Inspection on 02/06/05 for Brook Care Home

This inspection was carried out on 2nd June 2005.

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

Brook Care Home 18/06/07

Brook Care Home 06/06/06

Brook Care Home 23/11/05

Brook Care Home 07/02/05

Brook Care Home 16/04/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOMES FOR OLDER PEOPLE Brook Care Home 17 Brook Close Rochford Essex SS14 1HN Lead Inspector Nikki Gibson Unannounced Thursday 2nd June 2005 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 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. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brook Care Home Address 17 Brook Close Rochford Essex SS14 1HN 01702 549499 01702 549499 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Vijay Luxmi Rattan Vacant Post CRH Care Home 20 Category(ies) of DE Dementia (20) registration, with number DE(E) Dementia-over 65 (20) of places MD Mental Disorder (20) MD(E) Mental Disorder (20) Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Personal care to be provided to no more than 20 service users with dementia over the age of 65 years. 2. Personal care to be provided to no more than 20 service users with mental disorder, excluding learning disability, over the age of 65 years. 3. Personal care to be provided to no more than 20 service users user with dementia over the age of 55 years. 4. Personal care to be provided to no more than 20 service users with a mental disorder, excluding learning disability, over the age of 55 years. 5. Total number of service users accommodated not to exceed 20. (Total number20) Date of last inspection 7th February 2005 Brief Description of the Service: Brook Care Home is registered to provide care and accommodation for up to twenty people over the age of 55 years who have dementia or a mental health disorder. The premises were purpose built and have been extended in recent years. Accommodation is provided on two floors and access is provided to all areas via stairs and passenger lift. There are ten single and two double rooms with ensuite facilities; there are an additional three double rooms without en-suite facilities. There are separate lounge, visitor’s room and dining room. There is a spacious conservatory, which is used by residents and staff who wish to smoke and there is a large garden. Brook Care Home is situated on a bus route near to the centre of Rochford and it is half a mile from the railway station. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which lasted six hours. During the inspection there was a tour of the premises and records and documents were looked at. Time was spent talking with the residents privately and in communal areas. A mealtime was observed and eight residents were spoken to about life at Brook Care Home. The deputy manager and members of staff were also spoken with. No visitors were present during the time of the inspection. Since the last inspection the registered manager has left and at the present time the home is run by an acting manager who has been in post four months and a deputy manager who has been in post for one week. At the time of the inspection the acting manager was on holiday and the inspection took place with the help of the very newly appointed deputy manager. The staff and residents were most helpful throughout the inspection and this was greatly appreciated. Discussion of the inspection findings took place with the deputy manager throughout and at the end the inspection and advice and guidance was given. What the service does well: What has improved since the last inspection? At the last inspection the home had ten requirements that had to be addressed. Some have now been progressed and some completed. A new doorbell, fax machine and telephone have been installed to improve communication. Some improvements have been made to preventing the spread of infection with the introduction of paper towels in bathrooms. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 6 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. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 4, 6 When adequate staffing levels are not maintained and when the staff left in charge lack the necessary skills residents’ needs are not meet and they are put at risk. EVIDENCE: Some residents said that there were times when they felt anxious because of the challenging behaviours of some residents and some staff’s inability to manage the situation. It was recorded in the daily notes of one resident that she had spent the day ‘hiding’ from another resident who had been aggressive to residents and staff. The home is registered to care for people from the age of 55 years with dementia or mental disorder. This is a challenging field which requires highly skilled and trained staff in sufficient numbers. Some residents have considerable abilities and following a risk assessment greater independence needs to be encouraged. Some residents would benefit from a programme of developing and maintaining skills with the support of staff. This would assist them to address some of their feelings of frustration and improve their quality of life. Brook Care Home does not provide intermediate care. