Inspection on 04/01/07 for Bethesda

This inspection was carried out on 4th January 2007.

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

Bethesda 03/10/07

Bethesda 22/11/05

Bethesda 14/06/05

Bethesda 09/11/04

Bethesda 01/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Bethesda 25 Croft Road Torquay Devon TQ2 5UD Lead Inspector Stella Lindsay Key Inspection (Unannounced) 4th January 2007 10:15 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 Bethesda DS0000018327.V310964.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. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bethesda Address 25 Croft Road Torquay Devon TQ2 5UD 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) 01803 292466 01803 292466 www.cch-uk.com Christadelphian Care Homes Mrs Lesley Gillian Craddock Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability over 65 years of age of places (23) Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2005 Brief Description of the Service: Bethesda provides residential care for up to 23 older people who may have physical disabilities. Bethesda is one of a group of homes run by Christadelphian Care Homes, a registered charity. There are 23 registered places at Bethesda. Two rooms are large enough to be used as double rooms. Building was in progress at the time of this inspection to provide two new rooms with accessible en suite facilities. There are bathing facilities suitable for independent wheel chair users. A shaft lift gives access to all four floors, and a new lift gives access to the mezzanine floor. Work was in progress at the time of this inspection to give free access throughout the ground floor. Bethesda has a pleasant garden and is close to Torquay sea front and town centre. The aim of the Home is to ‘provide loving individual care enabling people to lead fulfilling lives within a spiritual environment centred on the Christadelphian ethos.’ Current fees range from £345 to £465. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two days in January 2007. It involved a tour of the premises, and examination of care records, staff files, health and safety records and the medication system. The inspector met with seven residents, three staff on duty, and the Registered Manager, Mrs Lesley Craddock, who had provided supporting information about the service prior to the inspection. All core standards were inspected. What the service does well: What has improved since the last inspection? Some of the alterations were complete and already in use. The lounge windows had been renewed. The new bathroom had been completed and was in use. The new bathroom had a shower with a ramp, and a Malibu bath with a hoist, which may be operated by the bather if they are able. A toilet, hand basin and hair-dressing sink had been installed in the small bathroom adjacent. A new lift had been installed so that all areas of the building will be accessible. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 6 The central heating system had been upgraded, to assure reliable and efficient heating in the years ahead, and an extra hot water cylinder is being installed to avoid any anxiety about running out of hot water. The ceiling of the drying room has been resurfaced, and its walls redecorated, so that they can be kept clean. The two new residents’ rooms which were in preparation at the time of this inspection had been designed with their en suite facilities large enough for a turning circle, to accommodate independent wheelchair users, and promote their independence. 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. The summary of this inspection report can be made available in other formats on request. Bethesda DS0000018327.V310964.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 Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Because Bethesda is part of a larger Christadelphian community, residents are familiar with the home and with some other residents before moving in, and their choice can be a positive one. 1,3 EVIDENCE: Bethesda has produced a new Handbook, containing interesting and useful information about the home and the service provided. Residents had been asked for contributions of ideas, and quotations are included with their advice for people thinking of moving in. A DVD has been produced, showing the work of the Christadelphian Care Homes across the country, with many contributions from residents as well as staff and management. Two recently admitted residents were interviewed. They had been aware of Bethesda as they had been members of the Christadelphian community previously, and already knew people who were living here. Three files were examined, and contained information from previous carers where it was available, as well as the Manager’s up to date assessment of the Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 9 person’s care needs, and a letter from her saying that Bethesda is able to meet these needs, and confirming the fee. The home has a checklist to ensure that all parts of the admission process have been completed, including completion of assessment, provision of references, and arrangement of funding, if necessary. There was a confirmation, signed by the residents, that they had received a copy of the home’s Statement of Purpose and Residents’ Guide. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were completed and reviewed, personal and health care was good and the system for administering medication was sound. Staff provide good care where it is needed, while promoting the independence of residents. 7,8,9,10 EVIDENCE: Three residents’ files were examined. The care plans were clearly written, and there were risk assessments based on physical attributes for risk of falls, nutritional screening, and ‘resident handling’. The initial needs assessments were stored separately. Each individual had their own emergency evacuation plan. A Resident’s Profile, up-to date care plan, and staff task sheet for each resident are kept in ring binder for quick reference by staff. All care plans seen had been up-dated within the past month, to maintain accuracy and ensure that staff know what is required of them. The task lists are individually written for each resident. They are in the form of a chart so that staff initials show who took responsibility for each task on each day, to assure accountability. Some residents are largely independent, while others need detailed care plans. