Inspection on 18/08/05 for Abbotsford Nursing Home

This inspection was carried out on 18th August 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 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

Abbotsford Nursing Home 04/12/08

Abbotsford Nursing Home 06/12/06

Abbotsford Nursing Home 21/12/05

Abbotsford Nursing Home 12/05/04

Abbotsford Nursing Home 30/12/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Abbotsford Nursing Home 21 Gilbert Road Romford Essex RM1 3BX Lead Inspector Julie Legg Unannounced Inspection 18 &22 August 10.30 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 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. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Abbotsford Nursing Home Address 21 Gilbert Road, Romford, Essex RM1 3BX 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) 01708 740355 Mrs Carmel Elizabeth Dempsey Indira Sandhu CRH Care Home 19 Category(ies) of DE Dementia (3) registration, with number OP Old Age (16) of places Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16 March 2005 Brief Description of the Service: Abbotsford is a privately owned nursing home and is registered to provide accomodation and nursing care to nineteen older people. Most of the residents have moderate to high needs due to their physical fraility or dementia. The home is situated in a quiet residential area of Romford and is close to the local shopping centre. The home is well served by public transport, both buses and the main line train station are within walking distance. The home is wheelchair accessible and a passenger lift is installed. There are two single bedrooms and eight double bedrooms, none of these rooms are ensuite. The home has a large back garden and there is off street parking at the front of the house. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over two days and lasted twelve hours. The inspector spoke to a number of the residents and seven relatives to ask them for their views and comments on the home. Discussion took place with the manager, nursing and care staff, administrator and the cook. A tour of the home was undertaken and a number of care and staff records were looked at. The current registered manager has been in post for a year and has a good understanding of the areas in which the home needs to improve and develop. She is well supported by the nursing and care staff and staff spoken to commented that they are also committed to improving the standards within the home. The inspector would like to thank the residents, their relatives and staff for their input during the inspection. Following the inspection an anonymous letter was received by the Commission for Social Care Inspection. The letter identified 19 areas of concern about the service, many of which had already been addressed as part of the inspection. Any issues not covered in this report will be followed up via future inspections of the service. A full response to all 19 issues has been received from the service provider. What the service does well: The home has a ‘family like’ ethos and this was borne out by comments received from residents, relatives and other care professionals. Residents who were able to express a view were very happy with the quality of care they received. One resident commented “The girls are lovely, they really look after me”. Relatives were also very complimentary of the quality of the care. They said that they were made to feel very welcome by the staff and that they could share their concerns and worries with the management and staff as they were very approachable. A relative commented “ I can sleep easy at night, because my mum is cared for”. Another relative stated “I am very happy with the care my mum is getting, she has come along in leaps and bounds since being here”. The home has a happy and relaxed atmosphere. The staff’s interaction with the residents was open and friendly but always respectful. The privacy of the residents was maintained at all times, this was most apparent around people who were nursed in bed. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Areas where the home needs to improve were discussed and agreed with the manager. The manager has introduced a new care planning system but there needs to be a system in place to ensure the regular auditing of care plans and risk assessments. The manager should ensure that residents care plans are regularly reviewed to ensure that the home can continue to meet their needs. The manager must ensure that all staff receive regular supervision. The management must ensure that in the current refurbishment programme, the sluice is not placed in a room that residents are accessing for toileting or bathing. The home has a varied activities programme but the manager needs to look at activities that are appropriate for residents with dementia and cognitive impairment. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 7 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. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3 and4 Each resident, and/or their representatives, know the terms and conditions attached to their living in the home. A comprehensive pre-admission assessment is undertaken for all prospective residents prior to them moving into the home. Care plans are drawn up from this assessment, ensuring that the needs of the resident are identified and met. This will then enable the staff to provide the right level of care to assist the resident to continue to live as full a life as possible. EVIDENCE: All of the files inspected had a copy of the home’s contract/ statement of the terms and conditions. The contracts stated the fees of the home and had been signed by the resident or their relative. Individual files are kept for each of the residents, six of these files were inspected. All had full assessments that had been carried out by the manager. Where appropriate further information had been provided by the placing local authority and health professionals. Residents, where capable, and relatives were involved in the assessment and admission process. A resident’s daughter commented that she had visited a number of homes prior to visiting Abbotsford, which she had visited unannounced. On arriving Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 10 she was made to feel very welcome and shown around the home. She was able to discuss her mother’s needs with the manager and the nursing staff. There was evidence that the manager had carried out an assessment and gathered additional information from the local authority and the hospital prior to the resident’s admission. Though the resident was unable to visit the home prior to moving in, on admission she had received flowers and a card welcoming her to the home. The home does not offer Intermediate Care. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Residents, health and personal care needs are identified in individual care plans but not all care plans accurately reflect the current needs. Neither do they provide the staff with sufficient information to ensure that care needs are being met on a daily basis. Due to the level of disability residents are unable to administer their own medication. The home has clear medication policies and procedures for the staff to follow and the staff receive appropriate training to ensure that medication is administered safely. Residents are treated with respect and the arrangements for their personal care ensures that their right to privacy is upheld. EVIDENCE: Individual care plans were available for each of the residents. These care plans followed on from a full assessment of the resident’s needs. In March of this year the manager introduced a new care planning system. It was evident from the six records examined that neither the nursing or care staff are using the system appropriately. There is a lack of recording regarding social activities, particularly for those with dementia. There are inconsistencies in the daily Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 12 recordings regarding residents’ personal care and toileting and weight charts are not completed regularly. The manager needs to undertake training with the nursing and care staff to ensure they are fully understanding of the care planning system. This will assist with the compliance of staff recording daily entries onto the care plans. The manager also needs to monitor and review care plans on a regular basis to ensure that the home can continue to meet each resident’s needs. Risk assessments regarding breakdown of pressure areas, nutritional intake, continence and falls have been completed but not regularly reviewed. The manager needs to ensure that a review system is put in place to ensure the well being of the residents. Daily records of fluid charts, nutritional intake and turning charts were examined and found to be satisfactory. Recordings of fluid input/output were noted and food intake charts recorded the type of food and amount. Records indicated that residents were seen by other health professionals such as doctors, dentists, chiropodist, opticians and specialist nurses. Medication Administration Records (MAR) and the medication trolley were examined and found to be satisfactory. Discussion with the staff showed that they are following the policies and procedures and had also received training regarding the administration of medicines. Staff were observed to treat residents in a respectful manner. The domestic was talking to the residents asking them how they were, whilst hoovering the lounge. One of the residents is blind and the cook was seen ensuring that his drink was within his reach. Care staff talked about residents’ dignity and right to privacy. Staff were observed knocking on bedroom doors before entering and speaking to residents in a friendly but respectful manner. Residents and relatives confirmed that the staff were respectful and comments such as “they look after my mum as I would”. A resident said “all of the staff are so kind”. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 15 There is a varied activities programme available. More consideration needs to be given to planning activities which are suitable for those residents with specialist needs such as dementia. Visiting times are flexible and people are made to feel welcome, which ensures that residents are able to maintain contact with their friends and family as they wish. The meals in the home are well presented and nutritionally balanced. They offer both choice and variety to residents. EVIDENCE: There is a general programme of daily activities within the home such as arts and crafts, manicures and foot spas, musical movement, classical films and reminiscence. There are also regular entertainers at the home and residents who are able to, go out with their relatives. One of the residents is blind and the home have been very pro-active in contacting the Royal National Institute for the Blind for information and resources such as talking books and braille Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 14 playing cards. The home does need to look at activities that are appropriate for residents with specialist needs such as dementia and cognitive impairment. During the inspection seven residents had relatives visiting, some of these visits took place in the lounge and others in the resident’s bedroom. Visiting times are flexible and all seven relatives commented “that they were made to feel very welcome and they were always offered a cup of tea”. All of the relatives spoken to said that they visited at least once a week, some three times a week. It was apparent that relatives and staff saw each other regularly as a member of staff was heard asking a relative if she was feeling better. One of the relatives told the inspector that he visited his wife every day and that he was provided with a meal and that this was particularly appreciated on Christmas day. Meals are served in the lounge, where residents eat off small tables in front of them. The chef has worked at the home for a number of years and knows the likes and dislikes of each resident and the residents who require a special diet such as diabetic meals. Menus were inspected and found to be balanced in nutrition, two choices are offered at lunch time but residents can choose to have an alternative meal. One resident said ”that if she didn’t like either of the meals, then the chef would cook her an omelette, which she enjoys”. The tea menu has eighteen choices and on the day of the inspection the chef was seen to prepare seven different teas ranging from a meat salad, egg and chips, jacket potato, boiled eggs, beans on toast, ham and chips and sandwiches. All of the residents spoken to were unanimous in their praise of the food. Comments were “the food is really lovely” and “we can ask for anything”. Some of the residents require feeding. Staff were seen to carry out this task appropriately, talking to them and not rushing the person. A few of the residents lost interest in their food, again staff acted appropriately offering words of encouragement to eat. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a satisfactory complaints policy and procedure in place and residents and relatives/representatives feel confident that their complaints and concerns are listened to and acted upon. The home has a satisfactory policy and procedure regarding allegations of abuse. The staff have undertaken training in Adult Protection/Abuse Awareness to ensure that there is an appropriate response to any allegations of abuse. EVIDENCE: The home has a written complaints policy and procedure and the records inspected show the number of complaints received, details and outcome of the investigation, any action taken and the response to the complainant. There are also details of how to refer complaints to the Commission, should the complainant wish to do so. Residents and relatives spoken to said that they felt confident that their complaints were taken seriously and acted upon. A relative stated “That it didn’t matter how small or trivial the concern was, she was always listened to and it was put right”. There is a written policy and procedure for dealing with allegations of abuse and whistle blowing. The home also has a copy of the Department of Health’s document ‘No Secrets’ and copies of the local authority (Havering) and placing authorities documentation on abuse. Training on Adult Protection/ Abuse Awareness has been undertaken by all staff including ancillary and administrative staff and this is documented in staff training files. This training will be on a rolling programme, this will ensure all new staff have the opportunity to attend. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21 and 26 The home is very welcoming and provides the residents with a safe, clean and comfortable environment in which to live. However, the siting of the sluice needs to be in area that does not compromise the well- being of the residents and one of the bedrooms requires some redecoration. EVIDENCE: The home has an ongoing redecoration programme and since the last inspection a number of the bedrooms have been redecorated and, where needed, carpets have been replaced. The lounge has been redecorated and the carpet replaced. One of these bedrooms has a damp patch on the wall due to a leak from the upstairs bathroom, this needs to be attended to. The remaining bedrooms and the exterior of the home will be the next phase of the redecoration programme. One of the upstairs bathrooms is currently being refurbished with an electrically operated rise and fall bath, this work is due to be commenced within the next six weeks. The registered provider has refurbished the other upstairs bathroom with a new toilet and wash handbasin. The inspector was advised that a new sluice was to be installed in this room. Consideration needs to be given to an Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 17 alternative siting, as sluices have to be located away from residents’ toilets and bathing facilities. Throughout the inspection all areas of the home were found to be clean, tidy and free from odour. Comments from residents and relatives indicated that they were satisfied with the standard of hygiene within the home. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 The home’s staffing levels are satisfactory and there are sufficient staff on duty, who have the skills and training to meet the individual needs of the residents. The procedure for recruitment of staff are robust and provide protection for the residents. EVIDENCE: The home has a relatively stable workforce. On the day of the inspection, staffing levels were observed to be appropriate to meet the needs of the residents. The home operates a ratio of one qualified nursing staff to three care staff per shift during the day and one qualified nursing staff to one care staff at night. The home also employs a part time domestic a chef and an administrator. Staff files show that staff have undergone training in areas such as fire safety, food hygiene, manual handling, care of medicines, skin and pressure care, dementia awareness and Adult Protection/Abuse Awareness. Over half the staff have either achieved or undertaking NVQ2 and NVQ3. This demonstrates a positive commitment to training from both the registered provider, the manager and the staff. Seven staff files were examined and indicated that all necessary recruitment checks are taking place to ensure the protection of residents. Four care staff were asked about their recruitment and training. All confirmed that they had not commenced their employment until all necessary checks such as two Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 19 references and clearance from the Criminal Records Bureau had been received. All had attended essential training and three were currently undertaking their NVQ2/3. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 36 The manager of the home is very experienced and well qualified. However it is essential that the manager has dedicated time to carry out the day to day management of the home to ensure it is run in the best interest of the service users. EVIDENCE: The manager is a registered nurse and has substantial clinical and management experience. She has a good understanding of the needs of the residents and the areas of the home that need to improve and develop. She has a high visible presence within the home and comments from staff and relatives were very complimentary. One relative indicated that “she found the manager very helpful and nothing is too much trouble for her”. One of the care staff stated “that she likes the manager and she is very approachable”. From discussion with staff and the manager there is informal supervision on a day to day basis but there is no evidence that both care and nursing staff Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 21 receive regular formal supervision. All staff should receive supervision as part of their ongoing career development and to look at any practice issues. The manager is rotered as the qualified nurse on all her shifts. The registered provider must ensure that the manager has some dedicated time to enable her to carry out tasks such as the auditing of care plans and risk assessments (this issue is dealt with under Health and Personal Care), staff supervision and any other identified administrative tasks. The Commission would expect a manager to lead by example, including “hands on care”, but it is essential that they are not routinely rotered as the qualified nurse on shift, allowing time for managerial tasks and the development of the service. Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_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 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 2 x 2 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x x x 2 x x Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 23 no 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 7 Regulation 15 (2)(b) Requirement All residents service plans(including care plans and risk assessments) must be reviewed at least once a month. The manager shall ensure that all records are kept upto date The manager must ensure that staff receive training appropriate to the work they perform. The home must provide a more varied programme of activities with consideration given to those residents with dementia and cognitive impairment All areas of the home need to be adequately maintained to improve the safety and comfort of the residents. Any necessary sluicing facilities are not provided in the residents toilets or bathrooms. The registered provider shall ensure that the manager has adequate time to carry out her managerial tasks, such as reviews of care plans and risk assessments and staff supervision. The manager shall ensure that staff working at the home Version 1.40 Timescale for action 30/11/05 2. 3. 4. 7 7 12 17 (3) (a) 18 (1)(c)(i) 16(2)(n) 30/10/05 30/12/05 30/12/05 5. 19 23(2)(d) 3011/05 6. 7. 21 31 23(2)(k) 10(1) 30/11/05 30/10/05 8. 36 18(2) 30/10/05 Page 24 Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc receive supervision at least six times a year. 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 Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Abbotsford Nursing Home G55_S0000034878_Abbotsford_V244662_180805_Stage 4.doc Version 1.40 Page 26 - 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. 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