control training. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 16 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The needs of people living in the home are met by trained caring cheerful staff, who have good morale and good support. EVIDENCE: The home employs a staff team of nurses, care staff, kitchen, maintenance and housekeeping, as well as a registered manager. The staff rota shows that there is sufficient numbers and a mix of staff members on duty with the skills to deliver the care for the people in the home. People at the home made complimentary comments about the caring qualities of the staff team, and several said that the cheerfulness of the staff was good for them. One individual said the best thing about the home was the ‘happy people’ who looked after everyone. New staff members take the home’s induction programme which is to the appropriate standard, complete the workbooks and are encouraged to enroll on the National Vocational Qualifications in Care (NVQ). At present, of 19 care staff excluding nurses there are 12 care staff members with the NVQ Level 2 in Care, and 5 staff members hold the NVQ Level 4. This exceeds the National Minimum Standard of 50 trained care staff and shows the home’s commitment to training. An analysis of staff training needs has been completed with the help of an outside organisation and the training programme has been developed because of this. The home has internal trainers in care and safety topics. All members Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 17 of staff have completed basic training in dementia care, and care staff have a further training programme of dementia care based on separate units of work from a reputable organisation. All staff have taken training in first aid, safeguarding vulnerable people and food safety. Nurses have appropriate update training, such as in wound care and palliative care. Other training is offered to staff on an ongoing basis. Staff meetings take place regularly, and the manager makes herself available to discuss issues arising with staff. Staff members confirmed to us that training was encouraged and that they felt supported in their work. We looked at three staff recruitment files to check the home’s recruitment procedure. All the recruitment information needed by legislation was available, apart from photographs of two members of staff working in the home since December 2007. The manager explained that the photographs were taken but remained in the camera and had not been printed out. She confirmed the next working day that the photographs were now in the files. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 18 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, 33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the people living there, by management and staff teams who are focussed on their health, and social and emotional needs. EVIDENCE: The manager returned her AQAA in time as agreed and, because it was completed some months ago, some information was outdated and the manager supplied the updated information. The home’s management has coped with significant changes since the last inspection. The home was evacuated last summer when the home was at risk of flooding, and people living in the home were transferred to other accommodation. This caused major disruption for the staff team and for the people living there, but did not last long. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 19 The extension to the home has been completed, and the numbers have increased by 12 more people to 42. The registered manager, who holds the Registered Manager’s Award, has overseen the developments with the proprietor, who works at the home on a regular basis. She is enthusiastic, highly skilled and confident in managing the home and in motivating staff, and as a result people living in the home feel safe and content. The home has continued to improve over the past years, because of the staff training and the management’s commitment to improvement. Staff members also said that they were encouraged and supported to take as much training as possible. People living at the home praised the manager as a person they trusted to manage the home well. The registered manager works on the floor for three days of the week and has two days to carry out her managerial duties. It is not clear that this gives her sufficient time to manage tasks such as arranging visits and showing people around the home, as the number of people living in the home have increased, and there is no administrative support available at the home. The home carries out a quality review of the home involving relatives and people living in the home annually, and holds meetings with relatives to discuss any isues arising. No petty cash is kept on behalf of people living in the home, and invoices are sent for expenses paid for on their behalf. The manager and another member of staff share responsibility for the health and safety issues in the home. There is a health and safety policy statement, and training is provided on health and safety topics. A fire safety risk assessment has been carried out to make sure that risks are minimised, and the home’s annual quality assessment information shows that contracts are in place to maintain services and facilities in good order. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 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 X 3 X 3 X X 3 Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP12 OP19 OP29 Good Practice Recommendations The weekly activities plan should include the activities for the weekend. The registered manager should consider how the shared upstairs rooms could meet prospective residents’ needs. To assist the home in keeping track of the procedures undertaken by the home for all new applicants, the inspector recommends that a checklist be used to record dates when action to progress the application was completed. Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection 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 Meadowview Nursing Home DS0000027163.V364618.R01.S.doc Version 5.2 Page 23 - 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. 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