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7, 9, 10 There was a detailed and extensive care planning system in place which provides staff with the information they need to be able to provide appropriate care for the residents. The system for the administration of medication requires some improvements to ensure that it does not put residents at risk. Further action is required to protect residents’ privacy and dignity. EVIDENCE: The home has comprehensive care plans and associated documentation such as risk assessments. There was evidence from studying these that they included the involvement of the residents and were regularly reviewed. One resident spoke of a past hobby he would like to take up again and the care plan identified the action being taken by the acting manager to enable him to do this. Daily notes are recorded separately and the home is advised to consider how staff can be helped to utilise the care plan as a working document. Some out dated information in the care plans was due to be archived and this would also improve the usefulness of the care plans. A medication round was observed. This was conducted by two members of staff, however the person signing that the medication had been taken was doing so before the medication had been given. The home did not have a Controlled Drugs book; Patient information leaflets were not available for all Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 10 medications. Where there was a choice of one or two tablets the number given was not recorded. There were no protocols for medication that was prescribed ‘as and when required’ (PRN). The staff giving out medication were not aware of the Royal Pharmaceutical Society of Great Britain guidelines for ‘The Administration and Control of Medicines in Care Homes and Children’s Services’. A copy can be obtained by contacting 0207 572 2409 or e-mailing ifearon@rpsgb.org.uk The content must be known to staff and the good practice followed to reduce the risk of errors occurring. One resident complained that some staff, particularly new staff, enter her room without knocking. All staff need to be instructed to treat resident with respect at all times. At present residents do not have suitable means of locking their bedroom doors. One resident said she has been instructed not to use the lock on the bathroom door. This was confirmed by a member of staff. One resident said that she gets very distressed, when she is being helped to bath by a member of staff, that other residents enter the bathroom. These are unacceptable practices and changes must be made that respect the privacy and dignity of residents. The home has provided a new telephone for the use of residents in the entrance hall. One resident said that although it was not completely private it was better than using the one in the office. Residents reported that unfortunately the bell could not be easily hear and one caller said that they no longer use it as the calls are not answered. This needs to be addressed One resident said that he was happy to share a room as he enjoyed the company. It was noted that privacy curtaining was in place. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12, 13, 14, 15 Some social activities take place however some residents were bored and frustrated and would welcome more activities. While the meals were well cooked the lack of fresh fruit and vegetable was of concern. EVIDENCE: Little in the way of stimulation was observed during the inspection. Residents were seen to spend their day smoking or watching television. Several residents said that they were frequently bored. One resident however said she had recently been accompanied by a member of staff to Southend for a shopping trip which she had thoroughly enjoyed. The home has a mini bus but residents reported that the only outing so far had been to the sister home. One resident said he used to be able to make drinks in his room but the facilities had recently been removed. Staff said this was for cleaning purposes and it had been forgotten to be returned. Ways of providing residents with meaning pastimes in keeping with their interests and abilities must be pursued. One resident said that there is a monthly church group who visited the home, and residents could choose whether to attend or not. Visitors are generally made welcome and offered drinks and a private visitors room is available. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 12 One resident said that since the last inspection arrangements have been made for her to see the particular television programmes she enjoys. On a number of occasions residents spoke of ‘not being allowed’ or ‘having special privileges’. For example “ not allowed to lock the WC door” “ not allowed an early morning drink”, “special privilege to have a late night drink”. Many lacked self-confidence and were unaware of their rights. This was discussed with the new deputy manager who said she would look at staff and resident attitudes. She would raise residents’ rights at their meetings and look to ways of promoting choice and autonomy. Meals were discussed with staff and residents and the lack of fresh fruit and vegetable was raised by both. The cook confirmed that fresh vegetables are only provided on a Sunday and at Christmas. It is acknowledged that frozen vegetables may have the same nutritional value, however they differ in colour, taste, texture and smell to fresh vegetables. The cook also confirmed that bananas tend to be the only fresh fruit and these are supplied once a week. When fruit is supplied the cook said that there is not enough for each residents. So for example when apples are supplied she makes applesauce to go with the pork so that all the residents get a little. One resident said that with the present advice for 5 portions of fruit and vegetables a day she worried that she had a poor diet. Two residents said that they supplied their own tea and coffee, as they do not like what they considered to be inferior brands purchased by the home. The home is advised to review the ingredients provided to the home. On the day of inspection the residents had the choice of pork chops or sausages and three frozen vegetables. The meal looked and smelt appetising and residents’ views were generally positive. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16 Procedures must be followed that give complainants confidence that their concerns will be investigated. EVIDENCE: A complaint had recently been made a week previously by a resident, however at the time of the inspection staff were unable to track down where it had been recorded. No response had been made to the complainant however twenty eight days had not elapsed since the complaint had been made. Staff spoken to were unable to provide a copy of the home’s complaint policy. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19, 20, 24, 26 Some improvements to the environment have been made and the premises are clean, however some areas continue to look worn which makes the home look less attractive. EVIDENCE: Brook Care Home was conveniently situated and in keeping with houses in the locality. A new fax machine and doorbell were in place and some redecoration has taken place since the last inspection. Some of the requirements to improve the premises detailed in the last report have been completed, however some remain unsatisfactory. The entrance door was damaged and the area at the bottom of the stairs was untidy which did not give a good and welcoming impression. Scuffed walls, worn settees and armchairs, old filing cabinets in communal areas all detracted from the homely feel of the place. The privacy curtains in one room were hanging loose and a number of tiles were missing from behind one toilet. The deputy manager was unaware of any record of planned maintenance and refurbishment. There was a large patio and lawn area for use by the residents. The greenhouse was disused and the flowerbeds were overgrown, following a risk assessment with the support of staff the garden could be better utilised by the residents. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 15 Individual bedrooms were clean and personalised to varying degrees. Appropriate locks have not been fitted to bedroom doors and residents complained of a lack of privacy. This has been raised at previous inspections and must be addressed. This inspection took place on a warm spring day, concerns raised at the last inspection with regard to the central heating will be considered at another inspection. Since the last inspection paper towels and liquid soap had been provided in bathrooms, however the communal terry towel was still in place in one bathroom and remained a source of possible spread of infection. In other bathrooms and toilets liquid soap, paper towels and lidded bins were not all in use. These need to be provided to reduce the risk of cross infection. Again the home is advised to contact Essex Health Protection Unit 01376 302282 for advice on infection control. The laundry was seen to be clean and tidy and residents said that they were pleased with the laundry service. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29) Only limited progress has been made in addressing staff shortages and as a result residents do not receive consistent care. The vetting and recruitment practices seen at the time of the inspection continue to be poor and potentially put residents at risk. EVIDENCE: In the morning of the inspection the home was running under staffed due to a member of staff calling in sick. This was borne in mind during the inspection process. The deputy manager was covering this work, as she did not have authority to engage agency staff. Another member of staff on duty had only been in post two shifts and was not supernumerary. The deputy had only been in post one week and the acting manager was on leave. The homes previous policy of not using agency staff must be reviewed if the home is unable to cover shifts adequately with their own staff. Following concerns raised at previous inspections the home had gone some way to improve staffing levels, however this has been inconsistent. During the day from 8.00 am to 9 00 pm there must be a minimum of three care staff plus the manager or shift leader. This should not be reduced in the afternoon or weekends and care staff should not be undertaking domestic or catering duties which take them away from the care of the residents. Residents spoke of being anxious that some staff were unable to manage the challenges of some residents and this was particularly worrying to them when the home was short staffed. The recruitment file of the newest member of staff was requested and studied. It did not contain evidence of a robust recruitment procedure being followed. The deputy manager thought there might be other documents to which she did Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 17 not have access. Records required by legislation should be available for inspection at all times. