Inspection on 09/08/06 for Avon House

This inspection was carried out on 9th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Avon House 25/06/08

Avon House 11/07/07

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Avon House Stockcroft Road Balcombe West Sussex RH17 6LG Lead Inspector Mrs J Hough Key Unannounced Inspection 9th August 2006 09:30a 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 Avon House DS0000066866.V302850.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. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avon House Address Stockcroft Road Balcombe West Sussex RH17 6LG 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) 01444 811282 Fresh Green Limited Mrs Veronica Vivien Freeman Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New registration Brief Description of the Service: Avon House is a care home for up to 19 elderly residents over 65 years of age. The registered provider is Fresh Green Limited and the registered manager responsible for the day-to day running of the home is Veronica Freeman. The ownership of the home changed and the home was newly registered on 31st March 2006. The home is a large Edwardian property located in a pleasant residential road in the village of Balcombe in West Sussex, with local shops a short distance away. Resident’s accommodation is arranged on two floors with a passenger lift giving access to both floors. Accommodation consists of thirteen single and three double rooms all with ensuite facilities. There is a large dining/lounge area on the ground floor. The home is surrounded by a large rear and front garden both of which are accessible to residents. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 9th August 2006 and took over 5 hours to complete. Veronica Freeman the registered manager was present for part of the inspection. A follow-up visit of 2 hours took place on the 10th August to provide the registered manager with feedback from the inspection. A tour of the premises took place and residents and staff were individually spoken with to find out what it was like living and working in the home. Records were examined in relation to resident’s care notes, accident and complaints books, maintenance checks, staff files and staff rosters. The registered manager completed a pre-inspection questionnaire that provided some of the evidence for this report. Comment cards from the Commission of Social Care Inspection were sent to the home for distribution to residents and relatives and six were completed and returned from relatives and seven from residents, all giving positive feedback. On the day of the inspection there were 16 residents accommodated. This is a newly registered care home and the key standards were assessed at this inspection. On giving feedback from the inspection the registered manager/proprietor Veronica Freeman expressed her commitment to the home in wanting to provide the residents with an excellent service. Faced with some setbacks since taking ownership of Avon House at the end of March 2006 had resulted in paperwork and some planned work falling behind. From feedback prior to the inspection and evidence gathered during the inspection it was clear that the residents feel they were well looked after and were happy with the home. The requirements made as a result of this inspection have therefore been given realistic timescales in agreement with Veronica Freeman to enable her to meet them. The current scale of charges are from £337.00 to £520.00 Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Not all the residents had a care plan in place and the registered manager was in the process of reassessing residents and completing new care plans. Some staff files did not contain evidence that all the relevant checks had been carried out on staff prior to employment. Some references had not been taken Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 7 up and immediate action was taken by the registered manager to obtain verbal references as an interim measure. In-house maintenance checks had not been carried out since March 2006 on systems and equipment used in the home. There was no planned training programme for staff but discussions had been held with a trainer with regard to providing the appropriate training in the near future. Staffing levels at night were not sufficient to ensure the health and safety of residents. An immediate requirement was made with regard to this matter and the registered manager responded promptly to meet this requirement by placing another member of staff on the premises at night. There was no monitoring system in place to obtain the views of residents and relatives about the home. 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. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Avon House DS0000066866.V302850.R01.S.doc Version 5.2 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 the following standard(s): 1,3,6. Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. The Statement of Purpose for the home needs reviewing to reflect the current staffing structure. The admission procedures for the home were thorough The home does not provide intermediate care. EVIDENCE: The Statement of Purpose for the home needs amending to reflect the current staffing structure. The care notes of a new resident who moved into the home in June 2006 showed that a thorough pre-admission assessment had been carried out prior to any agreement being made for admission. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 10 The resident visited the home with relatives before making a decision about the home. The home does not provide intermediate care. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10. Quality in this outcome is adequate. This judgement has been made using available evidence including a site visit to this service. Resident’s needs were met by staff although individual care plans were not in place for all residents. Medication records were accurate and staff had training in the safe administration of medicines. The resident’s privacy and dignity is respected by staff. EVIDENCE: Care notes were read that included a recent admission to the home that showed that a full assessment had been carried out although no care plan had been completed. Some care plans were in place but the majority of residents still did not have a fully completed plan. The registered manager was in the process of re-assessing all residents and completing new care plans, but due to Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 12 setbacks since taking ownership of the home, paperwork and plans had been delayed. A sample of the new format for care plans was seen that gave a detailed account of resident’s needs. Speaking with residents and from feedback on the surveys from the Commission of Social Care Inspection (CSCI) it was clear that the needs of the residents were met, although the documentation was not in place to support this. Staff spoken with confirmed that information on the care needs of residents was gained from discussions held between staff and the manager at the change of each shift. Observations made of staff interacting with residents showed they had a good understanding of resident’s individual needs and that residents and staff appeared to have formed good relationships. The home has no hoists or handling equipment so