Inspection on 27/11/08 for Amberley Lodge

This inspection was carried out on 27th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Amberley Lodge 03/07/06

Amberley Lodge 10/11/05

Amberley Lodge 09/12/04

Amberley Lodge 12/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

Tudor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Amberley Lodge Amberley Lodge Nursing Home 86 -94 Downlands Road Purley Surrey CR8 4JF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Williams     Date: 2 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Amberley Lodge 86 -94 Downlands Road Amberley Lodge Nursing Home Purley Surrey CR8 4JF 02086680999 02086680378 manager.amberleylodge@careuk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Care UK Community Partnerships Ltd care home 60 Number of places (if applicable): Under 65 Over 65 0 0 60 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 60 60 0 The maximum number of service users who can be accommodated is: 60 The registered person may provide the following categories of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Mental disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Amberley Lodge is a large purpose built Care Home registered to provide care for up to 60 service users. On the ground and first floors it provides personal and nursing care for people over 60 years of age and who have dementia. The second top floor has changed registration and now provides personal and nursing care for up to 23 older Care Homes for Older People Page 4 of 28 Brief description of the care home people who have past or present mental disorder including PTSD Post-Traumatic Stress Disorder or who have dementia. The home has a single Manager with team leaders on each floor. Whilst the home is not registered to cater for service users with physical disabilities the home is adapted to meet the needs of service users who may have mobility problems; this includes assisted baths, ramps, grab rails and similar aids. Laundry and catering services are provided centrally with lounge and dining areas on each floor. The homes Statement of Purpose states that the single bedrooms are at least 12 square metres and have ensuite toilets. The home itself is located in Purley to the South of the main A22/A23 Purley junction and is therefore close to shops and transport. Fees range from 407 to 793 pounds per week depending upon the arrangements at time of admission plus extras for personal items and extra fees for extra care may also be negotiated with the fee payers if the need arises. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: As part of our Key Inspection a site visit took place on 27 November 2008. We also made a random unannounced visit on the 3 September 2008 during which visit we checked care planning in some detail and met with the new Acting Manager. In addition to this inspection visit a number of questionnaires were distributed to residents, their visitors, care managers, health professionals and to the staff team. In compiling this inspection report the Commission also took account of information we received including details of complaints, untoward incidents and general correspondence. During the course of the inspection visit as many residents who wished to meet with the inspector were given the opportunity to do so but many residents no longer have the capacity to express anything other than an immediate response to simple questions given the level of their dependency. Several staff were Care Homes for Older People Page 6 of 28 interviewed by the inspector. We also met with a regional manager since the Acting Manager was on leave when we visited in November. The premises were toured and documentation, including records, checked. What the care home does well: What has improved since the last inspection? What they could do better: Amongst the questionnaires we received back some thought there were too few staff on duty or that they worked long hours. There are no minimum standards for the actual number of staff to be on duty at any one time but the providers state that there are enough staff on duty to meet the needs of residents. This care home provides for residents who have considerable issues of dependency and since our last full inspection 2006 the home has not always met the challenge well. Amberley has experienced a very wide range of serious problems in 2008 culminating in the resignation of the manager Mrs Leslie Bell who is the subject of ongoing enquiries by the safeguarding team that includes social service staff and the police and other professional agencies. A number of untoward incidents involving residents have occurred in recent months and this has required the intervention of the Social Service Safeguarding team. When the safety and well being of residents is thought to be at risk the Social Service are the lead agency required to investigate such matters. The several incidents referred to the Safeguarding Team are in various stages of investigation but the new manager is working with the care Managers and others to address issues needing improvement. This report is divided into seven sections to reflect the National Minimum Standards the Standards and in each of the seven section problems have been identified. In the first section it was apparent that residents were not being properly assessed in order to gauge whether or not a prospective residents needs could be met. This has resulted in inappropriate admission. Care Planning dealt with in section two was not kept up to date and accurate in order to reflect changing needs and in particular challenging behaviour. Daily life and social care is dealt with in the next