Inspection on 10/08/06 for 5 Ellasdale Road

This inspection was carried out on 10th August 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 but made no statutory requirements on the home.

Other inspections for this house

5 Ellasdale Road 20/08/07

5 Ellasdale Road 11/01/06

5 Ellasdale Road 19/07/05

5 Ellasdale Road 09/02/05

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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 5 Ellasdale Road 5 Ellasdale Road Bognor Regis West Sussex PO21 2SG Lead Inspector Mr D Bannier Key Unannounced Inspection 10th August 2006 13:30 5 Ellasdale Road DS0000061616.V305729.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 5 Ellasdale Road DS0000061616.V305729.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. 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 5 Ellasdale Road Address 5 Ellasdale Road Bognor Regis West Sussex PO21 2SG 01243 865459 01424 202221 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) Sussex Autistic Community Trust (Care Services) Limited Ms Alexandra Reeve Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2006 Brief Description of the Service: 5 Ellasdale Road is a care home, which is registered to provide personal care for up to six service users in the category learning disability (LD) who are between the ages of 18 to 65 years of age. The service has been set up to provide care and accommodation for younger adults with autistic spectrum disorders. It is a semi- detached property, which has been extended and adapted for its current use, and is located in the town of Bognor Regis. The property is a three storey building providing private accommodation to service users in six single bedrooms located on the first and second floors. Communal accommodation is made up of two lounges and a dining room located on the ground floor. An enclosed garden, which is available to service users, is located to the rear of the premises. Fee levels currently range from £69,000 to £99,000 per annum. The registered provider of this service is Sussex Autistic Community Trust (SACT). The Responsible Individual acting on behalf of the organisation is Mrs Jean Rose. Ms Alex Reeve is the registered manager and is responsible for the day to day running of the care home. 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report has been written using new methods introduced on 1st April 2006. Some evidence used to assess standards has been gathered before this visit took place. For example, information has been used from information provided by the manager in a questionnaire and satisfaction questionnaires completed by residents’ relatives; information has also been used from written reports of visits to the care home made by representatives of the registered provider. This visit was unannounced and started at 1.30pm. It took place over three and a half hours. Due to severe disabilities it was not possible to have meaningful discussions with residents. It was also very difficult to spend much time with residents. This is due to residents being intolerant of changes to routines however; the inspector did meet and spoke briefly with four of the six residents who are currently living at 5 Ellasdale Road. The inspector also briefly observed care practices. This gave the inspector a picture of how it is to live at this care home. The inspector also attended a handover between the morning and afternoon shifts. In this way the inspector spoke to three staff who were on duty. This helped the inspector to gain a sense of the work staff are expected to do. The inspector saw the communal areas and some of the private accommodation. Some records were also examined. The inspector looked at those standards that are about how new residents are admitted to the care home; how residents are cared for; the daily life and social activities provided for residents; how the care home deals with complaints and how they protect residents from abuse; the environment in which residents live; how staff are recruited and trained; and how the care home is managed. Alex Reeve, the registered manager, was present throughout the inspection and kindly assisted the inspector with his enquiries. What the service does well: This is a care home where younger adults with autism are well looked after. Staff on duty were very caring and understood how care to residents should be provided. The atmosphere was very calm and very homely. 5 Ellasdale Road DS0000061616.V305729.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. 5 Ellasdale Road DS0000061616.V305729.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 5 Ellasdale Road DS0000061616.V305729.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The registered provider has developed a format to ensure all new residents’ needs are thoroughly assessed before they are admitted. Quality in this outcome area is good. EVIDENCE: The manager confirmed that no new residents have been admitted since the last inspection. During a visit that took place on 11th January there was evidence to confirm that, “The registered provider has developed an assessment format to determine the needs and aspirations of prospective residents.” However, it has not been possible to determine how this format has been implemented. 5 Ellasdale Road DS0000061616.V305729.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 The majority of residents are incapable of knowing about care plans. Their relatives have been made aware of residents’ care plans. The manager has identified that some work is needed to ensure relatives are kept up to date with residents’ changing needs. Due to the severity of their disabilities, the majority of residents have very little capability to make decisions about their lives, and in taking risks as part of an independent lifestyle, even with assistance. However, where possible the registered manager has shown a commitment to ensure residents are supported in making any such decisions. Quality in this outcome area is good. EVIDENCE: Care plans were not examined on this occasion. The manager has confirmed that they have been reviewed and improved in line with recommendations made during the inspector’s last visit. This means that care plans provide staff with clear information and guidance regarding the level of care and support 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 10 each resident needs. This will ensure care and support provided consistently and taking into account, wherever possible, the wishes of each resident. The inspector spoke to four of the six residents accommodated at 5 Ellasdale Road. However, due to communication difficulties linked with autistic spectrum disorders, it was not possible to have anything other than very simple conversations with residents. No relatives were present during the inspector’s visit. However, the manager gave the inspector copies of satisfaction questionnaires completed by the relatives of four residents. Comments made about communication between the service and the relatives included, “Would like to be informed of any doctor’s or hospital visits as soon as possible”; “There has been occasional lapses in communication;” “sometimes calls and messages do not get through to the appropriate person and calls are not always returned;” and “We’d like to be kept more informed of staff changes.” The registered manager confirmed she was aware of these difficulties. She informed the inspector that a partnership day has been planned to take place on 3rd September 2006. This is an annual event where relatives are invited to meet with representatives of the registered provider, including the registered manager. Relatives have been asked to complete the satisfaction questionnaires prior to the event. Issues raised will be discussed during the event. Due to the severity of their disabilities, the majority of residents have very little capability to make decisions about their lives, even with assistance. However, one resident has demonstrated more ability than first thought to be the case. Following a case review with the resident and their relative, it has been agreed that work will commence with the resident to establish a more independent lifestyle within their capabilities. 