Inspection on 08/03/06 for 57 Crabbe Street

This inspection was carried out on 8th March 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

57 Crabbe Street 18/05/06

57 Crabbe Street 04/07/05

57 Crabbe Street 22/12/04

57 Crabbe Street 07/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE 57 Crabbe Street 57 Crabbe Street Ipswich Suffolk IP4 5HS Lead Inspector Kevin Dally Unannounced Inspection 8th March 2006 09:30 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 57 Crabbe Street DS0000036814.V286274.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 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. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 57 Crabbe Street Address 57 Crabbe Street Ipswich Suffolk IP4 5HS 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) 01473 588508 01473 712869 Suffolk County Council Mrs Pamela D J Purnell Care Home 26 Category(ies) of Dementia - over 65 years of age (13), Old age, registration, with number not falling within any other category (13) of places 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2005 Brief Description of the Service: 57 Crabbe Street is a local authority owned home for older people and is located in a quiet area of East Ipswich, within walking distance of local shops. The centre of the town can be reached by bus. The home currently provides personal care to 26 residents. There are three units, Glencoe which is divided into two and provides care to 13 people with special needs, dementia. Killarney and Windermere are long-term care units and provide places for 5 and 8 people respectively. The CSCI is currently assessing an application from the home to include these 13 places as special needs, dementia. There is a fourth unit, Snowdonia, which had provided accommodation for five tenants. At present these rooms are empty while the CSCI assesses an application to include these, as part of the special needs service. The home has applied to have all 31 rooms registered for special needs, dementia. Each of the units is self-contained and have a sitting room, kitchen/diner, and bath and laundry facilities. Meals are provided from the main kitchen but residents can cook, with staff, to make cakes and snacks. All bedrooms are single and have an en-suite facility comprising shower, hand basin and WC. There is a central kitchen, which is well equipped, and in addition to providing meals for the residents, they also provide meals for those using the day care facility and also a number of community meals. Residents also have access to a hairdressing service at the home. There are good garden facilities for use by residents. The gardens are well maintained and can be accessed by wheelchair users. Each garden provides seating and cover from the hot weather. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced inspection at 57 Crabbe St, a Local Authority care home for 26 older people. The inspection was conducted over an 8.5 hour period from 9.20am to 5.45pm. Mrs Purnell, the manager, was present at the inspection and contributed throughout the day. This inspection focused on the Glencoe unit, the special needs service, as the home now proposes to expand this service to all rooms. A site visit of Snowdonia was conducted at the end of the day, but this did not form part of this report. Glencoe residents and staff were spoken with, and their interaction observed throughout the morning. This included observation of residents’ participation in the morning activities, and receiving their midday meal. Various records, including menu sheets and care plans were checked to assess the level of care offered to residents’ with special needs. The environment and a number of residents’ rooms were checked. This inspection found that of the 26 National Minimum Standards inspected, that the home met 25 of these, with 1 being partially met, and that the overall quality of care continued to be of a very high standard. What the service does well: This inspection concluded that the service provided to residents’ with special needs was to a high standard. Residents spoken with confirmed this and were happy living at the home. Staff were well trained, experienced and capable of meeting the specialist needs of the service user group. Staff were polite, patient and inclusive of residents as they undertook their morning duties, and they empowered service users to be as independent as possible. The staff group received regular training, supervision, and good leadership from the home. Due to the high quality of the provision of care, 5 standards were assessed as “Standard Exceeded”. These standards were; meeting residents needs, meeting residents healthcare needs, leisure pursuits, staff training and the home’s cleanliness. Care plans were seen to be of a good quality, which demonstrated a holistic approach so ensured that each resident’s care needs were appropriately documented. The home continued to closely monitor resident’s changing conditions, including monitoring of falls. The environment was also well maintained, clean and hygienic. Residents had access to a number of well-appointed lounges, dining rooms, and a snoozelum for their comfort and relaxation. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 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. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 7 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 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4 People can expect that their assessed care needs would be thoroughly met by the home. EVIDENCE: This inspection focused on the Glencoe unit, the special needs service. Residents were observed having breakfast, which was unhurried, with positive support from care staff. One more poorly resident received one to one staff assistance with their breakfast and help was offered in a thoughtful and supportive manner. There was a calm, happy atmosphere throughout the home, and staff took time to speak individually with residents about the events of the morning. During the day, residents’ moved freely about the unit and selected activities they wished to be involved with. One resident enjoyed listening to classical music within the snoozelum, while other residents enjoyed watching a video. Staff periodically checked on residents, but without interruption to the morning events. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 9 Discussion with residents confirmed that they were happy at the home. “Staff will help you” stated one resident, while another confirmed, “I have my own paper to read”. Residents were seen to be well groomed and in their preferred choice of clothes. Staff interaction with residents was very positive, service user focused, which empowered people to make their own choices. From observation of the staff, care workers spoken with and records checked that staff were thoroughly capable and trained to meet the needs of residents with special needs. The environment of the home was appropriately adapted and well maintained to meet the residents’ specialised needs. Therefore standard 4 was assessed as “standard exceeded”. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The promotion of health at the home was taken seriously so people could expect that they would receive properly planned care. Residents could expect their healthcare needs to be met and monitored by staff and visiting healthcare professionals. People could expect the staff team to be well trained and who would treat residents with respect and dignity. EVIDENCE: The home continued to ensure that residents’ care needs were thoroughly assessed and documented within a plan of care. The care plan of a resident with special needs was checked which confirmed the home had undertaken a comprehensive assessment of their special needs. A personal history/story gave very good insight about the resident’s former work, family and leisure background. Personal preferences and choices were highlighted, and gave an understanding of a resident’s normal daily routines, and activities. For example, normal rising and retiring times. The care plan included detailed nutritional screening information, a weight chart, risk assessments, medical information, a falls record and personal care preferences. Contact with medical care professionals was recorded and visits by the Doctor, Chiropodist, Dentist, and the Optician had been listed. Current medication received was listed. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 11 Records revealed the home had a very holistic view of a resident’s needs. Some records within the plan, including a moving and handling risk assessment, required updating to confirm they remained current. The accident records were checked for the months of January and February 2006, which revealed that 19 accidents had occurred during that period. Detailed falls monitoring continued, including identifying residents who are at risk of falls. Falls risk assessments were completed for all residents. Staff members’ spoken with, and one staff member’s records examined revealed they received comprehensive training. Core and specialist training included National Vocational Qualification level 3, (NVQ 3), Unisafe training, Protection of Vulnerable Adults training, working with dementia, risk assessment, loss and bereavement, prevention of falls, fire training, moving and handling training, first aid and food hygiene training. This confirmed that staff would be able to meet the special care needs of the residents. Residents spoken with stated they were well treated by staff and their privacy respected. Staff were very polite, respectful, and knocked on residents doors before entering. Staff were observed to empower vulnerable residents by positive support and shared decision-making processes. The home had medication policy guidance provided by the Local Authority. The home had formerly used the Nomad system of administration but had recently moved to the medication dispensing system (MDS) with blister pack and medication administration recording (MAR) sheets Staff authorised to administer medication would first attend a training course. Senior staff undertake ordering of medication, and the visiting nurse would give insulin. Medication records checked for one resident revealed that good records were maintained, and included staff signatures and the dates administered. Medication stocks could be easily audited. Staff records checked confirmed they had received medication training. