Inspection on 10/08/06 for Antokol

This inspection was carried out on 10th August 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Antokol 10/06/08

Antokol 14/01/08

Antokol 18/09/07

Antokol 18/10/05

Antokol 27/06/05

Antokol 15/03/05

Antokol 26/10/04

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 Antokol Antokol 45 Holbrook Lane Chislehurst Kent BR7 6PE Lead Inspector Miss Rosemary Blenkinsopp Unannounced Inspection 10th August 2006 10:00 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 Antokol DS0000006883.V303077.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. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Antokol Address Antokol 45 Holbrook Lane Chislehurst Kent BR7 6PE 020 8467 8102 020 8468 7190 antokolhome@btconnect.com 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) Polish Citizens Committee Housing Association Limited Ms Alina Gaskin Care Home 34 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (32) of places Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 places registered for service user category DE(E) relate to named service users only. 18th October 2005 Date of last inspection Brief Description of the Service: Antokol is a large detached house built in 1905. It was extended in 1986 and can now provide care to thirty-four elderly Polish people living in this country. The home maintains the Polish traditions, which the residents were accustomed to in their younger days. Stairs and a lift access all areas in the home. All the rooms have wash-hand basins. The bathrooms, shower room and toilets are located on both the ground floor and first floor. Some of these facilities have special adaptations and equipment to meet the needs of the residents. On the ground floor there is a large dining room, a sitting room with a library, and a separate lounge, which has a Polish satellite TV. Residents may have telephones in their own rooms at their own expense. A pay phone is provided for both incoming and outgoing calls. There is parking to the front of the building and some off street parking available. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted unannounced by one inspector. At the time of the inspection the Manager was off sick and the Deputy Manager was on annual leave. The administrator for the home facilitated the inspection as at that time there were no other staff in the home that could speak English. The administrator was helpful but unable to provide all of the information requested; hence a second visit was required once the Deputy Manager returned from annual leave. At the time of the inspection there were five vacancies. The weekly fee for this home is £485.00-£550.00 as stated by the administrator. Extra fees are payable for hairdressing, chiropody and newspapers. The first visit provided a good opportunity to meet with residents and visitors in the home as well as observe daily routines. The second visit was by arrangement and provided sufficient information to complete the inspection process. Comment cards were received from the GP, a care manager, relatives and residents themselves. From the eight comment cards received from residents, the information was favourable about home the staff and the care that they received. Comments relating to activities was varied, some saying that they did not want any activities as they enjoyed the religious service twice weekly as well as spending time in the garden. What the service does well: The home has developed a strong emphasis on community living with Polish values. This is evident throughout the home with Polish TV, newspapers, and Polish speaking staff. Meals are prepared in traditional Polish fashion and in the main enjoyed by residents. Staff demonstrated a positive approach to residents and all residents looked well cared for with signs of wellbeing evident. The presence of the religious sisters, who form part of the work force, provides a calming, spiritual atmosphere. The twice-weekly services were valued by residents. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Antokol DS0000006883.V303077.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 Antokol DS0000006883.V303077.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The quality rating in this section is adequate. This is based on all of the information available including the site visit. Assessment information was inspected and outlined needs including activities of daily living. This information was also available in Polish. There is a Statement of Purpose and Service Users Guide for residents and available within the home. These documents were also produced in English. EVIDENCE: The information of the two latest admissions to the home was inspected. The admission assessments were available although the inspector was unable to assess this as it was in Polish. During the second visit the Deputy Manager produced the admission assessments conducted by senior staff in the home which were available in English. The assessments covered stated needs and activities of daily living. Photographs of residents were in the files. In one file there was a hospital transfer letter. Available within the home there was the Statement of Purpose and a Service Users Guide – which was written in English and information clearly laid out. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 9 Apart from the assessment information the inspector was unable to establish if pre-admission visits had been arranged or what other information had been provided to residents and their families prior to admission. All assessment and pre-admission information must be documented including introductory and trial visits before a decision regarding placement is taken and this must be made available to staff. Please see requirement 1. Antokol DS0000006883.V303077.