CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE
Rectory Road (87) 87 Rectory Road Pitsea Essex SS13 2AF Lead Inspector
Mr Trevor Davey Unannounced Inspection 12.00 23 March 2006
rd X10029.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 Rectory Road (87) DS0000036721.V280995.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 and 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. Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Rectory Road (87) Address 87 Rectory Road Pitsea Essex SS13 2AF 01268 583634 01268 584347 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) MCCH Society Limited Mr Francis Anthony Winn Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (7) Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. To accommodate the five service users under the age of 65 years who have a diagnosed mental disorder (excluding learning disability or dementia). To accommodate the seven service users over the age of 65 years, who have a diagnosed mental disorder (excluding learning disability or dementia). 26/09/05 Date of last inspection Brief Description of the Service: 87, Rectory Road provides accommodation, nursing care and support for twelve residents who have severe and enduring mental health illness. The home is a purpose built property on two floors in a mainly residential area of Pitsea, within close proximity of local shops and has transport links to Basildon and Southend-on-Sea. All bedrooms are single with en-suite facilities and a passenger lift is provided to all levels. There is a communal bathroom on both floors and a large lounge/dining room on the ground floor with a separate activities room. Residents are able to access a large garden/patio area and on site car parking is available. The home has the use of a vehicle for transporting residents. Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place on 23rd March 2006 lasting 3.50 hours. The inspection process included discussions with the manager, five staff and seven residents. A tour of the premises took place and a sample of policies and records were inspected. Ten standards were assessed and requirements and recommendations are listed in the report. As the age range of the majority of residents’ falls within the older person category, the Older Person National Minimum Standards have been used for the basis of this inspection. What the service does well:
The management and staff team are good and consulting with residents on an individual basis taking into account identified needs and choices, which are clearly recorded in personal care records. Care planning together with risk assessments are detailed and reviewed on a regular basis. The home is good at meetings the social and leisure expectations of residents and staff regularly accompany residents on a variety of outings, holidays and visits to the local community. One of the staff team has the primary task of organising activities who liaises with staff and works together with residents on an individual and group basis. The home is good at utilising the varied skills of the staff team for the benefit of residents and maximising their quality of life. Some of the residents spoken to clearly enjoyed the homely atmosphere and the interaction with members of staff in recreational and social activities. Other residents’ spoke about some of the items they had purchased at local shops and were able to recall some of their holiday experiences. There is clear evidence of the ability of the staff team to communicate and work well together as well as taking on challenges and pressures in the home in a professional way. The Registered Provider provides good and frequent training opportunities to ensure staff are fully equipped and updated in all aspects of the service. The home is accepted and well supported by the local community and neighbourhood. Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better:
Although some recruitment records were available for inspection, not all documentation was in place to show that appropriate checks had been completed. Although some information was available for inspection, the Registered Provider maintains a record of recruitment checks, including Criminal Record Bureau forms and references, in their central office in Maidstone. To enable the Commission for Social Care Inspection to be satisfied that thorough recruitment checks have been completed for all staff employed in the home, written confirmation must be made available to the Manager of the home by the Registered Provider confirming that all recruitment procedures have been completed as required under Regulation 19 (schedule 2) of the Care Homes Regulations. Alternatively, an agreed arrangement must be made by the Registered Provider with the C. S. C. I. to make recruitment records available for inspection when required. A requirement from the last inspection for contracts specifying terms/conditions, including the costs of services provided by the Funding Authority and other items which are the responsibility of the resident, has not been met. It is understood that the Manager is still waiting for financial figures from the Primary Care Trust. From the sample checks made of records relating to residents personal allowances, not all the balances shown in the financial transactions, coincided with the cash being held at the time. Although these discrepancies were minor, some improvements need to be made to the recording procedures of financial transactions, including two signatures, which
Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 7 should include the resident if possible, or a second member of staff. Residents still tend to sit together in the dining room/lounge area, which can become noisy at times and apart from the activities room, there is no other quieter communal area where residents can relax unless they go to their own bedrooms. It is acknowledged, however, that arrangements have been made to have a more flexible arrangement for meals so that not all residents are necessarily together at the same time. 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. Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Existing contracts terms/conditions do not specify clearly for residents and/or their representatives, the breakdown of costings in respect of the responsibility of the South Essex Partnership Trust and other items, which are the responsibility of the resident. EVIDENCE: The Inspector was advised that the Manager was still in the process of updating contracts and this had been discussed with the South Essex Partnership Trust. Although figures from the S.E.P.T. had been requested, these had still not been made available. This shortfall was identified in the last inspection and contracts together with terms/conditions must be clear for residents and/or their representatives to indicate clearly costs of services and who is responsible.
Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 10 The Homes philosophy of care and interaction by the staff team, ensures that residents are treated with respect and their right to privacy is upheld. EVIDENCE: All residents are accommodated in single bedrooms with the advantage that all have the availability of their own private space. The care and support of residents is person centred and an identified key worker is allocated to each individual. The holistic needs of residents are varied and diverse but personal care records are regularly updated, together with risk assessments, to ensure appropriate care and support is given. These issues are discussed with
Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 11 residents and/or relatives as well as other health care professionals as required. All aspects of daily living including individual preferences are taken into account and are discussed on a one-to-one basis or in groups. Residents meetings also take place. Some of the residents spoken to enjoyed the homely atmosphere and the company of some of the other residents. It was also observed during inspection that there was a good rapport between members of the staff team and individual residents, which included a sense of humour but without compromising the respect and dignity shown to residents. Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): X EVIDENCE: Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 There is an established complaints procedure in place and up- to- date policies and procedures for the protection of vulnerable adults. These are regarded as effective in dealing with issues, which arise in the Home and promoting the safety of residents. EVIDENCE: The Registered Provider has demonstrated a competence in using policies and procedures for dealing effectively and promptly with issues relating to complaints and staff disciplinary matters where the safety and well-being of residents could have been at risk. Appropriate investigations have taken place by the Registered Provider and as a result of the outcomes, policies and procedures have been updated to clarify staff accountability and areas of responsibility in the interest and well-being of the resident group. Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The premises are purpose built with a main communal lounge/dining facility but with no suitable alternative sitting or quiet area for the use of residents. EVIDENCE: Overall, the accommodation and facilities provided for residents is of a good standard and well maintained. The main dining/lounge area, however, is one room and although this can be useful for residents to meet together for a range of activities, there is no alternative communal sitting/quiet area which means residents are limited in their choice of surroundings unless they choose
Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 15 to spend time in their own bedrooms. There is an activities room, which is sometimes used, but residents tend to congregate in the main dining/lounge area and this can become very noisy at times which some of the residents find disturbing. The Registered Provider should look into the possibility of creating more alternative communal space to give residents more choice to spend time in a quieter and a more relaxed area. This issue was raised in the last inspection. Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the 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 The deployment and number of staff available at the time of inspection, was sufficient to meet the needs of residents. There was insufficient evidence in the Home to show that the Register Provider had carried out all recruitment checks on staff to ensure residents are supported and protected by the Homes recruitment policy and practices, as required by Regulation. Staff are trained and equipped to fulfil their caring/supporting role in order to meet the needs of residents. EVIDENCE: At the time of inspection, sufficient managerial, supervisory and support workers were on duty in the home. There was one vacancy for a support worker and a Registered Mental Nurse was currently being recruited. A staff rota showing the deployment of staff was available. Records were available of training courses completed by staff, which included food hygiene, adult protection awareness, multi sensory concepts as well as loss and bereavement. Staff spoken to found the training and ongoing development opportunities good, which the Registered Provider regards as a priority. Three staff have
Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 17 attended core induction standards for new staff and the Manager has been asked by the Registered Provider to compile a course of training of mental health awareness. It is envisaged that this course will be used for the benefit of staff employed by all M.C.C.H. homes in the area. Sample checks were made of recruitment records and some of these were complete but other records were being held in the Registered Providers central office and were not available for inspection. There was not always evidence to show that Criminal Record Bureau checks had been completed for staff and that satisfactory references had been received. The Registered Provider must enter into an agreed arrangement with the Commission for Social Care Inspection to enable all recruitment records to be made available for inspection as required by Regulation. This was highlighted as a requirement in the last inspection. Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) 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 & 35 The Registered Manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. Whilst procedures are in place to safeguard the personal allowances of residents, these need to be reviewed to ensure records of financial transactions are accurate, checked and clearly documented.
Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 19 EVIDENCE: The current Registered Manager has been in post since 2002 and has considerable previous experience in mental health nursing units as well as setting up and managing a crisis intervention team. The Manager is currently studying for the Registered Managers Award and expects to complete his studies in December 2006. The Registered Provider has also asked the Manager to compile a course of training for mental health awareness. Periodic meetings have taken place together with other managers, with the Provider Relationship Manager of the C. S. C. I. The Inspector was advised that these had proved useful in keeping up to date with possible changes for the future in the inspection process. A sample check was made of the records relating to the personal allowances of residents and this showed minor discrepancies between the amount of cash held and the financial transactions recorded. Where transactions had taken place, there was only one staff signature on the record sheet. Wherever possible, residents should be encouraged to sign for any cash received as well as having a staff signature as a witness. Where residents are incapable of signing for their own money, two members of staff should sign to confirm any financial transactions, which have taken, place on behalf of residents. Receipts had been kept of expenditure relating to purchases and services paid for on behalf of residents. Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 20 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 x 2 2 3 x 4 x 5 x 6 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 ENVIRONMENT Standard No Score 19 x 20 2 21 x 22 x 23 x 24 x 25 x 26 x STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 x 33 x 34 x 35 2 36 x 37 x 38 x Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 21 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 OP2 Regulation 5(1) Requirement The Registered Provider must produce a contract terms/conditions which identifies the costs of services provided by the Funding Authority and for items which are the responsibility of the service user. (Schedule 4 also refers). (Previous timescales of 31/10/05 & 01/12/05 not met). The Registered Provider shall having regard to the number and needs of the service uses, ensure that the physical design and layout of the premises to be used as the care home meets the residents needs. This is in reference to the need to create an alternative quiet/lounge area for the benefit of residents. (previous timescale of 31/03/06 not met). The Registered Provider shall not employ a person to work at the care home unless all recruitment checks have been carried out and are available for inspection as required by
DS0000036721.V280995.R01.S.doc Timescale for action 01/06/06 2. OP20 23(2) 30/11/06 3. OP29 19 30/05/06 Rectory Road (87) Version 5.1 Page 22 4. OP35 17 Regulation. (Schedule 2 also refers. (previous timescales of 31/03/05 and 30/11/05 not met). The Registered Provider shall maintain in the care home a record of all money or other valuables deposited by a service user for safekeeping or received on the service use s behalf, which shall state the date on which the money or valuables were deposited or received, the dates on which any money or valuables were returned to a service user or used, at the request of the service user, on his behalf and, where applicable, the purpose for which the money or valuables were used; and shall include the written acknowledgement of the return of the money or valuables. A staff signature should be recorded to witness the signature of the resident and if the resident is incapable of signing, then two staff signatures should be included for this purpose. (Schedule 4 refers). 30/04/06 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 Rectory Road (87) DS0000036721.V280995.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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. Rectory Road (87) DS0000036721.V280995.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!