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 11 Monthly Resident Reviews were completed by a Senior Carer together with the resident. One recorded that she would like singing as a regular activity. Medical histories were recorded separately, to maintain clarity. There were records of staff and managers accompanying residents to appointments and health specialists, including sight and hearing specialists. Some residents are competent to administer their own medication, and suitable assessment forms were seen on file to show that their competence had been assessed to assure their safety, and they had agreed to store their medication safely, to not exceed the given dose, and to inform a Senior Carer of any problem. Drugs awareness training had been supplied, and the list of staff competent to administer medication was in the process of being up-dated. A Senior Carer takes responsibility for ordering and checking medication, and records were found to be accurate. New storage facilities were planned. No Controlled Drugs were in use. There was a locked fridge to contain insulin. Several residents were using herbal remedies, which were all recorded in the same way. The Manager stated that the GPs’ approval had been obtained. Bethesda DS0000018327.V310964.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff were helping residents maintain a meaningful life amongst the disruption of the on-going building work. 12,13,14,15 EVIDENCE: The routines of daily life at Bethesda are arranged to suit the residents, and any changes are only introduced with their agreement. This includes the time, place and person who will help with their bath, and the time for cleaning their room. Residents told the inspector they were very pleased with the standard of the laundry service. Residents were needing to take different routes around the building, to avoid alterations in progress, and staff helped by thinking ahead and guiding people. Some were choosing to remain in their room more than usual. The Manager said that residents had been offered accommodation in other Christadelphian homes for the duration of the work, but all had chosen to stay. With the help of staff, they felt they were braving it together as a community. Each month the programme of events and activities is printed and displayed throughout the house. There had been a coffee morning at the Ecclesial Hall on New Years Day. The residents join in Bible readings every evening, except Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 13 Sundays and Thursdays when the minibus takes those who are well enough to their Ecclesia. Readings are often lead by residents of Bethesda, but visitors from the Ecclesia lead them once or twice a week. An exercise group is held every Monday and Friday. This has been maintained over a long period, and found to be beneficial. Some residents are able to take themselves out every day, whether for a walk, bus ride, or in their own car. Outings were not planned for January, but through the summer months residents are offered a fortnightly ride in the home’s minibus to one of the local beauty spots, stopping for coffee. At lunch-time, the Senior on duty tells the company any news, and also who will be coming on duty later that day. She will say who is visiting to take the readings in the evening, or ask for a volunteer from amongst the residents. A choice of main course and pudding is offered, with other alternatives made available if necessary. Residents are given a menu sheet to fill in their choices for the week ahead. They keep a copy, so they know what they have ordered. This enables the chef to plan and order. He is normally able to make smallscale adjustments if people change their mind. At the time of this inspection the home was endeavouring to provide the best possible meals during the rebuilding of the dining room floor and the refitting of the kitchen. Outside caterers were employed to provide the main meal each day, and staff provided all snacks and drinks from a kitchenette. The chef was ensuring that residents had fresh fruit. Lunch is a time when the residents gather as a community, unless they are unwell. They are encouraged to come to the dining room for tea, but many choose to stay in their room. Residents can request groceries to be delivered to their rooms. Orders are taken weekly, including household items such as soap and toilet paper, which leaves the resident in charge of their own housekeeping. Bethesda DS0000018327.V310964.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Bethesda has a satisfactory complaints procedure, and residents feel their views are listened to and acted upon. Residents are protected from abuse by the systems of support that are in place. 16,18 EVIDENCE: Bethesda has a Complaints procedure which is comprehensive and fulfils the requirements of this Standard. A hard backed book is kept to record complaints and untoward incidents. Any notes of a personal nature are kept in Service Users’ files. There had been no formal complaints since the last inspection, and no disciplinary action had been needed. Staff had received training in the protection of vulnerable adults, and are provided with this training annually, to maintain their awareness. CCH has a policy on abuse which was updated in June 2005, and includes the requirement for staff at Bethesda to be aware of the Alerters’ Guidance issued by Torbay Council. The Staff Handbook includes policies on harassment and Whistle blowing. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management was providing the best facilities and accessibility that could be arranged within this building. 19,26 EVIDENCE: Major investment is being made to improve the facilities and accessibility of the home, as well as repair work found to be necessary in the process. The work was underway at the time of this inspection. There was therefore, unavoidable noise, dust and disruption to the residents’ lives. All efforts were being made to ensure their safety, and maintain their quality of life. The new bathroom has been completed and was in use. It has a shower with a ramp and a Malibu bath with a hoist, which may be operated by the bather if they are able. A toilet and a hairdressing sink have been installed in the small bathroom adjacent. A new lift has been installed so that all areas of the building will be accessible. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 16 The central heating system has been upgraded, to assure reliable and efficient heating in the years ahead, and an extra hot water cylinder is being installed to avoid any anxiety about running out of hot water. Four bedrooms have had their en suite showers refurbished, to make them accessible to enhance the residents’ independence. There had been hot pipes in the wall of a bedroom, making it impossible for the occupant to control the temperature of the room in summertime. These have been lagged, to overcome this problem. At the time of this inspection work was in progress to raise the dining room floor, to give residents level access. The kitchen and dining room were in the process of total refurbishment. An ideal system for dishwashing and drying was being provided, plus a combination steamer/cooker, and back-up gas cooker. There was a new dry store and cold store, a blast chiller, a waterboiler, and cold drink dispenser, a bain-marie by the serving area, and a knee operated hand basin for staff hand-washing. A new residents’ assisted cloakroom and staff cloakroom were also being installed. The lounge was temporarily in use as a dining room. The two new residents’ rooms which were in preparation at the time of this inspection had been designed with their en suite facilities large enough for a turning circle, to accommodate independent wheelchair users, and promote their independence. The ceiling of the drying room had been resurfaced, and its walls redecorated, so that they can be easily cleaned. Soluble red bags are available for soiled laundry, but are not in general use at present, as residents are currently free from continence problems. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Well-motivated, welltrained and caring staff are employed in sufficient numbers to meet the needs of the residents and enable them to maintain their quality of life. 27,28,29,30 EVIDENCE: A rota is kept, showing who is on duty and in what capacity. There is a Senior Carer on duty from 8am until 9pm, and on-call at night unless the Registered Manager is sleeping in. Two other care staff are employed 24 hours per day. A Cook, a Kitchen Assistant, and two morning cleaners on weekdays are in addition to the care staff. This level of staffing is found to meet residents’ current needs. Staff who returned surveys to the CSCI were proud of the standard of care they were providing, ‘given with real friendliness, support and affection.’ A resident said that her sight is very poor, and she was pleased that staff remember to put things in the right place so that she can find them. Another was very pleased with Senior staff – describing them as capable and discreet – ‘there is nothing bossy about them’. Eleven of the seventeen care staff had achieved at least NVQ2 or equivalent, and two more were engaged in this training. The four others were intending to start later this year. This shows excellent commitment to maintaining a qualified workforce. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 18 The files of the three most recently appointed staff members were examined. All had good written references, and all the checks necessary to assure residents’ safety had been carried out. Proof of identity had been obtained in this process, but needs to be retained, in accordance with schedule 4 of the regulations. Induction training had been provided, and health and safety training had continued. One staff member said that the Manager is ‘always looking for training courses to benefit the home and interest staff.’ During the past year fourteen staff (including the Manager) had attended a course on Person Centred care, and eight had received training in dealing with bereavement and loss. One of the Senior Carers was looking forward to IT training and all the Senior Carers were looking forward to up-dating their Supervision and Appraisal skills training. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management team work consistently to provide and improve the service and facilities for residents. The support and auditing systems are reliable, with attention to detail, with opportunities to hear residents’ views built in. 31,33,35,38 EVIDENCE: Mrs Lesley Craddock is the Registered Manager of Bethesda. She qualified as a State Registered Nurse in 1966. Since then she has undertaken training courses, including Advanced Certificate in Counselling (Nottingham University) 1996, ENB Teaching and Assessing in the Workplace - 1996, and in June 2004 completed the Higher National Certificate in Managing Health and Care Services at Birmingham College of Food, Tourism and Creative Studies. She keeps up to date her health and safety training along with all her staff, as well Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 20 as person centred care, protection of vulnerable adults, falls awareness, bereavement and loss. She is energetically obtaining improved equipment and facilities for the residents. She is a life-long member of the Christadelphian community. Residents commented that the Manager had been calm and cheerful throughout the period of building work, which made the disruption easier to bear. One staff member who completed a survey form said that ‘our new Manager is exceptional’, and another that ‘over the years they have brought out the best in me’. The Christadelphian Care Homes gives caring and consistent support to the home. Financial support and improvement to the building and service is ongoing, with major investment to improve facilities and accessibility for the residents. The Home’s Trustee carries out a monthly visit during which he speaks with staff and residents, and checks cash held in the home’s safe. He supplies a copy of his informative report to the CSCI. The Assistant General Manager provides professional support and supervision to the Registered Manager, and also carries out a six-monthly inspection at which the home’s performance in regard to all the National Minimum Standards is assessed. A copy of his report, along with discussion points and action to be taken, is sent to the CSCI. A Quality Assurance Report is produced annually, the latest having been produced on 3rd January 2007. It includes a report of feedback from residents, comparing their satisfaction in a range of areas, and comparing this with last year. This demonstrates high satisfaction overall, with almost 100 in the maintenance of dignity and contacts with family and friends. Interestingly, it shows a very slight lessening in knowing how the home is run, and in catering, and an increase in having someone to confide in. Action was taken last year to make sure residents had a confidante, following this feedback. Residents’ meetings are held two-monthly, to keep residents informed of what is going on in respect to any material changes to the building and any staff changes, and to gather feedback and ideas about religious observances, meals, outings and other activities. The meetings are held before the Welfare Committee meetings, so that any ideas or feed back can be considered. This committee meets every eight weeks on average, and arranges monthly outings and coffee mornings. The Manager does not act as appointee for any resident. Some are able to manage their own finances. The Assistant General Manager checks the cash kept in the safe on behalf of some residents, and the accuracy of the recording, during his monthly inspections of the home. There is a Residents’ Fund which receives donations from surrounding Christadelphian Churches, and other sources, including sale of the resident potter’s work. Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 21 Professional fire training is provided every six months. Moving and Handling training is provided annually, health and safety two-yearly, and food hygiene three yearly, as appropriate. Fire risk assessments are reviewed every six months, or more frequently if necessary. Each stage of the building work was risk assessed, and safety measures discussed with the builders at every step. Bethesda DS0000018327.V310964.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 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bethesda DS0000018327.V310964.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!