Inspection on 09/06/05 for 10 Leyton Avenue

This inspection was carried out on 9th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

10 Leyton Avenue 03/10/08

10 Leyton Avenue 09/11/06

10 Leyton Avenue 22/12/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 10 Leyton Avenue 10 Leyton Avenue Gillingham Kent ME7 3DB Lead Inspector Sue McGrath Announced 9 June 2005 09:30 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 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 Stationary 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. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 10 Leyton Avenue Address 10 Leyton Avenue Gillingham Kent ME7 3DB 01622 769100 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) MCCH Society Limited Care Home 3 Category(ies) of Learning Disability (3) registration, with number of places 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 10 Leyton Avenue is one of a number of homes managed by MCCH Society Ltd. The home offers 24-hour care for 3 adults with a learning disability. It is located within a pleasant residential area. There is a local bus route nearby giving access to Gillingham town centre. The home is a semi-detached premise’s with accommodation on two floors. There are three single bedrooms. The first floor can only be accessed by a stairway. It employs one manager (unregistered) care staff and sessional staff. There is one member of staff at night on “sleep-in” and the organisation has an emergency “on-call” system for emergency cover. Catering, domestic chores, gardening and administration is dealt with by the care staff. Service users are encouraged to take part in daily activities to the best of their abilities and access the local community and amenities 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection of 10 Leyton Avenue and took place on 9th June 2005. The home had recently changed providers to MCCH Society Ltd who are in the process of re-registering with the Commission. Many judgements about the quality of life for residents were taken from observations, speaking with staff, reviewing records and from direct discussion with Residents. What the service does well: What has improved since the last inspection? New fridges, freezers and microwave have been purchased as well as fire blankets and a fire extinguisher for the kitchen. Permission has been given for the home to be re-decorated throughout and the residents have been involved with choosing the colour schemes. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 6 Holidays are now being planned. One resident stated that she was looking forward to having candles on her birthday cake the following week and a barbecue was being arranged. These activities had previously been denied due to over zealous risk assessments. 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. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 Prospective residents are currently not provided with the information they need to make an informed choice about moving into the home. Residents’ benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Residents and families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. Contracts stating terms and condition are not currently supplied. EVIDENCE: Due to the recent change of provider the homes does not have a Statement of Purpose or a Service User Guide. Time was spent with the manager discussing the format and contents of any proposed documents. This was not seen as a deliberate attempt not to comply with the regulations, but clearly these documents must be produced and approved as soon as possible. The assessment process was discussed, as the home had not had any new residents for some time. The processed discussed would provide the home with adequate information on which to make a judgement over whether they could meet the prospective residents needs. The process of admission was also discussed with prospective resident being given the opportunity to visit several times and then to stay overnight and to meet with other residents to ensure everyone was comfortable with each other. It was clear that the manager 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 9 thought it was vital that the new resident fitted in well with the existing residents. The residents currently do not have any contracts or statements of terms and condition due to the recent change of provider. The manager was confident these issues would be dealt with very soon. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10 Resident benefit from knowing their assessed and changing needs are reflected in their individual plan and that they are involved with making decisions about their lives where possible. Resident’s benefit from a robust confidentiality policy. EVIDENCE: All three care plans were viewed and were found to be comprehensive and gave clear guidelines in respect of routines, particular lifestyle agreements and details if individual programmes. The home operates a key worker system and regular reviews take place. During the course of the inspection staff were seen to interact well with the residents and were observed encouraging residents to make choices. Where residents were unable to make informed judgements staff were seen to be supportive and caring. Care plans were seen to have current details of specialist requirements and how these were to be met. One resident confirmed that meetings were held regularly and the minutes of these meetings were made available. It was clear that where possible residents views were acted upon. Staff were aware of the gestures and the body language of the residents where verbal communication was difficult. The care plans contained comprehensive risk assessments, which were regularly updated; residents had been given training about personal safety. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 11 The issue of having too many risk assessment and therefore preventing any risks from being taken was discussed with the manager. The level of risk allowed was consistent with every day living and did not prevent residents from enjoying normal everyday activities. Staff spoken to confirmed that they were aware of confidentiality regarding the residents and this was an important part of the induction of new staff. The homes policy on Confidentiality was seen. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 Resident’s benefit from having the opportunity for personal development with their daily living skills and have appropriate level of leisure activities. Residents also benefit from being part of the local community. Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The resident’s benefit from the appetising meals and balanced diet offered by the home. EVIDENCE: Residents were actively encouraged to learn and use practical life skills as part of their daily life. Residents, where possible were encouraged to keep their own personal room tidy and assist in the daily running of the home. One resident enjoys making cups of tea and helping with the cooking. Due to the level of disability none of the residents have employment. Further education was tried but had proved unsuccessful, so the emphasis had been placed on social and appropriate leisure activities. These ranged from line dancing, keep fit, going to shows, eating out, MenCap club, coach trips and going for walks. All of the 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 13 activities were planned in consultation with the residents, taking into account their preferred interests. The manager confirmed that residents could receive visits from families and friends in their own room or in the communal room. There is no private room in which to meet. Discussion with the manager and other staff indicated that the daily routines and house rules promoted independence and choice where possible. The staff confirmed that they encouraged service users to make choices over daily decision such as what to wear, what to eat and what times to rise and what times to go to bed. Staff members were seen to communicate appropriately with residents. All service users had unrestricted access to communal areas. Meals were offered three times a day with a full range of snacks and hot and cold drinks available at all times. Food cupboards were well stocked with a wide range of food and fresh fruit and vegetables. Records were maintained that indicated that a wide range of foods was offered and a choice was given. Assistance to eat would be given as required. It was clear that the residents were fully involved with deciding what the choice of food would be each day. Residents also helped with the shopping and had built up good relationships with local traders. Meal times were flexible to meet the needs of the resident’s individual activities. The residents can have alcohol in the home if there are no medical reasons not to do so, but the residents preferred to go out to local pubs and make it a social event. Good relationships with neighbours had been encouraged and the local residents were very supportive of the home. Holidays are currently being discussed with the residents for the coming year. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20,21 Service users have clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Health needs are met and service users have full access to all professional health care services as required. Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: The resident’s personal support was offered in a very flexible way with independence encouraged at all times. Intimate care was always given in private with residents choosing what to wear each day. Two of the residents go to the hairdressers and the other one has a home visit, as she prefers to remain at home. One resident enjoys regular sessions with an aromatherapist and a physiotherapist. The other two resident choose not to participate. All residents are registered with a local GP and have full access to all other health professionals as required. All residents have an annual health check and their medication is reviewed regularly. Residents are offered routine flu inoculations, smear tests and other yearly blood tests. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 15 All of the residents have their own personal armchairs and specialist beds. None of the resident self medicates and the home takes full responsibility for the safe administration of their medication. The manager has completed a recognised training course on the safe administration of medication and regularly reviews other staff’s ability to safely administer the medication. The medication is administered within the guidelines from the Royal Pharmaceutical Society of Great Britain. The controlled drugs register was viewed and an audit was undertaken. The audit found that the drugs were correct. The home has developed a good relationship with the local pharmacist who will visit if requested. The home has a good policy on dealing with ageing and illness. If terminal care were to be needed then, where possible, the resident would be able to remain in the home with additional support from the local nursing team. The home actively encourages residents and their families to draw up Wills and Last Testaments to ensure their final wished are adhered to. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The home has a robust complaints system and the home’s Adult Protection Policy and procedures protect residents from abuse. EVIDENCE: The home has a new complaints procedure with the new provider and staff are currently digesting all the new procedures. The procedure was seen to be robust and include a whistle blowing policy. The manager was aware of the Protection of Vulnerable Adults register (POVA). The home has adopted Kent and Medway’s procedure on Adult Abuse and all staff are trained in this subject. Discussion with staff confirmed they had a good knowledge of Adult Abuse. There had been no complaints in the past 12 months. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,30 The home needs to be refurbished for the benefit of service users. Service users have access to safe and comfortable indoor and outdoor communal areas. Service users are encouraged to maximise their independence by having access to the range of specialist equipment supplied by the home. Whilst service users’ rooms are homely and comfortable not all service users benefit from living in rooms that meet the requirements for space. The residents do benefit from living in a clean environment EVIDENCE: A tour of the home was undertaken including the resident’s bedrooms, bathrooms facilities and the communal area. The manager stated that she had recently been given permission to decorate throughout the home and was currently discussing with the residents the colour schemes. The extension on the side of the building that held the laundry room, toilet and small office was extremely damp with the entire walls covered in mould. There did not appear to be an adequate damp course in the external walls and it was cold and unpleasant. This needs to be addressed urgently. The laundry room 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 18 floor was not impermeable and the walls were not easily cleanable as required by standard 30.4. The garden was large with a pleasant patio area. Residents were looking forward to holding bar-b–cues this summer. The bathroom needs new flooring and a new bath panel. All sinks and baths have thermostatic mixers valve to prevent scalding. Two of the bedrooms were of a good size but one was very small and was not appropriate for