Inspection on 20/09/06 for Brecklands Nursing Home

This inspection was carried out on 20th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Brecklands Nursing Home 13/02/07

Brecklands Nursing Home 11/01/06

Brecklands Nursing Home 11/08/05

Brecklands Nursing Home 29/11/04

Brecklands Nursing Home 25/06/04

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 Brecklands Nursing Home 28 Burnham Avenue Bognor Regis West Sussex P021 2JU Lead Inspector Miss Helen Tomlinson Unannounced Inspection 10:00 20 & 26 September 2006 th th 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 Brecklands Nursing Home DS0000024124.V300151.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. Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brecklands Nursing Home Address 28 Burnham Avenue Bognor Regis West Sussex P021 2JU 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) 01243 863218 01243 869769 Mrs Janet Mary Cole Mrs Lynda Rehman Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2006 Brief Description of the Service: Brecklands nursing home is a privately owned care home providing nursing care for up to nineteen residents in the category of older people. The home is a detached two-storey property in a residential area of the town of Bognor Regis. It is close to the town centre, within easy access to all local amenities and is half a mile from the sea front. Accommodation is provided in fifteen single and two double rooms. Four of the single rooms have en-suite facilities. A lounge with adjoined conservatory and a smaller dining room provide the communal space. A seating area is available on the first floor. I Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took part over two days on the 20th September 2006 with a second visit to the home on the 26th September 2006. The registered manager was not present at the first visit and some necessary information and records could not be accessed. At the time of the inspection seventeen residents were accommodated in the home. Prior to the visit to the home information was gathered from previous inspections and information received regarding the service. During the inspection a full tour of the premises took place, the inspector spoke to the residents, staff and visitors. Care practices were observed, care plans examined and other documents seen as necessary throughout the inspection. Following the last inspection six requirements were made. At this inspection five of these remained outstanding with eight more being made. The Commission will monitor compliance with the requirements and the provider should be contacted directly to enquire about progress made towards meeting them. What the service does well: Residents said the staff treated them with respect and protected their privacy and dignity when offering care and support. They said they were polite, kind and friendly. Residents were supported and assisted to continue with their pastimes and hobbies. Some activities were organised in the home and residents could choose to join in with these should they wish. Visitors were welcomed into the home at any reasonable time. Residents enjoyed the food served, saying there was plenty to eat and it was well cooked. The cook catered well for individual likes and dislikes. Residents said the manager was approachable and they would discuss with her, any complaints or issues they might have. The environment was homely and domestic in nature, clean and free from offensive odours. Residents could personalise their bedroom should they wish to do so. A good sized, well maintained and accessible garden was available for residents. Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: All prospective residents must have their needs assessed, prior to being accommodated in the home, to ensure the facilities and services are adequate to meet these needs. Plans of how to meet the assessed needs must be documented and provide guidance for staff into offering appropriate care and support for the residents. All risks to health and safety must be identified, assessed and have a plan of management and prevention in place. Medication storage, administration and recording must meet the guidance of the Nursing and Midwifery Council and safeguard the residents. All persons working in the care home must complete training in the protection of vulnerable adults. Those who may be in charge of the care home must be aware of the correct procedures to follow to ensure residents are protected from abuse. All staff must ensure fire safety procedures in the home protect the residents. All fire exits must be kept clear and fire doors kept closed, unless held open by a device which meets the guidance of the fire authority. Areas available for resident’s use, such as toilets, must not be used for storage. An assessment of the size and layout of the bedrooms, to include any risks posed by necessary equipment, space and moving and handling restrictions, should be done. Staff working at the home must have the necessary checks completed, prior to starting work, to ensure they are fit to work with vulnerable adults. All staff must complete the training necessary for the work they are to perform. This must include induction training. The registered manager must have sufficient time, when she is not working as the nurse on duty, to fulfil her managerial role adequately and carry on the care home in line with the Regulations. A system of reviewing the quality of service delivered must be present, which includes the unannounced visits by the provider, which are required in the Regulations. All aspects of health and safety of residents and staff must be maintained. Staff should receive training in health and safety. All accidents must be correctly recorded. Please contact the provider for advice of actions taken in response to this Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brecklands Nursing Home DS0000024124.V300151.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 Brecklands Nursing Home DS0000024124.V300151.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): 3 Residents were admitted to the care home without having their needs assessed to ensure they can be met fully met. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The latest person to be admitted to the care home had not received a needs assessment prior to them becoming accommodated in the home. No member of staff from the home had visited the prospective resident and there was no assessment of whether the services and facilities at Brecklands could meet their needs. The manager stated they had been admitted in an emergency with some information being obtained from a family member. One resident had been admitted for a short stay. They had been resident in the home six months prior and their records from this stay were in use. No reassessment of their needs had taken place, despite written records which documented changes to the residents general condition. Brecklands Nursing Home DS0000024124.V300151.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 and 10 Not all residents had an assessment of their health and personal care needs and risks or a plan of how these should be met. The practices of medication storage, administration and recording did not safeguard the residents. Residents were treated with respect and their privacy and dignity were protected. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The latest resident to be admitted to the home did not have any documented assessments of health and personal care needs or plans of how staff should meet these needs. Some information regarding care given and action taken was documented in the daily notes. This did not include their own preferences and choices, plans of how to deliver care or any assessments of risks to health and safety. For this resident other health professionals had been consulted to Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 11 ensure the most appropriate care was given; however this was not fully documented. For a resident who was in the home for a short stay the health assessments and care plans, from their admission six months previously, were in use. These had not been reviewed when the resident was re-admitted to the home, despite a change in condition, including no review of their pressure area risk assessment and plan of care, despite a deterioration in skin condition. For another resident with a pressure sore it was unclear what dressings were being used. For some residents who had bed rails in place no protectors, to reduce the risk of injury, were in use. The language used by staff in some of the daily records was inappropriate and should be reviewed. Where it was recorded there was some resistance to care, by the residents, there was no plan of how to appropriately or safely manage this. The medication in the home was administered by registered nurses. Not all practices of storage, administration or recording were within the code of practice of qualified nurses, or assured the safety of the residents. The door to the medication room was propped open, medication was incorrectly documented on hand written administration charts, variable doses were not recorded and the medication administered to the residents during the morning had not been documented. Residents spoken with said the staff were polite and respectful, protecting their privacy and dignity when giving support and assistance. Staff knocked on bedroom doors prior to entering and ensured bedroom and bathroom doors were closed when personal care was being given. Brecklands Nursing Home DS0000024124.V300151.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 and 15 Some activities were available for residents to join in with, should they wish. Staff supported residents to continue with individual pastimes and interests. Visitors were welcomed into the home at any reasonable time. Residents’ choices and preferences were respected. Residents enjoyed the meals offered. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The activities which took place in the home included a very popular gardening club, entertainers visiting and some one to one activities with care staff. Residents spoken with said there were activities to join in with, should they wish, but their decision not to was also respected. Individual residents had newspapers, books, talking books, television, radios and music centres in their own bedrooms, should they wish. Residents were able to go out of the home unaccompanied, should they be safely able to do this. Others discussed how they got out in the good weather, to the seafront and sat in the garden. At the last inspection it was discussed that a more detailed history of the residents Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 13 hobbies and interests would assist staff to meet their social needs. This had not been carried out. Residents said they could have visitors at any reasonable time and could go out with them, should they wish. Some information in the plans of care indicated the resident’s choices and preferences regarding their care had been sought and was respected. Those spoken with said staff did respect their individual wishes. Residents said they enjoyed the food served saying they got plenty to eat and it was well cooked. A rotating menu was in operation which showed nutritious meals were served. There was some repetition of the types of food offered, in the same week. Specialist diets were catered for if required. Residents said they could choose to eat their meals in the dining room or in their bedrooms as they preferred. Whilst a choice of main meals was not actively offered the cook had a thorough knowledge of the residents likes and dislikes and several different main meals were served. Brecklands Nursing Home DS0000024124.V300151.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 and 18 Residents feel able to discuss any complaints they may have. Most staff had received training in the protection of vulnerable adults, however not all those persons, who may be in charge of the care home, had completed the training or were aware of the correct procedure to follow, should an allegation of abuse be made. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. EVIDENCE: No complaints had been received regarding this service since the last inspection. A complaints procedure was present in the home. Residents spoken with said they would approach the manager with any issues or complaints they may have. Most staff completed training in the protection of vulnerable adults in January 2006. The person in charge at the time of the inspection had not completed this training and was unaware of the correct procedure, should an allegation of abuse be made to them. This could potentially place residents at risk of abuse. Those care staff spoken with were aware of their responsibilities to protect the vulnerable adults in their care. Brecklands Nursing Home DS0000024124.V300151.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Residents live in a clean and homely environment. Some issues, which could potentially cause a hazard to the health and safety of the residents, were raised. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home was clean and homely and residents said they liked their own bedrooms and the communal areas, which were kept pleasant. Some residents discussed how they had enjoyed the gardens in the good summer weather. The home was generally well maintained, however one bathroom required refurbishment and one toilet had items unsafely stored in it. The hairdresser was assisting residents to have their hair done, on the first floor. Whilst this was underway the corridor and one fire exit were completely blocked. The safety of residents walking down the corridor was further Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 16 jeopardized by wires being across their path. At the last two inspections fire doors have been wedged open. At this inspection several devices, approved by the fire service, were in place to keep doors open. However doors without these devices were wedged open, including the laundry and doors to communal areas. Throughout the inspection staff made no effort to close these doors. At the time of the second visit to the home all fire doors were closed. One fire exit on the ground floor was blocked throughout the first visit. The fire safety procedures in the home should be reviewed with all staff and fire doors kept closed at all times, unless an appropriate device is in place. Some bedrooms, bathrooms and communal areas present a restricted space for those residents who require the use of equipment, such as a hoist for moving and handling. A requirement was made at the last inspection that risk assessments for the use of such equipment, in these areas of the home, must be carried out. These had not been done and the requirement is outstanding. Staff wore appropriate protective clothing and hand washing facilities were available throughout the home. Brecklands Nursing Home DS0000024124.V300151.