5 Ellasdale Road DS0000061616.V305729.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 The registered provider has taken appropriate steps to ensure residents are enabled to take part in appropriate activities. The registered manager has ensured residents are encouraged to be part of the local community. The registered manager has ensured residents have appropriate personal and family relationships. The registered provider has taken appropriate steps to ensure residents’ rights are respected and responsibilities recognised in their daily lives. The registered manager has ensured residents are offered a healthy diet and enjoy their meals and mealtimes. Quality in this outcome area is good. 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 12 EVIDENCE: According to information provided by the manager after the visit the registered provider opened a resource centre in March 2006 dedicated to providing activities to people with autistic spectrum disorders. Five of the six residents accommodated attend the centre five days a week. Activities are led by a teacher/tutor who is qualified in the activity provided. Residents are supported by the staff from the care home. It has been agreed that it is more beneficial for the sixth resident to enjoy activities based from the care home. The activities provided from the resource centre are wide ranging and include horse riding, yoga, arts and crafts, music therapy, massage, and baking. In addition residents also attend sessions at a local college where they are learning office and domestic skills. The sixth resident enjoys a range of activities based at the care home including domestic skills, water therapy, and music. A member of staff supports this resident on a one to one basis. Residents are also provided with activities and entertainment based in the community. This includes walks in the local area, trips out in the car, and visits to the theatre, the local pub, cafes and community fairs. There was evidence at a previous inspection that confirmed residents are encouraged and supported in having appropriate personal and family relationships. The inspector sat in on a staff handover between the morning shift and the afternoon/evening shift. Staff discussed the events of the morning with particular reference to the needs of individual residents. It was clear form discussions and brief observations of care practices observations that, where possible, staff respect residents rights and treat them as individuals. There was evidence at a previous inspection that residents are provided with a wholesome, nutritious and balanced diet. Due to their disabilities, resident’s mealtimes are planned to ensure they taken individually with staff or with residents they are able to tolerate. 5 Ellasdale Road DS0000061616.V305729.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 The registered manager has taken appropriate steps to ensure that staff on duty are aware of and sensitive to the way in which residents prefer to receive personal support. The registered manager has demonstrated that appropriate action has been taken to ensure residents’ physical and health care needs have been met. Currently no residents are considered to be capable of administering their own medication. The registered manager has ensured that current policies and practices are robust and ensure residents are suitably protected. Quality in this outcome area is good. EVIDENCE: There was evidence to confirm that staff provide care and support in accordance with the preferences of each resident. There was also evidence to confirm that residents’ physical and health care needs have been met. 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 14 The registered manager confirmed that there have been general improvements to the way in which medication is being administered since the last inspection. Medication cabinets are to be fitted in each resident’s bedroom. Risk assessments will be carried out for each resident. The designated shift leader will have the keys to each cabinet and will be responsible for administering medication on their shift. It is planned that medication will be administered to the residents in their bedrooms; the shift leader will return to the office to sign off each residents’ medication once administered. Policies and procedures are not in place yet. The manager was advised to ensure they are robust and clearly inform staff what is expected of them. This will ensure the risk of mistakes occurring is reduced. The manager also confirmed she intends to monitor its implementation on a monthly basis via staff meetings. The manager informed the inspector that the Deputy Manager has been delegated responsibility for overseeing medication, including ensuring each resident has been fully assessed. The inspector was shown the work that has taken place so far. Currently assessments are generic in terms of the process and content. The inspector was informed that they would be reviewed each month against the needs of each resident. Where necessary an individual assessment will be generated. Whilst they were not examined on this occasion, the inspector noted that it is the current practice for the incoming shift leader to check the medication records before they are handed over from the previous shift leader who about to finish. This means that any errors can be identified and put right before the end of the shift. At the time of the visit no residents were self-medicating. However, evidence in one resident’s care records demonstrated work is underway to support them in administering their own medication in the near future. There was also clear evidence that demonstrated this has been appropriately risk assessed. 5 Ellasdale Road DS0000061616.V305729.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The registered manager has taken appropriate steps to ensure, as far as possible, residents views are listened to and acted upon. The registered provider has taken appropriate steps to ensure residents are protected from abuse, neglect and self-harm. Quality in this outcome area is good. EVIDENCE: It is the opinion of the registered manager that residents meetings are unworkable. This is due to the individual communication difficulties and disabilities of each resident accommodated. However, a member of staff has been identified to work with each resident on an individual basis. Regular meetings are organised between the resident and the allocated member of staff. The staff member is expected to develop appropriate communication skills in order to establish a relationship to enable the resident to express their own view within their capabilities. Information supplied by the registered manager prior to this visit confirmed that all staff continue to be provided with a comprehensive programme of training including identifying and reporting incidents of abuse. The inspector spoke to a group of staff who were on duty. They confirmed they knew how to recognise different forms of abuse and also knew what they should do to ensure it has been reported to the appropriate agencies. This will ensure vulnerable residents are protected from possible abuse. 