Inspection on 27/06/06 for 62 Second Avenue

This inspection was carried out on 27th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

62 Second Avenue 23/10/08

62 Second Avenue 25/04/07

62 Second Avenue 25/10/05

62 Second Avenue 01/06/05

62 Second Avenue 05/01/05

62 Second Avenue 14/07/04

62 Second Avenue 04/02/04

Similar services:

Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 62 Second Avenue, Carlton Nottingham NG4 1GS Lead Inspector Susan Lewis Key Unannounced Inspection 27th June 2006 10:00 62 Second Avenue, DS0000008792.V299274.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 62 Second Avenue, DS0000008792.V299274.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. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 62 Second Avenue, Address Carlton Nottingham NG4 1GS 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) 0115 9117230 0115 910 4267 www.ncha.org.uk NCHA Kelly Marie Maloney Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users shall be within Category LD Date of last inspection 25th October 2005 Brief Description of the Service: 62 Second Avenue is a home providing care and support for up to four adults with a learning disability. The home is a detached property within a residential area of Carlton, conveniently located for easy access to all community amenities. There is parking available at the front of the house for about three to four cars. The garden to the rear of the house is private and secure. All of the bedrooms are located on the first floor via a winding staircase. Therefore, the property is unsuitable for people with mobility problems. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation. The inspection was unannounced and took place over 7 hours one Tuesday in June 2006, and was conducted by one inspector and was the key inspection for 2006/07 A tour of the building took place and a selection of residents’ bedrooms was inspected. Residents’ records were inspected. Due to the profound learning disability and subsequent limited communication and understanding of the residents the inspector was unable to speak with them, other than some brief interaction with one resident. What the service does well: What has improved since the last inspection? What they could do better: A contract specific to Second Avenue and that addresses the needs of adults with a learning disability and challenging behaviour still needs to be developed and has been an outstanding requirement for sometime. Ensuring confidentiality could be done better if the physical design of the house is changed. The office is attached to the main lounge by an open archway and entering the lounge is via the office. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 6 This means that staff have nowhere private to go if they need to discuss a difficult situation or make a phone call about a resident. This layout also impinges on residents’ communal space. This requirement remains outstanding after three years. The Registered Person must ensure that where the identified resident is showing signs of aggression to other residents that staff receive appropriate support and/or training to minimise the risk to other residents in their own home. Staff files containing references and evidence of police checks are held centrally and not at the home, these records must be made available at the home on the day of inspection. This is to ensure that residents are protected by all necessary checks being carried out prior to staff commencing employment and that recruitment procedures are robust in protecting residents against potential abuse. 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. 62 Second Avenue, DS0000008792.V299274.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 62 Second Avenue, DS0000008792.V299274.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 and 5 The quality in this outcome area is adequate. Prospective residents’ individual needs and aspirations are assessed. Work has yet to be completed on developing a suitable contract to meet the needs of residents. EVIDENCE: Evidence was seen that assessments are obtained regarding residents needs prior to their being admitted. The home develops with each resident over time a plan based on the assessment that details any restrictions on freedom, services or facilities. Discussion with staff showed that plans are discussed with residents and attempts are made to ensure that they are in agreement with their plans. It has been explained at the previous inspection that the Housing and Support Team of Nottingham Community Housing Association will be developing a license agreement that is suitable to the needs of residents with a learning disability / displaying challenging behaviour. The requirement still stands that the contract includes all items as specified in Standard 5 of the National Minimum Standards. 62 Second Avenue, DS0000008792.V299274.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, 9 and 10 The quality in this outcome area is good. Residents are assured that their needs are assessed and changing needs are reflected in their plan. Residents are supported to take risks and have an active independent lifestyle. EVIDENCE: Support plans are created from the assessment carried out by the social worker. These plans enable staff to work appropriately with residents to meet their needs and ensure they maintain an independent lifestyle. There is some limited use of pictures in plans to enable residents to understand their own support plan and staff spoken with said that when they review plans with residents that they use pictures to enable residents to participate in this process. A relative spoken with said that they had had been some involvement in drawing up the plan. There are risk assessments to ensure the safe participation of chosen activities, including where they may be some limitation on the activity to minimise risk to the resident, such as alcohol consumption in relation to a resident’s medication. There was also evidence of advocate involvement in creating and reviewing residents support plans where there are no family or other representatives involved. This ensures that the resident receives independent support in creating an appropriate plan. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 10 A requirement was made at the last inspection regarding the fact that the office area is attached to the lounge by an open archway and entrance to the lounge is through the office, this means that staff have nowhere to discuss confidential information in private. This requirement has not been met and therefore remains as a requirement in this report. 62 Second Avenue, DS0000008792.V299274.