Inspection on 14/02/06 for 70 Castleton Road

This inspection was carried out on 14th February 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

70 Castleton Road 21/02/07

70 Castleton Road 11/08/05

70 Castleton Road 18/01/05

70 Castleton Road 19/07/04

70 Castleton Road 05/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Castleton Road 70 Castleton Road Walthamstow London E17 4AR Lead Inspector Rob Cole Unannounced Inspection 14th February 2006 10:00 Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 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 Castleton Road DS0000007280.V282525.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 Adults 18-65. 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. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Castleton Road Address 70 Castleton Road Walthamstow London E17 4AR 020 8531 5561 020 8531 5574 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) SENSE UK Ms Julie Sandra Jordon Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th August 2005 Brief Description of the Service: Castleton Road is a six-bed home for adults with learning disabilities and sensory impairments. The service users all have complex needs and some have additional physical disabilities and challenging behaviour. The home is part of SENSE and is situated in a residential area of Walthamstow in the London Borough of Waltham Forest, and is close to shops and other local amenities. The house is similar to others in the locality. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 14/2/06 and was unannounced. The inspector had the opportunity of speaking with service users, staff and the home’s manager was present throughout the inspection. Overall the inspector was satisfied that this is a well run home. Service users receive high levels of individual support, and expressed satisfaction with the care provided. What the service does well: 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. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 and 5 The inspector was satisfied that service users are provided with sufficient information about the home in order to make an informed choice as to move in or not. This information is provided through documentation and the opportunity of visiting the home. EVIDENCE: The home has both a Statement of Purpose and Service User Guide in place. The Statement includes all information required by National Minimum Standards (NMS). The Guide includes details of the homes physical environment and the homes complaints procedure, and is now in line with NMS. Both documents are written in plain English and pictorial form. The home has an occupancy agreement in place for all service users, these included the terms of occupancy and the support provided. These are signed by a representative of the organisation and the service user or their representative were appropriate. Agreements have been updated since the last inspection, and now include details of fees payable and what they cover. From observation and discussion with staff and management there was evidence that the home is able to meet the assessed needs of service users. For example staff were able to demonstrate an ability to effectively communicate with service users who have complex communication needs. For instance the home has drawn up a picture book for use with one service user, the inspector observed that this enabled the service to make choices and have Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 8 more control over their daily life. Efforts are made to meet the cultural needs of service users, through dress, food, music and appropriate social activities. The home has a clear admissions procedure, and the manager demonstrated a good understanding of the procedure. The inspector was informed that prospective service users and their family have the opportunity to visit the home, including for overnight stays, prior to making a decision as to move in or not. There was evidence that meetings take place to review placements after six weeks, and these are attended by the service user, their family, keyworker, social worker and the homes manager. The home does not accept emergency admissions. There have been no new admissions to the home since the last inspection. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 The inspector was satisfied that service users are supported to have as much control over their daily lives and the running of the home as possible. Care plans and risk assessments are generally of a good standard, and staff have a good understanding of issues around confidentiality. EVIDENCE: All service users have clear and individualised care plans in place. Plans are drawn up with the involvement of the service user, their family, social worker, keyworker and the home’s manager. There was evidence that since the last inspection care plans are now regularly reviewed, at least once every six months. Plans covered needs associated with mobility, medication, culture and social and leisure needs. Service users are encouraged to take reasonable risks to allow them to participate in everyday activities and to encourage independence. Service users have risk assessments in place which are very clear and comprehensive, covering all areas of potential risk, including medication, accessing the community and holidays. Some service users exhibit challenging behaviours on occasions, and there were clear guidelines in place for managing this. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 10 The home is on a waiting list to receive support from a local advocacy group. All service users have a designated keyworker who will advocate on behalf of service users, and they also all have a social worker. Due to the nature of their disability, service users have only a limited ability to make choices over their lives, and are unable to manage their own finances. However, service users were observed to be offered as much choice as possible. For example on the day of inspection two service users indicated that they wished to go out, and this was arranged. Service users have only limited abilities to participate in the day-to-day running of the home. However, service users are able to participate in the recruitment process for new staff to the home, by a system of observing their interaction with prospective staff. Other areas where service users are able to contribute to the running of the home include menu planning and helping to choose decoration schemes for bedrooms. The home has a confidentiality policy in place, this includes details of when a confidence may have to be broken in the health, safety and welfare interests of service users and others. Confidential records are stored securely; staff and service users can access confidential records as appropriate. Staff spoken to demonstrated a good understanding of issues around confidentiality. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15 and 17 It is the view of the inspector that service users are supported to live valued and fulfilling lives. Service users have access to a wide variety of social and leisure activities, and the home has made efforts to develop service users independence and daily living skills. EVIDENCE: One service user currently attends a local college, where they are involved in a variety of activities including paining and developing life skills. The home itself also has programmes in place to help develop service users independence, for example around dressing and toileting. Service users regularly access the local community, for example using the laundrette, postal services, the library, shops and parks. Service users access public transport, including buses and tubes, and the home has its own unmarked vehicle which service users use to access the community. The home has invited the community liaison officer from the local police to the home, who has given advice to the home on how the home can be made more secure and on personal safety for both staff and service users. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 12 Service users have access to a wide range of social and leisure activities both in house and in the community. In house service users have access to TV, video, music, one to one beauty sessions with staff, foot spa’s and the home organises parties to celebrate special occasions. In the community service users go to pubs, cafes, and play snooker. Day trips are arranged, for instance to France and Southend, and service users recently attended a black tie ball. On the day of inspection one service user went bowling, while another went out for lunch. All service users are offered an annual holiday as part of their basic contract price. Last year service users had holidays in Turkey, Blackpool and Kent. The mother of one service user has recently moved to Turkey, and it is intended that this service user will be able to visit their mother in the future, and a considerable amount of planning and thought has gone into how this can be best achieved. Service users are able to maintain contact with their family, including visiting them for overnight stays. Family and friends are able to visit the home, and see their relative in private if they so wish. Service users are involved in planning menus, records are kept of menus and these indicated that service users are offered a varied, balanced and nutritious diet. Service users are also involved in food preparation. Service users are offered three meals a day, and are supported to have drinks and snacks throughout the day. On the day of inspection the kitchen was clean and tidy, and food was stored appropriately. However, several of the staff team have not had any training in food hygiene, even though they regularly prepare meals. It is required that all staff who are involved in food preparation receive training in food hygiene. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21 It is the view of the inspector that the home is able to meet the personal and health care needs of service users. Service users have access to health care professionals as appropriate, and medications were generally recorded and administered appropriately. EVIDENCE: Service users are encouraged to manage their own personal care as much as possible, in line with their care plans. Staff were observed to knock and wait before entering bedrooms. At times during the inspection service users made it clear they wished to be left alone, and this was seen to be respected by staff. Service users are able to choose their own clothes to wear, and all were appropriately dressed on the day of inspection. All service users are registered with a GP. Records are maintained of medical appointments, including details of any follow up action. Records indicated that service users have access to health professionals as appropriate, including psychiatrists, psychologists, dentists and opticians. The home makes use of the Continence Advisory Service, and used continence products are disposed of appropriately. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 14 The home has a comprehensive mediation policy in place, and all staff receive training before they are able to administer medications. The home’s supplying pharmacist visits the home every three months to check medication practices and procedures. Records are kept of medications that enter the home, and the home has a book for recording medications returned to the pharmacist. However, the last entry in this book was dated January 2002, yet one service user had a medication that was dated 14/2/05 and has been discontinued. It is required that disused medications are returned to the pharmacist, and that these are recorded. The home maintains MAR charts, and those checked by the inspector appeared to be accurate and up to date. Medications are stored in individual locked cabinets inside service user’s bedrooms. The home has a policy in place on death and dying. The home has sought the views of service users, or their relatives where appropriate, on their wishes for arrangements to be made in the event of their death. The manager informed the inspector service users could stay in the home with a terminal illness, as long as the home was able to meet their medical needs. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The inspector was satisfied that the home has suitable policies and procedures in place around complaints and protection issues. However, to further ensure the safety of service users, all staff must receive training in adult protection issues. EVIDENCE: The home has a complaints log, although the manager informed the inspector that the home has not received any complaints within the past twelve months. There is also a complaints procedure, which is in plain English and pictorial form. The complaints procedure was prominently displayed within the home, and includes contact details of the CSCI. The home has a policy in place on adult protection, which appeared to be in line with current legislation, the home also had a copy of the Local Authority adult protection procedures. However, the manager informed the inspector that most of the staff in the home have not received training in adult protection issues, even though the home’s own policy states that staff should receive this training within six months of commencing work for the organisation. It is a repeat requirement that all staff receive training in adult protection issues. The home holds money on behalf of service users in a locked cabinet. Records and receipts are maintained of transactions involving service users monies. The inspector checked several service users finances at random, all of which appeared to be satisfactory. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 16 Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30 It is the view of the inspector that the homes physical environment is suitable to meet its stated purpose. Service users have adequate private and communal space to meet their needs, and the home was generally well maintained, both internally and externally. EVIDENCE: The home is situated in a residential area of Walthamstow, in the London Borough of Waltham Forest, and is close to shops and other local amenities. The home is in keeping with other homes in the area, and has recently had a lot of renovation work done to the outside of the building, and is now in a generally good state of repair. At the previous inspection there was some damage to internal walls in the home caused by damp, and this has been satisfactorily addressed. The home is accessible to service users who make use of a wheelchair, and suitable to meet its stated aims. On the day of inspection the home was clean, tidy and free from offensive odour. The home has a sitting room, garden, dinning/kitchen area and conservatory. The downstairs communal areas have recently been painted, and had a new carpet fitted. The manager informed the inspector that there are plans to Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 18 convert half of the conservatory into a specialist sensory room. The garden has appropriate garden furniture and a BBQ, and is accessible to all service users. As well as the three ensuite bedrooms there is one bathroom/toilet, one shower room/toilet and one toilet on its own. Bathrooms and toilets have been adapted and are accessible to all service users. All bathrooms have locks fitted, with an emergency override device. Bathrooms were clean, tidy and free from offensive odour on the day of inspection. However, the toilet seat in the downstairs bathroom was broken on the day of inspection, and this must be replaced or repaired. All service users have their own bedrooms, three of which are ensuite, and the others all have hand basins in them. Bedrooms are decorated to service users own personal tastes. Bedrooms had appropriate furniture, including table and chair, wardrobe and chest of draws. Carpets, bedding and curtains were all well maintained. Rooms all had adequate natural lighting and ventilation, and windows were fitted with appropriate safety devices. On the day of inspection bedrooms were clean, tidy and free from offensive odours. Bedrooms meet National Minimum Standards on size requirements. There are numerous adaptations around the home. As mentioned, bathrooms have been adapted, and the home has a lift between floors which is regularly serviced. Carpets and walls have contrasting colours, to aid service users with sensory impairments to find their way around the home. The home has a policy in place on infection control, and protective clothing such as gloves and aprons were available to staff. COSHH products were stored appropriately. Laundry facilities were domestic in scale and suitable to meet the homes needs. Hand washing facilities were situated throughout the home. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None The standards in this section were not tested on this occasion, but will be tested as part of the next inspection. EVIDENCE: The standards in this section were not tested on this occasion, but will be tested as part of the next inspection. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42 and 43 The inspector believes this to be a well run home, and that the manager is suitably experienced and competent to carry out their duties. Appropriate systems are in place around quality assurance, and record keeping is of a generally good standard. EVIDENCE: The manager has fifteen years experience of working with adults with learning disabilities, including nine years in a managerial capacity. They have a City and Guilds advanced management in care certificate and the Registered Managers Award. The registration certificate was on display in the home, and accurately reflected the homes situation. The home also has a deputy manager and two senior support workers. From discussion with the staff team, there was evidence that the management approach to the home creates an open and inclusive atmosphere. Staff were observed to interact with the manager in a relaxed manner. The home has a policy in place on equal opportunities, and the recruitment procedure outlined by the manager demonstrated a commitment to equal opportunities. Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 21 Care plan reviews, staff supervisions and staff meetings all contribute to the quality assurance within the home. Copies of previous inspection reports were available to view, and since the last inspection there is evidence that the home now has monthly unannounced Regulation 26 visits. The home carries out an annual self audit, which includes seeking the views of relatives. Feedback seen by the inspector was generally very positive, one relative commented that “ X is very happy with the home, I feel this is mainly due to the dedicated staff and manager who always put service users first.” The home has a comprehensive set of policies, most of which have been updated recently. The inspector checked several at random, including recruitment and selection, equal opportunities and adult protection. All of which appeared to be satisfactory. All confidential records were stored securely, and staff and service users can access their records as appropriate. Fire fighting equipment was situated around the home, and last serviced in July 2005. Fire exits were clearly signed and free from obstruction. Fire alarms are checked weekly, and the home holds regular fire drills. The home had a fire risk assessment in place. The Local Fire Authority visited the home on the 17/8/05, and found everything to be satisfactory. COSHH products were stored securely, and the home tests and records fridge/freezer and hot water temperatures. The home had in date PAT testing and electrical installation safety certificates, however, there was no evidence of any gas safety testing been carried out in the past twelve months, and this must be addressed. Staff training records indicated that staff have not received all necessary statutory health and safety training, as mentioned not all staff have undertaken food hygiene training, and it was also found that some staff have not had any recent training in fire safety, first aid and moving and handling. All of this must be addressed. The home has in date employer’s liability insurance cover. Castleton Road DS0000007280.V282525.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 Adults 18-65 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 3 2 X 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 3 3 3 3 2 3 Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA23 Regulation 13 Requirement The registered person must ensure that all staff employed at the home receive appropriate training in adult protection issues. (Timescale 30/11/05 not met) The registered person must ensure that all disused medications are returned to the supplying pharmacist, and that records are maintained of all medications returned to the pharmacist. The registered person must ensure that the broken toilet seat in the downstairs toilet is replaced or repaired. The registered person must ensure that the home has a landlord’s gas safety check carried out in the home at least once every twelve months. The registered person must ensure that all staff receive all necessary statutory health and safety training. Timescale for action 31/05/06 2 YA20 13 31/05/06 3 YA27 23 31/05/06 4 YA42 13 and 23 31/05/06 5 YA42 13 and 18 31/05/06 Castleton Road DS0000007280.V282525.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 Castleton Road DS0000007280.V282525.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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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