section and again staff were not given clear guidance about to supervise and support residents most obviously a resident who should have been receiving one to one care that is very close support was not receiving this support and this lead to a complaint about poor care that was potentially abusive. Complaints and protection are dealt with in section four of the report and here the local authority have been heavily involved in trying to improve the Care Homes for Older People Page 8 of 28 quality of care for residents. The environment is improving but the regional manager conceded that recent decorating work has been very disappointing paint was not applied properly to the doors and is already peeling off so the home has made arrangements for this to be corrected. A number of staff were suspended from duties or have resigned and this indicates that there have been serious shortcomings in the quality of care provided to residents. However it is to be noted that where complaints were not substantiated staff were reinstated to their former duties. The abrupt resignation of the registered manager is indicative of poor leadership and in her case may indicate a serious breach of trust but this is being investigated. If substantiated it may lead to her being deemed unsuitable to work with vulnerable people in future if she is referred to the POVA list Protection of Vulnerable Adults Act. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We cannot assure prospective residents that the home will always admit residents appropriately following an assessment of need. Evidence: This standard was assessed by speaking to residents and where possible their visitors to evaluated information given to them prior to, or at the point of admission. A sample of residents case files were examined to check these assessments were in place and being used to compile the plans of care. We have in recent months found that the decision to admit may not have been entirely appropriate, despite initial assessments by the home, leading to serious lapses in meeting the persons needs. In this instance a resident was moved to more appropriate accommodation. The Statement of Purpose and Service User Guide have previously been checked by the Commission and found acceptable. Visitors tell us that they were told about the home and what services, including for example nursing care, would be available to them when they enter the Care Homes for Older People Page 11 of 28 Evidence: home. But there have been instances when the pre-admission assessment has led to inappropriate admission and for this reason this section is assessed as adequate and a requirement is made in this respect. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for care planning, the provision of health care are not always satisfactory so as to ensure the social, and health care of residents can be met. Evidence: To assess this standard a sample of residents case files were examined. Residents were given the opportunity to comment if they wished to do so but few were able to reflect upon the care they receive with any great clarity given the degree of memory loss they now have. Relatives also contributed to our assessment of this standard and confirmed that they are involved in the assessments and review of residents care needs and health problems. A doctor was on site for one of our previous visits and confirmed that a doctor from the surgery visits weekly and she confirmed she has had no complaints about the service or the manner in which she is able to examine and treat her patients. Nurses are employed to provide support to residents and they were also interviewed to Care Homes for Older People Page 13 of 28 Evidence: ensure they were aware of the specific needs of each resident in their care. Whilst they appeared well informed and were complimented by relatives for their caring approach we nevertheless found that care plans were not always being updated to reflect changing needs and in some instances the guidance to assist staff in managing challenging behaviour was not clear enough to ensure the safety and well being of residents. In particular we found that staff were not clear about when or whether they could use physical means to restrain residents and if so how to do it safely and record events clearly. We have been advised about several instances where residents have attempted to leave or have left the care home without the support of staff they needed. Staff have failed to provide adequate support and supervision and have been uncertain of the legal position when residents are putting themselves at possible risk. With the introduction of the mental capacity all staff must be a lot clearer about issues of capacity, decision making and restraint. We have checked the procedures for dealing with medicines, their ordering, storage, administration and disposal and found no errors on this occasion. The support that can be provided for residents towards the end of their lives was not examined in great detailed during this visit. In previous years we have assessed this are of care as good. The care plans do provide for end of life care by recording personal details, the familys wishes and any last wishes, advance directives or any religious or cultural expectations. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Within the limits of their conditions residents can experience a satisfactory social life, maintain links with family and friends and have a reasonable standard of catering. Evidence: Each resident has a care plan, now computerised but staff print a copy so that they or their representative can sign a copy to be held in their room for ready access for them and their carers. The care plans follow a typical pattern with assessments care plans or goals and systems for monitoring and updating plans. General risk and health assessments are in place. Visitors were on site to confirm that they are welcomed into the home and information is shared with them as the need arises. In some instances residents are still able to visit their family for short breaks away from the home. Representatives from the community including church people were also on site to confirm they visit regularly and their visits are clearly appreciated by residents. The more able residents are free to exercise choice over the lives and this includes regular access to the community, they are free to smoke, they can pass the day in the manner they choose and so forth. Other more dependent residents need considerable support from staff and their visitors to make even simple choices about daily living, choice of clothing, meals and activities for example. The cooks were complimented for providing Care Homes for Older People Page 15 of 28 Evidence: nice food, several options are made available and so residents and relatives said the food is always very good in this home. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their visitors can be confident their concerns will be dealt with promptly and effectively but they cannot be assured at this time that residents will always be safeguarded from possible abuse. Evidence: A record of complaints is in place and complaints are being correctly recorded and the correspondence shows that the matters have been dealt with professional and promptly as they arose. Although there continues to be a steady flow of compliments from appreciative relatives about the care provided in Amberley Lodge it is regrettable that there have also been a number of serious complaints, 4 as recorded by the home, and 5 alleging abuse. These complaints have required the intervention of the Safeguarding team from the Social Service and Primary Care Trust - and in some instances the police have also assisted in the investigations. We know from previous inspections that the providers, Care UK, have instructed staff about how they must conduct themselves, that is, with respect for residents and staff have received instructions about how to deal with allegations of abuse, by reporting it without delay. The home has a copy of the local authoritys procedures for dealing with allegations of abuse. The coordinator for Protection of Vulnerable Adults, London Borough Croydon, under the auspices of the CHST, the Care Home Support Team, has visited the home to give guidance and advice to the staff team. Despite the training and information available to all staff, including the former manager, there have been serious lapses in Care Homes for Older People Page 17 of 28 Evidence: the quality of care and it is evident that residents are not always being protected from harm so this section is assessed as adequate. For example when residents can leave the premises without appropriate staff support or when residents are physically restrained, inappropriately, from leaving the premises. Staff need training in the implication of the new Mental Capacity Act in particular issues of restraint, and how to report and record such events Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is providing a clean, safe and comfortable environment for the residents. Evidence: We toured the premises observing matters such as fire doors and general fire-safety matters; the use of cleaning materials and how they are stored, the quality of floor coverings, furnishings and fittings and the general decor of the home. The inspector also checked a number of bedrooms and communal areas such as the lounges and dining rooms plus facilities such as bathrooms and toilets to confirm they are in good decorative order and at a comfortable temperature and that they have suitable fixtures and fittings for the residents. The home is in a good state of repair and furniture and equipment is well maintained and the home was clean and tidy and free of offensive odours. We note the improved decor which is much brighter but we also saw the new paint is already and was finished to poor standard, otherwise standards are good and it is noted that new floor coverings have been fitted in various locations throughout the home. New, more secure window locks have been fitted to all windows that residents have access to. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The providers claim the home has adequate numbers of staff and the staff recruitment procedures, induction, training, support and supervision regime is in place but this has not wholly protected residents from allegations of abuse. Evidence: Whilst there is no minimum requirement for staff levels the manager state that enough staff are being employed to meet the needs of residents. On the day of inspection it was noted that for 59 residents there were 3 Nurses and 12 care staff plus the regional manager, who is also a qualified Nurse. The home also employs a wide range of ancillary staff including cleaners, catering, laundry staff and maintenance staff. We have checked staff recruitment several times and we now find them to be methodically laid out with a checklist so managers can monitor the progress of recruitment of staff and their subsequent employment. The manager asserts that all staff have had a CRB police check and a sample of CRB checks were examined to confirm this. Other recruitment processes are in place including application forms, references, health and qualification checks and interviews. The overall process appears sound. In respect of