Inspection on 04/10/05 for 807 Pershore Road

This inspection was carried out on 4th October 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

807 Pershore Road 19/05/08

807 Pershore Road 21/06/07

807 Pershore Road 21/04/05

807 Pershore Road 07/12/04

807 Pershore Road 14/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Pershore Road 807 Pershore Road Selly Park Birmingham B29 7LR Lead Inspector Brenda ONeill Announced 4 October 2005 th 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 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 Stationary 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. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Pershore Road Address 807 Pershore Road, Selly Park, Birmingham B29 7LR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0121 415 5684 0121 415 5684 Mind In Birmingham Philip Glenholmes (acting) Care Home 10 Category(ies) of Mental Disorder (10) registration, with number of places Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years 2. That two named people, who are over sixty five years of age can be accommodated and cared for in this Home. Date of last inspection 21st April 2005 Brief Description of the Service: 807 Pershore Road is a large detached double fronted three storey, Victorian style property in Selly Park. The home provides care and support for up to ten people with mental health needs and describes itself as a rehabilitation unit. The home is well placed in terms of access to the local community, being close to a number of shops, pubs, park, Stirchley village and local bus and rail services. The front of the house has a well-maintained walled garden, which provides parking for some cars, the rear garden is large and very private and is utilised by residents in the summer. The house feels spacious and homely, it appears to be a well established home with a clear philosophy of care that clearly suits the service user group. All bedrooms are of single occupancy and two have en-suite facilities. There are showering/bathing facilities on each floor and toilets are shared by no more than three residents. There are also kitchenettes on each floor for the use of the residents. Communal space comprises of two large lounges, one smoking and one non smoking and a large dining room which are all located on the ground floor. Also located on the ground floor are a laundry, main kitchen and small office. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and was carried out over one day in October 2005. This was the second of the two statutory inspections for 2005/2006. To get a full overview of all the standards assessed at this home this report should be read in conjunction with the report from the inspection carried out on April 21st 2005. During this visit a partial tour of the premises was made, two residents files, staff training records, health and safety records and some policies and procedures were sampled. Four of the nine residents, the acting care manager, the service manager, the cook and two of the care staff on duty were spoken with. What the service does well: Resident involvement was seen as high priority at the home and residents were fully involved in drawing up their own care plans and risk assessments and could be involved in staff recruitment, staff training and quality audits if they wished. All residents spoken with were satisfied that their needs were being met. Staff were very aware of any residents whose mental health was causing concern and of the strategies in place to manage this. Residents living at the home were encouraged to develop and maintain independent living skills such as laundry, cooking and travelling on public transport. All residents had keys to the home and their bedrooms. The home generally had a very ‘easy going’ atmosphere that appeared to make the residents comfortable. The catering arrangements at the home were very good with the opportunity for residents to self cater as much as they were able. The menus in the home were very varied and offered choices. Residents were encouraged to self administer their medication wherever possible. Risk assessments were carried out to determine the resident’s ability to self administer and there were instructions for staff as to what support they were to give to the residents to enable them to self administer. The staff at the home were well trained and staffing levels appeared to meet the needs of the residents. There had been no staff turnover at the home which was very good for the continuity of care of the residents. The home was very spacious and generally comfortable and residents spoken with were satisfied with their bedrooms. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 standard(s) 1 and 3. There was information available to ensure that prospective residents had the information they needed to make an informed choice about where they live. The arrangements for assessments of prospective residents were good and took into account the individual’s aims and aspirations. EVIDENCE: The statement of purpose for the home had been updated as was required at the last inspection and included the required information. There had been no new admissions to the home for a considerable period of time therefore the initial assessment process was not inspected. The inspector was aware from previous inspections that prior to admission to the home a thorough assessment of prospective residents’ needs took place that involved a variety of professionals. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 standard(s) 6 and 9 There was a good system in place for care planning and assessing risks that evidenced full consultation with the residents had taken place. EVIDENCE: Two care plans were sampled during this inspection these, were entitled essential lifestyle plans. Both evidenced they had been compiled with the full involvement of the individual residents. They gave clear, concise information in relation to the individuals’ routines, likes, dislikes and responsibilities. Also included was what was important to the individuals and what others needed to know to support them. One of the residents had an ongoing health issue which was clearly documented and showed how this was monitored. The other resident preferred quite a set routine and this was evident in the plan, for example, when to launder clothes and when to cook. There was evidence on the files of monthly evaluations of the essential lifestyle plans undertaken by key workers in consultation with the residents these noted any significant changes to the resident together with specific changes to the plans. There were also regular six monthly reviews with the involvement of other professionals as necessary and a summary of the reviews and the resulting action plans were evident on the files. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 10 Both files sampled included an array of risk assessments that were written from the resident’s perspective and the actions to be taken had been agreed with them. Risk assessments included such topics as self neglect, diabetes, self harm and aggression. These were being reviewed on a regular basis. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 and 17. Residents were able to access the local community and were supported as necessary to engage in appropriate activities and pursue their interests and hobbies. The meals in the home were good with choices available and residents had the opportunity to self cater if they were able. EVIDENCE: A variety of opportunities for college courses, day centres, exercise and days out were made available for the residents at the home. Staff enabled the residents to undertake their preferred activities wherever possible. At the time of the inspection activities that residents were involved in included, gardening projects, I.T. courses, music courses, French lessons, swimming, playing golf, drop in centres and day centres. One of the residents went out regularly with a befriender, another continued to go to mass every week, another chose to spend a lot of time with his friends. Residents were supported by staff to attend their activities when necessary however at the time of the inspection the majority of the residents were able to access the community independently. Some of the residents spoken with talked about using public transport, others liked to use taxis when they could and one resident had recently passed his driving test. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 12 During the course of the inspection residents were seen to come and go from the home as they wished. They accessed the facilities in the local community as they wished, for example, shops, pubs and doctors. All but one of the residents was doing some cooking during the week. Residents were able to self cater to whatever extent they were able and a budget was allocated to them accordingly. Some residents shopped for their own foods others were supported by staff until such time as they were able to do this independently. Residents had access to kitchen facilities and foods at all times. The menus in the home were drawn up after consultation with the residents and they evidenced a vast array of choices. Residents were always asked prior to the main meal what they wanted to eat if they were not doing their own cooking. All the residents spoken with were happy with the catering arrangements at the home. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20. Staff had a good understanding of the resident’s personal and health care needs and ensured these were met whilst maximising their independence and control over their lives. EVIDENCE: The residents at the home were independent in terms of personal care and only needed prompting by staff. There was only one female resident at the home and she had been there for some time. The inspector spoke with her and she again confirmed she did not feel isolated as she had good relationships with the female staff and also had a female befriender who she went out with. The appearances of the residents appropriately reflected their difference in personalities and age groups. Throughout the inspection the acting manager gave evidence of the actions taken when the residents mental health was causing concern, for example, contacting community psychiatric nurses, medication being reviewed, residents seeing their psychologists and staff being extra vigilant in relation to residents taking their medication or when they are isolating themselves. Residents were supported as necessary to attend health care appointments. One of the residents continued to have twice daily visits from the district nurse to administer insulin, another had attended the hospital on the day of the inspection for a blood test. Residents were also encouraged to pursue a healthy lifestyle via both exercise and diet. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 14 The medication system in the home was generally well managed. Residents were encouraged to self administer their medication wherever possible. Risk assessments were carried out to determine the resident’s ability to self administer and there were instructions for staff as to what support they were give to the residents to enable them to self administer. There was evidence of self administering progress sheets to ensure the residents were monitored. All the medication being received into the home were signed for and audited regularly, copies of prescriptions were being kept and medication administration records were being completed appropriately. The home had a general written protocol for the administration of PRN (as and when necessary) medication which stated that the guidelines for individuals must be followed, however one of the residents who was having PRN medication had no written guidelines. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 standard(s) 23 There were policies and procedures on site for the prevention of abuse and staff had received training in the prevention of abuse to ensure the protection of the residents. EVIDENCE: Staff had received training in the issues surrounding adult protection. No issues had arisen at the home. There were policies and procedures on site both from the organisation and the most recent multi agency guidelines for adult protection. It was noted that the organisation’s procedures differed slightly from the multi agency guidelines in respect of investigations and whether to report to social care and health. This was discussed with the service manager who was to address with the procedure writers. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 standard(s) 24, 27, 28, and 30. The home was spacious and met the needs of the residents. To ensure the comfort and availability of adequate facilities for the residents some replacement furnishings were urgently needed and some redecoration to the communal areas and a new kitchen. EVIDENCE: There had been no changes to the layout of the home since the last inspection which was suitable for its stated purpose. The home was generally safe however, there had been a recent visit from the fire officer and the registered person needed to ensure that the requirements from this were met within the given time scale. The need to have the water system checked for the prevention of legionella was discussed with the service manager. Since the last inspection new flooring had been fitted in the corridors, entrance hall and dining room downstairs and one of the toilets had been redecorated. There were adequate toilets and bathrooms/showers throughout the home, no more than three residents shared each bathroom and toilet. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 17 There was ample communal space for all residents with designated dining and smoking areas. The redecoration of the dining room and replacement furniture in the lounges remained outstanding from the last two inspections. The furnishings in the lounges were very badly worn and in urgent need of replacing. The kitchenettes on the upper floors, the main kitchen on the ground floor and laundry were domestic in size and accessible to residents. The home was clean and odour free with the laundry being appropriately located. The COSHH substances that were stored in the laundry were not being stored securely and presented a risk for residents. This was also a requirement at the last inspection and staff needed to be more vigilant in relation to this issue. The main kitchen, which was used by the residents, had not been improved and remained in need of refurbishment. This is an outstanding requirement from the previous two inspections. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 35. Adequate staffing levels were being maintained by a well trained staff group that could meet the needs of the residents. The recruitment procedures were robust and ensured the protection of the residents. EVIDENCE: Throughout the course of the inspection there were very positive interactions between the staff and the residents. Residents spoken with were very happy with the staff team and the support they received from them. Discussions with staff evidenced they had a clear understanding of the needs of the residents and the support they needed. There had been no staff turnover at the home since the last inspection and the two vacancies that had been frozen had been filled by staff transferring from a home that had closed. The home was continuing to use an agency cook and employed a domestic assistant. The staffing levels appeared to meet the needs of the residents at the time of the inspection. The inspector was aware that MIND operates within very robust recruitment and selection procedures. There was an outstanding requirement in relation to all documentation being available for inspection this was made mainly in relation to a CRB that was not available. At the time of this inspection all the CRBs that had not been seen by the inspector were made available and all were appropriate. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 19 The inspector had the opportunity to view the training programme for MIND for this year and this demonstrated they were clearly committed to having a well trained staff group. There was an induction procedure followed by other training that encompassed all the regulatory training plus other topics, for example, essential lifestyle plans, self harm, recovery and protection from abuse. The manager did need to ensure that the induction training records are available on site and that all staff have individual training records as those that had transferred had no records on site. Fifty percent of the staff had been trained to either NVQ level 2 or 3. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 42 and 43. The home was well managed with an open and inclusive atmosphere where the health and safety of the residents and staff was promoted and protected. Quality audits needed to be carried out on a regular basis to ensure the quality of the service offered to the residents was being monitored. EVIDENCE: The manager of the home had been seconded to a different post for a short time therefore one of the care officers had been appointed as acting manager. CSCI had not received an application for registration from the substantive manager and this was an outstanding requirement from the previous inspection. The acting manager had worked at the home for a number of years and demonstrated a very good knowledge of the residents’ support needs and of how he knew when their mental health was deteriorating. Relationships between him, staff and the residents appeared to be good. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 21 Residents spoken with stated they would have no hesitation in approaching the acting manager or any of the staff team with any issues that arose and were confident these would be resolved. One of the residents was able to cite an occasion when he had done this and the issue was resolved quickly. Residents were encouraged to take part in the running of the home and were able to take part in staff recruitment and staff training if they wished. MIND had a quality assurance system which incorporated internal audits of the standards of the service being carried out. These audits had lapsed at the home and would normally have been carried out by staff, committee members and residents. Residents meetings were being held monthly and other internal audits were being carried out, for example, health and safety checks on bedrooms and medication. Health and safety was very well maintained at the home. Staff had received training in safe working practices including, fire procedures, first aid and food hygiene and protective clothing was available as needed. Issues that arose during this visit were relatively minor. There was evidence on site of the regular servicing and required checks of fire alarms, emergency lighting, fire extinguishers, gas appliances, portable electrical appliances and electrical wiring. There was comprehensive insurance cover for the home and evidence of this was seen on site. The acting manager received regular support and supervision from his line manager. CSCI were receiving some copies of Regulation 26 visit reports however this was not being done on a monthly basis as required. Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 3 1 x 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Pershore Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 2 x x 2 2 E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 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. 1. Standard 20 Regulation 13(2) Requirement There must be individual written guidelines for staff to follow for any PRN medication being administered to residents. The responsible individual for the organisation must ensure that the adult protection procedure is in line with the multi agency guidelines. The registered person must enusre that the requirements made following the fire officers visit are met within the given time scales. The registered person must ensure the water system is checked for the prevention of legionella. The dining room is in need of decoration. (Previous time scales of 01/02/05 and 01/07/05 not met.) The furniture in the lounges is badly worn and must be replaced. (Previous time scales of 01/02/05 and 01/07/05 not met.) The main kitchen must be refurbished. (Previous time scales of 01/04/05 and 01/06/05 Timescale for action 01/11/05 2. 23 13(6) 01/12/05 3. 24 23(4) 20/10/05 4. 24 13(3) 01/12/05 5. 28 23(2)(d) 01/12/05 6. 28 16(2)(c) 01/12/05 7. 30 23(2)(b) & 13(3) 01/01/06 Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 24 not met.) 8. 30 13(3) All COSHH substances must be locked away when not in use. (Previous time scale of 22/04/05 not met.) The registered person must ensure that records are maintained of the induction training undertaken by staff. (Previous time scale of 01/06/05 not met. All staff must have individual training records on site. 10. 37 8(1)(a)(b) An application for the registration of the manager must be forwarded to the CSCI. (Previous tie scale of 01/06/05 not met.) The registered person must ensure that the quality audits are undertaken to measure the homes progress in its stated aims and objectives. Copies of the monthly visit reports made by the representative of the organisation must be available for inspection. 01/12/05 01/11/05 9. 35 18(1)(a) 01/12/05 11. 39 24(1) 01/12/05 12. 43 26 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Pershore Road E54 S16858 807PershoreRd V245215 041005 AI stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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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