Inspection on 22/05/08 for Washington Grange

This inspection was carried out on 22nd May 2008.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Washington Grange 30/05/07

Washington Grange 20/06/06

Washington Grange 27/09/05

Washington Grange 05/05/05

Washington Grange 21/12/04

Washington Grange 17/06/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Washington Grange Burnhope Road Barmston Washington NE38 8HZ Lead Inspector Mrs Eileen Hulse Unannounced Inspection 22nd May 2008 09:00a X10015.doc Version 1.40 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 Washington Grange DS0000054917.V364114.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 Older People. 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. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Washington Grange Address Burnhope Road Barmston Washington NE38 8HZ 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) 0191 419 1955 0191 417 0100 washingtongrange@barchester.com Barchester Healthcare Paula Joicey Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Old age, registration, with number not falling within any other category (40) of places Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 40 Dementia, over 65 years of age - Code DE(E), maximum number of places: 40 The maximum number of service users who can be accommodated is: 40 30th May 2007 2. Date of last inspection Brief Description of the Service: Washington Grange owned by Barchester Healthcare Limited is a purpose-built care home situated on the edge of the Barmston housing estate in Washington. The home is close to a local health centre, pharmacy and a social club. A short walk to the nearest bus stop provides access to the Galleries shopping centre and all its amenities, Sunderland City centre and to other parts of the surrounding areas. The home is a two-storey building offering single bedrooms with en-suite facilities that are easily reached by a passenger lift and stairways. There are 19 bedrooms for older people on the ground floor and 21 bedrooms for older people with dementia care needs on the first floor. There is a range of bathrooms and showers, WCs, lounges and dining rooms on both floors. All parts of the building are easily reached. The home cannot provide nursing care. The weekly fees are £402:00 to £507:00 per week depending upon care needs. Additional charges are made for personal items, hairdressing, and toiletries. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use this service experience adequate quality outcomes. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 30th May 2007 • How the service dealt with any complaints & concerns since the last visit • Any changes to how the home is run • The provider’s view of how well they care for people • The views of people who use the service, their relatives and staff. The Visit: An un-announced visit was made on 22nd May 2008. During the visit we: • Observed staff practice and talked with people who use the service, relatives, staff and the deputy manager • looked at information about the people who use the service & how well their needs are met • looked at other records which must be kept • checked that staff had the knowledge, skills & training to meet the needs of the people they care for • looked around the parts of the building to make sure it was clean, safe & comfortable • checked if any improvements had recently been made. We told the deputy manager what we found. What the service does well: The home makes sure that all prospective service users and their families have the information they need and that the home completes assessments so that they know they can meet the needs before a service user moves into the home. Good healthcare arrangements are available with district nurses and other healthcare specialists visiting the home when requested. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 6 The quality of food is good and service users likes and dislikes are taken into account and they can choose from a number of options on the menu what they would like to eat. The staff team are caring and committed and offer all service users the help and support they need in a dignified and respectful manner. All staff receive good training and this helps people to know they will be well looked after regardless of their various and complex needs. The home is clean and generally well looked after and provides a comfortable and homely place for service users to live in. Service users and their families have made many positive comments about the home and the service they receive. What has improved since the last inspection? What they could do better: The care plans need to include monitoring and evaluation to make sure the care needs for people have not changed and the content needs to have up to date information included to make sure staff understand how to carry out tasks so that all the care needs are met. Medication must be given to people safely and therefore staff must follow guidelines set by the home’s policies. The activity records and complaints records should be completed with the necessary information. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 7 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. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre admission assessments from both the care managers and the home are included within the care plans for all service users. These help to form the basis of their care plan and all service users are given the information they need to make an informed choice about moving into the home. The home does not provide intermediate care. EVIDENCE: All prospective service users have an individual assessment before moving into the home completed by the home manager. This helps the home to know if they can meet the needs of the prospective service user. Prior to the admission, the home manager will ensure the home receives a personalised care plan from the care manager, which helps to form the basis of the persons care. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 10 Referrals are made to the home from care managers and families and when a referral is made, this is followed by the home manager visiting the person to carry out an assessment of need either in hospital or in their own home. Following the completed assessment, a place is offered to the person and a date for admission is arranged that is suitable to both the service user and the home. Prospective service users are invited to visit the home to have a look around and some people decide to spend some time there to meet other service users and to decide if they would like to live there. After six weeks, a review meeting is then held between representatives of the home, service user, family and care manager to discuss if the service user wants to live in the home permanently and to make sure the home can meet all of the needs. There is plenty of information about the service that is made available to everyone. Leaflets are located in the entrance that includes all the information that service users and their families will need. Both service users and families spoken with felt they had good information prior to moving into the home. One service user stated, ‘I came and had a look around before coming in to stay’ and relatives felt they were given good information before making any long term decisions. A relative stated their ‘relative has been in other homes but this home was by far the best’ and they were given ‘all the information they needed’. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All service users have a plan of care but they do not include information that staff can follow to ensure the care needs of people are met. Service users have access to all healthcare facilities that promote health and wellbeing but medication procedures are not always followed by staff and therefore medication is not always given safely. EVIDENCE: The care plans are organised and laid out into various sections with a section index and this helps to access information quickly. In depth admission assessment details include medical history, social preferences and healthcare needs and the information helps staff to get to know the person. This information is used to form the basis of the care plan and reviews are held regularly to update the person’s care needs. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 12 However, not all of the information is consistent, one care plan stated that (name) is able to go from a sitting position to a standing position with staff assistance but further into the plan of care it stated that (name) cannot stand on her own. Staff were observed to use moving and handling equipment on this person to move them out of the chair but this was not noted within the care plan. Another care plan detailed that a person was able to walk with a walking aid but the progress notes stated that mobility was poor and the person was now using a wheelchair to mobilize but the care plan had not been updated to inform staff what the current needs of the person were. Although the care plans are evaluated, the information is very limited and in the care plans looked at they repeatedly stated ‘no change’, they are not monitored on a regular basis to ensure the care needs remain unchanged and therefore, staff cannot be sure that the care needs recorded are still in place or that any changes have been made to the original plan of care. Dates and service users or their representative’s signatures are not evident throughout the care plan and therefore it does not confirm that service users are made aware of the content of their care plan. Risk assessments are linked to the individual plans of care but again information is limited and out of date. The healthcare arrangements are accessible to all service users regardless of their needs. All service users have their choice of GP following admission into the home and other healthcare professionals are brought into the home when they are required and this includes specialist consultants, district nurses, chiropodists, dieticians and dentists. A member of staff escorts service users who attend hospital appointments. The home has a detailed policy and procedure on the administration of medication and all of the senior staff has completed medication training. Medication administration records for individual service users were completed and signed but some records had been altered and changed by staff and therefore staff do not always follow the home’s medication procedure. A medication audit confirmed the records and medication were correct. Service users made the following comments regarding their healthcare needs: ‘The staff make sure I get my tablets when I need them’ ‘If I need the doctor staff don’t hesitate to call him in to see me’ Observation showed the staff are very caring and service users are treat with respect at all times and called by their preferred name. Staff were also Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 13 observed knocking on bedroom doors before entering, respecting the privacy of service users. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily routines are flexible and a range of activities are available and families and friends can visit anytime and this enables service users to make choices on how they prefer to spend their days. However, there are only limited records to reflect that social activities have taken place. Service users are offered and receive varied and nutritious meals that contribute to their general health and wellbeing. EVIDENCE: Care staff are currently providing social activities in the absence of the activity co-ordinator who is not available through sickness. Some planned activities were displayed on the wall to inform service users what events had been planned but there were limited records to reflect that social activities were in place. Each service user has an activities sheet within the care plan but these records consist of pre populated boxes that only require a tick and they do not describe Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 15 what the activity is, if a service user has refused to participate or what the outcome was for the service user of taking part in the activity. During discussions with service users about activities, two service users talked about going out but there was no written evidence to say an outing had taken place. Other comments made by service users included: ‘There is not much to do here’ ‘There is always something going on’ ‘The girls try their best to amuse us but it’s hard when they are busy’ ‘I like my TV and my room so I’m not interested in doing anything’ The dementia unit has been refurbished so that service users have access to various items at all times. Service users were not able to discuss what they thought of the changes but observation showed that the areas are well used by people who found plenty of things to do when they felt like it. The areas included the following, one area features a beach area, there is a reminiscence corner, an area dedicated to items and pictures of well known film stars, a wedding area and an alcove prepared as a garden and all areas have seating within them. During the visit, lunch was taken with the service users in the dementia unit. Tables were well set with tablecloths, serviettes, condiments and floral decorations. Each service user was shown the meals to enable them to choose what they wanted to eat and people requiring help with their meal were given help from staff in a sensitive and dignified way with staff sitting with them until they finished their meal with sufficient time to sit and enjoy their meal without being hurried. People were offered second helpings of food and some service users were heard to say ‘I love this dinner’ and other comments about the meals throughout the day included: ‘The meals are always very good in here’ ‘We have good cooks in here’ ‘I love the food in here, we can have anything we want’ ‘Best custard I have had in a long time’ Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have the information they need to make a complaint and are confident their complaints will be dealt with effectively. Good adult protection procedures are available that help to protect service users should an abuse