equality issues, it is evident that an open and unbiased approach is taken when recruiting staff so that minority and other special needs groups are not disadvantaged by the recruitment process. The home employs a staff from a range of Care Homes for Older People Page 20 of 28 Evidence: cultural and ethnic minority backgrounds, the majority are African, Caribbean or Asian, but the home does employ some staff, who reflect the culture and background of the residents, who are mainly, 42 of 49, white British. The staff training files are now computerised and a matrix of training opportunities confirms that a wide range of training is offered and staff are required to attend a set number of safety related training course each year. Despite the well organised procedures for recruiting, inducting, training and managing staff their have been lapses in the quality of care and supervision of residents and the local Social Services in partnership with the PCT, Primary Care Trust, have been visiting the care home regularly to provide further training and guidance for staff. The providers, Care UK, have cooperated fully in this support project and whilst it is clearly to the benefit of residents to have this additional staff support, it does indicate that Southern Cross has not fully protected residents nor fully met residents needs without this injection of additional expertise. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has not always been well managed and has not always been safe for residents. Evidence: The former registered Manager Mrs Leslie Bell resigned during the course of an ongoing police investigation. Since she left the services of Care UK her position as manager of Amberley has been temporarily filled by acting managers and the latest, Mrs Couch is a very experienced manager bringing a sense leadership and confidence to a service that has been the subject of a number of enquiries under the auspices of the local authoritys Safeguarding protocols. Not all the allegations of abuse or poor care have been substantiated but the local authority has thought it necessary to provide additional staff support and guidance through the Care Home Support Team, particularly in respect of recognising and dealing with allegation of abuse. So this care home support team comprising social workers and nurses have been attending the home in recent months. The safety and protection of residents has been compromised Care Homes for Older People Page 22 of 28 Evidence: in various ways, in one major instance a resident have been the subject of alleged theft and mishandling residents monies; whilst in another resident was able to leave the building without the support they should expect given their dependency. Another resident was subject to restrictions and was indicative of poor management of challenging behaviour and in this case the original admission was a poor management decision since it could be predicated that the residents needs could not be fully met in this particular service. Care Planning, although much improved has during the course of the year, 2008, been somewhat inadequate and was not reflecting current need nor did they give adequate guidance to staff in managing particular needs such as challenging behaviour. Since the home is now in need of permanent registered manager and clear leadership and in view of the numerous safeguarding issues that have arisen this year this section about management can now longer be judged as good and is assessed as adequate on this occasion. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 Residents must not be 30/01/2009 admitted without their needs being assessed by suitably qualified person. So as to confirm that the home can meet their needs. 2 7 15 Care plans must be prepared 30/01/2009 and kept under review. Standard 7 and 8 apply. So as to provide details about how residents needs will be met. 3 16 22 Each resident or their representative must be provided with an up to date copy of the homes procedures for complaining including details of the local social services care management teams. So people know how to complain about poor services. 30/01/2009 Care Homes for Older People Page 25 of 28 4 17 13 All staff must receive training in the new mental capacity act. Standards 17 and 30 apply. So that they are familiar with decision making on behalf of residents so that residents rights are protected. 30/01/2009 5 18 13 The home is to provide the 30/01/2009 Commission with evidence that all staff have been given refresher training each year on the protection of vulnerable from abuse. So all staff are familiar with the procedures for recognising and reporting abuse. 6 27 18 The Commission must be provided with a sample four week duty roster. So as to demonstrate how staffing levels will be maintained in order to meet the needs of residents particularly those requiring close supervision or one to one care. 30/01/2009 7 31 8 A suitably qualified and 30/03/2009 experienced manager must be appointed and registered to be in day to day charge of the service. This so that staff and residents will be properly managed and supervised. Care Homes for Older People Page 26 of 28 8 35 16 Proper provisions must be made for residents to hold their own money for it to be managed safely by the home. So residents have choice about personal funds and their money will be held safely. 30/01/2009 9 38 13 Policies and procedures and guidance must be made available to all staff. So as to show that the home is taking reasonable steps to prevent resident being harmed or abused. 30/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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