Care Home: Merlyn House

What the care home does well The home ensures that new service users have their needs assessed before they move into the home, so that the home is sure it can meet their needs. Service users make their own decisions about every day life and the running of the home. Visitors are welcome in the home. Service users enjoy their food and are involved in choosing and preparing it. The home has equipment such as hoists for those who need it. Service users see healthcare professionals as necessary and have choice with regard to their personal care needs. Medication is stored appropriately and staff keep accurate records of medication given. The home seeks the views of people who live there and service users told us they feel listened to. An independent advocate visits to spend time with service users. Complaints are logged, investigated and followed up. Staff are aware of the procedure to follow regarding safeguarding adults. One of the service users sits on the interview panel when new staff are recruited. New staff are recruited after the necessary checks have been completed. Health and safety practices are followed, such as the correct storage of cleaning fluids and maintenance of equipment. What has improved since the last inspection? Support plans are detailed and reviewed regularly. Risk assessments are now in place and cover challenging behaviour. The staff team has increased and service users have benefited by being able to do more activities and go out more. The environment has improved, with carpets and ceiling tiles being replaced. We were told that the home is kept clean, and the home was clean on the day of the inspection. The management arrangements have improved which has resulted in better outcomes for service users. What the care home could do better: Systems need to be in place to ensure staff receive regular core training, such as moving and handling. CARE HOME ADULTS 18-65 Merlyn House West End Road West End Southampton Hampshire SO30 3BT Lead Inspector Beverley Rand Unannounced Inspection 16/09/08 09:30a Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merlyn House Address West End Road West End Southampton Hampshire SO30 3BT 023 8047 3166 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) jodie.morrison@scope.org.uk www.scope.org.uk SCOPE Care Home 10 Category(ies) of Physical disability (10) registration, with number of places Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th March 2008 Brief Description of the Service: Merlyn House is a registered home that provides personal care for 10 physically disabled adults. It is owned and run by Scope. The home is situated on the outskirts of Southampton within easy reach of local shops and amenities. The home consists of a two-storey building. The garden is landscaped and is maintained by volunteers. All the bedrooms are single. There is a passenger lift. Some of the people attend social services day services once or twice a week. Other day service provision and activities are arranged by the home. Fees for the care provided by the home range from £615 to £923 a week. Additional charges are made for social events, outings and holidays. Merlyn House DS0000011918.V370906.R02.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 a key unannounced inspection. Before we visited the home we looked at the Annual Quality Assurance Assessment which was completed by the acting manager. We also looked at the last inspection report. During the inspection we spoke with four service users, three staff and the acting manager. We looked at records such as care plans and walked around the home. What the service does well: What has improved since the last inspection? Support plans are detailed and reviewed regularly. Risk assessments are now in place and cover challenging behaviour. The staff team has increased and service users have benefited by being able to do more activities and go out more. The environment has improved, with carpets and ceiling tiles being replaced. We were told that the home is kept clean, and the home was clean on the day of the inspection. The management arrangements have improved which has resulted in better outcomes for service users. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples’ needs are fully assessed prior to admission so that the individual and the home can be sure that the home is right for them and will meet the person’s needs. EVIDENCE: This standard was met at the last inspection. During this inspection we found there had not been any new service users since we last looked at preadmission assessments. Therefore, we did not look at them again. However, we spoke to the acting manager about the process she would follow if the home had a vacancy. She told us that the potential service user would be invited to visit the home, she would do a care profile to assess the persons physical, medication, social and emotional needs as well as a risk assessment. The potential service user would then be invited to have an overnight stay at the home, or shorter visits as appropriate. The acting manager would also seek information from professionals who knew the person. A service user moves in on a four week trial basis. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users support plans cover all their needs and identify individual choices and risks. EVIDENCE: The support plans of three people were looked at during the visit to the home. We saw that people had signed their own support plans and had them in their room if they wanted to. Support plans provided detail around peoples’ personal care support needs such as: the support they required with getting up going to bed; dressing; using the toilet; eating and drinking. Written risk assessments were in place regarding peoples’ moving and handling support needs and there was evidence that these had been reviewed. Risk assessments were thorough and demonstrated that people were supported to take risks. The support plans have improved since the last inspection. They are now reviewed regularly and cover all areas of support needed. An example highlighted at the last inspection was that of a service user who can be Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 10 verbally aggressive. Clear information and strategies have now been written down for staff to read. Another issue raised at the last inspection was around the importance of life histories of service users. The acting manager said life histories were easier to ascertain for newer service users but that for those who had been there longer, it was harder. She agreed that more time could be devoted to this piece of work. People were observed to make their own choices during the visit and minutes of house meetings demonstrated that people could input into the day-to-day running of the home and make decisions such as purchases for the home. Service users choose what time to get up, if at all, what to wear, how they would like support with personal care, when to bath and what activities to do. Risk assessments were in place which showed that service users were supported to take appropriate risks in their everyday lives. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Better staffing levels have ensured that service users have more opportunity to undertake activities of their choice. Service users enjoy their meals which are of their choosing. EVIDENCE: Since the last inspection the home has employed more staff and everyone we spoke to said this had improved the daily lives for service users. There is now an activities co-ordinator whose role is to organise college courses, hydrotherapy, trips out to local places, art sessions at home or supporting individuals with activities of their choice. Information recorded in the AQAA listed a variety of educational and leisure activities available to people at the home. These included college courses, shopping trips, attending religious meetings and attending social and community based activities. We saw that some service users appeared to Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 12 undertake very little activity but when we discussed this we were told that staff always tried to encourage more activity but that service users often declined. This was confirmed by talking with service users. Other service users were out more of the time, at college or day centres, shopping, on holiday or other activities in the community. Service users told us that their visitors were made welcome. The AQAA shows that service users are supported to interact with their relatives and to engage in relationships and friendships. We saw evidence of this with two service users expressing a desire to go on holiday together and this being arranged. Since the last inspection the acting manager has asked all the service users if they would like a key to their room and some of them said they would. However, no-one has a key yet. We discussed the individual circumstances of three service users who had ticked the survey box to say they would like a key, with the acting manager. We were told that two would not be physically able to manipulate the locks and that the acting manager was looking into alternative systems which they could manage. However, there was no reason why the third had not yet been given a key. The acting manager should give keys to those who wish them and can use them as a matter of priority. Service users told us they liked the food and that alternatives were always available. We saw the lunch and evening meals provided during the inspection and they appeared well presented and colourful. Service users are involved in choosing, shopping for and preparation of food. The home employs a cook throughout the week who also runs a cookery group with service users once a week. The home currently caters for a diabetic diet and all food provided is recorded. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal and physical support needs are met in ways which suit them. Medication systems ensure service users receive their medication as prescribed but further training may benefit service users. EVIDENCE: As has been detailed above, support plans showed that staff supported personal care needs in ways preferred by service users. Both men and women are employed at the home and the acting manager is alert to the issues this raises, for example, ensuring that female service users who do not wish to have male support workers, do not have to do so. Records demonstrated that the home liaises with outside professionals and other agencies as appropriate and that people had access to a range of healthcare services such as podiatrists, GP’s and opticians. We saw evidence that peoples’ healthcare support needs are monitored and that people are supported to attend appointments as necessary. There is equipment in place, such as overhead track hoists, for those who need this support. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 14 Medication was generally stored appropriately and safely. However, we found one bottle of eyedrops which were stored in a fridge in a communal area which were not locked away. The acting manager immediately found a locking tin and rectified this. The home does not currently have any controlled drugs prescribed to service users. The legal requirements for the storage of controlled drugs has changed so a recommendation regarding meeting the regulations has been included in this report. Staff complete the Medication Administration Records fully and we did not see any gaps. Staff said they signed the records after the medication had been given or taken. Clear individual care plans were in place for medication which is prescribed, as needed which ensures consistency in such medicines being administered. Medication administration training is provided in-house, that is, staff pass training on to new staff. The acting manager told us that there was a three stage training process. The first stage included familiarisation of medicines used and a questionnaire and this training is provided by a team co-ordinator who has undertaken a one day training course in medication with the local pharmacist. Stage 2 is being supervised by other staff to give medication, for a total of sixteen times, (four each of four different times of day). At stage 3, the staff member gives the medication alone, but their work is checked after the round. Although we did not identify any concerns with regard to the administration of medication, it is unlikely that this level of training is sufficient for staff supporting service users and more formal training should be included in the training programme. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel able to complain and feel listened to. Procedures are in place to protect service users from abuse. EVIDENCE: We spoke with a service user who said they felt they were consulted about the running of the home and that they could to the acting manager if they were unhappy about anything. The home has a complaints procedure and we looked at the complaints log book. This showed that two recent complaints had been fully investigated and followed up. One resulted in an issue needing to be raised at a team meeting, which it was. We have not received any complaints about the home. We spoke to staff about the Protection of Vulnerable Adults procedures. They were aware of the need to report any suspected or alleged abuse to the acting manager, or another manager if necessary. The organisation has been working on updated policies, procedures and training in this area and all staff are expected to have a full days training within a few months. Service users manage their own money with support if necessary. The home keeps records of money in and out and keeps receipts. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment has been improved which benefits the service users who live there. The home is kept clean. EVIDENCE: Improvements have been made to the home since the last inspection. The stained ceiling tiles have been replaced. New carpet has been fitted between the hallway and the kitchen as well as on the stairs. Two bedrooms have had new flooring laid. A bedroom blind which was broken at the last inspection has been replaced, as has a toilet seat upstairs. We were told that the whole home has been, deep cleaned. Service users are involved in choosing the décor of the home, both with the communal areas and their own bedrooms. One of the service users has been involved with the re-decoration of their room since the last inspection. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 17 During the last inspection, we found that the door to the dining room, (which forms part of the fire escape route) did not close properly. During this inspection, the door still did not close properly. The acting manager told us that the door had been fixed after the last inspection but had gone wrong again about ten days ago. The acting manager has been in almost daily contact, (with the contracted company) trying to sort the problem, thereby demonstrating her awareness of the situation. Service users told us that the home was kept clean and we saw that it was clean during the inspection. The home does not employ staff specifically to undertake cleaning tasks, support staff do this. We spoke to three staff about how they supported service users and kept the home clean. They all felt it was manageable now that the staffing had increased. The home has a laundry which is accessed through the kitchen. Staff we spoke to said that they used a lidded bin to carry laundry through the kitchen. We saw liquid soap and paper towels around the home. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have benefited from the increase in the number of staff, but may benefit further by better training for staff. EVIDENCE: New staff, including a part time administrator, have been recruited since the last inspection. This has meant that the staff rota now shows three support staff on duty. The rota is supplemented by the acting manager, the day care co-ordinator and the cook. There are also two team co-ordinators. We spoke to service users about the staff team. We were told that the staff were, ‘very nice, friendly, quite helpful’ and, ‘very good’. One of the service users told us how they were involved in the interviewing of potential new staff. We looked at the recruitment files for three new staff and found they contained all the necessary pre-employment checks. Protection of Vulnerable Adults checks, Criminal Records Bureau checks and two written references were on file. There was not a record of when the references were actually received. The acting manager said that references would be received before someone started work and they were dated as being written before Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 19 start dates. We advised the acting manager that references need to be dated when they are received so that this standard can be better met. The acting manager did not have a system in place to identify which staff had attended or needed specific training. The last training day for moving and handling had been in April 2007 which means that staff who had attended that training have not had the annual refresher. New staff have covered the topic during their induction. The acting manager said that she has had the training which enables her to train staff, but has not been able to do so due to a lack of resources. She said she has raised this issue with the organisation and another team member is due to go on the training course which means she will be able to train staff. The acting manager said that all the staff have had training in the tasks they undertake and there have been no changes to service users’ moving and handling needs. Most staff have received training in Food Hygiene, but two have not and they prepare some food. The organisation has planned some new training for safeguarding adults and this should be provided for all staff in the near future. Staff have had training in epilepsy, risk assessment and fire safety. New staff complete the common induction standards and a National Vocational Qualification, (NVQ) programme is in place. Out of eleven permanent care staff, eight have achieved a NVQ in care, level 2 and one is starting NVQ level 3. The acting manager said that some service users had mild learning disabilities, but none of the staff have any training in this area. Similarly, some of the service users are older and the staff have not had any training about ageing. The acting manager felt that training in ageing and bereavement could be good. We spoke with an older service user who felt that staff did understand their needs. Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although there is still not a registered manager in place, the management of the home has improved, resulting in better outcomes for service users. The home is run with regard to health and safety. EVIDENCE: The home has been without a registered manager since August 2007. The acting manager is in the process of putting together her application but currently manages another home in the organisation as well as Merlyn House. Since the last inspection, the management arrangements have been improved and these improvements have been noted throughout this report. The acting manager has worked for SCOPE for sixteen years, starting as a support worker and then an assistant manager before taking the management Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 21 role at Merlyn House. She has a NVQ2 in care, NVQ4 in management and is working towards completing the Registered Manager’s Award. Service users’ meetings are held every two months, generally, and minutes are taken. We looked at some of the minutes and found that issues raised had been addressed. Service users have access to an independent advocate who visits when requested. A service user told us that they, ‘felt consulted’. Staff meetings are held monthly and staff sign to say they have read the minutes. Monthly visits are also taking place which identify issues and monitor ongoing improvements. The acting manager said she was planning a survey for service users and could also give a survey to relatives. She has also put a management monitoring form in place, which she completes on a regular basis. There is a system in place which ensures fire alarms are tested weekly and emergency lighting is tested monthly. The home provides fire safety training on a six monthly basis and this was due. The acting manager said she was aware of this and has asked a team leader to organise. An external company visits to check the fire equipment every six months. Certificates were available for maintenance on equipment such as hoists. Food and cleaning fluids were stored appropriately. Merlyn House DS0000011918.V370906.R02.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? 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 YA35 Regulation 18 (1, c, I) Requirement Staff must have regular, appropriate training to meet service users needs and there must be systems in place to ensure this happens. Timescale for action 16/12/08 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 YA26 YA20 Good Practice Recommendations People should be provided with a means of locking their rooms appropriate to their needs. It is recommended that a Controlled Drugs cupboard, which complies with the Misuse of Drugs (Safe Custody) Regulations 1973, is provided for the secure storage of any Controlled Drugs which may be prescribed for service users in the future. Merlyn House DS0000011918.V370906.R02.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. Extracts may not be used or reproduced without the express permission of CSCI Merlyn House DS0000011918.V370906.R02.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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