Inspection on 17/07/07 for 2 3 and 4 Nightingale Close

This inspection was carried out on 17th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 3 and 4 Nightingale Close 20/07/06

2 3 and 4 Nightingale Close 07/03/06

2 3 and 4 Nightingale Close 15/02/05

2 3 and 4 Nightingale Close 14/07/04

2 3 and 4 Nightingale Close 22/01/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 2 to 3 Nightingale Close Witham Essex CM8 1AP Lead Inspector Pauline Marshall Unannounced Inspection 17th July 2007 09:35 2 to 3 Nightingale Close DS0000017733.V344825.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 2 to 3 Nightingale Close DS0000017733.V344825.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. 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 to 3 Nightingale Close Address Witham Essex CM8 1AP 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) 01376 511057 01376 503705 East Living Limited Ms Isobel Norton Care Home 12 Category(ies) of Learning disability (12) registration, with number of places 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 12 persons) 20/07/06 Date of last inspection Brief Description of the Service: On 8th August 2006 2, Nightingale Close was merged with 3, Nightingale Close and is now managed by Isobel Norton with support from the manager of number 4 Nightingale Close. Numbers 2 and 3 Nightingale Close are purpose-built bungalows, which are registered to provide care to people with learning disabilities. Both premises are well equipped with appropriate fittings and fixtures to meet the needs of the residents living in them. The homes are situated in a cul-de-sac with one other home offering similar facilities next door. Both bungalows have well-maintained gardens and patio areas and are close to the local facilities of Witham town centre. All prospective residents are provided with a Statement of Purpose and Service User Guide that supplies them with up to date information on the home. Fees range from £1,391.00 to £1,539 and there are additional charges for hairdressing, toiletries, clothing, newspapers and magazines, and any personal activities undertaken including holidays, the home provides a small sum each year to assist residents with their annual holidays. 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that lasted for five hours and fiftyfive minutes. The process included a tour of both bungalows, discussions with the manager, the staff and residents and examination of a random sample of staff and residents files. As part of this inspection surveys were sent to six residents, six relatives’ six health and social care professionals and ten care workers to obtain their views on the service the home provides. At the time of writing this report three resident’s surveys, two relatives surveys, three health care professional survey and four care workers surveys were returned and most were positive in their responses. Comments included “the home offers residents consistent, loving support, reliability, security and fun” and “the home creates a homely environment where residents are well looked after”. The negative comments were that “bungalow number 2 has a general lack of organisation, e.g. messages not passed on”. “Having two managers sometimes causes confusion as they have different ways of doing things”. Twenty-six of the forty-three standards were inspected. What the service does well: The homes support plans are very detailed and are written jointly with residents and describe the help that residents want and need. Risk Assessments have been carried out for all areas of identified risk and there are clear plans on how to reduce any risks. The home offers its residents a large range of educational and occupational opportunities and staff support residents with accessing the local and wider community. Daily routines are built around the residents and mealtimes are a pleasant experience. The home has health action plans and hospital cards in pictorial format and encourages residents to be as independent as possible including selfmedicating with support. 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 6 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. 2 to 3 Nightingale Close DS0000017733.V344825.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 2 to 3 Nightingale Close DS0000017733.V344825.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with the information that they need to make an informed choice and will have their needs fully assessed. EVIDENCE: The homes Statement of Purpose and Service User Guide were last reviewed in February 2007 and are available in a pictorial format; they provide comprehensive information on the service that the home provides and copies will be included in the residents’ information pack that the home will distribute to any future prospective residents. There have been no admissions since 2003 and two of the three care files examined were for the last two residents admitted. None of the care files contained the homes own pre-admission assessment and the manager explained that until now the social workers assessment had been used to inform the residents care plans. All future admissions will include a thorough pre-admission assessment carried out by the home manager using the homes comprehensive and user-friendly pre-admission assessment check form. 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents assessed and changing needs are documented in the care plans. Residents make decisions about their daily lives. Residents are supported to take risks. EVIDENCE: Three care files were examined and each contained thorough details of the level of support required by each individual. Each of the care plans includes a profile entitled “my story” and this explains the level of support required from the residents point of view and is worked on by the resident and their key workers and is reviewed on a regular basis and amended to reflect any changing needs. Residents meetings and residents spoken with confirmed that they are very much involved in the running of the home and that they make decisions on 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 10 everyday issues such as food and activities. Residents are also involved in deciding on the décor of the home and have recently been involved in choosing new items of furniture. Staff interaction with residents was observed and staff showed a good understanding of each resident’s different communication skills. Residents surveyed said that they “liked being at the home” and relatives surveyed said that their relation “always seemed happy and that they were happy with the care provided”. Each of the care plans examined contained clear risk assessments covering many areas of identified risks; each of the risk assessments included a comprehensive management plan. The management plans were clear concise and gave staff good instructions on minimising any risks. 