Inspection on 05/12/05 for Byker Hall

This inspection was carried out on 5th December 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 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

Byker Hall 27/10/08

Byker Hall 12/05/08

Byker Hall 26/06/07

Byker Hall 29/06/06

Byker Hall 22/04/05

Byker Hall 09/12/04

Byker Hall 27/07/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Byker Hall Allendale Road Byker Newcastle Upon Tyne Tyne & Wear NE6 2SB Lead Inspector Mrs Irene Bowater Unannounced Inspection 09:30 5 and 7th December 2005 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 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. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Byker Hall Address Allendale Road Byker Newcastle Upon Tyne Tyne & Wear NE6 2SB 0191 224 0588 0191 276 3080 byker.hall@fshc.co.uk 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) Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care Limited) Vacant Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user under pensionable age, category PD, is known to have regular respite care. No further admissions in this category can take place without the prior agreement of CSCI. 22nd April 2005 Date of last inspection Brief Description of the Service: Byker Hall Care Home is purpose built and is situated in a residential area of Byker, Newcastle upon Tyne. The site is shared with another home owned by the same company. The home is within easy reach of shops, public transport and all other amenities. Byker Hall provides general nursing care for up to 49 older people in single ensuite rooms. There are bathrooms, shower rooms and toilets close to all resident areas, which provide facilities for those with disabilities. There are communal lounges, dining rooms and smoking rooms on each floor. The laundry and kitchen area are on the lower ground floor, separate from resident areas. All areas of the home are accessible and a passenger lift services all floors. Externally there is a pleasant garden area and ample car parking. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two afternoons. This was because the manager was unavailable on the first visit and the inspector could not access all required records. Arrangements regarding the day and time were made with the manager to finish the inspection process. Ten staff, thirteen residents and five relatives were spoken to throughout the inspection. Most of the first day was spent touring the premises, spending time with residents and relatives, talking to staff and inspecting care records. The second day was spent in the office talking to the manager and inspecting other records. What the service does well: What has improved since the last inspection? Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 6 All of the requirements from the previous inspection have been met which has improved several areas of the home. The residents who are paying for their care privately are now given a contract which sets out their and the providers rights and obligations. Several of the en-suite toilets have had new flooring and the communal areas have benefited from some refurbishment. There has been some improvement in the choices available for the teatime menu and drinks and snacks are readily available throughout the day. The standard of general cleanliness has improved and there is a member of the domestic staff on all day. A safe storage area has been provided for both clinical and household waste. What they could do better: The standard of care planning needs to improve to ensure all health care needs are assessed and the appropriate care delivered with details of all actions taken. The staff need to contact other professionals regarding tissue viability, wound care and have suitable training. The daily activities need to be more organised to ensure all residents have their preferences taken into account. Further review of the menus should be undertaken to ensure a wider choice at tea times. The tea trolleys need replacing as it is not possible to clean them effectively. The refurbishment and redecoration programme must be implemented to ensure the home is kept in a sound state and is comfortable for residents to live in. Further specialist training must be sought to ensure well-qualified staff always meet residents’ needs. NVQ level 2 training must recommence to ensure 50 of care staff are suitably trained. The staffing levels and the deployment of staff must be reviewed especially at peak times. Residents’ views should be sought and acted upon to help develop the service. The recruitment of staff must continue to form a stable staff team, which provides consistent quality care. The manager must progress with the application to become registered with the Commission. The home must ensure that it follows the requirements of the Fire Officer in regard to fire prevention in the home. The use of artificial means including door chocks to wedge doors open is not supported. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 7 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. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 The implementation of the terms and conditions (or contact) for residents who are self funding ensures that the rights and obligations of both parties are clear. The admission procedures are clear and ensure that the staff can meet residents’ needs. EVIDENCE: Since the last inspection the company have produced a statement of terms and conditions (or contract). This is being given to the residents who are privately funded. The care plans inspected showed that appropriate assessments are received from Care Managers to enable the home to meet the residents’ needs. On initial admission the manager or a senior nurse carries out their own assessment and from these documents a care plan is produced. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 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): 7,8,10 The care planning system is not clear to provide staff with the information they need to meet residents’ needs. The arrangements for meeting all health care needs of residents is not consistent which places them at risk. The staff endeavour to promote residents rights to privacy and dignity in regards to personal care delivery. EVIDENCE: Each resident has a care plan base on the admission assessment. The plans use a recognised nursing model of care that covers all aspects of daily living. There is a good range of risk assessments available including moving and handling, nutrition, wound care, dependency and fall risk assessments. The daily progress records are generally up to date, however the changing needs of individual residents are not evaluated and brought up to dated. There is evidence that six-month reviews take place with residents and their representatives. The residents have access to all NHS facilities and there is evidence that other specialists are involved in residents care. These include speech and language therapists, tissue viability and continence nurses. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 11 Although the care plans for wound care are detailed in the first instance they do not record the outcome of the treatment, nor are they reviewed on a continual basis. The staff have not always identified residents who are at risk of developing pressure damage and have not ensured that the appropriate action and intervention has been taken. Throughout the two visits it was evident that staff were aware of residents right to privacy. Staff were observed knocking on doors and waiting before entering and all personal care was given in the private. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 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): 12,13,15 Further improvement in organising activities is needed to ensure residents preferences regarding social and leisure events takes place. Support from the local community and families are satisfactory and give residents opportunities to maintain previous lifestyle links. Some progress has been made to improve the varied menu especially at tea times. EVIDENCE: The home is currently without an activities organiser. Some activities have been planned including old time music hall, trips out in the mini bus, visits to the local shops and in house entertainment is planned for the Christmas party. Many of the residents were sitting in the lounges and their own rooms with little social intervention. The staff were very busy attending to residents personal care needs and had little time to stop and spend time with the residents. The care plans showed that the social assessments are completed to endeavour to meet residents’ individual needs. There were several relatives in the home during the inspection and they all confirmed that they are made welcome at any time, can visit in the communal areas or in their relatives’ own room. They also said that they could join in any activity arranged and stay for meals if they wished. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 13 Since the last inspection the teatime meals have been reviewed and hot and cold drinks are readily available. The residents spoken to said there had been some improvement but they still said they were “fed up” of the soup. The tables were appropriately set for the teatime meal. There were bowls of fruit, mainly bananas, readily available on the tables. Residents confirmed that choices are available and they are asked what they would like to eat from a menu. Many of the residents were served their teatime meal in their rooms and they need assistance and supervision. This meant that there was little supervision especially in the upstairs dining room. One resident was asleep at the table, which made his meal cold, and another resident found it very difficult to eat her soup, which resulted in it going cold and congealing. The tea trolley was very grimy and stained and there was limited fresh vegetables fruit and freshly made food available in the kitchen stores. Residents said the “food is good”, “I get enough to eat”, “I don’t like the soup and frozen mousse” and the “food is not bad”. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 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): 16,18 The complaints process within the home is currently satisfactory. The staff have knowledge of Adult Protection and would be able to use the procedures if necessary. EVIDENCE: The complaints policy and procedures are displayed in the home. Residents and relatives said they would be able to use the policy should they have a concern or complaint. There are records available to show that concerns are taken seriously, are clearly recorded with actions and outcomes. There are currently two complaints being investigated by the Commission for Social Care Inspection. The policies and procedures for the Protection of Vulnerable Adults are available in the home. The manager confirmed that the staff are being trained using the in house training workbook. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,24,25,26 The home is suitable for the residents who live there. There has been some investment which has improved the appearance of the communal areas, however further investment is needed to provide a safe, clean living environment for those who live there. EVIDENCE: The home’s location and layout are suitable for the residents’ current needs. There has been some redecoration and refurbishment in the home since the last inspection although a planned refurbishment and redecoration programme is not in place. The lounge carpets were generally grimy and stained and the upstairs corridor carpet was showing signs of wear and there was a strong odour of urine. Both kitchenette areas were generally clean and tidy. All of the bedrooms have an en-suite facility. Some of the flooring in these areas is showing signs of wear and an audit of these areas would be of benefit. There are bathrooms, shower rooms and toilets close to all resident areas. The downstairs shower room flooring is split between the vinyl flooring and the tiles. The tiles were generally dirty with ingrained grime and old soap. There Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 16 were communal toiletries stored in the cupboard and a used disposable razor was left on top of the cupboard. The upstairs shower room had broken tiles, which were dirty, bar soap left in the sink and sudocrem belonging to a named person stored in the cupboard. The flooring in both of the downstairs toilets near to the lounge areas is worn and is not easy to clean. The residents have brought personal items with them making their rooms comfortable, homely and individualised. The bedrooms are suitably furnished, however some have wheelchair damage to the walls and some furniture is showing signs of wear. The home has some profiling beds, which are used for residents who need nursing care. The problems noted at the last inspection have been resolved. During the inspection the home remained well ventilated and bright. The water temperatures checked were found to be satisfactory. The household rubbish and clinical waste is now appropriately stored within a secure bin area. The home was generally clean and tidy, however there was an odour problem particularly on the first floor. There are sluices on each floor, which were locked, both were untidy and had odour problems. The laundry is situated on the lower ground floor .The machines have specified programmes to meet disinfection standards. The laundry has separate areas for clean and soiled linen. Both areas would benefit from organisation regarding the piles of lined stored and clothing that is unclaimed. The manager confirmed that training in Infection Control was to commence in the near future. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 There are adequate staff employed for the numbers of residents, however the deployment of staff at mealtimes is not sufficient to meet the needs of residents. The procedures for the recruitment of staff are satisfactory and offer protection to residents living there. The residents do not always receive a quality of care, as the specialist training is not consistent. EVIDENCE: This home has experienced recruitment problems for some considerable time. Since the last inspection the registered manager and qualified nurses and care staff have left the home. The company have recruited a manager and is in the process of recruiting other staff. The staffing levels and shift patterns have been changed by the home during the last year. The home is currently staffed as follows: 2 qualified nurses from 8am to 8pm 1 qualified nurse from 8pm to 8am 5 carers from 8am to 2pm 4 carers from 2pm to 8pm 3 carers overnight There are domestics, laundry, maintenance, and cook and kitchen assistants. The home is currently without an activities organiser or administrator. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 18 There are several new staff in the home that are undertaking their induction training. Residents spoken to say there had been “lots” of changes in the staff, “they are run off their feet” and “there is never enough of them”. During the teatime meal the staff were extremely busy assisting residents with their meals, which left the dining rooms without any staff for some time. The NVQ training is currently not progressing, however the manager said it is top recommence in January 2006. A sample of staff files showed that the recruitment and selection procedures are being followed. There was evidence of two references, Criminal Record Bureau checks, medical checks and proof of identity. Staff are issued with terms and conditions of employment. There is a training programme, which confirms that staff have received training in first aid, moving and handling and fire prevention. It was confirmed that infection control training is to start and Protection of Vulnerable Adults training continues. There was little evidence to support that qualified staff have received training in tissue viability, nutrition, or wound care. The manager said that wound care training was planned for January 2006. The NVQ training for care staff is currently on hold and is to recommence in January 2006. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 The manager has an understanding of the areas in which the home needs to improve. The systems for resident consultation need to improve to ensure their views are sought and acted upon. The financial procedures are satisfactory and safeguard residents’ interests. The staff receive suitable supervision from senior staff. There are some health and safety issues, which place residents at potential risk. EVIDENCE: A new manager has been appointed since the last inspection. She is a first level registered nurse with experience in the care of older people. She is aware of the issues in the home and is endeavouring to address them. She has yet to complete the process to become registered manager with the Commission. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 20 Although there have been staff and health and safety meetings there have been no recent resident and relative meetings. The last internal audit was carried out in August 2004,and it was disappointing to note that the residents’ suggestion box, which was always in reception, is no longer there. The personal allowances are held in a non-interest bearing account. Plans are being implemented to ensure that when residents’ money goes into this account the interest will be available to them. Several of the residents have had separate accounts opened for them. The staff receive training in safe working practices including fire, first aid, moving and handling and food hygiene. The home holds Health and Safety meetings with minutes recorded. The last meeting was held on 23rd September 2005 and risk assessments are available. Accidents recording are satisfactory although some of the hand written entries were difficult to read. Contract maintenance certificates were available and in house weekly tests are carried out with records kept. Many of the doors did not have door guards fitted and were held open with wooden chocks, wheel chairs and footstools. Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 1 2 X 2 3 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 2 Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 22 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 OP7 Regulation 13,15 Requirement Timescale for action 01/03/06 2 OP8 12,13,16, 17 3 OP12 12,16 The home must ensure that all care plans set out in detail the action to be taken by staff to ensure all aspects of the health, social and personal care needs of residents are met. The care plans must be reviewed at least monthly and updated to reflect changing needs and current objectives for health and personal care. 01/03/06 The home must ensure that appropriate assessments are implemented for identifying residents at risk of developing pressure damage. Incidence of pressure damage, treatment and outcomes must be recorded in care plans and reviewed on a continual basis. Advice regarding pressure sores must be sought and acted upon. All equipment for the promotion of tissue viability, prevention or treatment pf pressures sores must be in working order at all times. The home must provide 01/03/06 opportunities for stimulation both within and outside the DS0000000396.V258102.R01.S.doc Version 5.0 Byker Hall Page 23 4 OP19 13,23 5 OP20 23 6 OP21 23 7 OP24 16,23 8 OP26 12,13,16, 23 9 OP27 18, 10 OP28 18 home, which suits their needs and preferences. Up to date information about any activity must be circulated to all residents. The home must ensure that all areas are of sound construction and kept in a good state of repair internally. The home must ensure that the carpets in communal areas are deep cleaned. The upstairs corridor carpet requires replacement. The tiling in bathrooms and shower rooms must be replaced. The vinyl flooring in the two downstairs toilets must be replaced. The flooring in the en-suite toilets must be audited and replaced as part of an ongoing refurbishment programme. The home must ensure that there is suitable furniture, fitting and floor coverings in residents’ bedrooms. Redecoration of walls in bedrooms is required where there has been wheelchair or other damager. The home must ensure that all areas of the home are kept clean and free from offensive odours. The sluices must be cleaned on a regular basis. The clean linen cupboards must be organised to ensure laundry is kept off the floor. The home must ensure that at all times suitably qualified, competent and experienced persons are working in such numbers that are appropriate for the health and welfare of residents. The home must ensure that care staff receive appropriate NVQ training. DS0000000396.V258102.R01.S.doc 01/03/06 01/03/06 01/03/06 01/03/06 01/03/06 01/03/06 01/03/06 Byker Hall Version 5.0 Page 24 11 OP30 12,13,18 12 13 OP31 OP33 9,10 12,24 14 OP38 13,23 The home must ensure that care staff and qualified nurses receive specialist training appropriate to the work they do. The manager must progress with application to become registered with the Commission. The home must ensure that it reviews the quality of care provided and provide systems for consultation with residents. The home must ensure that consultation takes place with the Fire Officer regarding the use of door wedges to hold fire doors open. Doors held open must have approved fire risk assessments in place. The home must replace the tea trolleys to prevent any possibility of food contamination. 01/03/06 01/03/06 01/03/06 01/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Byker Hall DS0000000396.V258102.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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