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality rating in this section is adequate. This is based on all of the information available including the site visit. The inspector was unable to assess all of the information because, as previously stated, some of this was in Polish. Risk assessments and healthcare appointments were recorded. Medications were stored correctly with supporting records in place. EVIDENCE: The care plans of two residents were inspected. Again the information was in Polish although some care plan information was available in English. The care plans outlined activities of daily living which was reviewed 30/03/06. In addition there was a prevention of falls dated June 2005 and a general overview of risk dated March 2006 which covered falls. A “restrictions during handling” form was also in place. There was a list of multi-disciplinary appointments. The daily events were written in Polish therefore the inspector was unable to assess if these reflected the actual problems identified. Whilst this is beneficial for staff it makes it difficult for other disciplines to assess the information. There was discussion with members of the Committee regarding this matter. It was agreed that all records including daily events would be written in English and that at all times a staff member would be on duty who Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 11 could document these accurately. This and other topics were covered in separate correspondence to Mr Englert. The second care plan was similar in content with issues and risk assessments in place. Support and health care is provided within Antokol with the support of the District Nurses and other health care professionals. The inspector was advised that the home receives good support from GP who visits regularly. There was evidence of specialist equipment for those residents who required it . The medication storage and systems were inspected. Medications are stored in a lockable trolley within a separate lockable clinical room. The storage area was inspected. All items were in date and no overstocking noted. Medication charts were completed with photographs of residents and most had the allergies section completed. At the time of the inspection there were no controlled drugs in use. In the records there was a list of staff signatures that administer medications. All staff that administer medications are assessed as competent by the Manager, staff stated this was on a six monthly basis. Three residents are currently self-medicating. Risk assessments were in place for this although these were dated November 2005. These should be reviewed in light of any changes in circumstances including the resident’s health and ability to self-administer. Records relating to medications received into the home were in place. On some charts the hand transcriptions of medications had one staff initial. It is recommended that two staff sign to confirm the accuracy of the information recorded. Those medications, which had not been administered as prescribed, had the reasons detailed on the reverse of the medication chart. It was noted that some medications were either refused or for other reasons not administered. In such cases the medication should be reviewed by the prescribing GP. There was confirmation by the GP regarding residents who buy their own over the counter medications. An approved list was in place to cover these items signed by the GP. Those medications, which are given as required, need to have full instructions stated, including maximum dose and the duration where applicable. Please see requirements 2 and 3. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 12,13,14, 15. The quality rating in this section is good. This is based on all of the information available including the site visit. It was evident that the daily routines are built around residents’ choices and needs. The lifestyle experienced by residents includes previous traditions including social and cultural interests. EVIDENCE: It was evident that residents have flexibility and choice in their day. Residents were seen to spend periods either in their own bedrooms or the communal areas. They were engaged in a number of activities including reading, watching TV, assisting with laying the dining tables whilst some had visitors. There was a relaxed atmosphere throughout the home. Residents were seen to be engaging with one another, whilst staff spontaneously interacted with residents, not on a task orientation basis, as is the case in some homes. Residents themselves made favourable comments regarding their stay in Antokol. There are a number of religious sisters working in the home who demonstrated an air of calmness and tranquillity. There is a twice-weekly service conducted by the sisters for any one who wishes to attend. During interviews with residents they all confirmed that choice, privacy, dignity and kindness from staff were implicit within their day. One resident was Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 13 however concerned about the number of vacancies and was worried that the home may close . This was further discussed and this is referenced under Management and Administration section. One relative met with the inspector and again she related positive comments regarding the staff and the care of her mother .The resident herself was present and she also contributed to the conversation confirming a good standard of care. This relative visits every other day. Comment cards reflected positive experiences whilst living in the home. Lunch was a relaxed affair with residents engaging with staff. Tables were nicely presented, as was the food. Drinks were served and available through out. The afternoon tea was served with many choices of snacks including biscuits, fruit yoghurts and cake. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 16,18 The quality rating in this section is adequate. This is based on all of the information available including the site visit. Complaint information and avenues whereby complaints can be referred are available. Staff were aware of what action to take in respect of adult protection although had little knowledge of the external avenues to report this through EVIDENCE: The CSCI has received no complaints regarding this service since the last inspection .The complaints procedure was available in Polish and English reference to this procedure was also included in the contract issued to residents. Within the home’s complaint file there was one compliant dated 26/07/06, which detailed the issues of concern and the action taken to address this. Prior to this the last compliant had been 30/12/2004. It is recommended that the information should include a record stating whether the complainant was satisfied with outcome. The inspector was unable to independently assess one staff’s knowledge in respect of adult protection and whistle blowing. This was done with another staff member interpreting; however even with this, the staff member had a limited understanding of the terms and action to take. Two other staff were interviewed as part of the second day of the inspection. These two staff, whilst having some difficulty with the English terms, did confirm to the inspector that they had an adequate knowledge and understanding of adult protection and whistle blowing. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 15 In respect of whistle blowing and abuse the staff member was unable to understand the terms and unable to demonstrate any knowledge of what action to take. The staff member who translated for her could not recall the full information she had received on her NVQ training but was aware to report it. On the pre-inspection questionnaire it stated that five staff had attended external training on this topic, and one staff had attended internal training. Please see requirement 4 Antokol DS0000006883.V303077.R01.S.doc Version 5.2 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 the following standard(s): 19,26 The quality rating in this section is adequate. This is based on all of the information available including the site visit. The home is an adapted building although within this the needs of residents can be met. Communal areas were homely whilst bedrooms were personalised and individual. Refurbishment of other areas should be undertaken. EVIDENCE: The inspector toured communal areas including the kitchen and sitting areas and a few individual bedrooms. Bedrooms were personalised with mementos and individual pieces of furniture, they were laid out to meet the needs of the residents. For example one lady had as small table in her room where she liked to sit. In another bedroom the gentleman was quite dependant and used a special chair, the chair was positioned so that he could look out of the window, the radio was playing classical music, which the inspector identified was his favourite type of music. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 17 The newly refurbished kitchen and dining room have greatly improved these areas. New dining chairs had also been purchased. Hot water temperatures were satisfactory and those call bells tested were functioning and responded to quickly. The tiles in ground floor bathroom were cracked and need addressing. The lounge areas were comfortable although residents were seen to use areas such as the garden and corridors to sit. The garden was beautifully maintained and residents were seen to spend time in this area. The external paintwork and windowsills need attention. Specialised equipment was available such s pressure relieving mattresses and cushions. Hoists wheelchairs and walking aids were seen to be in use. There was evidence of protective clothing including gloves and aprons for staff. The use of portable fans/heaters should be risk assessed in view of the type of residents within the home. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The quality rating in this section is adequate. This is based on all of the information available including the site visit. Staff are provided in sufficient numbers to meet the residents’ needs. Some training is provided although this is limited and does not meet the statutory training requirements or the updates required. EVIDENCE: On the first day of the inspection the inspector met with one afternoon staff that was able to speak English. The staff member had met with the inspector on a previous occasion therefore it was felt not to be appropriate to interview her again. Another staff member was selected who was said to have a little English language. It was apparent that she had insufficient English to answer the questions and asked for the other care staff to interpret for her. She was unfamiliar with commonly used terms such as abuse as whistle blowing. On the second visit two other staff were interviewed, including a religious sister, who had worked in the home for six years. The second staff has worked in the home for two months. Three religious sisters work in Antokol. The two staff confirmed orientation and induction and ongoing support from the staff team. They felt they were well supported by the manger and her deputy. The newest staff member confirmed that his induction had included health and safety topics, manual handling and fire procedures. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 19 The other staff member confirmed training in medication procedures, manual handling, first aid abuse and Dementia. She is currently taking her NVQ level 2. Within the pre-inspection information it was stated that five staff have the NVQ two, out of seventeen. Two staff are undertaking NVQ 3. Other training included infection control – three staff, care planning two staff and dementia four staff. It was stated that in-house training included fire training, manual handling and food hygiene. The information provided did not confirm that all staff had received mandatory training and the updates that such training requires. All staff must receive mandatory training and updates in these topics this includes administration, ancillary as well as the care team. Two staff recruitment files were inspected during the second visit. The information was in Polish and the Deputy Manager confirmed the documents to the inspector. Application forms passport, references, CRB and a health questionnaire were available in one. The second staff had commenced employment 12 August 2006; the file contained all the above records except confirmation of POVA or CRB. As stated earlier the Committee have developed Terms and Conditions for al staff. These were discussed with Mr Englert, at the second visit and covered in separate correspondence, an agreement that these will be fully operational by 27 October 2006, was reached. Please see requirements 5 and 6. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38 The quality rating in this section is adequate. This is based on all of the information available including the site visit. Service certificates for some items were available. The business accounts have been found to be satisfactory. Quality assurance measures were in place although limited in some areas. EVIDENCE: The Manager and her Deputy work collaboratively managing the home. Staff felt that the two managers were very supportive; residents and relatives confirmed this. All of those staff, residents, and relatives spoken to commented on the positive, management style. On the two days of the inspection the Manager was sick and on the first occasion the Deputy was on holiday therefore the administrator coordinated the first day if the inspection. The inspector was advised that the Responsible Individual is no longer with the Polish Citizens Association. Three new Committee Members have been appointed .The CSCI need to be advised of the changes and the named responsible individual. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 21 Two residents’ accounts were inspected. Receipts are in place and signatures for expenditures. More care is required with balance checks to ensure additions are accurate. The Regulation 26 visits have not been conducted for some considerable time. These need to be recommenced, monthly, unannounced. The inspector was advised that a member of the Committee does visit unannounced, however, a report is not produced from these visits. Minutes of residents’ meetings and staff meetings were available. A selection of service certificates including those for the lift and items under LOLER, were inspected and found to be satisfactory. The service certificates for the fire equipment and alarm testing were current. The weekly fire alarm testing had not been conducted since 4/7/06.The electrical certificates were not available- it was requested that these be forwarded to the CSCI. Please see requirements 7 and 8. Please see recommendation 1. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 x 3 X X 2 Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? yes 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 OP3 Regulation 14 Requirement The Registered Manager must ensure that all assessment information is available and fully represents comprehensive assessment procedures. The Registered Manager must ensure that care plan information including daily events is available for all residents, written in English, fully reflective of needs and kept under review. The Registered Manager must ensure that all PRN medication has comprehensive instructions in place. Previous time frame for action 30/7/05.This is now outstanding. The Registered Manager must ensure that all staff are aware of adult protection and whistle blowing procedures including reporting to external bodies. Timescale for action 30/12/06 2. OP7 15 30/12/06 3. OP9 13 30/09/06 4. OP18 20 30/09/06 Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 24 5. OP29 19 The Registered Manager must ensure that staff are subject to robust recruitment procedures including CRB, POVA and fully completed application forms with supporting references are in place prior to employment. Previous time frame for action 31/8/05. The Registered Manager must ensure that staff are provided with mandatory training at appropriate intervals. Previous timeframe for action 30/11/05. The Registered Manager must ensure that quality assurance measures including the Regulation 26 visits are conducted. The Registered Manager must ensure that all health and safety issues are addressed including weekly fire alarm testing. 30/09/06 6. OP30 18 30/12/06 7 OP33 26 30/09/06 8 OP38 23 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP33 Good Practice Recommendations The Registered Manager should review the quality assurance systems to ensure that all quality indicators are included and applied consistently. Antokol DS0000006883.V303077.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Antokol DS0000006883.V303077.R01.S.doc Version 5.2 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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