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents participate in appropriate activities both in the home and outside in the local and the wider community. Residents have appropriate relationships and their rights and responsibilities are recognised and they enjoy a healthy diet of their choice in nice surroundings. EVIDENCE: Residents are very much involved in their person centred plans and they work together with their key workers to compile the information. Residents spoken with said that they enjoyed putting together the pictures and symbols that help to make up the plans. The home uses picture boards to assist residents in recognising regular activities and residents were eager to share details of their outings saying that they had really enjoyed their trips and holidays. 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 12 One resident works in a local garden centre shop and they talked about how nice it was to sell plants and flowers and garden ornaments; they also said that they looked forward to meeting people in this part time work and how they had made many friends from this. Other residents attend local adult education colleges in term time and undertake a range of courses including social dancing, art classes, relaxation and cookery. Out of term time residents participate in various trips using the homes transport and have recently visited Southend, Walton-on-Naze and more local places like Brocking, where residents are able to have a lunch that is prepared and served by local learning-disabled people. Other residents attend the Leywood Suite in Braintree, which is a small day centre where residents are able to participate in a range of activities. Leywood arranges monthly disco nights and sometimes provides live entertainment in place of the disco; residents spoken with said how they enjoyed going to the discos at Leywood and that they also went to quiz nights, barbeques, bingo and craft nights at The Witham Meeting Place. The care plans examined contained details of each resident’s family and friends and included birthdays and other special dates. The home encourages regular contact with family and friends and one resident spoken with shared their positive experiences of their regular visits to Germany to spend time with their family. Residents spoken with said that they felt well treated and respected and it was evident from observing staff interaction that staff treated residents respectfully. The care plans identified the residents’ rights and responsibilities and residents spoken with had a clear understanding of their responsibilities within the home. Residents spoken with talked of the way they participated in choosing the weekly menu and that they generally made their decisions on what food they wanted on a Sunday. It was evident from the menus and nutrition records that residents were able to make their choices on a daily basis from a good range of nutritious foods. There was plenty of fresh fruit and vegetables available and the food stock was good. Health and Social Care Professionals surveyed said, “the homes staff are interested in nutrition and promote healthy eating”. 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents receive their support in a way that they prefer and their physical and emotional health care needs are fully met. The homes policy and procedure on medication protects residents and encourages them to administer their own medication whenever possible. EVIDENCE: Residents spoken with said how they decided when to go to bed and when to get up and that staff helped them with their support needs in the way that they wanted. Staff was observed communicating well with residents throughout the inspection and they offered assistance only when required and in a caring manner. Residents spoken with confirmed that staff was very helpful when needed and that they felt able to talk with them, particularly with their key workers. 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 14 The home has a Health Action Plan in place for all residents and has pictorial hospital cards for use when a resident attends hospital; the cards include symbols and pictures to help with communication difficulties in the hospital environment. All health appointments were recorded and included the details of any follow up actions that were required. The home has clear policies and procedures for the administration of medication and staff encourage self-administration wherever possible. One resident administers their own medication in the presence of staff that signs the administration record to confirm that the medication has been taken. The medication records examined were fully completed and a check of the prescribed medication was carried out and was in order. 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home takes complaints seriously and acts upon them swiftly; residents and their relatives are confident that complaints will be dealt with effectively. Residents are protected from abuse. EVIDENCE: The home has a good complaints procedure and residents spoken with were aware of how to complain if they wish to. The complaints records showed that all complaints are treated seriously and that action is taken to try to prevent any reoccurrence. Three residents cash records were examined and the cash balances agreed with the balances on the record sheets. The cash sheets examined for residents in house number two had regular entries of £7. 08 for Sky television, the staff member said that all residents paid an equal amount and that Sky television was purchased as one of the residents really enjoyed TV and that this could be watched in their bedrooms. One of the residents contributing to this is registered blind and does not have a TV in her bedroom. There was no evidence of this being an agreed purchase by all of the residents of number two. There was entries on each of the residents cash sheets for the purchase of cat food; the amounts varied and staff said this depended on who bought 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 16 the food and that the make and cost varied. There was no evidence of this being an agreed purchase by all of the residents of number two. A discussion took place with the manager with regard to the need to have written agreement to sharing expenses for items that are purchased for the house and the relevance of these items. The manager said that the cat food should be paid for by the home and that this would be remedied immediately and that residents should not have been paying for cat food. The home has a good Protection of Vulnerable Adults procedure and staff spoken with was fully aware of the policy and the need to refer any suspected abuse to the Local Authority in the first instance. All staff has received training and has been given their own copy of the guidelines for staff working with vulnerable adults in Essex. 