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 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 and 30 The registered provider has taken appropriate steps to ensure residents live in a homely, comfortable and safe environment. The registered provider has taken appropriate steps to ensure the home is clean and hygienic. Quality in this outcome area is good. EVIDENCE: The inspector visited several bedrooms, toilets, bathrooms, the lounge and dining room, the utility room and the kitchen. Those areas of the home seen were presented in a homely and comfortable manner. The decoration and furnishings provided ensured residents live in a comfortable and safe environment. Comments made by relatives in satisfaction questionnaires were positive regarding residents’ private accommodation and the environment in general. Information supplied by the registered manager prior to this visit confirmed that the premises has been visited regularly by the local fire officer and any 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 17 work required to ensure the premises meets fire safety standards has been completed. The registered provider has also taken appropriate steps to ensure the premises and equipment within the care home is safe for use. The inspector viewed the kitchen, the utility room and some bathrooms and toilets. These areas of the premises were fresh, clean and hygienic. Comments made by relatives in satisfaction questionnaires were positive regarding the standards of hygiene maintained in the care home. 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 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 and 35 The registered provider has ensured residents are supported by competent and qualified staff. The registered manager has taken appropriate action to ensure residents are supported and protected by the home’s recruitment policy and practices. The registered provider has ensured residents’ individual and joint needs are met by appropriately trained staff. Quality in this outcome area is good. EVIDENCE: The inspector examined the recruitment records of two staff who have been appointed since the last inspection. All appropriate checks were in place. However, it was noted that they had begun working at the care home before criminal record checks had been returned. Following discussion, the manager confirmed that she had taken the necessary steps to ensure the safety and wellbeing of residents had been protected whilst awaiting their return. Information supplied by the registered manager prior to this visit confirmed that all staff have been provided with a comprehensive training programme including an in house induction package. All staff receive supervision every 4 to 6 weeks. The inspector examined the notes of one such session. Supervision 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 19 also provides an opportunity to identify individual training needs of the member of staff. The inspector noted such discussions are recorded within the supervision record. The registered manager confirmed that she is in the process of developing a training profile for each member of her team. Six of the team of thirteen staff have completed a course leading the National Vocational Qualification (NVQ) in care. Four more staff are currently on the same course. 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 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 and 42 The registered manager and the registered provider have taken appropriate steps to ensure residents’ benefit from a well run home. The registered provider has taken steps to ensure residents and their relatives, are confident their views underpin all self -monitoring, review and development of the home. The registered provider has ensured the health, safety and welfare of service users are promoted and protected. Quality in this outcome area is good. EVIDENCE: Ms Alex Reeve is the registered manager of this care home. As a result of the registration process she has demonstrated she has the necessary skills, knowledge and experience to manage a service for younger adults with autistic spectrum disorders. 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 21 Representatives of the registered provider visit 5 Ellasdale Road each month to ensure this care home is being run in the best interests of residents. Reports of such visits were available for the inspector to examine. Reports include details of discussions with staff on duty and, where possible, discussions with residents or observations of care and support provided. The registered manager has demonstrated she meets regularly with her staff team to discuss issues related to service provided and the individual care needs of residents. This ensures the staff team are clear about what is expected of them and are aware of how the aims and objectives of the service should implemented. The registered provider has set up a regular event known as a Partnership Day where the relatives of residents are invited to meet with representatives of the registered provider. This takes place twice a year. The day includes a formal meeting that provides a forum for relatives to learn about proposals to develop the service. Relatives are also asked to complete satisfaction questionnaires in which they can make their views known about the service provided at the care home. The inspector was provided with a copy of four such questionnaires. The registered manager confirmed that there would be an opportunity to discuss comments made at the next event, which is due to take place in September 2006. Information supplied by the registered manager prior to this visit confirmed that the premises has been visited regularly by the local fire officer and any work required to ensure the premises meets fire safety standards has been completed. The registered provider has also taken appropriate steps to ensure the premises and equipment within the care home is safe for use. The registered manager has developed a system for monitoring incidents and accidents, which have occurred in the care home. The appropriate agencies, including the Commission, have been notified of those incidents and accidents which are required to be reported. The purpose of the monitoring system is to review incidents to identify any areas where improvements can be made to ensure residents and staff safety has been fully protected. 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 22 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 X 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 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 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 5 Ellasdale Road DS0000061616.V305729.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. 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