Inspection on 09/05/06 for Buchan House

This inspection was carried out on 9th May 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Buchan House 22/04/08

Buchan House 20/09/05

Buchan House 11/05/05

Buchan House 03/12/04

Buchan House 08/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Buchan House Buchan Street Kings Hedges Road Cambridge CB4 2XF Lead Inspector Don Traylen Key Unannounced Inspection 9th May 2006 10:00 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 Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 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. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Buchan House Address Buchan Street Kings Hedges Road Cambridge CB4 2XF 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) 01223 712111 01223 712113 Buchan Healthcare Ltd Care Home 66 Category(ies) of Dementia - over 65 years of age (33), Old age, registration, with number not falling within any other category (66) of places Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 33 residents over 65 years of age with dementia (DE(E)) 20th September 2005 Date of last inspection Brief Description of the Service: Buchan House is a purpose built home for the elderly, built on two floors and is registered to accommodate up to 66 persons. The home was previously owned and operated by the Local Authority until Excelcare Holdings purchased the home in 2001 when they and also purchased a number of other care homes from Cambridgeshire County Council. The home has since been extended and increased the number of places for service users. The home is divided into three units, Snowdrop Sunflower and Iris. Snowdrop and Sunflower are on the ground floor and respectively accommodate 18 and 33 people. Sunflower is the part of the home where service users with dementia care related need are looked after. Iris is located on the upper floor and is a smaller area for 13 people. All rooms are single occupancy and all have en-suite facilities of toilet and washing facilities. Stairs and a passenger lift provide access to the upper floor. The home has two enclosed gardens and a visitors car park, and offers a dedicated and safe facility for service users with dementia. The home is located close to the King Hedges residential area of Cambridge on the outskirts of north side of Cambridge City. The home is accessible by car from the A14 Histon turnoff and can be reached by a city bus service. On the 09/06/06 the fees charged ranged from £361 to £600 per person per week. 44 of the places are advance “block purchased” arrangements by Cambridgeshire County Council, whereby numbers of guaranteed places are commissioned and arranged through Cambridgeshire County Council for service users who they part fund. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on the 09/05/06 by two inspectors, Don Traylen and Janie Buchanen. The inspection covered all the key National Minimum Standards. The inspection commenced at 9:45 am and was completed at 14:25pm. One inspector focused on the dementia care unit whilst the other inspector looked at staff and training records and procedures operated by the home . Both inspectors assessed the administration of medications in different parts of the home. A brief tour of the premises was undertaken by both inspectors. A number of service users with differing needs care assistants and a visiting District Nurse spoke to the inspectors. What the service does well: What has improved since the last inspection? A new manager who is registered nurse has been appointed. She is in the process of applying to become the registered manager and at the time of inspection had applied for a CRB check and was awaiting a CRB disclosure. The manager has clear ideas of how she intends to improve the service and has agreed to forward this to the CSCI. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 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. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 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 the following standard(s): 1,2,3,4,5,6, The quality outcome for this group of Standards is good. Information about the home and the services it offers, a trial period and an open viewing arrangement is available to help prospective residents and relatives make an informed choice about whether or not the home is suitable. EVIDENCE: The fees charged ranged from £361 to £600 per person per week. 44 of the places are advance “block purchased” arrangements by Cambridgeshire County Council, whereby numbers of guaranteed places are commissioned and arranged through Cambridgeshire County Council for service users whom they part fund. On the day of inspection there were 10 privately funding service users living in the home. The home has a Statement of Purpose and Service User Guide, both of which give good information about the services and facilities on offer. Included is the home’s mission statement and objectives; its admission criteria; staffing Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 9 information; accommodation details and the organisational structure of the home. Both documents are available in large print for people with a visual impairment. The address of the Commission for Social Care Inspection should be updated in the statement of purpose. All residents are assessed thoroughly before being admitted to the home and pre-admission assessments were viewed on all the residents’ files viewed by the inspector. One resident had recently been admitted from a home in Cornwell. As staff at Buchan House could not visit him, the unit manager had contacted this resident’s family, his local GP and community psychiatric nurse in order to get full information about him before he was admitted. She also faxed a copy of the home’s pre-admission documents to be filled in by staff at his current placement. Prospective residents are given the opportunity to visit the home before they move in, and residents told the inspector that they, or their families, had visited to assess the quality of the facilities. Intermediate care is not provided. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 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): 7,8,9,10, The quality outcome for this group of Standards is adequate, but would have been considered good if it were not for the poor performance around the medication administration records. EVIDENCE: Four residents’ care plans were viewed. These were generally very detailed and set out clearly the action to be taken by staff to ensure that all aspects of residents’ health and personal care needs were met. Residents’ social history was afforded a high priority (of particular importance in a dementia care unit) and there were details in the plans about where residents had lived, their past occupations, their war time experiences and their proudest moments. Risk assessments had also been completed in relation to falls and going outside. There was evidence that the plans had been reviewed regularly and that the home’s manager had audited them to ensure their quality. A number of health professionals visit the home regularly: the district nurses visit every Tuesday and Friday, a community psychiatric nurse visits monthly and the home has a dedicated dietician. The home and service users are supported by arrangements made with a local surgery involving 3 GPs who Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 11 visit the home each week. Meetings with the home and the same surgery are arranged monthly and involve District Nurses and a Pharmacist. Support is also provided by the ‘START’ team, an out of hours PCT health service provision. Regular contact with a lead Community Psychiatric Nurse has been arranged. Some of these supporting initiatives have developed from previous concerns where service users have been at risk. On the day of inspection a district nurse was on site, she told the inspector that residents rarely develop pressure sores. Interaction between staff and residents on the dementia care unit was mostly positive and respectful, and staff intervened quickly and sensitively to a resident who was becoming distressed. The home’s medication storage and a sample of residents’ administration records were checked on the Sunflower, dementia care unit and in the Snowdrop unit. On the Sunflower unit there were some handwritten additions to the records that had not been signed. It was also noted that the fridge for accommodating medicines that require cool storage was unlocked throughout the inspection. There was an omission from the Medication Administration Record sheets in the Snowdrop unit when a care worker had not signed for medication that had been given on the morning of the inspection, the 09/05/06. This was discussed with the person responsible and with the manager. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 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): 12,13,14,15, The quality outcome for this group of Standards is good. Service users benefit from regular family contacts. EVIDENCE: The home has an activities co-ordinator and there is a well-publicised activities schedule in place. Forthcoming events included Frank Mann and his music on the 16 May, a coffee morning on May 20 and a trip to Bedford Butterfly Park on the May 25. Residents’ nutritional needs are monitored closely. Nutritional screening is undertaken on admission, and residents are weighed monthly and more frequently if required. Staff were able to tell the inspector those residents on the dementia care unit that were nutritionally at risk, and what additional measures had been put in place as a result. Residents’ eating habits were clearly documented in their care plans. Lunch on the day of inspection consisted of beef stew with cabbage, peas, carrots and potato, followed by a dessert of pineapple upside down cake. It was disappointing to note that the meal was served to residents fully plated up on the dementia care unit, thereby denying them the social and practical independence associated with mealtimes thereby slightly disabling people from making decisions about what, and how much, to eat. Residents were able to choose where to eat and a staff Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 13 member told the inspector they often served one resident their lunch in a bowl, allowing them to eat while they wander. A range of cutlery and plate guards were available to assist residents eat their lunch. Three generations of visitors were visiting one service user who they were planning to take out in her wheelchair. They said the care and attention is good and that they often visit at irregular times and felt comfortable about informing the manager about any concern they might have. One service user was looking forward to moving to and living in France on the day following the inspection. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 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): 16,17,18, The quality outcome for this group of Standards is good. There are systems and policies in place to protect service users from abuse and to listen to complaints. EVIDENCE: Two visiting relatives informed the inspector they would inform the manager if they had any concerns. To enable anyone to make a complaint, the home has an open and accessible method that allows anybody to raise a complaint or concern. Inside the main entrance of the home there are a number of documents that inform visitors and service users how a complaint shall be dealt with. A list of potential contacts include the Local Authority and The CSCI. A complaints book and a compliments book were both kept near to the main door and there were entries made in both of these books. Another book with confidential details of the complaint was maintained and kept in the manager’s office. The home had received written compliments for the care given to a number of residents. In addition to the complaints procedure, there was information about abuse and contacts to report suspicions or allegations of abuse to. This is considered good practice. One of the unit managers has completed the key practitioner training provided by Cambridge County Council Adult protection initiative. This entails the individual and the organisation having specific legal and contractual responsibilities to continuously fulfil in relation to their conduct and methods to protect vulnerable adults from abuse. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 15 The home’s abuse policy did not state the organisation was working in accordance with the guidelines given by Cambridgeshire County Council although they were. The manager was asked to review the policy. Staff files revealed that as part of their employment contract, staff are expected to sign a ‘abuse declaration’, agreeing to report any suspicion or allegation of abuse. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 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 the following standard(s): 19,20,21,22,23,24, 25,26, The quality outcome for this group of Standards is good. Service users benefit from a relaxed and quiet environment. EVIDENCE: The three units have their own dining areas and kitchens and lounges and sufficient communal and private space. The home has a spacious feel and has wide corridors to allow easy manoeuvring of wheelchairs. The home has a total of 6 bathrooms and 5 toilets plus all rooms have en-suite toilet facilities and some rooms have en-suite showers. Bathrooms were large and fitted with mechanical assisted seating and hoists. A range of different types of slings are used to assist service users to manoeuvre. The manager has contacted an Occupational Therapist and requested an environmental assessment to be made. There were many positive aspects in the design and environment of the home’s dementia care unit. Bedroom doors opened outwards enabling them to be opened from the outside in the event of a resident collapsing behind the Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 17 door, or being unable to remember how to open it for themselves. Service users have access to two pleasantly maintained, enclosed gardens that allowing them to enjoy fresh air and sunlight and be able to walk without jeopardising their safety. A number of orientation aids were in place, such as differently coloured walls intended to demarcate different areas, and pictorial representations of toilets on toilet doors. However, corridors were very long, similar looking and some lacked natural light and this could confuse orientation. These long corridors make it difficult for staff to always assist service users. The main lounge and dining areas wasn’t particularly homely and the manager described it as ‘more like a British rail waiting room’. The manager qualified this statement with informing the inspectors that she would like to make changes to the environment and hence to the pattern of care provided in the dementia care part of the home as the size of the unit presents some challenges. A number of wheelchairs were stored, unsafely, in the lounge areas. The manager was made aware of these items during the feedback from the inspectors and she is fully aware of the importance of a good environment for residents with dementia and has a number of plans in place to improve it. Generally the home was well maintained although a lot of the paintwork on the bottom of doors was scuffed and worn. The manager should consider installing kick plates to preserve the paintwork from getting repeatedly damaged. One area of the home smelled strongly of urine and this was pointed out to the manager who was walking with the two inspectors at the time. There was a badly leaking tap in the bathroom of the dementia care unit. Service users rooms were kept homely and those seen contained service users personal possessions and furniture. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30, The quality outcome for this group of Standards is adequate. However, continued improvements in staff training arrangements in key topics are required to ensure the safety for service users. EVIDENCE: The home employs a number of overseas staff and on the day of inspection the dementia care unit was staffed entirely by overseas workers. Although their care practices were excellent and they obviously had good rapport with the residents in their care, it was of concern that these staff did not posses a complete command of the English language or share the same cultural backgrounds of service users whose history is often important to revisit when engaging with people with dementia. The training matrix showed that very few staff had received dementia care training and that some of the recently arranged dementia care training had been cancelled. An ‘in-house’ trainer from Excelcare provides dementia training for staff. Dementia care training is required for ALL staff in light of the numbers of the home’s service users with dementia related care needs and because of the increasing diagnosis of dementia in the growing elderly population. The manager was asked to provide the CSCI with the content and programme of this training. The training matrix also showed that not all staff had received training in the protection of vulnerable adults. All staff must receive training to ensure vulnerable adults are protected from abuse. The manager was informed that the induction programme for new staff must include training in this subject. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 19 One of the unit managers has completed the training provided by Cambridgeshire County Council to become a key practitioner. This role is a positive step forward in the initiative to provide safety and security to vulnerable elderly service users. The role of key practitioner allows her to instruct care staff in the procedures designed by the Council to protect vulnerable adults from abuse and carries a ‘Contract of Intent’ and a responsibility to act as trainer and developer and supervisor of the policy to protect vulnerable adults within the care home that employs her. 7 care staff have achieved an NVQ level 3 award in care and 10 staff have an NVQ level 2 award and there are a number of staff undertaking the qualification who are yet to complete. The manger stated that training care staff is an area that she has made a priority to improve. The staff rota showed there were 9 care staff and two unit managers working as care staff, plus the general manager, an administrator, sufficient cleaners, two laundry workers and a fulltime maintenance worker and two kitchen staff and an activities support worker. The organisation’s recruitment policies and procedures are sound. Two staff files were read and contained a CRB check and one care worker had started employment after a satisfactory Pova first check had been received. Two references, an application form, and an interview questionnaire were held in each person’s file. A job description and staff handbook are issued and all staff are required to agree and sign an abuse declaration. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 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 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): 31,33,36,37,38, The quality outcome for this group of Standards is adequate. Although the manager is not registered she has reinforced systems to protect service users. EVIDENCE: The manager is in the process of applying to become the registered manager. She is a registered nurse and has been in post as manager for 5 months. The manager stated that she has identified a set of priorities for improvement: training, supervision, the environment of the dementia care unit and building upon the working relationship with GPs and community health professionals. The standards of leadership and proven management are yet to be assessed. However there is an open management approach and a expectation to include relatives and service users in decision making. Five dates for Relatives meetings had been advertised and were posted in the home. Regular service user meeting are held. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 21 Supervision arrangements have been firmed up since the manager commenced employment and guidelines have been issued to all staff that explain the purpose and benefit of regular recorded supervision. A number of audits are conducted by the home to verify medication records and Care Plans and there are frequent night and weekend audits for a range of topics to be assessed. The maintenance file was read and checks were recorded monthly for the nurse alarm call, emergency lights and water temperatures and an annual check on portable appliances. The ‘Home Manual’ recorded reports for Lift maintenance 03/06/05 & 23/02/06; Fire Safety on 08/03/04; Gas appliances 16/03/06; Pharmacist check 06/09/05; contract with Nuffield Health Centre 02/08/05; copies of Care Homes Regulations 26 & 37 reports and a letter from Environmental Service requesting monitoring of temperatures of frozen food deliveries. Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X 3 2 3 Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2), 17(1)(a) & Sch3 13(6) Requirement Medication Administration Records sheets must be accurately maintained and safe storage of medication must be maintained. Arrangements must be made for all staff to undertake training in the Protection of Vulnerable Adults (POVA) training and the Induction programme for new care staff must include training in the Protection of Vulnerable Adults. Arrangements must be made for all staff to receive training in Dementia Care. The manager must submit to the CSCI a written outline of the improvement plan she discussed with the inspector. The homes adult abuse policy must be reviewed and include a commitment to Cambridgeshire County Councils guidance and procedures for reporting abuse. Timescale for action 01/06/06 2 OP30 01/07/06 3 4 OP30 OP33 18(1)(c) 24(2) 01/07/06 01/06/06 5 OP37 24(1) 01/07/06 Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 24 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 Buchan House DS0000015236.V288172.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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. 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