Inspection on 31/08/05 for Carlton Mansions

This inspection was carried out on 31st August 2005.

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

Other inspections for this house

Carlton Mansions 10/10/07

Carlton Mansions 07/07/06

Carlton Mansions 21/02/06

Carlton Mansions 24/02/05

Carlton Mansions 28/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Carlton Mansions 8 Apsley Road Clifton Bristol BS8 2SP Lead Inspector Grace Agu Announced 30 & 31 August 2005 09:30 th st 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. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Carlton Mansions Address 8 Apsley Road Clifton Bristol BS8 2SP 0117 9734394 0117 9238603 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) Acegold Limited - a wholly owned subsidiary of Four Seasons Health Care Ltd Mss Sugandhva Jadeja Care Home for Older People 26 Category(ies) of OP Old Age 24, DE Dementia 2 registration, with number of places Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 2 named people who have dementia. Certificate will revert to 26 OP when persons leave. Date of last inspection 24 February 2005 Brief Description of the Service: Carlton Mansions is one of a group of residential care homes owned and operated by Four Seasons Health Care. The Home is registered with the Commission for Social Care Inspection to provide accommodation and personal care for 26 people aged 65 years and over. Within the registration the home are registered to provide care for two named persons with a dementia. Carlton Mansions is located in a residential suburb of the city of Bristol. Local shops and amenities are located nearby. The home is a large Victorian property, and accommodation is arranged over four floors – a passenger lift enabling access. Individual rooms are comfortable, well maintained and personalised by the residents. The communal space consists of two lounges, a dining area and a conservatory overlooking the courtyard garden to the rear of the property. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection which was undertaken over fifteen hours to review the requirements made at the last inspection and also review the care practice to ensure that it is in line with the legislation and that current and best practice is followed at the home. At the last inspection eight requirements were made in relation to different areas of service provision at the home. It was pleasing to note that the home had made tremendous efforts to ensure that all the requirements made were met, however one immediate requirement was made in relation to accurate recording of controlled drugs at this inspection. Generally, the home was found warm, well lit, tidy and free from unpleasant odours. The residents were found to be relaxed and well cared for. Some residents were also noted moving about freely without restrictions in their homely environment. The manager and staff were seen interacting with residents in a dignified and sensitive manner. A tour of the building was undertaken and a number of records were viewed. Six residents and two staff members were spoken with during the inspection. What the service does well: The home has a statement of purpose and a service user’s guide, which provide information about the services provided at the home. The service users guide is given to prospective service users and their relatives before admission to enable them to make an informed choice about the home. Families, friends, relatives and other visitors are encouraged to visit the home to ensure that regular contact is maintained. Nutritious food is provided at the home and residents confirmed that they enjoyed their meals. There are ongoing training courses to enable staff to meet individual residents needs and to ensure that staff are aware of how to protect residents from harm and abuse. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4.5. The process of admission is well planned and managed with clear information to enable the residents to make a decision about the services provided at the home. EVIDENCE: The home has a Service User’s Guide that is given to prospective residents and their relatives when they visit to view the home to enable them to make an informed choice about moving to the home. The care files of two recently admitted residents showed that the residents were assessed before admission to the home. Furthermore the two new residents confirmed that they visited the home before making a choice to live at the home. During discussion the manager stated that prospective residents are informed of the one-month trial period to enable the home and the resident to decide if the home is suitable and able to meet the needs of the resident. Terms and Conditions in relation to services provided at the home and fees to be paid are given to both local authority and self-funding residents. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10. The home offers support to residents throughout their lives and towards the end, it also protects them by reviewing their health needs, however, it fails to protect the residents by inappropriate drug administration and recording. EVIDENCE: Seven care files reviewed showed evidence of detailed pre-admission assessment of the needs of the residents to ensure that holistic care plans are in place specifying how the assessed needs were to be met. One resident who was recently admitted to the home stated that he visited the home before deciding to move to the home because “ I wanted to have an idea of the home and that it was suitable for me”. All the care files viewed contained care plans relating to different needs and how the staff were to meet these needs. These care plans were regularly reviewed. However, it was noted that the seven care files lacked different care plans in relation to mouth ulcers, visual impairment, and aggression, wandering and hearing impairment. A requirement was made for the care plans to be developed to ensure that staff are aware of these needs and how they are to be met. Evidence of individual risk assessments were noted on the care files. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 10 The care files contained evidence of visits from the health professionals to include doctors, physiotherapists, and chiropodists for urgent or routine appointments or review of resident’s health care needs. Two residents spoken with stated that “staff treat me well, staff are wonderful, staff get things done when I ask them”, another resident confirmed that staff respect her and always ensure that her privacy is maintained. Care staff were noted knocking at the doors and waiting to be allowed in before going into the residents bedrooms to assist them with personal care. Some residents had private telephones installed in their rooms to enable them to have private conversation with their families, relatives and representatives whenever they wish. Medication was reviewed and it was disappointing to note that the balance of two accountable night medications recorded in the controlled drug register was not correct. The balance recorded did not correspond with the balance in the blister packs. The manager explained that the night health support worker failed to record the administered medications for two nights and that this had made the balance incorrect. An immediate requirement was made for the mistake to be corrected and a written explanation sent to the Commission for Social Care inspection. This requirement was met on 12/09/05. The letter received by the Commission was clear and satisfactory. A requirement was also made for a review of staff training on Basic Medication administration, also for all hand written medication on the medication administration sheet to be signed and dated that the resident on self-administration to be risk assessed to ensure that residents are adequately protected. A requirement was made at the last inspection in relation to one of the issues mentioned above. The registered manager must now ensure residents are protected through appropriate medication procedures. Staff spoken with demonstrated knowledge of policies and procedures in relation to death and dying. The staff members stated that they are aware of the importance of keeping the information about residents confidential. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15. The home enables residents to maintain contact with family’s, friends, advocates and the community. It also provides them with meaningful activities and choice in respect of meals. EVIDENCE: Evidence of discussion with residents and staff showed that the home actively supports the residents to maintain contact with their families, representatives and friends. One resident stated that her friends call her frequently on her private telephone and that she prefers to stay in her room and watch the digital video device and television. Another resident stated that his sons visit regularly. When asked how he participated in activities provided at the home he stated “staff know I have bad eyesight, they come to my room and talk to me, I go out with other people when I can”. Weekly and monthly activities undertaken by staff to ensure that residents are regularly stimulated include, bingo, Scrabble, chair aerobics, cooking; these are supplemented by outside entertainment and outings. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 12 Residents spoken with stated that they have a choice with their daily routine and that staff are “quite flexible” and encourage them to do as they wished. One resident described how she usually “lazes about in bed until 10 am before getting, washed and dressed and having a cup of tea”. She also stated “I have a siesta in the afternoon as a routine for me”. Residents were pleased with the food provided at the home. The menu on the first day of the inspection was Gammon and pineapple with creamed potatoes and a selection of vegetables and cheese sauce. There was an alternative of lamb casserole. It was noted that that residents were being assisted by staff and especially those residents who were finding it difficult to concentrate and eat their meals. A particular resident with eating difficulty was fed by staff in a sensitive and dignified manner. One resident that preferred to have fish and chips stated that she enjoyed her meal Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 Residents are enabled to complain and are confident that they would be listened to and protected from harm and abuse. EVIDENCE: The home has a complaint procedure, which has information about the Commission for Social Care inspection to enable the residents and their representatives to contact the Commission if their complaint was not satisfactorily resolved. There is also a Whistle Blowing policy to enable staff to report bad practices without fear of reprisal. Staff members spoken with confirmed awareness of these policies including the Protection Of Vulnerable Adult from Abuse policy. Measures to be taken in the event of noticing abuse was clearly described by staff members interviewed. Residents spoken with stated that feel safe at the home and that they have no complaints. One resident stated “I would talk to the manager if I have any concerns, I have none at the moment”. Another resident also said that she would speak to the manager if she had any complaint about any of the services provided at the home. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 14 Two newly appointed staff members files viewed contained relevant employment information required before commencement of employment. Resident’s monies checked showed a good accountability of how residents spend their monies. The recorded amount in the books and the computer system corresponded with the amount deposited in the secured lockable safe. During discussion with residents two people confirmed that they were enabled to vote using the postal voting system. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25,26 The residents enjoy a safe standard of accommodation, and a well maintained environment however, the home’s hygiene practices needs improvement. EVIDENCE: The home was found to be well maintained and suited for it’s purpose. Whilst walking round the home, it was noted that several rooms have been redecorated and the kitchen has been refurbished. The registered manager stated that the current ongoing refurbishment and redecoration is to improve the environment for the residents and that this is expected to be completed by June 2006. The bedrooms seen were clean, tidy, personalised and were pleasantly furnished. The residents met in their bedrooms stated that they were satisfied with the décor and could bring in their own furniture if they wanted to. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 16 The corridors were fitted with handrails on both sides to assist with residents mobility, however the corridor on the ground floor extension had unpleasant odours, the manager explained that it was due to a resident’s incontinence, but that the problem has been resolved. The carpet is to be replaced. The bathrooms and toilets were fitted with grab rails and various manual handling equipment and aids to assist staff with meeting the residents’ needs, however one of the bathrooms was being used for storage of staff personal belongings. This impacts on the number of bathroom and toilets available to be used by the residents. A requirement was made for the home to provide appropriate storage facilities for staff personal belongings. The laundry facilities were noted to be satisfactory. The washing machines have sluicing facilities to ensure that clean bedding and clothing are provided for the residents at all times and that infection control is promoted at the home. The laundry person stated that she changes the residents’ bedding on a rota basis and puts away in the individual wardrobes to minimise incidences of missing or lost clothing and also to ensure continuity. The staff member confirmed that she had attended Control of Substances Hazardous to Health training to ensure that she is aware of measures to be taken in the event of chemical accidents. The kitchen was clean and control measures in relation to food safety and hygiene were in place. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 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 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) 27,28,29,30. The recruitment procedure of the home offer protection to the residents, there is sufficient numbers of staff trained and are competent to meet the residents needs. EVIDENCE: Records of two recently appointed persons contained relevant employment information to ensure that residents are protected. Staff members interviewed showed knowledge of their roles and responsibilities in relation to meeting the needs of the residents. The training record viewed showed six staff members have completed the National Vocational Qualification (NVQ) in care at level 2 and three staff members are to commence NVQ in care at level 3. On the day of the inspection one staff member was noted receiving training on the NVQ key skills from her assessor. The assessor explained his role in relation to the training and also stated the staff member will be completing the training in three weeks time. Other training courses attended by staff include Protection of Vulnerable Adult from abuse, manual handling, first aid, fire safety and infection control. The manager stated that Four Seasons Health Care had employed a training manager to provide in house training on challenging behaviour, dementia care and death and dying. All staff are provided with training packs and the manager would go through it with them to ensure good understanding. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 18 Evidence from the rota seen on both days of inspection showed that the home has adequate numbers of staff to meet the needs of the present category of residents. In addition, the home also employs a laundry person, domestic staff, a maintenance person and an administrator to assist the manager with her administrative duties. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36,37,38. The home benefits from good leadership and management, however it’s practices do not offer protection to the health and safety of the residents living at the home. EVIDENCE: Carlton Mansions is managed by an experienced and well-qualified home manager. Residents and staff members spoken with on the day of inspection commented positively and highly of the manager’s ability to manage the home. One resident stated, ”The manager is good she looks after us”, another resident said that the manager is very kind; somebody described her as “a nice person”. Two staff interviewed stated that they get on well with the manager and that she is somebody you can talk to and she listens. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 20 The manager, during discussion, stated that she had attended several training courses to include computer studies to enable her to access information in relation to good practice from the Internet and Four Season’s network. Other training courses that she has completed include the Registered Managers Award training, nutrition for the elderly, first aid and would be undertaking the manual handling update to enable her to supervise the staff to ensure that they are handling residents in a skilled and competent manner. Mrs Sugandhva Jadeja was nominated by her residents and subsequently received the Lord Mayor’s Award in May 2005 for her contribution towards the care of the residents at Carlton Mansions. Evidence from the staff files showed that supervision of staff is being carried out and staff interviewed confirmed that they have received supervision. The manager stated that she is responsible for supervising the senior care staff and the deputy manager supervises the remaining staff members, this takes place monthly. Review of the records showed that this is not carried out regularly for all staff. The manager must ensure that staff are regularly supervised to ensure that residents are protected against potential staff incompetence’s. The manager described the different ways of monitoring the quality of its services. These include review of care plans and, residents meetings, the last meeting was on 10/5/05 (discussion was centred on food, activities and care of the residents). Other monitoring tools used are discussions at staff meetings, provider’s monthly self auditing (Regulation 26) and review of policies and procedures. ”Thank you” cards from families and pre-inspection comment cards received had positive and complimentary comments. It was agreed that the home develops a quality monitoring system that includes the views of other professionals that are involved at the home. The fire logbook is well maintained. The home employs a maintenance person who ensures that all fire checks are carried out satisfactorily. The manager stated that the maintenance person was booked to attend health and safety training to enable him to carry out the home’s generic and fire risk assessments. This training was taking place on 31/8/05. It was agreed that these risk assessments are carried out as a matter of urgency following a resident’s fall in the dining area on 13/8/05. Evidence showed that staff have attended fire drills regularly and that there are regular servicing of passenger lifts, bath hoists and all portable appliances have been electrically tested. Residents’ monies and records were noted to be securely locked. The manager stated that two residents have access to solicitors to assist them with their financial management. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 21 The accident book showed that accidents were regularly recorded, however they were not satisfactorily reviewed. Concerns were expressed in relation to one resident’s record of six falls between 24/4/05 and 19/5/05. At the discussion with the manager, it was agreed that the home reviews all accidents to ensure that all injuries (if any) have been resolved satisfactorily. Policies and procedures at the home included, confidentiality, missing persons and infection control. Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 2 3 3 Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 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. 2. Standard 7 9 Regulation 15 13 Requirement Prepare a written care plan on identified residents needs Ensure that all hand written medication on Medication Administration Sheet (MARS) are signed and dated. Resident on self medication must be risk assessed and consent obtained. Ensure that drugs recorded in the controlled drug register are accurate after administration. Provide staff with appropriate storage facilities. Ensure that all staff are regularly supervised. Ensure that generic and fire risk assessments are carried out at the home. Carry out a risk assessment of the dining area following a fall. Ensure that all accidents are satisfactorily reviewed . Timescale for action 20/9/05 6/9/05 3. 4. 5. 6. 7. 8. 9. 9 9 21 36 38 38 38 13 13 23 18 13 13 15 6/9/05 6/9/05 30/11/05 30/10/05 30/11/05 30/9/05 30/9/05 Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 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. 1. Refer to Standard Good Practice Recommendations Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire BS32 4RG 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 Carlton Mansions D56_D05 S26500_CarltonMansions_V229531_300805_Stage4.doc Version 1.30 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!