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Sufficient numbers of staff were on duty to meet the needs of the residents accommodated. The recruitment of new staff did not protect the vulnerable adults accommodated. Staff were not adequately trained for the work they were to perform. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There were sufficient numbers of staff on duty to meet the needs of the residents accommodated. A duty rota was recorded which showed a registered nurse to be on duty at all times. Two staff files were examined and these did not contain all the necessary information or checks required to ensure staff are fit to work with vulnerable adults. At the time of the inspection two of the four staff on duty had not been checked against the Protection of Vulnerable Adults register or had a Criminal Records Bureau check completed. They were not working under the supervision of a suitable member of staff. Since the last inspection some staff training had taken place, with half of the staff having completed moving and handling training and all but one the protection of vulnerable adults training. The remaining staff were to complete the moving and handling training later in October. No records of induction Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 18 training for new members of staff were available. Not all statutory training had been completed or was booked. A requirement for this remains outstanding. Twenty five per cent of staff had completed the NVQ level two training. Brecklands Nursing Home DS0000024124.V300151.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 The manager has the qualifications and experience necessary to manage the care home. She had insufficient hours dedicated to the management of the care home, in order to carry out this role satisfactorily. No system of quality review was presently used in the home. The management of resident’s personal money safeguarded them from. Some practices and environmental factors presented health and safety risks for the residents. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The registered manager is a qualified general nurse. She has many years experience working with older people and of managing a care home. She Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 20 confirmed that she attends appropriate training courses and keeps her practice up to date. She does not hold a management qualification and was aware this was necessary. Staff and residents spoke highly of the manager, saying she was approachable, kind and caring. At the time of this inspection the manager was working as one of the registered nurses on the duty rota, with only two hours per week to complete the managerial tasks. This is insufficient and must be reviewed in order that the manager can meet the requirement to manage the care home with sufficient care, competence and skill. There was no system in the home, to assess the quality of service and facilities provided. The registered person did not carry out unannounced visits to the care home and make reports, as required in the Care Home Regulations. Some small amounts of resident’s money were managed by the home. Records were accurately kept and money safely stored. Some issues of health and safety, such as fire safety, unsafe storage and lack of risk assessments, have been discussed throughout the report. Accident records were kept, however not for all accidents which had occurred in the home. Staff had not received training in health and safety. Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 21 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 2 X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 2 Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 22 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 person shall not provide accommodation to a resident unless their needs have been assessed by a suitably qualified person. All residents will have a written plan, drawn up in consultation with them, which is kept under review. All health needs of the resident must be assessed and met. All risks to the health and safety of the resident must be identified and as far as possible eliminated. All medication kept in the care home must be safely stored, administered and recorded. This requirement remains unmet since the inspection of 11/01/06 The timescale given of 31/03/06 has expired. Residents must be protected from abuse by training of staff and other means. All staff who may be in charge of the care home must be fully aware of the DS0000024124.V300151.R01.S.doc Timescale for action 31/10/06 2 OP7 15 31/10/06 3 4 OP8 OP8 12 13(4)(c) 31/10/06 31/10/06 5 OP9 13(2) 31/10/06 6 OP18 13(6) 31/10/06 Brecklands Nursing Home Version 5.2 Page 23 6 OP19 23(4)(c) (i) correct procedure to follow. Fire doors must be closed at all times, unless held open by a device which meets the guidance of the fire service. This requirement remains unmet since the inspection of 11/01/06 The timescale given of 11/01/06 has expired. Fire exits must not be blocked at any time. The bathroom on the first floor must be in good repair. This requirement remains unmet since the inspection of 11/01/06 The timescale given of 30/04/06 has expired. No staff must work in the care home without all information to ensure they are fit to work with vulnerable adults, having been obtained All staff must have training for the work they are to perform. This requirement remains unmet since the inspection of 11/01/06 The timescale given of 30/04/06 has expired The registered provider and the registered manager, shall, having regard to the size of the care home, the statement of purpose, and the number and needs of the service users, carry on or manage the care home with sufficient care, competence and skill. A system of reviewing and improving the quality of care provided at the home must be maintained. Visits under this regulation, with written reports must be completed. DS0000024124.V300151.R01.S.doc 31/10/06 7 OP21 23(2)(d) 31/10/06 8 OP29 19 and schedule 2 18(c) 31/10/06 9 OP30 30/11/06 10 OP31 10(1) 31/10/06 11 OP33 24 30/11/06 12 OP33 26 31/10/06 Brecklands Nursing Home Version 5.2 Page 24 10 OP38 23(2)(f) The size and layout of the rooms must be suitable for the needs of the resident. Assessments of suitability of the bedrooms should be done for residents. This requirement remains unmet since the inspection of 11/01/06 The timescale given of 31/03/06 has expired. 31/10/06 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 Brecklands Nursing Home DS0000024124.V300151.R01.S.doc Version 5.2 Page 25 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 Brecklands Nursing Home DS0000024124.V300151.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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