CARE HOMES FOR OLDER PEOPLE
Brownscombe House Nursing and Residential Home Hindhead Road Haslemere Surrey GU27 3PL Lead Inspector
Kathy Martin Announced 14 October 2005 10:00
th 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. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Brownscombe House Nursing and Residential Home Hindhead Road, Haslemere, Surrey, GU27 3PL Address 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) 01428 643528 Mr L Hasham Elizabeth McAllister CRH N 36 Category(ies) of OP- Old Age - 36 registration, with number DE(E) - Dementia - over 65 - 3 of places SI(E) - Sensory Impairment - over 65 - 1 Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Up to 25 beds may be used for the provision of nursing care for elderly people from the age of 60 years One (1) named service user within the category SI/E (Sensory Impairment over 65 years of age) may be accommodated. Date of last inspection 3rd May 2005 Brief Description of the Service: Brownscoombe House is a care home offering nursing care to 36 residents with old age. The home is owned by Care Homes of Distinction who also own and run similar establishments in the county. The home is a large detached building set in large grounds in Haslemere. The home provides accommodation over 3 floors which are accessible via a lift. The home offeres in-house catering and parking for several vehicles in the front of the premises. There are good links to all major routes in the area. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second inspection undertaken this year by the CSCI. The first inspection took place in May 2005. All the key national minimum standards have now been assessed over both visits. This was an announced inspection meaning that the manager, staff and residents were made aware in advance. The manager was sent a pre-inspection questionnaire relating to how the home operates ahead of the inspection. This document provided information that has been used in this report. The inspector spoke with several residents during the visit and to some members of staff. The CSCI sent out feedback cards that the home distributed to residents, their visitors and visiting professionals. Several comments were received most very complimentary of the way the home run and how residents were cared for. During the course of the inspection the inspector looked at records and also toured the building. The home was running efficiently during the visit. The staff rapport towards the residents was friendly and relaxed. The residents were in various areas of the communal rooms and some were in their bedrooms. The home was clean and tidy and well maintained for the exception of some carpets and furniture that needed replacing. Residents received regular activities, which is organised by the activities organiser. The staff were very supportive towards each other. The manager was present throughout the inspection. The inspector wishes to thank all the residents, their relatives and the visiting professionals who either completed the written feedback or spoke directly to the inspector on the day, to contribute to this report. What the service does well:
The home sent out comments cards to residents, their visitors and visiting professionals. Extracts from their comments included: “the staff are kind and friendly” “The staff especially (staff member’s name) are simply marvellous and very kind in every way” The responses ticked on the comments cards indicated that generally residents were happy and comfortable with their environment, the staff and the services
Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 6 they received. Relatives felt welcome and were able to participate in the care of the residents. In addition, during the visit, the inspector had opportunity to speak with a relative who visited regularly and had very positive feedback. The residents stated that they were well looked after and were able to participate in organised activities or pursue their own interests. Some preferred to stay in their bedrooms and join in group activities in accordance with their wishes. On the whole residents were empowered to run their lives as much as they could thus remaining independent. They were able to receive their visitors in private, have a telephone line and were able to go out when they liked. What has improved since the last inspection? What they could do better:
During the inspection a complaint was also looked at which initially went to Social Services and was being investigated under the Vulnerable Adults procedures. The home has been co-operative throughout the investigation, which had not concluded at the point of the inspection. A Requirement was made regarding staff recruitment from an agency that the home employed. The requirement asked the home to ensure it obtained information relating to the staff’s fitness prior to them working in the home. Additionally, the home was required to ascertain those members of staff’s competence and training achieved prior to working in Brownscoombe House. That way an induction can be offered to ensure they are all equipped with the same level of standard that the manager of Brownscoombe House expects of the permanent staff prior to them working with vulnerable people.
Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 7 The complaint also dealt with the admission process in place, which was not clear regarding the nip-in bed for emergency type admissions. This was especially important, as often information obtained prior to the admission is not comprehensive. The CSCI made a requirement for the admission procedure to the nip-in bed to be revised and made clearer. Whilst discussing staffing hours, there was evidence to suggest that the care hours had been reduced. The home is not permitted to reduce its staffing without the CSCI permission. Therefore a requirement was made to restore staffing to original agreed numbers. During the tour of the building it was observed that a number of pieces of furniture and carpets needed to be replaced. The manager and the owners had already listed these on an audit, which was shown to the inspector. A requirement was made for the home to replace identified furniture and carpets. The inspector also tested the call bell system and found that it was not possible for the bell to be heard from the ground floor near the office. A requirement was therefore made for the call bell system to be checked to ensure staff from both floors are able to hear the call bells when activated. Requirement no. 2 from the inspection in May 2005 was not met. This related to replacing the 30 hours of the administrator who had left then. The home had not managed to recruit a replacement. The inspector was advised that interviews were being held. In the meantime the manager was allotted some administrator’s hours from another home on an ad hoc basis. 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. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 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 standard(s) 3 The home has policies and procedures for the admission of residents, which worked well for those coming in for long-term stay. However, some issues of late evidenced that the procedures for the nip-in bed needed to be reviewed. EVIDENCE: This section was inspected during the May 2005 inspection and the comments made then remained current. During the investigation of a complaint referred to Social Services, under the Vulnerable Adults procedures, it was apparent that the admission procedures for the nip-in beds (for emergency) needed to be reviewed. The inspector looked at the said admission procedure and had a lengthy discussion with the manager. The staff did endeavour to obtain as much information as possible before accepting a new resident in the nip-in bed but this system does not always allow them to obtain a whole picture of the prospective resident before the admission takes place. Therefore a greater need for specific information about their needs and background needs to be sought before a bed is offered. This way the staff would be more prepared to receive them and to would be more able to ensure that they had everything they needed. A requirement was
Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 10 therefore made for the admission procedure to the nip-in bed to be revised and made clearer. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 and 10 The care plans were well maintained in good details and including risk assessments. The medication procedures were in place and being updated to include the returns of medicines. The home has systems in place to promote the rights of residents and especially their right to privacy. EVIDENCE: Standard 7: All residents have a care plan detailing their areas of needs, goals and aspirations. These are commenced shortly after their admission. The named nurses regularly updated the plans. The documentation was comprehensive and gave full details of how the residents were cared for. There were risk assessments in place for moving and handling, choking/ aspiration, falls and pressure sores. Standard 9: The home has policies and procedures for the management of medication. The registered nurses were responsible to follow procedures and also were accountable to the NMC (Nurses and Midwifery Council) for their professional guidelines on the management of medicines. The manager has obtained leaflets for the nurses who needed to refer to these guidelines. Staff are
Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 12 offered training updates in medication management. There are regular staff meetings when professional issues including medication are discussed openly. The storage was appropriate and the medication records were clear with no unexplainable gaps. The manager sampled these regularly. The procedure for the returns of medicines is being reviewed to include the new legislation that medication no longer returns to the supplying chemist but has to remain in the home until it is picked up by external contractors for safe disposal. Standard 11: The home provides induction training and updates, NVQ and close monitoring to all staff in regard to upholding privacy. All residents are referred to by their preferred terms of address. Those who wish to, have their names on their doors. Residents are able to receive their guests in private and there are areas in the home where residents can use to sit with their guests if they did not want to use their bedrooms. Those who wish to participate in group activity are encouraged to do so. Some prefer to stay in their rooms even at meal times and the staff respects their wishes although staff do offer companionship and a friendly ear to prevent isolation. Residents wear their own clothing and are able to bring in personal items to personalise their bedrooms to varying degrees. Some residents have a telephone in their bedrooms. There are several bedrooms with an en suite toilet. Staff are trained to observe the practice of knocking on bedroom doors and being invited to enter residents’ bedrooms. The home also has a policy on respecting residents’ privacy and the staff handbook does refer to this. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 The home has systems in place to encourage residents to make choices in daily tasks and to take control over their lives as much as possible. EVIDENCE: The home encourages choice in many different ways. The residents are able to choose what they wish to wear, how they spent their day, who to receive as visitors and go out as they wished. There are a number of residents however who are very physically frail and dependent on staff and relatives to assist them with choice. The care plans are written to ensure preferences and dislikes are noted clearly to advise staff of resident’s decisions. Residents are able to choose where they liked to sit in the communal areas and where they liked to eat (in the dining room or in their bedrooms). When residents are admitted the home obtains information on their previous hobbies, interests and community participation, which enables the staff to encourage them to maintain their skills and interests after admission. They are encouraged to make decisions for themselves sometimes with the assistance of relatives or a solicitor or care manager. The residents are able to choose the fellow residents they wish to make friends with and participate in group activities of their choice. Staff are offered training to gain skills in how they can offer choice at all possible times when caring for the residents. Staff are also
Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 14 offered training to encourage residents to maintain control over their lives and to express themselves and complain. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has policies and procedures to deal with complaints and for the protection of vulnerable adults. EVIDENCE: The home has a clear complaints procedure for residents, staff and visitors. The manager maintains a log of any complaints received in a dedicated file. Generally, residents and visitors approached the nurse in charge or the manager when they wish to voice a concern. The management of the home takes all complaints seriously and aim to resolve any issues on the day as they arise. The home also has a Surrey Multi-Agency policy and procedure for the protection of vulnerable adults (POVA). At the time of the inspection a case was referred under those procedures to Social Services and was being investigated. This had not reached conclusion at the time. Two requirements were made from this inspection in connection with this complaint regarding the procedures for the nip-in bed, which needed to be revised and make clearer. Additionally the staff employed by the home from an agency needed to provide information relating to their fitness before they come to work with vulnerable adults. All staff were offered training in POVA. The home was acting appropriately with the investigation and was co-operating with the Social Services in accordance with the POVA procedures. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 The environment was clean and well maintained. However there were pieces of bedroom furniture and carpets that were in need of replacement. EVIDENCE: This section was inspected at the inspection of May 2005 and the comments made then remain current. The home remained well maintained and offered a homely and comfortable environment. Standard 24 The bedrooms were clean and comfortable and homely in decor. Residents proudly showed the inspector their bedrooms and there was evidence of varying degrees of personalisation with small furniture items, bedding, photographs and ornaments. The manager completed an audit, which highlighted the need to replace identified furniture and carpets from residents’ bedrooms. One resident in particular had a very stained carpet and the furniture was not appropriate. This was discussed with the manager who was
Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 17 aware of the problem and a budget was being discussed to rectify the issues. A requirement was made for those pieces of furniture and carpets to be replaced. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 and 29 The home has an establishment agreed with the CSCI but has reduced staffing hours in recent weeks without the CSCI permission as it was operating under its maximum occupancy. The recruitment procedures for the permanent staff was good but there were shortfalls regarding those staff introduced from an agency. EVIDENCE: Standard 27: The inspector was advised during the investigation under the vulnerable adults procedures that the staffing levels had been dropped when the home did not operate to its full capacity that is 36 residents. The inspector explained to the manager that the CSCI had agreed on a staffing establishment and care hours based not only on the bed occupancy but also taking into account the size and layout of the home with its many corridors and staircases and 3 floors. The sheer geography of the home makes it difficult for staff to be far from each other which happens when there are less staff around as residents are spread all across the building and may be put at risk. Therefore the home was not permitted to reduce its staffing unless they seek permission from the CSCI who would have to re-assess their staffing figures before a decision is made. Therefore a requirement was made for the home to restore the staffing to the original agreed numbers. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 19 Standard 29: The home has a good policy and procedures for the recruitment of new staff (permanent as opposed to agency staff). Staff are subject to police checks, have to provide references and give clear work history on an application form and attend an interview. Each staff have an individual file with copies of their identification, qualification, passport and visa requirements as appropriate. The home verifies the PIN number checks for all the registered nurses to ensure they are still registered with the NMC. Contracts and job descriptions are issued on appointment. However during the course of an investigation of a complaint referred under the POVA procedures, it was not clear as to what information was in place for the manager to verify the status of staff referred to the home from an introductory agency (these agencies are not registered by the CSCI). The home did not have all the necessary evidence in place to suggest that they had ascertained their fitness prior to them working in the home. A Requirement was made for the home to ensure it obtained information relating to the staff’s fitness prior to them working with vulnerable adults. The home was also required to ascertain those members of staff’s competence and training achieved prior to working in Brownscoombe House. This would then provide the manager with prior knowledge of what to offer in terms of induction training such as abuse awareness, basic food hygiene, moving and handling and First Aid. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 33, 35 and 38 There is evidence to suggest that the home took residents’ experience and welfare seriously and aim to provide a reasonable and happy environment. There are policies established to help residents manage their money although the home does not take responsibility for their finances. There were policies and procedures for health and safety but the call bell needed reviewing on the ground floor. EVIDENCE: Standard 33: The home welcomes feedback from all the visitors and the residents. There are consistent efforts from both the management and the care staff to encourage residents to take part in the running of the home. The residents and their families are regularly consulted when changes are planned. There are opportunities offered for one to one discussions with the manager. The management style is proactive. Staff met regularly to discuss their involvement in the home and there is much teamwork observed. Staff
Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 21 appeared encouraged to suggest changes if they thought of any ideas that would benefit the residents. Standard 35: The home has polices and procedures to deal with residents’ finances. The residents’ families and solicitors mainly dealt with those if residents were unable to do so themselves. Staff did not take responsibilities to manage residents’ monies. There are procedures to safeguard residents from potential financial abuse and they are not encouraged to keep money if they can’t look after this themselves. Standard 38: There are a number of good health and safety policies and procedures in the home. The staff received training in all aspects of health and safety with regular yearly updates including fire. There is a maintenance man available to take care of any day-to-day repairs and general checks on premises and equipment and contractors are also used. Temperatures are checked and recorded on clinical pharmaceutical fridge that houses any medication needed to be stored there. Additionally the temperatures of all the kitchen refrigeration equipment are also recorded daily and any faults duly reported and fixed. The inspector activated a call bell on the ground floor and it was clear that it was not possible for anyone from the ground floor to hear it. However it was good to note that the staff from the first floor did attend to it promptly. This would be especially important at night times when there are fewer staff on duty, possibly engaged with other residents and therefore not being able to clearly hear a bell being activated is not safe. A requirement was made for the call bell system to be checked to ensure staff from both floors are able to hear the call bells when activated. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x
COMPLAINTS AND PROTECTION x x x x x 2 x x STAFFING Standard No Score 27 2 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 3 x 3 x x 3 x 3 x x 2 Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 23 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 29 Regulation 19 Requirement The home must ensure that information is obtained relating to staff’s fitness prior to them working in the home. (This applied to staff from agencies) The home must ascertain staff’s competence and training achieved prior to working in Brownscoombe House (this applied to staff from agencies) It is required that the admission procedure to the nip-in bed be revised and made clearer. The home must restore staffing to original agreed numbers. To replace identified furniture and carpets The call bell system needs to be checked to ensure staff from both floors are able to hear the call bells when activated. Timescale for action 14/12/05 2. 29 19, 18 (1) (2) 14/12/05 3. 4. 5. 6. 3 27 24 38 14 18 16 (2) (c) 13 (6) 14/11/05 30/11/05 28/02/06 14/12/05 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 Good Practice Recommendations
h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 24 Brownscombe House Nursing and Residential Home Standard 1. Brownscombe House Nursing and Residential Home h09-h58 s17596 Brownscombe House v241220 141005 stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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