2 to 3 Nightingale Close DS0000017733.V344825.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, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable, clean environment and are provided with any aids and adaptations they require to improve their quality of life. EVIDENCE: Both number two and number three Nightingale Close have been redecorated throughout; new furniture has been purchased for number two. New carpet has been laid in the hallway and office and the newly decorated bedrooms have been refurbished and individual residents have purchased many new small items of a personal nature. Residents spoken with talked of their shopping trips and said how much they enjoyed looking for items to brighten up their rooms. The garden furniture has recently been refurbished and the garden patio areas were in the process of being cleaned during the inspection. The tumble dryer has been replaced with a new one in number three. Number 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 18 two has a gazebo in the garden opposite the office door; this is currently used as a staff smoking area. One resident has recently been assessed as needing an overhead hoist to improve their quality of life and is awaiting confirmation that this will be fully funded by the Local Authority. The home was clean, tidy and hygienic and staff was working together with residents to maintain this. 2 to 3 Nightingale Close DS0000017733.V344825.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are competent, well trained and qualified and an effective staff team supports residents. Recruitment practices need to be more robust. Staff are well supported and supervised. EVIDENCE: There is three staff on duty in each of the houses throughout the daytime hours and the managers’ hours are in addition to this. There is a stable staff team that has worked at the home for many years and some of the staff worked at the hospitals with the residents prior to their admission to 2/3 Nightingale Close. The home employs a total of twenty-one permanent Care staff and six bank care staff (that work as and when required); twentyone of the care staff is NVQ qualified. As many of the staff was transferred over to East Living Limited from the NHS the information held on them was at that time limited. East Living has since 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 20 obtained most of the documents required under Schedule 2 of the regulations. The Human Resources department at East Living Limited carries out all the required checks on new appointments and the most recently employed staff member had evidence of this on the staff file. There was no copy of the application form and the manager said that it was completed on line and that the CV on the staff file was provided as evidence of employment history. The CV covered the last eight years so did not provide a full history that could be checked. Old CRB checks were seen by the previous inspector and then destroyed as required in the CRB guidance. None of the staff files examined contained evidence that staff were physically and mentally fit to do the work that is required of them. A discussion took place around the importance of identifying and exploring gaps in employment and the need to obtain written confirmation that workers are physically and mentally fit to work at the home. There was evidence on each of the staff files examined of regular training and updates taking place and some staff had recently completed a training course on Aspergers syndrome. The manager said that this training will form part of an in house training programme for all new staff and the whole team will share the information and knowledge gained on the training course. The home provides all staff with regular support and supervision. Staff surveys said “staff and service users are happy and relaxed and staff do all that they can to make service users happy”. 2 to 3 Nightingale Close DS0000017733.V344825.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a well run home and their views underpin the development of the home. The health, safety and welfare of residents are promoted and protected. EVIDENCE: The registered manager has worked at the home since 1993 and has an NVQ4 qualification in Care and has achieved the Registered Managers Award; she is also an NVQ assessor. The manager regularly updates her knowledge and skills and has recently undertaken training in infection control and the Mental Capacity Act 2005. The manager is very experienced and now has greater responsibility due to the merger of number two and three Nightingale Close 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 22 that took place last year. The manager of number four Nightingale Close, who helps with supporting and supervising the staff team, provides assistance in this role. The registered manager said that East Living has recently employed a new service manager and that he will be very much involved in working together with the registered manager and supporting her in this extended role. Health and social care professional’s surveys stated “house number 2 has a general lack of organisation, e.g. not passing messages on”. Staff surveyed said “ there are 2 managers and they both have different ways of doing things and it can get confusing”. The homes quality assurance system has been developed since the last inspection and surveys have been distributed to relevant people to obtain their views on the quality of care that the home provides. The manager expects the whole process to be completed and a report written by October 2007. Surveys are user friendly and the system includes full details of how reviews will be carried out. All safety certificates were up to date and in place and regular fire drills have taken place. Water regulators are fitted at all outlets and checks are carried out in the kitchen and bathroom only and not on any of the other outlets. 2 to 3 Nightingale Close DS0000017733.V344825.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 3 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 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 4 X 3 X 3 X X 3 X 2 to 3 Nightingale Close DS0000017733.V344825.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 YA34 Regulation 19 (1) (b) (i) Schedule 2 Requirement The registered person shall not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in Schedule 2. This refers to evidence of fitness, identifying and exploring gaps in employment. Timescale for action 28/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 2 to 3 Nightingale Close DS0000017733.V344825.R01.S.doc Version 5.2 Page 26 - 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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