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Inspection on 16/12/08 for Haddon (32a)

Also see our care home review for Haddon (32a) for more information

This is the latest available inspection report for this service, carried out on 16th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Haddon (32a) 32a Haddon Great Holm Milton Keynes Bucks MK8 9HP two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Barbara Mulligan Date: 1 6 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Haddon (32a) 32a Haddon Great Holm Milton Keynes Bucks MK8 9HP 01908262814 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Macintyre Care Name of registered manager (if applicable) Mrs Claire Helen Dove Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 14 0 care home 14 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD The maximum number of service users who can be accommodated is: 14 Date of last inspection 0 3 0 1 2 0 0 8 A bit about the care home. Set on the edge of Great Holm, no.32a Haddon, owned by MacIntyre Care, is located within a campus style complex, in amongst private housing. It provides accommodation to adults with learning disabilities. 32a Haddon is situated within walking distance of the local shops, church and local pubs. The building itself contains five self contained flats and a small garden area. There is a further complex of buildings that comprise of no. 42a and no. 52a Haddon, the organisations day care services, a hall, a nursery and garden centre, a craft shop, a coffee shop and a bakery. The coffee shop and bakery occupy the corner of the site and this provides occupational opportunities for service users and enables local residents to visit the shop. The nursery, garden centre and craft shop also provide occupational activities for service users and are open to the public. The centre of Milton Keynes is close by offering a large shopping centre, cinema, a range of restaurants and recreational activities, cycle tracks and many other attractions. Service users are encouraged and supported to use public transport to which they have access. Fees range from £18000 to £39000 per year. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home. This unannounced key inspection was conducted on the 16th December 2009 and covered the key National Minimum Standards for younger adults. A second visit was arranged on the 30th December to examine staff recruitment files which were not available during the first visit. Prior to the visit, a detailed selfassessment questionnaire was sent to the manager for completion. Surveys were distributed to visiting professionals, service users and staff prior to the inspection. Feedback received from people who use the service indicates that people are happy with the care provided and staff listen to their needs. The inspection consisted of examination of some of the units required records, observation of practice, discussions with the deputy manager and staff on duty and a tour of the premises. Feedback on the inspection findings and areas needing improvement was given to the carer who assisted during the inspection. All requirements from the last inspection have been complied with and this inspection has resulted in one requirement. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. The manager, staff and service users are thanked for their co-operation and hospitality during this unannounced visit. What the care home does well The home is a nice and comfortable place to live. People who want to live at 32A Haddon will have their needs assessed before they move in, to make sure the staff can meet the needs of the people who live there. People who use the service are supported to pursue their leisure interests and given opportunities to use community resources. Staff support people who use the service to keep in contact with their family and friends. The home provides good healthy meals for all the people The home is a nice and comfortable place to live. There are safe recruitment practices are in place that protect the people living in the home. Staff working in the home have received up to date training. The home deals with a number of diverse care needs and always makes sure the different needs of people living in the home are met. What has got better from the last inspection Records about people’s health are up to date and recorded in care plans. Care plans have been revised and are detailed and user friendly. Accurate records of medicines given to people using the service are kept. Detailed recruitment records are kept in the unit of all staff employed by the organisation. What the care home could do better This inspection at the home has shown 1 things need to be done to make it okay. All complaints must be fully recorded, including the date, the action taken, the outcome and the person dealing with the complaint. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Barbara Mulligan Burgner Ho, 4630 Kingsgate,Cascade Way Oxford Business Park Cowley Oxford OX4 2SU 018 6539 7750 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has an admission procedure in place, which ensures that the home is able to meet individuals assessed needs. Evidence: There have not been any new admissions to the service in the past twelve months, according to information supplied prior to the inspection. At the last inspection, documents relating to the most recently admitted service user were examined and found to be in good order with a detailed and comprehensive needs assessment which indicated that the service user had been involved in the process. People using the service who were supported to complete the CSCI surveys indicated that they had been asked if they wanted to move into the home and had received enough information about it beforehand. The home does not take emergency admissions and is not registered to provide intermediate care. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Effective and detailed care plans are in place which adequately document service users needs and how these are to be met, within a risk assessment framework. Evidence: At the previous inspection it was identified that care plans contained a lot of duplicated information, the files were heavy and bulky and not user friendly. The care of three people using the service was case tracked and their care plans were examined. Service user files have been updated and completed using a more user friendly format. Each file contains a photograph of the person, for easy identification, and a detailed care plan and accompanying risk assessments. They contain essential information about the person, an all about me pen picture, details of people who support the person, intimate care guidelines including preferred gender of staff to give assistance, and an outline of the persons daily routines. New additions added to the care plans since the last inspection include details of support needs in relation to eating and drinking, cooking, personal space, domestic tasks and decision making and choices. These outline how people using the service make decisions in these areas and are divided into decisions the person can make for themselves, those they need some support with and those they need full support with. Each file contains a vulnerability action plan, the persons likes and dislikes, how the person communicates, their learning activities, support in managing finances and cultural and faith needs. The individuals physical and mental health needs have been documented and include information about any other people involved in their care, such as a dietician. The individuals physical and emotional care needs have been recorded as have behaviours causing concern, with information on how to support people in these areas. All Evidence: information has been dated and shows evidence of regular review. Overall the service user files are nicely presented and user friendly. Flat meetings are held between people who use the service and staff, to share and discuss any issues and pass on news. Minutes are kept of these and demonstrate that issues raised are managed appropriately. In service user files there are minutes of link worker meetings which are held with people using the service, on a monthly basis. These show that agreed actions are taking place to meet care needs. Additionally, a fortnightly peoples forum takes place, facilitated by an independent person which is open to all people who us the MacIntyre services at the Great Holm site. People who use the service were seen to make decisions during the inspection, such as what to make for lunch, where to go shopping and what to buy at the shop. Money is well managed for people who live at Great Holm. There are individual wallets kept secure and transaction sheets to record expenditure. Receipts are in place to verify purchases. Reports of the providers monthly monitoring visits show that service users money is checked routinely as part of that visit, which is a good practice. Risk assessments were observed to be in place and these are signed and dated. All of these show that they are reviewed and updated regularly. Examples of risk assessments seen include managing personal money, an individual fire risk assessment, personal care, using public transport, working in the kitchen and refusal to be weighed. Missing person procedures are in place in the event of anyone being absent from the home without notice and for staff to refer to, if need be. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users are supported to have a varied, active and independent lifestyle which reflects their interests, provides them with nourishing meals and allows them to have contact with family, friends and the community. Evidence: There is good regard for the diverse needs of the people living at the home and their requirements related to their disabilities, lifestyle choices and personal preferences. On the day of the visit service users were attending day services, visiting family or Christmas shopping. The new care plan format provides details of what individuals do during the week, social likes and dislikes and information about how they access the community. Family and social contacts were seen recorded in all files. People completing the CSCI survey forms said that staff help them keep in touch with family and friends. In service user files there is evidence of the activities undertaken by people using the service. Most of these are based locally at Great Holm, where there is a coffee shop, a craft shop and a nursery. On site there are opportunities for individuals to take part in craft, drama and computer classes. There are also opportunities for those that wish, to develop office skills and undertake a National Vocational Qualification working at the providers central headquarters. Some people who use the service go to college to learn social skills and life skills. This may include literacy skills, money management, sex education, advocacy, fire training Evidence: and relationship discussions. Service users were seen to have keys to their doors and had freedom to be alone in their rooms or in the communal areas. Each flat that was seen has its own menu drawn up by people who use the service. It was noted that special diets and individual preferences are included in the menus. Files demonstrate that most individuals are weighed regularly. However several people using the service dont wish to be weighed monthly and risk assessments are in place for these people. One service user said on the completed survey form, I like the food we have in our flat. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. Evidence: Care plan files provide detailed information about the type of support and assistance people using the service need. In each file there is an intimate care policy that details how personal care is to be delivered to each person in a way they prefer. During the previous inspection it was identified that information about the healthcare needs of people using the service was not up to date and many files did not reflect the service users present situation. A requirement was issued for the changing health care needs of people using the service to be recorded in their care plans. The three service user files examined as part of the case tracking contain a personal health profile which was completed for each person. The medication needs are also noted in their care plans. There are good records maintained of healthcare screening, appointments attended by people using the service and the outcome. Examples seen include visits to the dentist, the optician, evidence of cervical screening, podiatry, well woman appointments and appointments attended at the hospital. There are risk assessments in place regarding weight and fitness and for people who self administer their own medicines. One person using the service was choosing to self-administer their own medication, with support from care staff. There is a risk assessment in place for this which is up to date and signed. Since April 2007 the home has been using a Monitored Dosage System (MDS). At the previous inspection it was identified that numerous omissions, Evidence: mainly for creams and lotions were evident on Medication Administer Records (MAR) and a requirement was issued for improvement in this area. During this inspection the MAR charts were examined and it is pleasing to note that there were no omissions noted. Staff training has been via the supplying pharmacist and training records demonstrate this. Care staff are now expected to complete medication training via E Learning which is completed on the units computer. The inspector was told by staff that this is not very practicable as staff were working in a cramped office with poor natural light and little ventilation. It was difficult to concentrate as the phone is always ringing and the computer was needed for the everyday running of the unit. This needs to be addressed by the organisation. Training records demonstrate that all staff have received training about the administration of medicines. The organisation has recently introduced medication workbooks which care staff are expected to complete. At the previous inspection it was noted that numerous hand-written entries on medication records were not signed or dated. These must be signed by two staff and dated and this was strongly recommended. It is pleasing to see that handwritten entries are now signed and dated by two staff. There is a medication policy dated January 2007. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Procedures for managing complaints and adult protection are in place ensuring people who use the service are listened to, kept safe and protect service users from abuse. However the unit must ensure that all complaints received are fully recorded. Evidence: Most people completing the CSCI surveys are aware of how to make a complaint about the service. Those who had needed to raise issues added that the service had responded appropriately. The organisation are presently revising and updating the complaints procedure. There are posters in each flat for people using the service that guides them on how to make a complaint. There were no complaints noted in the pre-inspection self-assessment, however there was one complaint recorded in the complaints log kept at the service. This is not dated and the deputy manager thought this may be a recent complaint. There was no information about who dealt with this complaint. The unit must ensure that all complaints are dated, the action and outcome recorded and the complaint must detail who managed the complaint. A requirement is issued for improvement in this area. No complaints have been received by the Commission in respect of this service. The Annual Quality Assurance document indicates that there has been two Safeguarding of Vulnerable Adults referrals in the last twelve months. These have been responded to and dealt with appropriately. There are adult protection procedures in place. However these refer to out of date legislation and referred staff to the registering authority. Updating is needed to amend the legislative background, if the policy is to mention this. The unit has a copy of the local authority Safeguarding procedure. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The standard of the flats are good, providing service users with an attractive and homely place to live. Evidence: The service consists of five flats, numbered 24 to 32 Haddon in Great Holm. There are five flats that are divided into one, two, three and four bedroom flats. The staff office is separate to the flats although very close by. From Great Holm, service users have good access to the facilities within Milton Keynes city centre and there are good transport links. All of the five flats were toured as part of this visit and people who live in the flats were asked permission by staff for entry. Many people who use the service were out at work on the day of the inspection. New kitchens have been fitted in all the flats two assisted baths have been installed in two flats. Lounges in all flats are homely in appearance and looked bright and comfortable. In one lounge the people who live there have chosen to have a snooker table. The flats are generally clean with no odours. Laundry facilities are sited so that soiled articles, clothing and infected linen are not carried through areas where food is stored, prepared, cooked or eaten and do not intrude on service users. The home has an infection control policy and the inspector observed this. Training records demonstrate that all staff have attended Infection Control training in the last twelve months. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Recruitment procedures are undertaken and staff training is provided to ensure staff have the right skills and competencies to support the people who live there. Evidence: The staff on duty were confident in their roles and showed a good understanding of service users needs. Progress is being made with NVQ training. At the time of the visit the Annual Quality Assurance Assessment document indicates that there are four staff who have completed NVQ training, level 2 or above. The home has a small group of staff providing support and care to service users. The Annual Quality Assurance Assessment document shows that two staff have left in the twelve months prior to the inspection. The rotas demonstrate that adequate staff are on duty to meet the needs of the people using the service and the unit was not needing to use any agency staff to help cover the rota. It is noted that the organisation has a formal agreement with the Commission for it to hold centrally some specific staff recruitment documentation and maintain a signed checklist within the home. However this was not available to the inspector on the day of the visit and a second visit was undertaken on the 30th December 2008 to look at staff recruitment documents kept in the unit. At the previous inspection it was identified that one file for the most recent staff member did not contain evidence of a POVA or Criminal Records Bureau Check (CRB), no application form, references, photo or evidence of identification. The registered manager was waiting for those documents to arrive from the central office and a requirement was issued for recruitment records to be maintained at the home and available for inspection purposes. Five staff files were examined during this second visit, including those new to the service. These show that all necessary clearances have been undertaken and completed. There is an induction programme in place to ensure that new staff members are Evidence: familiarised with the organisation and their roles and responsibilities. This provides the staff member with a personal development portfolio. The induction includes fire safety, moving and handling techniques and core skills training. Training records reflect that staff have received mandatory training and records seen by the inspector show that this is up to date for all staff. There is specialist training available for staff, an example of this is Epilepsy training, mental capacity act training, bereavement training and personal relationships and sexuality training. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has a registered manager ensuring continuity of care, and there are systems within the home that are used to ensure that health, safety and welfare of the people who use the service are protected and promoted. Evidence: The service has a registered manager who has been in post since 1993. She has attained National Vocational Qualification level 4; her post comes with a job description outlining duties and responsibilities. Examples of further training in the past twelve months include, the mental capacity act, safeguarding vulnerable adults, effective appraisals, managing people through effective communication and dealing with performance problems in your team. The registered manager reports to an external line manager who carries out her supervision monthly and undertakes monitoring visits on behalf of the provider. These follow a detailed format and show that speaking with staff and service users is a regular feature of the visits, plus good practices such as examining a sample of service users money and staff training records. The organisation carries out an annual audit referred to as the Big Respect Audit. There is a forum that is held twice a week and is facilitated by an independent person. This is open to all people who us the MacIntyre services at the Great Holm site. Flat meetings and link worker meetings take place on a regular basis and minutes are kept of these which were observed at the inspection. A range of health and safety checks are in place at the service and carried out on a daily, weekly or monthly basis. The fire risk assessment was looked at and this is fully completed and dated 09/07/08. Training records show that all care staff have received up to date fire training. The last Evidence: visit by the fire authority was on the 16/01/07. Weekly fire checks are carried out and recorded. Fire drills involving people who use the service are undertaken regularly and recorded. There is written evidence of water and fridge and freezer temperatures. PAT testing was last carried out in September 2008 and gas appliances were serviced in January 2008. There is an Electrical Installation certificate dated 28/11/08. Are there any outstanding requirements from the last inspection? Yes No x Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 22 22 The registered person must ensure that all complaints are fully recorded, including the date, the action taken, the outcome and the person dealing with the complaint. 28/02/2009 To ensure an accurate record of all complaints is maintained. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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