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 quality in this outcome area is good. Residents take part in age appropriate activities, are part of the community and are able to maintain personal relationships with family and friends. Residents’ rights are respected and responsibilities recognised. Residents are offered a healthy diet. EVIDENCE: A relative spoken with confirmed that staff were very supportive in ensuring that residents were able to visit and that relatives were welcomed to visit regularly, staff spoken with were able to discuss how they supported residents in visiting relatives or having visitors to the home. Evidence was seen that residents were involved in a variety of different activities other than just attending the day service. A relative spoken with said that not only did the resident continue with activities that they were involved in prior to admission but had become involved in considerably more including going to the cinema and the pub. Evidence was seen that support plans identified what household responsibilities the resident had and what staff support was required to enable them to carry 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 12 this task out ensuring that the resident was actively involved in the day to day running of the home. This was a recommendation at the last inspection. Staff were observed interacting with residents when they returned from the day service and exclusively with each other showing that staff valued the residents and respected them. Support plans detailed how staff were to maintain residents privacy and dignity and staff spoken with clearly understood the importance of promoting this with residents. It had been recommended at the last inspection that a support plan should be created regarding each residents need for a key, this has now been done and residents have access to the key to their bedroom. The support plan mentions opening residents mail in front of them, as they do not always have the literacy skills to read letters. This shows sensitivity to the needs of the resident whilst maintaining their dignity. Although the main meal was not observed, evidence was seen that every effort is made to ensure that residents are provided with nutritious meals. Staff spoken with were able to demonstrate how residents were involved in choosing the menu for the week and evidence was seen that residents were given a wide choice. Residents weight was regularly monitored to ensure their nutritional needs were addressed and support plans were seen to show that where residents needed support that this was met. 62 Second Avenue, DS0000008792.V299274.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 quality in this outcome area is good. Residents are protected by the home’s policies and procedures for dealing with medicines EVIDENCE: Support plans viewed show that residents are bale to receive their care as they wish, staff spoken with understood the different needs and preferences of residents and understood the importance of ensuring residents needs were met this way. Staff were able to give examples of where they had supported residents to choose their clothes or other aspects of their appearance. Plans gave a good understanding of residents’ moods and what could trigger a resident to become agitated, and methods to de-escalate a situation. There was evidence in support plans and diary notes of residents attending GP appointments and other health care visits. A requirement had been made at the last inspection regarding ensuring that medication is always counted in and recorded on the MAR sheet. Evidence was seen that this has now been done and the requirement is met. MAR records seen were in order, and provided clear instructions for the administration of medication. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 14 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 quality in this outcome area is poor. Residents are supported to make complaints. Residents are not always protected against abuse. EVIDENCE: Staff spoken had a good understanding of the importance of enabling residents to voice their complaints, and where residents had limited communication they understood the need to look at other non-verbal communication methods. A relative spoken with said that she had received information regarding the complaints procedure in the Service User guide when their relative moved in. The Commission has received no complaints regarding this service and has no concerns in this area. There are clear policies and procedures for staff to follow in the event of a complaint. The home has received one complaint, which was recorded on the SuRe system. Although it was being dealt with appropriately in the notes attached to the complaint it showed that a member of staff had asked the complainant to put their complaint in writing. This is unnecessary and complainants should not have to put anything writing it is for the staff to follow policy and procedure and deal with a complaint accordingly. There have been a large number of Protection of Vulnerable Adult referrals concerning one resident and their behaviour to other residents within the home. Although the home has been dealing with this and increased staffing has been obtained to support the individual in question it does raise the question of the resident’s suitability to remain within the home, as there is a continued risk to other residents in their home. The Registered Person must ensure that the resident’s needs are appropriately met in this environment whilst ensuring that the other residents are not placed at risk. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 15 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, 28 and 30 The quality in this outcome area is poor. There are areas where poor maintenance of the building places residents at risk and the physical layout of the home does compromise confidentiality and impacts negatively on residents’ communal space. EVIDENCE: A tour of the premises took place and residents bedrooms and the communal areas were viewed. One bedroom had been decorated recently, however in two identified bedrooms where the radiators had been replaced there were large areas on the walls that needed repainting. Although the windows had restrainers fitted to minimise risk to residents of falling out of the opened window, they could not be opened due to the fact the windows were warped and if they were opened they could not be closed. Bedrooms were personalised and pleasant environments for residents to spend time in. The home was bright, cheerful and airy; it was also clean and hygienic. Furnishings and fittings appeared to be of good quality and provided a homely environment. Although general maintenance was carried out, there was no evidence that there was a planned renewal programme that would ensure that 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 16 areas such as the driveway to the front of the house, the windows, and the areas where the radiators had been replaced were to be repaired. The deputy manager reported that Nottingham Community Housing Association was aware of the problems but was unable to provide a time scale for their repair. The Registered Person must ensure that areas that place residents at risk are repaired. A requirement has been made at the last inspections regarding the layout of the lounge and the office. The issue is that access to the lounge is via the office and an open brick archway is the only thing that separates these two areas. This requirement has now been outstanding for over two years. Therefore, the requirement remains in this report. The Registered Person must ensure that this requirement is met to minimise the risk of breaches in confidentiality. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 17 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 quality in this outcome area is adequate. Residents are supported by staff who are competent and qualified, however residents are placed at potential risk by staff not having up to date mandatory training. There is no evidence to show that resident are protected by robust recruitment practices. EVIDENCE: Staff spoken with said that they assigned different roles focusing on different aspects of life within the home including activities and communication. This utilises individual strengths, enable staff to develop skills and take a lead in issues of interest. This benefits the residents and contributes to the efficient running of the home. It was clear from talking with staff that they are positive about providing quality care and support to the people that live at the project. Evidence was seen that staff have access to some training courses including NVQ training, Autism Awareness, Epilepsy Awareness, Computer Training, Spiritual Needs, all courses that are valuable to enable staff to carry out their support role. However the deputy manager reported that due to the project moving out of the health care Trusts control that they were no longer able to access training from that area and therefore some staff were in need of updating their mandatory training and were struggling to access this through Nottingham Community Housing Association. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 18 This has meant that some staff do not have up to date Food Hygiene certificates or First Aid Certificates. The Registered Person must ensure that staff receive the appropriate training to support residents. In discussion with staff they confirmed that they were able to access NVQ courses. Staff were observed interacting with residents in a positive manner, using a variety of skills including listening and staff appeared motivated and approachable with residents. This showed that staff had the competencies and qualities to meet residents’ needs. On 9th March 2006 two inspectors visited the Health Care Trust Offices to inspect staff recruitment files to ensure they followed robust recruitment procedures. The outcome was there was insufficient information in many files, in some cases they lacked two references and Criminal Records Bureau checks. The home itself has some information regarding recruitment and copies of Criminal Records Bureau checks are kept, however the deputy manager reported that they recently sent over their copies of references to Nottingham Community Housing Association head office as they were compiling staff files there. At the last inspection a requirement was made The Registered Person must ensure that staff files are made available for inspection during the inspection. This requirement is not met. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 19 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, 41 and 42 The quality in this outcome area is good. Residents’ benefit from a well run home, there are systems in place for monitoring and reviewing the quality of care that aim to be underpinned by the views of residents and the health, safety and welfare of service users are promoted and protected. EVIDENCE: Staff spoken to felt that the home was generally well run, that the manager was supportive and listened to staff. Nottingham Community Housing Association has a variety of monitoring tools including regular internal audits that use staff and residents from other services and also external audits. There are also residents meetings held every month. The home is signed up to the Nottinghamshire initiative ‘The Quality Tree’ that promotes quality assurance based on the involvement of residents. A requirement was made at the last inspection regarding regulation 37 reports notifying the Commission following incidents within the home. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 20 Although the Commission received several reports since this requirement was met, looking at The SuRe system showed that there were numerous incidents that had not been notified. Some were of low impact on other residents but some could have had the potential for impacting on the other residents’ life and as such the Commission should be notified on all incidents as detailed in Regulation 37 of The Care home Regulations 2001. The health and safety monitoring within the home is of a good standard and evidence was seen that fire tests are carried out and appropriate maintenance is carried out on equipment. Accidents are recorded on SuRe system and action taken as necessary to minimise risk to residents. Risk assessments are carried out of safe working practices within the home and reviewed regularly. This ensures that the environment is not only safe for residents but for staff also. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 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 X 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 2 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 1 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 1 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 2 3 X 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 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 YA5 Regulation 5(1)(c) Requirement Timescale for action 01/11/06 2. YA10 23(2)(a) 3 YA23 13(6) The Registered Person must develop a standard form of contract for the provision of service and facilities by the registered provider to service users; that is more applicable to the needs of residents with a learning disability. (Outstanding requirement 28/02/05) The Registered Person must 01/11/06 ensure that the needs of the residents can be met, the physical layout of the home must take into account how to safeguard confidentiality. (This is an outstanding requirement from previous inspections, initial timescale 30/09/03.) The Registered Person shall 01/08/06 make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Action must be taken to prevent residents being abused by an identified resident. 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 23 4 YA24 23(2)(b) 5. YA28 23(2)(e) 6. YA34 17(2)(3) 7 YA41 37 The Registered Person must ensure that the home the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally, identified areas must be repaired or replaced. The Registered Person must ensure that adequate communal accommodation is provided for service users. While the office remains as part of this communal space then this is not adequate. (This is an outstanding requirement from previous inspections, initial timescale 30/04/04.) The Registered Person must ensure that where records as specified in Schedule 4 are not maintained in the care home then there must be internal arrangements in place to ensure that these records are made available at the care home on the day of inspection. (Outstanding requirement 31/12/05). Ensure all incidents as specified in Regulation 37 are notified to the Commission. 01/09/06 01/11/06 01/09/06 01/09/06 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 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 62 Second Avenue, DS0000008792.V299274.R01.S.doc Version 5.2 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. 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