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 With staff support, people can expect the home to enable residents to be involved in meaningful recreational activities, exercise choice, and make decisions about the lifestyle they wished to pursue. Contact with relatives, friends, and family would be encouraged, with some opportunities to go into the community. People could expect that residents were provided with a good diet and choice of menu options, although these may not always be recorded. EVIDENCE: Observation and discussion with residents confirmed they are able to follow their own routines, a variety of leisure activities and personal pursuits. One resident’s records checked confirmed their preferred rising and settling times were recorded. On arrival at Glencoe unit at 9.20 some residents were completing their breakfast. The breakfast time was unhurried with staff positively responding to residents needs. Later in the morning residents were able to freely move within the unit, and join any of the morning activities. These included reading the paper, conversation with a friend, morning coffee, watching a reminiscence video, or enjoying music in the Snoozelum. Staff spoken with confirmed that planned activities were usually available from 11am. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 13 Meal times were also an opportunity for conversation and socialisation. Residents and staff spoken with confirmed the home offered a choice of good quality meals. The lunchtime meal was observed being served to residents in the special needs dining room. This was delivered directly to residents, and was served hot. The meal of the day was hot savoury roll and beans, or steak and ale pie. Alternative meal options included omelettes, a salad, fish, jacket potato, steak and kidney or vegetable pie. The main course was served with cabbage, mash potatoes, and mixed vegetables. The meal looked and smelt appetising, and was enjoyed by residents. The care plan for one special needs resident identified they had difficulty eating meals. Therefore their meal option records were requested. The current weeks records had been misplaced, so the previous weeks records were checked. This revealed the resident received very good menu choices for the lunchtime period. The evening meal records stated that they had only custard. However, after discussion with staff, it was confirmed the resident often enjoyed a wider selection of food. The home was required to ensure that meal records more fully record each special need resident’s meal choices. Further, the home was required to ensure that all menu records were safely maintained. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Residents could expect to have their complaints taken seriously, and that adult protection procedures would ensure their safety. EVIDENCE: The home had not received any complaints within the previous 12 month period. The home used the Local Authority complaints procedure, which included a record book for recording any complaints received. This procedure was also provided within an informative Statement of Purpose. Policy included that a complaint would be investigated within 28 days. The home had suitable Adult Protection policies and procedures in place and was aware of their obligation in the reporting of any allegations of abuse to Social Services. The Home’s recruitment procedures included Criminal Records Bureau (CRB) disclosures, Protection of Vulnerable Adults (POVA) procedures, 2 references, and identity checks for all staff. A sample of staff records checked found these records in place. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 People could expect a well-maintained environment with good communal provision, bedrooms, toilets and hand washing facilities. People could expect an exceptionally clean, hygienic and odour free home, which is well maintained and personalised. People could expect to find a safe environment. EVIDENCE: Crabbe Street is a Local Authority owned home for older people who provide care to 26 residents, 13 of who have special needs. The home has applied to register an additional 5 rooms, and change the use of its remaining 13 general purpose beds to special needs. There are three units, Glencoe, Killarney and Windermere. Each of the units are self-contained and have a sitting room, kitchen/diner and bath and laundry facilities. All bedrooms are single and have an en-suite facility comprising shower, wash hand basin and WC. Communal areas include a library and central dining room used by day care visitors. There is a central kitchen. Residents have access to a hairdressing service at the home. There are good garden facilities for use by residents which are well maintained and can be accessed by wheelchair users. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 16 At this inspection the special needs unit was checked and included a tour of the corridors, dining room, lounge, conservatory, one bathroom, one resident’s room, a toilet, the unit’s kitchen and laundry. These areas were found to be properly maintained, clean, and fresh smelling with no unpleasant odours detected. The resident’s room visited was found to be clean and tidy, warm and properly maintained. Residents were enabled to bring some of their own personal furniture, if they so wished. The home was found to be accessible to residents with appropriate aids, hoists and adaptations provided to meet the assessed needs of service users, identified though manual handling risk assessments. The home had a call bell system enabling service users to summon staff should they require assistance, and each door is alarmed to warn staff of a resident’s presence. Grab rails are provided in bathrooms and toilet areas and the bath had an assisted bath hoist. One bathroom had been carpeted, and was very personalised and homely, with pictures and decorations. From observations and staff spoken with confirmed that the home was always well maintained, clean and hygienic. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 People could expect the home would have consistent numbers of staff, in order that they can support residents and meet their care needs. People could expect that staff will have received thorough training. EVIDENCE: 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 18 the rotas for each unit are completed by the senior team leader and overseen by the manager. The three units have a senior member of staff who takes specific responsibility. The shift pattern is usually 07.00 – 15.00 and 14.00 – 22.00. Glencoe the special needs unit has two members of staff on duty between 07.00 and 22.00 hours and the remaining units, Killarney and Windermere only have one member of staff on during 07.00 and 22.00 hours. There are three support workers with specific responsibilities to assist residents and arrange activities. The shift pattern for support workers is usually 0900 to 1600, or 1600 to 2100. Night staff cover from 22.00 hours until 07.00 includes a senior team leader who covers all the units and two members of night staff. One member of night staff is always stationed within the Special Needs unit. There are currently 12 residents in the special needs unit, which is ‘divided’ into two with 6 and 7 beds respectively. The geographical layout of this unit is difficult and when two staff are on duty, they are at either end of the unit. The care staff rota was checked and this demonstrated the home had sufficient numbers of staff available to meet the current group of residents’ needs. The home provided comprehensive training for all staff. This included induction and foundation training for new staff members, which usually leads to NVQ level 2 or 3 training. Core training included fire, moving and handling, first aid, food hygiene, and infection control. Specific training included care of the dying, Unisafe training, safe handling of medicines, working with dementia care and risk assessment. Staff members spoken with confirmed that the home promoted and provided very good opportunities for learning within the home. One staff member’s records confirmed that they had received very good training. One staff member’s records revealed that employment and recruitment procedures were undertaken. These included Criminal Records Bureau (CRB) disclosures, Protection of Vulnerable Adults (POVA) procedures, 2 references and identity checks. Job descriptions had been provided. This inspection required a medical declaration of health status to be provided for one staff member. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36 People could expect the home to be very well managed and take resident’s views into account. They could expect the environment to be safely maintained. People could expect that staff would be properly supervised and would receive appropriate health and safety training to ensure that residents are safe. EVIDENCE: Mrs Pam Parnell, the Manager of the home is very experienced in working with older people in a variety of settings. Her training includes the Certificate in Social Service (CSS), an NVQ Assessor, a Diploma in the Management of Care Services and a Post Qualifying Award in Social Work, which was achieved in 2001. 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 20 From comments received from residents and staff, it was confirmed the home was managed in a transparent way, and responsive to the needs of residents. Staff spoken with and records examined, confirmed that staff received appropriate training and were regularly supported via the supervision process. The quality assurance process was checked. Regulation 26 visits were undertaken each month by a representative from the Local Authority and forwarded to the CSCI. The home ensured that residents’ views of the home were surveyed and a record was maintained. Residents’ views included “I have found that when agency staff have been used that they are not always aware of patient’s needs”. This comment had been followed up by the home, and new procedures put in place to ensure that agency staff are aware of residents’ needs. Further comments included, “The staff are a great team of carers doing a good job”. “All the family feel our relative is very well looked after”. 57 Crabbe Street DS0000036814.V286274.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 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 x x x 4 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 x 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 x x 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? N0 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. 2. 3. 4. Standard OP7 OP7 OP15 OP15 Regulation 15(2)(b) 13(5) 17(2) Sch 4(13) 17(2) Sch 4(13) Requirement Care plans must be regularly reviewed A moving and handling risk assessment must be updated. Old menu records must be maintained to evidence each resident’s meal choices. Menu records must fully record each resident’s food choices. Timescale for action 21/04/06 21/04/06 21/04/06 21/04/06 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 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 57 Crabbe Street DS0000036814.V286274.R01.S.doc Version 5.1 Page 24 - 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. 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