Inspection on 06/12/07 for Abbey Care Home

This inspection was carried out on 6th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Abbey Care Home 23/05/06

Abbey Care Home 14/02/06

Abbey Care Home 16/02/05

Abbey Care Home 17/06/04

Abbey Care Home 11/03/04

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

CARE HOMES FOR OLDER PEOPLE Abbey Care Home Collier Row Road Collier Row Romford RM5 2BH Lead Inspector Margaret Flaws Unannounced Inspection 6th December 2007 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbey Care Home DS0000053550.V356025.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbey Care Home Address Collier Row Road Collier Row Romford RM5 2BH 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) 01708 732658 0207 437 1137 Corvan Ltd vacant Care Home 20 Category(ies) of Dementia - over 65 years of age (20) registration, with number of places Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2007 Brief Description of the Service: Abbey Care Home provides accommodation and support for twenty older persons, mostly those who have dementia. This privately owned care home was purpose built, and is in a semi-rural location about a mile away from the main shops and transport links of Collier Row. A local bus stops outside the home. All bedrooms are singles, but are quite small, though they have their own en-suite toilets. It has a lift between the ground and first floors. The main communal room is an L-shaped combined lounge and diner. There is a second small lounge on the first-floor. One major drawback is that there are only two small bathrooms, but these both have special baths. Mr Anil Patel bought the home just over three years ago. He tried to get planning permission to expand the home, including increasing the limited communal space and adding bathrooms and toilets, but was not successful. He is now looking at other ways to solve space problems. There is plenty of garden space at the side and rear, and a large front forecourt for parking. The fees for the home are £480 to £500 per week. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This first inspection took place over one day and the Registered Individual and two management consultants assisted me throughout the inspection. I spoke to several people currently living in the home, to all staff on duty, to a visiting GP and observed interactions between residents and staff. The remainder of the inspection consisted of a tour of the premises and examining the home’s policies and procedures, care and staff records, health, safety and administrative records. The home also provided CSCI with an Annual Quality Assurance Assessment. Two relatives questionnaires were also received. What the service does well: What has improved since the last inspection? What they could do better: The home must provide CSCI with a copy of building refurbishment and improvement plans, along with projected dates and timeframes for the beginning and completion of work. The home must also supply CSCI with a copy of their plan for managing potential risks to residents, staff and visitors during the refurbishment and information on how their quality of life will be maintained during the period of works. All staff must be trained in first aid, health and safety, infection control, food hygiene, fire safety and adult protection. In the absence of a Registered Manager at the home, the Registered Person must urgently cover the post with another Registered Manager, who has the skills and existing qualifications to maintain service improvements. It would be beneficial if senior staff received training in advanced dementia care. A recommendation is given. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have their needs assessed so that the home can judge whether and how these can be met. EVIDENCE: The home had nineteen residents at the time of the inspection. The home has a reasonable Statement of Purpose and Service User Guide (called a Residents’ Handbook). A Visitor Information File is also provided in the main reception area. The assessment procedure is outlined in the Statement of Purpose and the Service User Guide. At the moment, in the absence of a Registered Manager, the two management consultants, Mr and Mrs Khan, undertake assessments. They are also upskilling the two senior staff to undertake assessments but the sustainability of good assessment processes will depend on having a Registered Manager in the home. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 9 I read the files of five residents and discussed these with Mrs. Khan. The files contained good quality assessments from the placing authorities and preadmission assessments completed by the service. These were of a good standard and provided a sound basis for care planning. The comprehensive assessment form covered physical, psychological and social needs. It was evident that there have been improvements in pre-admission assessments. During the inspection, a social worker rang to ask for an emergency placement but Mrs. Khan made it clear that the home was unable to accept such emergency admissions and outlined the assessment procedure to the social worker. I spoke to a visiting GP who said that the home is careful only to admit people with minimal physical needs and no significant challenging behaviour. She said this contributed to the home’s ability to meet the needs of the people they assessed. As a result of recent adult protection investigations, all placing authorities have reviewed the care of those they placed there. I read one review (by London Borough of Islington), which found that the care was good. Mrs. Khan confirmed that reviews by the other placing authorities had been positive. I sampled contracts and terms and conditions, which were held on file. These were in order. The home does not provide intermediate care. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, 10, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are outlined in care plans based on comprehensive assessments. Risks are generally well assessed. Medication – no judgement made here. CSCI Pharmacist separate inspection. Consideration is being given to residents’ wishes in case of death. EVIDENCE: Individual care plans were in place, with reasonable information and guidelines for staff to know and understand the residents’ needs and wishes and work to meet them. The care plans use a scoring system for working out the dependency levels of the residents and monitoring them accordingly. I spent some time in the lounge areas observing interactions between the residents and the staff. These interactions appeared healthy, positive and demonstrated a warmth and understanding between the staff and the residents. The staff demonstrably supported and encouraged the residents to Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 11 make decisions, to the extent to which they were able to express their wishes. The atmosphere in the home was relaxed and homely. They provided positive reassurance for one resident who became disorientated and cried out at regular intervals. Most people living in the home have some degree of dementia. According to the training matrix and what they told me, staff have been