Inspection on 31/07/06 for 24 Tower Road West

This inspection was carried out on 31st July 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

24 Tower Road West 19/03/09

24 Tower Road West 10/02/09

24 Tower Road West 28/03/08

24 Tower Road West 12/01/06

24 Tower Road West 25/08/05

24 Tower Road West 26/01/05

24 Tower Road West 27/10/04

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

CARE HOME ADULTS 18-65 24 Tower Road West 24 Tower Road West St Leonards-on-sea East Sussex TN38 0RG Lead Inspector Jeanette Denereaz Key Unannounced Inspection 31st July 2006 01:45 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 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 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 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. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 24 Tower Road West Address 24 Tower Road West St Leonards-on-sea East Sussex TN38 0RG 01424 427607 01424 721862 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) East View Housing Management Ltd Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of residents to be accommodated will be three (3) The people accommodated will be aged over eighteen (18) and under sixty-five (65) years on admission. 12th January 2006 Date of last inspection Brief Description of the Service: 24 Tower Road West is a large Victorian house, rented for its services users by East View Housing Management Limited (EVH). The house has a wide hallway and there are three communal rooms on the ground floor. There two lounges, with a small dining room next to the kitchen. There is also an office and a downstairs toilet. The bedrooms and one bathroom and toilet are on the first floor. The third floor is office space for the Health and Safety Officer of EVH; the CSCI has been assured the office is always locked when not in use. The back garden is large and has an uneven terrain. The house is in walking distance to the local shops, and is near the main bus route to Hastings and St Leonard’s on Sea town centres. The house is registered for three younger adults with learning disabilities. The current scales of fees range from £750 - £900 per week. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at 24 Tower Road West are referred to as ‘residents’. This was an unannounced inspection including a site visit, for the year running from April 1st 2006 to March 31st 2007. Time was spent with the recently appointed Team Leader, residents, staff and an evaluation of gathered information. Support staff on duty were interviewed during the visit. At the time of the preparation for this inspection visit there were only two residents living at the home, and they both were sent the ‘Have your say’ surveys about 24 Tower Road West. The residents with support from the staff completed the forms. From information gathered they were happy with the care they received. The surveys invite service users to speak to the inspector, and both requested an interview. Since the 7th June a third person has taken up residence, however, she has limited verbal skills to talk to the inspector, but through observation and discussions with the staff she has seemingly settled in well. As part the inspection process family members are contacted, and the newest resident’s sister was contacted and she gave positive feedback. She does have concerns regarding the condition of the garden and the overcrowding of furniture in her relative’s bedroom. The inspector escorted by the Team Leader undertook a full tour of the home, which included all the communal areas, bathroom and all bedrooms. Due to the nature of some of the service, it is difficult to reliably incorporate accurate reflections of the service in the report. Some judgements about quality of life and choices were taken from direct conversation with service users and their family, information received, and observation followed by discussions with the management, residents, staff members and evidencing records held in the home. What the service does well: The residents confirmed to the inspector that they are happy and relaxed with the home. The residents and staff interviewed all spoke positively about the home and the Team Leader. Also following a conversation with a family member who agreed that they are always made welcome when they visit the home. However, some staff can be abrupt when speaking on the telephone. The new resident has settled in very well, and it seems is getting on well with the other residents. The Inspector was impressed by the way staff interacted with residents, being aware of their individual needs and how they addressed them. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 6 A healthy and varied diet is provided. The building is homely and bedrooms are personalised. There is a good training programme on offer for staff, which now includes mental health training, and staff interviewed during this inspection visit were aware of what to do if they had an adult protection concern. Good medication training and systems are in place within the home. There have been staff changes over the last two years, and for over a year there has not been a manager in post. However, despite these fundamental changes in the resident’s lives they really feel this is their home. What has improved since the last inspection? What they could do better: The environment of the home has been a concern for the CSCI and with the EVH organisation for sometime, but the landlord who owes the house was not proactive in the upkeep of the house. Since the last inspection EVH has had a meeting with the landlord and repairs and improvements to the house were agreed. This work is in progress and the CSCI and the residents and staff of 24 Tower Road West await the results. One resident expressed she is not happy going to the day centre, she informed the inspector and she had discussed this with her key worker during a 1:1 meeting. There is a need to review day activities for residents if they are expressing their dissatisfaction with the arrangements now offered. The home 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 7 needs to be proactive and investigate other activities and record the research undertaken. 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. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 8 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 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 1,2 & 4 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Prospective service users are given the information they need to make an informed choice about living at 24 Tower Road West. EVIDENCE: Since the last inspection a new resident has moved into the home. Through talking with the team leader and the staff it is evident she has settled in well, and home had followed the robust admission policy and procedures of EVH. The new resident is in her fifties and therefore is compatible with the other two women living in the home. Her care plan is well organised and the inspector could follow care procedures and had a good idea how this woman likes to be supported in her life. All staff working in the home have familiarised themselves with the care plan and are confident in supporting and working with the new resident. The new resident continues to stay in contact with her family. The inspector contacted the resident’s sister as part of the inspection process and she confirmed their relative is very happy with her new home and has settled in well in a short time. There were a few concerns expressed about the building works and the state of the garden, also the relative felt her sister’s bedrooms were over crowded with furniture and on one visit the bedroom felt cold, and therefore was concerned that the room may be very cold in the winter. The relative felt she could discuss these issues with the staff and the inspector encouraged her to do so. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 & 9 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. The team leader and staff demonstrate their knowledge of the individual residents, and the residents feel safe and supported living in the home. However, one resident has expressed her displeasure with the day centre, and feels now she is sixty should not have to go to the day centre. EVIDENCE: Since the last inspection the residents have been more stable and calm, and the new staff team are well motivated and are having training in working with people with mental health issues as well as learning disabilities. One resident now has retired from day services and has a 1:1 support package for the day care. The inspector interviewed the resident and she informed the inspector that she is now retired; she recalled that as a young woman she did go out to work. She told the inspector that she was not going out on this day, but she had been to Bexhill on the Sunday by train and had fish and chips. She also told the inspector she liked the new resident and knew when her birthday was and thought it would be a good idea to have a party. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 11 The resident enjoys knitting and requested on her survey that her only complaint about the home was ‘Staff can’t cast on my stitches’. However, since writing her comment the home has employed a staff member that can knit and on the day of this inspection visit the staff member was helping the resident with her knitting. The new staff team are a group of mature women with the skills to support the residents living at 24 Tower Road West. The residents are encouraged to take part in the running of the home, and they have an opportunity to have their say about the menus and outings. Each resident has a 1:1 meeting with their key worker which is recorded, and one resident has expressed her displeasure with the day centre, and feels now she is sixty should not have to go to the day centre. She also discussed this with the inspector but there was no written evidence that her attendant to the day centre is being reviewed. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. It is evident that the residents are respected and their views are listened to. However, the issue of day services must be reviewed if a resident feels that the day centre is not appropriate for her now she is of retirement age. EVIDENCE: The residents enjoy community life and participates in local activities. This was evident with the recent visit to Bexhill when the three ladies went on the train and had a fish and chip supper. They attend local clubs, where possible have regular contact with their families. Two of the women are now sixty years old and the third is in her fifties, and therefore the home must reflect this is the weekly activities offered to the residents. As stated in the last standard one resident is strongly protesting about having to attend the day centre, she expressed this in her 1:1 meeting to her key worker, and to the inspector during this inspection. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 13 All residents are involved in the planning and shopping of the food, and from the menus seen and discussion with the residents and staff the home offers a healthy menu, including fresh vegetables and fruits. The home shops at the local supermarkets and the residents are encouraged to take part in this activity. A resident offered the inspector a drink, and she made the coffee and brought to the inspector. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 & 20 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Personal and healthcare needs are well documented and supported. The management of medication and the procedures of giving out medication ensure the safety of all residents. EVIDENCE: Staff spoken with said they felt they knew the residents very well and were very aware of their individual needs, how they wanted them met and how they preferred to be supported. The Inspector, from observations during the day at the home, concluded that staff are aware of residents’ needs and are sensitive to how they meet their needs. From records seen, the health care needs of residents are identified. Medication is stored in a medication cabinet located and is kept locked at all times. Medication procedures were observed and all aspects completed correctly. The home had clear medication records and all individual files personal information to aid staff when they administer medication. All staff have been or are in the process of being trained as part of their induction training, and no staff undertake the issuing of medication until they have undertaken the training and deemed competent. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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. Residents and their relatives’ complaints would be taken seriously and investigated. Staff have the knowledge and understanding to take the correct action to safeguard residents from abuse. EVIDENCE: The inspector saw the complaints book, and there were recorded incidents since the last inspection. During the interviews with the staff and residents the inspector asked about the homes complaints and concerns procedures. The residents that understood this concept all said they would speak to the staff and felt confident they would sort things out. The staff interviewed, all had a good understanding about the protection of vulnerable adults and what they would do if they saw or were told of any form of abuse within the home. The Family member spoken to also felt she would speak to the staff if and when she had any concerns. An incident within the home at the end of last year between a staff member and a resident was dealt with appropriately and all procedures were followed. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 24 & 30 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. The premises are suitable for the needs of the residents and are kept clean and homely. However, there are still outstanding areas of major repairs highlighted from previous inspection reports. EVIDENCE: EVH rent the house called 24 Tower Road West from a private landlord and for many years there have been discussions regarding the deterioration of the house, with serious cracking appearing on the back wall. There now has been an agreement for the Landlord to undertake this work, and the Landlord is in the process of repairing and decorating the outside of the house, front and back. However, there is to date no schedule of work submitted to the CSCI. The internal home is also in need of modernisation, redecorating and this is the responsibility of EVH. EVH rent the house called 24 Tower Road West from a private landlord and for many years there have been discussions regarding the deterioration of the house, with serious cracking appearing on the back wall. There now has been an agreement for the Landlord to undertake this work, and the Landlord is in the process of repairing and decorating the outside of 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 17 the house, front and back. However, to date there is no schedule of work submitted to the CSCI. The internal part of the home is also in need of modernisation, redecorating and this is the responsibility of EVH. Major work has started on the exterior of the house with scaffolding erected, which has further deteriorated the garden area, which at the inspection would be unsafe with staff and residents to enter. The team leader has plans to redesignate the rooms of the home and to re-design the garden area. To date no plans of maintenance work schedules have been submitted to the CSCI. Since the last inspection there has been a review and risk assessment undertaken of the handling of and sluicing of laundry, and for the present time incontinence waste bags are used to transport the soiled washing to the laundry. There are plans to improve the laundry facilities of the home. This will be included in a schedule of maintenance and works requested by CSCI. The Pre-Inspection Questionnaire was completed in May 2006; EVH was planning on de-registering the home because the Landlord was refusing to undertake the building work. However, since that time agreements have been made and EVH plan to stay at 24 Tower Road West. This is good news for the residents because for two of them, this has been home for many years and the position of the home is ideal, being near the town and shops and public transports, including the mainline railway. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. 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. Residents are protected by the home’s recruitment procedure. Staff have the skills to meet their needs and supports them. EVIDENCE: The inspector observed the staff working with the residents and was impressed with the respect and empathy shown by all the staff on duty. When questioned the staff had a good knowledge of the residents, and gave the residents a personal touch to their care, this is achieved by the established staff team working well together. The recruitment procedures for staff is robust but the inspector could not see all the information on the recruitment records for the newest of staff because this information was at the EVH Head Office and had not been forwarded to the home. The Head Office undertakes the first stages of recruitment and the senior of the homes are usually involved in the second interviews and induction of the staff. Training is very important to the management of EVH and the staff are encouraged to undertake training. The care staff interviewed during this 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 19 inspection visit were all interested in NVQ training and all would be put forward for LDFA (Learning Disability Framework Award) training. They all said the training they already had, was very good and relevant to their work, and more training was planned including more courses on working with people with mental health issues. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. 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 live in a safe, well-managed home that is run in their best interests and safeguards their rights. The new Team Leader has a good understanding on the area in which the home needs to improve, she has a clear plan and vision for the home. EVIDENCE: All the health and safety documentation was seen to be in order from inspecting documents held in the home, and from information supplied by the Responsible Individual on the Pre-Inspection Questionnaire sent to the CSCI on the 3rd May 2006. The home now has a permanent team leader, who has experience in leading a staff team and managing a home for the organisation, she is also working for her NVQ 4 and registered manager’s award. 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 21 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 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X X X X 3 X 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 22 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 YA7 Regulation 15(1) (2) See Schedule3 (1)(b) 12(2)(3) Requirement Timescale for action 01/12/06 1 YA6 15(1) (2) See Schedule3 (1)(b) 12(2)(3) 2 YA16 16(2)(m)(n) 12(4)(a) 2 YA12 16(2)(m)(n) 12(4)(a) The Team Leader and Responsible Individual must ensure residents are supported to make decisions about their own lives, and the home must facilitate and support the changing needs and aspirations of the individual resident, which respects the individual’s age and status. The Team Leader and 01/12/06 Responsible Individual must ensure residents are supported to make decisions about their own lives, and the home must facilitate and support the changing needs and aspirations of the individual resident, which respects the individual’s age and status. The Team Leader and 01/12/06 Responsible Individual must ensure staff support the residents to find appropriate fulfilling activities, which promotes independence, choice and freedom and respects the individual’s age and status. The Team Leader and 01/12/06 Responsible Individual must ensure staff support the residents to find appropriate DS0000021319.V290934.R01.S.doc Version 5.1 24 Tower Road West Page 23 3 YA24 23(2)(b) fulfilling activities, which promotes independence, choice and freedom and respects the individual’s age and status. The repair work required at 01/10/06 previous inspections is being undertaken, but the Responsible Individual must forward to the CSCI the maintenance and work schedules, with timescales for all the work external and internal including the plans to make the garden areas more accessible for residents and staff. 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 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 24 Tower Road West DS0000021319.V290934.R01.S.doc Version 5.1 Page 25 - 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!