Care Home: Sundial House

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What the care home does well Good procedures are in place for assessing residents prior to admission to the home. All prospective residents are also given the opportunity to visit the home prior to admission. Residents were supported in attending a range of social activities and were given choices about their lifestyle. Residents have choice about their diet and meetings are held so the they can choose the menus for the coming season. Menus are changed four times a year.Staff were knowledgeable about safeguarding adult procedures and the whistle blowing policy. Staff also confirmed that they had access to and were supported in attending regular training sessions. There was a relaxed atmosphere in the home on the day of inspection with good interaction observed between staff and residents. What has improved since the last inspection? No requirements were made following the last inspection in October 2006. One environmental good practice recommendation was made and this has been actioned. What the care home could do better: One requirement was made following this inspection. The statement of purpose and service user guide to be updated to reflect the current management arrangements in the home, the staffing hours and qualifications. CARE HOME ADULTS 18-65 Sundial House Sundial House Orchard Lane East Molesey Surrey KT8 0BN Lead Inspector Lesley Garrett Unannounced Inspection 30th April 2008 11:20a Sundial House DS0000013806.V361046.R01.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 Sundial House DS0000013806.V361046.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 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. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sundial House Address Sundial House Orchard Lane East Molesey Surrey KT8 0BN 020 8398 8620 020 8398 8620 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) The Sons of Divine Providence Post Vacant Care Home 7 Category(ies) of Learning disability (7), Mental disorder, registration, with number excluding learning disability or dementia (1) of places Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be: 30 65 Years One (1) service user in the category LD may have a mental disorder. Date of last inspection 19th October 2006 Brief Description of the Service: The Home provides accommodation for young adults with learning difficulties. It is situated in a quiet residential road and benefits from an adjoining Horticultural centre where some of the service users attend. The home is a two-storey building with bedroom accommodation on both levels. The lounge and dining areas are spacious and homely. The garden is extensive with a small patio garden in the front of the building where there are parking facilities. The home is owned by The Sons of Divine Providence, which is a Roman Catholic order of priest and brothers who are dedicated to the care of adults with learning disabilities. The current range of fees at the home are £483.66 to £789. Sundial House DS0000013806.V361046.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. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the care home was an unannounced ‘Key Inspection’. Mrs L Garrett Regulation Inspector carried out the inspection and the senior carer who was in charge on the day represented the service. For the purpose of the report the individuals using the service will be addressed as residents. The inspector arrived at the service at 11:20 and was in the home for four hours. It was a thorough look at how well the home is doing. The Commission did not send questionaires to people associated with the service. The manager had completed an AQAA (Annual Quality Assurance Assessment) to assist with the inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Documents sampled during the inspection included the home’s care plans, daily records and risk assessments, medication procedures and some policies and procedures. The inspector spoke to some residents and staff members. From the evidence seen by the inspector it is considered that the home would be able to provide a service to meet the needs of residents who have diverse religious, racial or cultural needs. What the service does well: Good procedures are in place for assessing residents prior to admission to the home. All prospective residents are also given the opportunity to visit the home prior to admission. Residents were supported in attending a range of social activities and were given choices about their lifestyle. Residents have choice about their diet and meetings are held so the they can choose the menus for the coming season. Menus are changed four times a year. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 6 Staff were knowledgeable about safeguarding adult procedures and the whistle blowing policy. Staff also confirmed that they had access to and were supported in attending regular training sessions. There was a relaxed atmosphere in the home on the day of inspection with good interaction observed between staff and residents. 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. Sundial House DS0000013806.V361046.R01.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 Sundial House DS0000013806.V361046.R01.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): 1&2 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The home’s admission and assessment procedures ensure that individual’s needs are appropriately identified and met. EVIDENCE: The service user guide and statement of purpose were both sampled. They had both been recently reviewed but did not reflect the current management arrangements for the home or the current staffing hours or qualifications and this will be a requirement at the end of the report. Both the statement of purpose and service user guide are available in makaton for those residents that require this easy read format. The home has not had an admission since 2004, as there are no empty bedrooms. The pre-admission assessment for the last admission to the home was sampled and it contained a pre-admission assessment, which was very detailed and enabled the manager to make a decision about the admission of the resident to the home. The senior carer stated that the manager would do all pre-admission assessments. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 9 Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 10 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): 67&9 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Residents’ needs are reflected in their individual care plans, and they are encouraged to make decisions and take risks as part of an independent lifestyle. EVIDENCE: The inspector sampled two care plans. Both of the care plans were noted to be well written demonstrating the care needs of the individual. All care plans had been agreed by the resident and there was evidence that they had been reviewed regularly with the resident and the resident’s keyworker. There was also evidence that six month reviews take place with the next of kin, care managers and keyworker. The senior carer stated that these are always planned and a date set. The care plan folders were very large documents containing all of the information since the resident was admitted to the home. This made the Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 11 folders very difficult to sample to gain information about each individual in the home. All the information was available, but not user friendly. It will be a recommendation at the end of the report for the home to compile a folder which contains current information about each resident so that old care plans can be filed. The care plans detailed that the keyworker sits down with the resident to discuss any issues relating to them and to review their care plans. The senior carer stated that this is time for the keyworker and resident to discuss decisions that need to be made and these meetings are documented and signed by both the keyworker and the resident. Residents have choices about getting up, going to bed and what to do during the day. The senior carer stated that all residents have a bank or savings account. A log is kept of all transactions and the carer and resident sign this. One resident’s personal allowance was sampled and found to be correct. Staff enable the residents to take risks and theses are all well documented. The risk assessments in place for all residents were well written and clear and include risks associated with activities in and out of the home. They had been signed by a member of staff and agreed by the resident. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 12 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 & 17 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Residents at this home have opportunities for personal development and to take part in a range of activities. They take part in local community activities and family and friendship links are encouraged. Residents are offered a healthy diet. EVIDENCE: The senior carer stated that the residents at the home could attend a horticultural centre, which is located next to the home. At the centre residents can participate in woodwork and gardening. The senior carer also stated that no resident has paid employment but one resident does attend college. Cooking classes are also available to some of the residents. Members of staff accompany most of the residents when they leave the home except for one resident who goes to college by bus. On the day of the Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 13 inspection one of the residents accompanied a member of staff to the supermarket to shop for lunch. The residents also have access to the local library and also go swimming. Other trips the residents have enjoyed are to London to the science museum, to the seaside and to Kingston for shopping. Meals out in local restaurants and pubs are also enjoyed. All activities are documented in the care plans and photographs are also taken and kept in the plans. The senior carer stated that families and friends are welcome at any time and relationships are maintained and evidenced in the care plans. It was also stated that all residents are asked if they would like to see their visitor before they are allowed to enter the home. During the inspection, interaction between the staff and residents was observed to be courteous and professional, with both parties using first names to address one another. The senior carer stated that locks are available for all bedroom doors and staff were observed to knock prior to entering the bedrooms or bathrooms. All post is kept in the office and residents check on a daily basis and open their own post. The residents that were at home on the day of the inspection were reluctant to speak with the inspector but did come to the office to meet her. The senior carer stated that the staff do all the cooking and sometimes some of the residents assist. At the residents meetings they are consulted about the foods they would like for the coming season. Menus are changed four times a year. It was observed that residents have their favourite meals documented in their care plans along with their likes and dislikes. The menus demonstrated that breakfast is usually cereal and toast but all residents have a cooked breakfast on a Saturday. Lunch is sandwiches with the main meal of the day being in the evening. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 14 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 & 20 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The home has consistent recording and documentation to evidence that residents attend health care appointments to ensure their wellbeing and welfare. The home’s medication procedures are robust to ensure the safety and wellbeing of all residents in the home. EVIDENCE: The senior carer stated that all of the residents are able to care for themselves except for two who require support with their hygiene needs. The care plans that were sampled were not clear how staff support these individuals due to the large amount of information. The senior carer stated that this information used to be held on each care plan but had not been transferred prior to some documentation being archived. A recommendation will be made at the end of the report that personal care needs for each individual to be clear and easy to read. The manager stated all residents are registered with the local general practitioner (GP). They can visit the GP whenever an appointment is needed Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 15 and a member of staff will accompany them if necessary. It was documented in the care plans that residents also have access to a dentist, chiropodist and optician. Staff will support individuals to attend hospital appointments if necessary. The two care plans sampled had health action plans in place for visits to the GP, dentist, opticians, chiropodist and specialist hospital visits. The folders are taken to each appointment and the healthcare professional will record the information so that everyone is clear as to the treatment carried out. The GP reviews all residents every year and this again is documented. The senior carer stated that the medications are delivered to the home every month, and in between if necessary, and arrive in blister packs. All residents have a medication profile and the medication administration records sampled demonstrated that the residents have minimal medications. The carer stated that the GP reviews medication for residents at least every year at their assessment and in between if necessary. Two of the residents do not have to take any medication. The senior carer stated that all staff that administer the medicines have received training but the individual training records are kept in their recruitment folders are they were not available on the day of inspection. Staff spoken to on the day stated that they had received training or were still in their induction period therefore not permitted to administer the medicines. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 16 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 & 23 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Residents’ complaints or concerns are listened to and they are protected from abuse. EVIDENCE: The home has a complaints procedure displayed on the wall and this document is available to all residents in their care plans. The procedure is also available in an easy read format. The complaints folder for the home was sampled and it showed that residents had raised concerns this year and that the home takes them seriously. More than one concern is written on the page and the timescales for investigation are not clear. It will be a recommendation at the end of the report that complaints or concerns are to be clearly documented so that there is one complaint or concern per page. No complainant has contacted CSCI with a concern. The inspector noted that the home has the local authority’s multi agency procedures for safeguarding adults and the senior carer advised that the home follows these procedures. The home also has its own policy but this is in line with that of the local authority. All staff have received training and this takes place yearly. The notice board in the office showed the training dates for this year’s safeguarding training, Staff spoken to on the day demonstrated clear knowledge of safeguarding procedures and whistle blowing policies. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 17 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 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The layout of the home enables residents to live in a safe environment. The home is clean, pleasant and hygienic throughout. EVIDENCE: The premises were found to be clean and hygienic. The ground floor has a kitchen, large dining room a lounge and a games room. The communal areas of the home were appropriately furnished and decorated. The AQAA stated that the hallway and kitchen had been painted in the last year. It also states that the residents have asked for new curtains in the house and have chosen the colour. One resident’s bedroom has been fitted with an en-suite toilet and wash hand basin. Consideration should be given to replacing the carpet in this room as there remains an offensive odour and this will be a recommendation at the end of the report. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 18 The bedroom observed on the day of inspection had been personalised to reflect the individual’s personality and interests. Not all residents were at home on the day of the inspection and it was not appropriate to visit these rooms without the individuals consent. The home has a designated laundry room and on the day of inspection this area was clean and tidy. The senior carer stated that the some residents could do their own washing but require assistance from staff. The home had gloves, aprons and appropriate hand washing facilities available. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 19 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 34 & 35 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. A competent and qualified staff team supports the residents and the home’s recruitment procedures protect them. EVIDENCE: The senior carer stated that the home has six permanent care workers and three members of these staff has the National Vocational Qualification (NVQ) level 3 and one has level 4. The senior carer confirmed that all new staff have an induction programme for the home and are then registered on a nationally recognised induction programme and the records confirmed this. Staff spoken to on the day said they had completed their induction and one member of staff said that she was still completing it as she had been recently employed. The completed AQAA stated that staff are rarely sick and there is a stable staff team. On the day of the inspection the manager was not available and all staff recruitment folders were kept securely and not available to be seen. Staff on duty on the day explained how they were recruited and the AQAA also Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 20 confirmed that recruitment checks are carried out prior to them starting work at the home. The senior carer and staff confirmed that regular training takes place and this is available for all staff. Records confirmed that fire awareness, food hygiene, safeguarding adults, manual handling and infection control are some of the courses staff have attended. It was also stated that the manager identifies training needs during one to one supervision sessions. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 21 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 & 42 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Residents benefit from a well run home and can be confident their views are taken into account. The health, safety and welfare of residents are promoted and there are appropriate risk assessments in place. EVIDENCE: The manager was not on duty on the day of the inspection but the staff rota demonstrated that good management arrangements were in place to cover in her absence. The management of Sundial House had not informed CSCI that a new manager had been in post since January 2008. The AQAA states that the current manager has experience in care and holds the level 3 NVQ. She was a former member of staff so there has been no change to the staff team following her appointment. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 22 The manager had completed an AQAA prior to the inspection and this had been hand written. The senior carer confirmed that the home has access to a computer so it is recommended that this document be completed on line, as the handwritten versions are difficult to read. Resident meetings are held every month. Minutes are kept, and were seen on the day of inspection. The responsible individual for the home also completes monthly unannounced visits to the home and these records were also seen. The senior carer also showed the inspector the weekly quality assurance check list that is completed which includes information on any resident that has visited the GP, any resident that has raised a concern, and any incidents that may have taken place. The call points are all tested at this time and any that are not working are immediately reported. The home does not seek the views of service users, their representatives or other stakeholders in the home routinely every year and this will be a recommendation at the end of the report. Documentation available on the day demonstrated that meetings are held and that residents do voice their concerns and these are acted upon. The home had the necessary certificates in place to evidence that health and safety checks had taken place. The fire alarms are tested weekly and are recorded. Fire drills take place every month and those records were also seen. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 23 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 2 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 X 34 3 35 3 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 3 X 3 X X 3 X Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4&5 Requirement The statement of purpose and service user guide to be updated to reflect the current management arrangements in the home, the staffing hours and qualifications. Timescale for action 30/06/08 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 3. Refer to Standard YA6 YA18 YA22 Good Practice Recommendations It is recommended that the home develops a care plan that is user friendly and to file all information that is now historical. It is recommended that personal care needs for each individual to be clear and easy to read. It is recommended that the complaints log for the home is made clearer with one complaint per page with clear timescales stated and the actions taken following the receipt of a complaint. It is recommended that consideration be given to the replacement of the carpet in particular bedroom identified during the inspection. DS0000013806.V361046.R01.S.doc Version 5.2 Page 25 4. YA24 Sundial House 5. 6. YA39 YA39 It is recommended that the home carry out a survey to seek the views of the residents, their representatives and other stakeholders in the home every year. It is recommended that the AQAA be completed on line, as the handwritten versions are difficult to read. Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 26 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 Sundial House DS0000013806.V361046.R01.S.doc Version 5.2 Page 27 - 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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