trained at an introductory level on dementia and in how to care for people affected by it. The home receives regular visits from a dementia care advisor. However, it would be beneficial if senior staff received training in advanced dementia care. A recommendation is given. The residents I spoke to said that they liked the staff and said that they cared for them well. Relatives surveyed were positive about the care and the support in the home. Daily notes were of reasonable quality. All people living in the home had their health needs monitored and had had regular health checks. During the inspection, a GP from the local surgery visited and I spoke to her. She said that the care in the home was good compared to some other homes that she visited. She also said that the staff were always in touch with the needs of the residents and communicated regularly with the local surgery if they had concerns. I sat in on the staff handover and had a discussion with the team. They demonstrated a clear knowledge of the residents and a professional approach to meeting their needs. In the residents’ files, risks to them had been assessed. These included behaviour patterns, falls, skin viability, mobility, moving and handling and nutrition. A procedure is in place for regularly reviewing care plans and risk assessments. Falls monitoring is in place and Dr. Khan described how falls patterns are regularly analysed. Significant events, including falls and hospital admissions, are reported regularly to CSCI using our Regulation 37 reporting format. In the case of one resident with English as a second language, staff have were observed talking to her in her mother tongue and I saw a comprehensive list of words that they use to communicate with her. The Pharmacy Inspector, on a separate inspection a few days before my visit, assessed the home’s compliance with the medication Standard Nine. He will report separately. I discussed end of life care at the home with Mrs. Khan. She is involved in a steering group working to improve end of life care for people living in the area, especially care for people living in care homes. Some staff have had Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 12 bereavement training and Mrs. Khan is working on protocols for end of life in the home, which will include identifying people’s wishes in case of death. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily activities and community involvement are reasonable to benefit the people living in the home. Family involvement is supported. Food and choices available are reasonable. EVIDENCE: During my visit, most people were sitting in one of the two lounges. Individual, small scale activities took place throughout the day, with staff spending time reading to people, dancing with them and playing games. Activities are planned for and recorded. A mobile library visits and residents take part in quizzes and games. Recent activities recorded included visits from entertainers and a church service. I saw photos of a recent visit from the young children at the local dance and drama school. They performed for the residents, with colourful changes of costumes and singing. The residents said they loved having the children visit. Mrs. Khan said that they will be coming regularly in the future. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 14 Planned activities over the Christmas period were outlined in a flyer to relatives and included Christmas lunch at the local pub, Christmas Carols, a clothes party and a Christmas party. Mrs. Khan said that there had been a residents’ and relatives’ meeting on the previous day, mainly to discuss building improvements but which also consulted on activities. This was confirmed by the agenda for the meeting. Several residents are local to the area and about half have family and friends who visit. I inspected the kitchen and food storage areas and spoke with the recently employed cook. Food supplies were reasonable. I checked the menu, which showed two choices of hot food at lunchtime. Residents said that they generally liked the food and had had a choice at lunchtime. I saw no poor quality value line products on this occasion. A requirement made at the last random inspection (to monitor the standard of the catering) is considered met. The cook has an NVQ 2 in Catering. Food, fridge and freezer temperatures were monitored daily and recorded. The Registered Person said that, as part of the refurbishment and to make more space inside the home, the dry goods storage will be moved to an outside shed. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a clear complaints policy and procedure that is made available to relatives and residents. Adult protection policies and procedures are in place and staff could explain what they would in response to an allegation of abuse. However, there are significant gaps in staff training that need resolving. EVIDENCE: There had been no documented complaints since the last inspection. The home has a clear complaints policy and procedure. There was, however, an adult protection investigation current at the time of the inspection, which resulted from a complaint to the local authority. Part of this investigation, regarding medication, triggered an inspection by the CSCI pharmacy inspector. The other element, concerning unexplained bruising on a resident, was still under investigation at the time of the inspection. The home was cooperating with the local authority. All residents had had their care reviewed by placing authorities and although I only saw one written report (positive) from a reviewing local authority, Mrs. Khan said that the other reviews had also been positive. I spoke to all staff on duty. They were able to give clear descriptions of what they would do in response to a concern or allegation of abuse. These were in line with the appropriate reporting procedures. However, on checking the staff Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 16 training records, I found that a significant number of staff had not received an updated safeguarding adults training. A requirement is given under Standard Thirty. The home has the local authority’s reporting procedures on site. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Plans for genuine improvements in the building appear to be underway to improve the space for the people who living there. The home was found to be clean and hygienic. EVIDENCE: There was evidence on this inspection that steps are being taken to improve maintenance and undertake long outstanding refurbishment and improvement. A requirement made at the last inspection is met. On two occasions, planning permission to expand the space available in the home was refused. Most recently, a request to build a conservatory as a means of increasing communal space was also turned down. The problem remains that the home is in an area designated green belt. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 18 In order to improve the quality of life in the home and create more communal space, the Registered Person described the plans for the major refurbishment due to commence in January 2008. This is a positive step. He said that he intends to expand the downstairs communal lounge into the current office space; move the office into a small area currently used as a staff changing room; provide staff facilities outside; lay new carpets; add an additional shower downstairs and move the dry food storage area outside. I saw the agenda of the resident/relative meeting that had been held the previous day to address the planned refurbishment. It was clear from this that the home is progressing these improvements and had explained their implications to relative and residents. Mfr. Patel said that they had also talked to relatives on the phone. A requirement is given that the home provides CSCI with a copy of these building refurbishment and improvement plans, along with projected dates and timeframes for the beginning and completion of work. The home must also supply CSCI with a copy of their plan for managing potential risks to residents during the refurbishment and information on how their quality of life will be maintained during the period of works. Twelve bedrooms in the home had been refurbished to a reasonable standard. Mrs. Khan said that some relatives are currently embroidering curtains for the rooms. The laundry area is small but appeared in good order on the day of the inspection. The home has recently had pest control visit to lay bait for mice after mice droppings were found. The home appeared clean and hygienic on the day of the inspection. There is a contract for clinical waste disposal. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home are protected by a safe staff recruitment and induction procedure and by the support of sufficient staff on duty. Positive progress is being made towards NVQ achievement. However, mandatory staff training needs updating. EVIDENCE: The home has a minimum of three staff on duty during morning and afternoon shifts and two waking night staff. Some of these staff are senior staff and act as shift leaders. Staff said that this was reasonable to meet the needs of the current residents. I inspected two files for new staff and spoke to two recently recruited staff. They described their inductions, which covered basic areas outlined in the Skills for Care. All pre-employment checks had been done and the files were in good order. NVQ achievement in the home is good. Two senior staff are completing NVQ4 Registered Managers’ Awards and more than 50 of staff have achieved either NVQ2 or NVQ3. Mrs. Khan gave me copies of the training matrices for the past two years and said that she was disappointed that improvements commenced earlier this year Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 20 when she and Dr. Khan had acted as consultants had not been sustained. Since the last inspection, most staff have been trained in medication and manual handling. However, there were significant gaps in the numbers of staff who have been trained recently in first aid, health and safety, infection control, food hygiene and fire safety. Adult protection also needs updating. Requirements are given. One staff member gave a good synopsis of the new Mental Capacity Act, in which she and other staff had recently been trained. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Current management arrangements, which have helped improve the service, are temporary and unsustainable. The home lacks a Registered Manager on site to work in the best interests of the people living in the home and must address this gap. The financial interests and health and safety of people living in the home are protected and basic quality assurance measures are in place. EVIDENCE: The home has had ongoing problems with the recruitment and retention of Registered Managers. This has been discussed with the Registered Individual in the past. The current manager, who has not completed her registration, has been on maternity leave since August 2007, having started work in January Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 22 2007. Dr and Mrs. Khan came back as advisors/consultants at this time. The previous manager was only at the home for a year. The two management consultants, whom the Registered Individual, Mr. Patel, engaged, have contributed their advice and hands on management support to the home. Staff said that they were very pleased to have the support of Dr. and Mrs Khan and that the management of the home had improved with their input. Their role continues to be a driver in the improvement and reform of the service. However, their input does not solve the problem of the lack of a Registered Manager on site. While the home has met the requirement made at the last key inspection to employ a manager and move them towards their registration, this person is now on maternity leave and the home still lacks a Registered Manager on site. The maintenance of stable management remains paramount to the goal of elevating and improving the service. In the absence of a Registered Manager at the home, the Registered Person must urgently cover the post with another Registered Manager, who has the skills and current qualifications to maintain service improvements. A requirement is given. Two senior care staff are undertaking their Registered Managers’ Awards, both said that they were due for completion in the first half of 2008. The home does not have responsibility for any residents’ finances. Questionnaires have been distributed to relatives for the annual quality assurance survey. I inspected the heath and safety records, including gas safety, electrical installation, water safety, lift and hoist maintenance. These were in order. Fire drills and alarm tests are held regularly and staff were able to describe what they would do if they encountered a fire hazard. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 X 3 x x 3 Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP19 Regulation 16(1)(2) 23(1) Requirement The Registered Person must ensure that the home provides CSCI with a copy of building refurbishment and improvement plans, along with projected dates and timeframes for the beginning and completion of work. The home must also supply CSCI with a copy of their plan for managing potential risks to residents, staff and visitors during the refurbishment and information on how their quality of life will be maintained during the period of works. 2. OP30 18(1) The Registered Person must ensure that all staff are trained in first aid, health and safety, infection control, food hygiene, fire safety and adult protection. The Registered Person must ensure that, in the absence of a Registered Manager at the home, the Registered Person must urgently cover the post with another Registered Manager, who has the skills and DS0000053550.V356025.R01.S.doc Timescale for action 17/01/08 28/02/08 3. OP31 8(1)(2) 28/02/08 Abbey Care Home Version 5.2 Page 25 qualifications to maintain service improvements. 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 OP30 Good Practice Recommendations Senior staff should receive training in advanced dementia care. Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Abbey Care Home DS0000053550.V356025.R01.S.doc Version 5.2 Page 27 - 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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