residents accommodated were able to transfer with minimal assistance. District nurses provide care and support where needed and visit on request. Special equipment is supplied when needed and one resident was seen to have a pressure-relieving cushion. Arrangements were made for residents to visit health professionals as and when necessary. The optician visits the home every 6 months and the chiropodist every 6 weeks. The medication administration records were examined and were well maintained. Most medicines were supplied in blister packs and others in bottles and packets that were all stored in locked cupboards in the staff room. When administering medicines to the residents they are transported around the home on an open trolley. Although the inspector was told that two members of the care staff carry out the task of administering medicines, consideration should be given to what happens to the trolley in an emergency situation with only two members of staff on duty during the day and one at night. There were no Controlled drugs being stored or administered at present. The staff on duty confirmed that they had undergone in- house training for medication with the registered manager. However, there was no written evidence available to the content of the training and that individual staff members were competent for this task. On speaking with residents about the staff they felt the staff respected their privacy and dignity at all times. Observations of staff with residents showed that staff approached residents in a courteous and caring manner. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. Activities are offered to suit the needs of the present residents. The residents are able to have visitors within reasonable times. The residents are offered a good choice of fresh home cooked food. EVIDENCE: The activities offered included a reminiscence session and keep fit session taking place weekly. The residents accommodated were happy with these events and did not express any wishes for more activities to take place. Resident’s choices and preferences were taken into account with regard to care issues and any activities of daily living. Residents said that visitors were made very welcome and visiting times were open, although visitors were asked to try and avoid mealtimes and visiting late in the evening. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 14 Most of the residents spoken with said the food had improved since the change of ownership of the home and said there was plenty to eat with fresh fruit on offer all day. One complaint was made about the supper on one evening when fried egg on toast was served and thought to be insufficient. The manager/proprietor has been doing the cooking due to not being able to find a cook, but a cook had now been appointed and the manager was in the process of planning menus with her. At present a weekly menu is set up and written in the diary and reviewed each week taking into account resident’s likes and dislikes in food. The week’s menus seen in the diary were varied and well balanced. Special diets are catered for when needed. Meals consist of a main meal at lunch- time and supper is a high tea for example beans or egg on toast, egg mayonnaise and salad, and bread and butter etc followed by homemade cake. Fresh fruit is always available in the dining room. The main meal on the day of inspection was homemade vegetable soup roast chicken, roast potatoes, cauliflower cheese and cabbage. Pudding was pineapple sponge and custard. All meals are freshly prepared and home cooked. The cook prepares the evening meal and the care staff cook and serve the supper. Residents can eat in the dining room or in their own room if preferred. None of the present residents need assistance with eating and drinking but this would be offered when needed. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. Complaints were responded to and acted upon in line with the homes complaint procedures. Staff showed they were aware of the correct way to respond to any suspicion or allegation of abuse within the home to ensure the residents are protected from harm. EVIDENCE: The home had a complaints procedure in place. The complaints log was read and there had been two complaints recorded since the new ownership of the home. One complaint had been satisfactorily concluded. The second complaint involved several issues relating to one resident. All issues were investigated and addressed by the registered manager and letters of response sent to the complainant within the timescales set out in the complaints procedure. The outcome of the complaint resulted in the resident being given one months notice to move from the home due to the home not being able to meet the needs of the resident. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 16 The West Sussex Adult Protection procedures were available in the home for reference purposes. The home had procedures in place for abuse that was last updated in 2002. The staff had not attended training on adult abuse but staff on duty on the day of the inspection were fully aware of their responsibilities in reporting any incidents or allegations of abuse within the home. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 22,26 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. The residents live in a comfortable, safe and clean home. EVIDENCE: A tour of the premises took place and all areas of the home were fresh and clean. The domestic had just left on maternity leave and it was now the responsibility of the care staff to clean the home and do the laundry. The dining area was in the process of being decorated and plans are in place to decorate the lounge and replace the curtains. Resident’s rooms were seen and some contained personal possessions and small items of furniture. Call bells were accessible and provided in all rooms. The rear garden has been cleared of rubbish and is now safe and accessible for residents. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 18 The pre-inspection questionnaire states the fire officers last visit was on 27/4/06 and all requirements/recommendations had been implemented. The laundry facilities consist of one washing machine and tumble drier and hand washing facilities were available. When speaking with staff they were fully aware of the importance of good infection control procedures when handling linen and providing personal care to residents. Training for all staff in infection control is being planned. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome is adequate. This judgement has been made using available evidence including a site visit to this service. Staffing numbers during the night were not sufficient to ensure all resident’s needs were met but following an immediate requirement being made an extra member of staff was placed on the premises at night. All the relevant checks on all new members of staff were not carried out to ensure the protection of residents. A training programme for staff needs to be put in place. EVIDENCE: Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 20 The staff rotas show that there are two care assistants working all day and one care assistant working during the night. The rotas show that generally care assistants work two full day shifts of 12 hours with two days off. Care staff are contracted to work 36 hours per week but can work overtime if wished. Residents spoken with were generally pleased with the response times from staff for assistance and felt there were sufficient numbers of staff on duty to look after them. However one resident made comment about having to wait too long for assistance at night. Concerns had also been raised as part of a formal complaint from a relative about the staffing numbers at night. During the inspection the issue of the health and welfare of residents in emergency situations at night was discussed with the registered manager and an immediate requirement was made to increase the number of staff on the premises at night. The registered manager responded promptly to meet this requirement. Staff spoken with felt the staffing numbers during the day where sufficient to care for the present residents, although they have to carry out extra duties such as cleaning, the laundry and cooking and serving supper. Observations made at suppertime showed that the two care assistants appeared to cope well. The pre-inspection questionnaire showed that there are 3 members of care staff who hold a current first aid certificate and one member of care staff was qualified to the National Vocational Qualifications (NVQ) level 2 or 3. No training had taken place for staff since the change of ownership of the home but contact had been made with a trainer to plan future training for all staff. Records showed that care staff employed were experienced carers who had worked in other care settings. Four staff files were examined of new staff and two files did not contain evidence of staff completing an application form and health declaration. One care assistant the cook and handyman had no record of having had any references. Some Criminal Records Bureau checks were still outstanding although the Protection of Vulnerable Adults checks had all been completed. Immediate action was taken by the registered manager to obtain verbal references for those members of staff without written references as an interim measure. Staff spoken with confirmed that they had an induction into the home and shadowed a member of staff for the first few shifts. However there was no documented evidence that induction training had taken place. A sample of an induction booklet was seen and plans were in place to complete these as evidence of induction training. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 21 Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 22 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): 31,33,35,38 Quality in this outcome is poor. This judgement has been made using available evidence including a site visit to this service. The home is run by an experienced manager. A monitoring system was not in place to obtain the views of residents and relatives of the home. The home has systems in place to safeguard the resident’s finances. Maintenance checks were not carried out within the appropriate timescales to protect the health and safety of residents and staff. EVIDENCE: Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 23 Veronica Freeman the registered manager/proprietor has 10 years experience running a care home and was registered with the Commission of Social Care Inspection (CSCI) in March 2006. She was due to commence training for the Registered Managers Award in May this year but due to work commitments this was postponed. There is no quality assurance system currently in place to gain the view of residents and relatives of the home. However surveys distributed from the Commission of Social Care Inspection (CSCI) prior to the inspection gave positive feedback on the home. The home’s policy is not to handle the financial affairs or money of residents. However small amounts of money were held for one resident and accurate records were maintained of all transactions. The money was held in a locked filing cabinet in the office. Policies and procedures in place require updating and reviewing as some had not been reviewed since 2003 and others in 2004. The pre-inspection questionnaire states that no mandatory training for staff had taken place since the new ownership of the home, but plans were in place to develop a training programme for staff in the near future. There was no evidence that in-house maintenance checks had been carried out since March 2006 with regard to all systems and equipment in the home that includes the fire alarm and fire doors. This was discussed with the registered manager who informed the inspector that the fire panel requires moving to a lower position to enable staff to access it safely. Enquiries had been made with a fire protection and fire alarm company to carry out this work. Meanwhile the maintenance man will be given the responsibility of checking fire systems at regular intervals. Records showed that the lift and fire equipment was tested in April 2006 by external specialists. The pre-inspection questionnaire states that the central heating system is due for servicing in the autumn 2006 and a gas and electrical contractors need to be located. The accident book was examined and there had been 13 minor accidents recorded since March 2006. All accidents, injuries and incidents had been reported to the appropriate authorities. One formal complaint made, raised the issue of staff not informing relatives of a minor accident to a resident. An apology was given to the relative and a note made for staff to notify the family of any future accidents. Generally the home’s policy is only to notify relatives of any serious incident or accident unless otherwise instructed by families. Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 24 Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 13 14 15 3 X X 3 X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 3 3 3 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 1 X 3 X X 1 Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 15(1) Requirement Timescale for action 30/09/06 2 OP27 3 OP29 4 OP30 5 OP33 The registered person shall prepare a written care plan for all residents setting out how the resident’s needs in respect of health and welfare are to be met. 18(1)(a) The registered person shall having regard to the size and the needs of residents ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of the residents. 19(1)(b)(c The registered person shall not ) employ a person to work at the care home unless he is satisfied on reasonable grounds as to the authenticity of the references. 18(1)(c)(i The registered person must ) ensure that persons employed to work at the care home receive the training appropriate to the work they perform. 24(1)(a)( The registered person shall b) establish and maintain a system for reviewing at appropriate intervals the quality of care at DS0000066866.V302850.R01.S.doc 14/08/06 30/09/06 31/10/06 30/11/06 Avon House Version 5.2 Page 27 6 OP38 the care home. 23(4)(c)(v The registered person shall after ) consultation with the fire authority ensure adequate arrangements are made for reviewing fire precautions and testing fire equipment at suitable intervals. 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. Refer to Standard Good Practice Recommendations Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Avon House DS0000066866.V302850.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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