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 Recent changes in senior staff and the lack of a registered manager has had an unsettling affect on the residents. EVIDENCE: The registered manager and some senior staff had left since the last inspection. The new acting manager had been in post a few months and residents were uneasy with the change, but positive about the new manager. At the time of inspection she was on leave. The new deputy manager who had been in post one week assisted with the inspection. She was helpful and open, and positive about the inspection process, however she had limited knowledge on some issues. Every effort should be made to put forward a registered manager to provide some leadership and stability in the home. The new manager needs to have a job description which enables them to take responsibility for fulfilling their duties. One resident said that at times when there was no management in the home she did not have access to her money. The deputy manager clarified that Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 19 some money could be accessed by senior staff, however the resident was not aware of this. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION 2 3 x x 3 2 x 2 STAFFING Standard No Score 27 1 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x 2 x x x x x x x Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 21 YES Are there any outstanding requirements from the last inspection? 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 4 Regulation 18(1) Requirement The Registered Person must ensure that with regards to the needs of the resident competent staff are working in the home. This refers to residents anxiety when sufficient competent staff are not on duty (Previous time scale of 14.03.05 not met). The Registered Person must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. The Registered Person must provide telephone facilities suitable for the residents. This refers to it being practical to use (Previous time scale of 14.03.05 not met The Registered Person must ensure that the home is conducted in a manner that respects the privacy and dignity of service users. (Previous time scale of 14.03.05 not met) The Registered Person must consult with residents about their interests and provide a Timescale for action 7 July 2005 2. 9 13(2) 7 July 2005 3. 10 16(2)(b) 7 July 2005 4. 10 12(4)(a) 7 July 2005 5. 12 16(2) 7 July 2005 Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 22 6. 14 12(2) 7. 15 16(2) 8. 9. 16 19 17(2) 23(2) 10. 25 23(2)(p) 11. 26 16(2) 12. 27 18(1) programme of activities and provide facilities for recreation. The Registered Person shall as far as is practical enable residents to make decisions with regard to their care, health and welfare. This refers to a choice in daily routines, particularly the provision of drinks and snacks The Registered Person must provide in adequate quantities, suitable, wholesome and nutritious food, which is varied and properly prepared, and available as may be reasonably required by the service users. This refers to the availabliity of fresh ingredients The Registered Person must maintain a record of all complaints and any action taken. The Registered Person must ensure that the home is adequately maintained, decorated and furnished The Registered Person must ensure that the premises are suitable and safe for the residents. This refers to adequate heating and appropriately regulated water temperatures. Not Inspected. The Registered Person must make arrangements to prevent the spread of infection and ensure satisfactory standards of hygiene. This refers to the provision of paper towels, liquid soap and lidded bins (Previous time scale of 14.03.05 not met) The Registered Person must ensure that at all times there are suitably qualified, competent and experienced persons working at the home in adequate 7 July 2005 7 July 2005 7 July 2005 7 July 2005 Carried forward to the next inspection 7 July 2005 7 July 2005 Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 23 13. 29 19(1) 14. 31 38 15. 33 26 numbers. (Previous time scale of 17.03.03 not met.) The Registered Person must ensure that all staff are fit to work in a care home. This refers to undertaking a robust recruitment procedure that protects residents and ensuring that all documents required by legislation are available for inspection. (Previous time scale 14.03.05 not met) The Registered Person must ensure that at all times there are suitably qualified, competent and experienced persons working at the home. This refers to the proposing of a person suitable to be registered to manage the home. The Registered Person must prepare a written report , as detailed in this regulation, on the conduct of the home and supply a copy to the manager and the CSCI at least once a month. Not inspected 7 July 2005 7 July 2005 Carried forward to next inspection RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 24 Good Practice Recommendations Suitable bedroom door locks which suit the capabilities of the residents and can be accessed by staff in an emergency should be fitted to maintain the privacy and dignity of the residents. Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS2 6BG 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 Brook Care Home I56 S18074 Brook Care Home V230841 310505 Stage 4.doc Version 1.30 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. 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