situation arise or be suspected. EVIDENCE: The home has a complaints procedure that is made available to each service user and their representative and forms part of the “contract of residency”. It is written in the Statement of Purpose and is included in the home’s brochure. People are given this information prior to admission and further copies can be obtained from the home so that the information is always made available. Suggestions and complaints made about the service are documented, including the nature of the complaint, who the complaint was made by and the date, however, it does not include who recorded the complaint and following the investigation if the complainant was happy with the outcome or the timescale to investigate the complaint. Discussions with service users highlighted that should they have a concern or a complaint they were confident it would be dealt with and comments included: Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 17 ‘I have plenty of friends here, I can’t complain at all’ ‘If I wasn’t happy I would see (staff name)’ ‘I am OK, I like living here, no complaints, if I had I would see the manager’ Relatives also stated they knew how to make a complaint if they needed to and comments they made included: ‘No complaints at all’ ‘When I have had a concern and approached the manager it has been dealt with effectively’ ‘I have a very positive view of this home’ The safeguarding procedures are in the home and accessible to the staff team. All of the staff regardless of their roles within the service receives accredited safeguarding training and all of the staff team have now received up to date training in safeguarding from Sunderland Local Authority. There have been no safeguarding issues reported either to CSCI or to the home to date. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a good standard of accommodation offering service users a comfortable, homely and safe place to live. EVIDENCE: Washington Grange is a purpose built property with accommodation provided over two floors. Service users have single bedrooms with en-suite facilities and bedrooms are accessible to meet their mobility needs. They are furnished and personalised with photographs, ornaments and other personal possessions to suit their individual choice and tastes. Refurbishment and decoration in all communal areas of the home has been completed, the memory lane project is being further developed and a new walk Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 19 in shower has been completed and is now in use giving service users the choice of bathing facilities. The home has a maintenance schedule that ensures all checks and repairs are carried out efficiently, a property maintenance team visits the home regularly to monitor the building and equipment in use. The corridor carpets are to be replaced the week following the visit to the home. The home have recently developed a sensory garden for service users and their families to use. It has ramped access and more seating has been installed. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good staffing levels, competent and qualified staff and robust recruitment procedures ensure that service users needs are met and they are kept safe from potential harm. EVIDENCE: There are good staffing levels and this was confirmed with a copy of the staff rota. At the time of the visit, there were ten care assistants on duty at various times throughout the day plus a senior carer over two units. Most of the staff team now hold NVQ in levels 2-4 and the home has achieved over 80 of the staff gaining a qualification in care. Staff are very positive about the service and in discussions with some of the staff on duty they made the following comments: ‘I have worked here a long time and have received a lot of training and all of the mandatory training’ ‘I have done NVQ level 2 and I am now in the middle of NVQ level 3 ’ ‘I get supervision and I find the managers very supportive’ ‘We have new staff and it’s been much better with the extra staff’ Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 21 ‘I think the home is getting better, my only issue is sometimes there isn’t enough staff but it’s improving’ ‘It’s particularly hard without an activities co-ordinator’ The home has a policy and procedure on staff recruitment that is used when the home need to replace staff. The recruitment policy is reviewed on a regular basis to ensure equal opportunities are promoted during the selection process of employees. The Deputy Manager was able to explain in detail the process that is used from sending out an application form, to the letter that tells prospective staff if they have been successful in gaining employment. Staff do not commence employment until a Criminal Records Bureau check has been completed. A sample of staff personal files were looked at and all the necessary checks and documentation was in place, including two references, Criminal Records Bureau check, past work history and personal documentation. However, the files did not include details discussed during the interview process. Individual staff supervision also takes place regularly and staff training is recorded on a database. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed by a person who is experienced and shows good leadership skills and this helps to ensure the service is run in the best interests of the service users and the risks to the health and safety of service users, visitors and staff are minimised. EVIDENCE: The Manager has eight years experience of working in the home holding various positions including eight months as acting manager. She has now been registered as manager of the service with CSCI and has NVQ Levels 2, 3 and 4 qualifications in care, other recent training completed includes yesterday, Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 23 today and tomorrow, Legionella awareness, managing dementia care and moving and handling as a trainer. Observation throughout the day showed that staff observe health and safety practice at all times. Staff were seen to use moving and handling equipment for service users requiring assistance to move safely. Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 12,13,15 Requirement The manager must ensure the care plans have all the relevant information to ensure the needs of service users is met. (Previous timescale of 01/08/07 not met) The manager ensure that the care plans set out in detail the action needed to be taken by staff and must include monitoring and evaluation to ensure the content is up to date (Previous timescale of 01/08/07 not met) Staff must follow the medication policy to ensure that service users are given their medication safely The corridor carpets must be replaced. (Previous timescale of 01/08/07 not met) Timescale for action 01/09/08 2 OP7 15 01/09/08 3 OP9 12 01/09/08 4 OP19 13 01/09/08 Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 26 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 Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Washington Grange DS0000054917.V364114.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!