that particular resident. She had requested a desk but the room was not big enough to accommodate one. There was no space for any chairs and the resident had to sit on her bed when enjoying her music. The staff had worked hard to decorate and personalise the rooms as far as possible. One resident likes to lock her own door and had her own key. The communal lounge is in need of redecoration, but staff have this in hand. The carpet in the lounge is frayed and stained in places and consideration should be given to replacing it before it becomes a trip hazard. Again the hallway is in need of re-decoration. It is advised that the area under the stairs that houses all the meters should be boxed in for Health and Safety reasons. The manager stated that new work surfaces had been ordered fro the kitchen and that the broken tiles had been replaced once but had been broken again. Consideration should be given into purchasing a strong splash back that will not keep breaking. Tiles may not be the best answer. New fire extinguishers and a new fire blanket had recently been fitted. A new fridge/freezer and a new microwave had also been purchased. Fridge temperatures had been recorded and the kitchen was very clean and tidy. The home was clean and hygienic on the day of the inspection 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 The residents benefit from being cared for by staff who have a good understanding of their needs, who are trained and competent to do their jobs and who enjoy good morale. EVIDENCE: All staff have clear job descriptions which clearly identify the roles and responsibilities of the staff members. Staff are familiar with and comply with the standards of conduct and practise set out by the General Social Care Council. The home does not have any volunteers. Staff were seen to be very familiar with their roles and responsibilities and were very pro-active in the care of the residents. Senior staff had both completed National Vocational Qualification (NVQ’S) to level 3 and four other staff members had attained level 2. Two other staff members are currently working towards level 2 and one is working toward level 3. Evidence was seen that the staff team was effective and supported the residents assessed needs at all times. Regular staff meetings take place with minutes being recorded. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 20 The manager has recently undertaken training in staff recruitment and is looking forward to being more involved with the recruitment of any new staff. MCCH recruitment procedure was seen and was found to be robust and comprehensive. The homes staff training and development programme was seen and records showed that the staff had attended a wide variety of courses covering every aspect of the care within of the home. Staff confirmed that they received supervision every six weeks and that the manager had been trained in delivering supervision. The manager was supervised by her line manager. Currently the staff do not benefit from yearly appraisal or have any developmental plans but the manager is expecting these to be development with the new organisation. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39 The resident’s benefit from having a manager who is supported well by senior staff in providing clear leadership throughout the home and by staff who demonstrate an awareness of their roles and responsibilities. Residents also benefit from having their views listened to. EVIDENCE: The manager has recently completed her Registered Managers Award and is hoping to apply to the commission to become the Registered Manager. She now holds the necessary qualification and experience to meet the homes stated purpose, and its aims and objectives. Throughout the inspection she demonstrated a sound knowledge of the residents needs and good management skills. The manager was able to communicate a clear sense of direction and leadership, which staff understood and were able to relate to and understand. She was very open and committed to the home. The score given reflects the fact that the home does not have a Registered Manager in place and does not reflect the current Managers capabilities. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 22 Feedback is actively sought from residents via regular home meetings and daily contact. Families are always invited to reviews. Opinions are also sought from care professional who can also attend reviews if relevant. The Manager is currently awaiting confirmation on MCCH plans for quality assurance. 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 3 3 1 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 3 2 2 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 10 Leyton Avenue Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 2 3 3 x x x x H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 24 NA 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 YA1 Regulation 4 Requirement The Registered Person shall compile in relation to the care home a written Staement of Purpose The Registered Person shall supply the with a copy of the agreement specifying the arrangement made for the provision of accommodation. The Registered Person shall having regard to the number and needs of ensure that the premises to be used as a care home are of sound contruction and kept in a good state of repair externally and internally.This requirement is made in respect of the damp extension. The Registered Person shall having regard to the number and needs of ensure that the premises to be used as a care home are of sound contruction and kept in a good state of repair externally and internally.This requirement is made in respect of the work required in the bathrooms and kitchen as highlighted in the report. Timescale for action Action plan by 31st July 2005 Action Plan by 31st July 2005 Action Plan by 31st July 2005 2. YA5 5(3) 3. YA24 23(2)(b) 4. YA27 23(2)(b) Action Plan by 31st July 2005 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 25 5. YA37 8and9 The Registered Provider shall appoint an individual to manage the home. Action plan by 31st July 2005 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. Refer to Standard 25 Good Practice Recommendations It is recommended that the small bedroom is used for a private lounge for visitors, as it is not fit for purpose for that particular resident and does not met her needs 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection The Oast Hermitage Court Hermitge Lane Maidstone Kent. ME16 9NT National Enquiry Line: 0845 015 0120 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 10 Leyton Avenue H56-H06 S64392 10 Leyton Avenue V225320 090605 Stage 4.doc Version 1.30 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. 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