Inspection on 24/04/07 for Charlton

This inspection was carried out on 24th April 2007.

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

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

Other inspections for this house

Charlton 07/12/06

Charlton 10/03/06

Charlton 03/08/05

Charlton 31/03/05

Charlton 28/09/04

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 Charlton Station Road Filton South Glos BS34 7BX Lead Inspector Jon Clarke Key Unannounced Inspection 24th April 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Charlton DS0000035466.V334600.R01.S.doc Version 5.2 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. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Charlton Address Station Road Filton South Glos BS34 7BX 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) 01454 866142 01454 866848 South Gloucestershire Council Mrs Rachel Dawn Brain Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 32 persons aged 65 years and over requiring personal care 7th December 2006 Date of last inspection Brief Description of the Service: Charlton was purpose built in 1974. It is a two-storey home providing care and accommodation for thirty two older people. Day care facilities are also provided for one person each day. The home is one of eight that operate as part of South Gloucestershire Councils Community Care Department. The home is located in an established residential area of Filton approximately four miles north of Bristol city centre. It is close to the Avon Ring Road and within easy reach of the motorway system. There are a range of shops, pubs and a church nearby in addition to a variety of shopping complexes including the Mall at Cribbs Causeway and the adjacent leisure complex. Accommodation is provided on both floors in single rooms. There is a passenger lift. Each bedroom has a wash hand basin. The home has a variety of communal areas and activity rooms. There are gardens to the rear of the home. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit as part of a key inspection which took place over one day. The manager was present throughout the inspection. As part of this inspection a number of records were looked at including care plans, preadmission assessments, staffing (including training), and recruitment. There was also an opportunity to talk with a number of residents and staff about their experience of living and working in Charlton House. “Have Your Say” questionnaires were sent and there were a number of responses from people who live in the home (15), relatives (6) and professionals (general practitioners, district nurse) who have contact or visit the home (5). These were used as evidence about the quality of care provided in the home. What the service does well: What has improved since the last inspection? Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 6 A number of requirements were made at the previous inspection; these have all been met, resulting in improved practice in a number of areas: health and safety and training. A number of requirements related to a particular individual which were addressed at the time of the inspection or shortly after. The individual is no longer in the home. 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. The summary of this inspection report can be made available in other formats on request. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Charlton DS0000035466.V334600.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. The homes Statement of Terms and Conditions whilst setting out clearly the arrangements for being a resident in the home fails to meet regulations about any increase in care fees. EVIDENCE: An assessment of an individual who was recently admitted to the home was looked at and showed the health and social needs. Individuals are admitted following an assessment by South Gloucestershire Community Care Services Department. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 9 In speaking with this individual she confirmed that she had been visited by a staff member from the home and had also had the opportunity to spend a day in the home before her admission. A review meeting had also been held at which a decision was made that she remain as a permanent resident. The home’s Statement of Terms and Conditions was looked at and gave full and comprehensive information about living in the home including what the fee includes and what services are not included such as chiropody and hairdressing. There was also a statement about what happens if an individual’s needs change; however, there is no statement about what notice individuals or the home has to give in the event they wish to leave the home or the home can no longer meet the persons care needs. It also speaks of how the individual is admitted “as a permanent guest”. I feel this doesn’t reflect the fact that Charlton becomes the individual’s home; rather, there is an implication that their move has a temporary nature? There is no statement about any increase in fees and how one month’s notice will be given and reasons for any increase. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care Planning and arrangements for meeting health care are generally good, providing staff with the necessary information so that the health and social care needs of residents are met and reflecting the individuality of people who live the home. Arrangements for managing resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: A number of care plans (3) were looked at and illustrated good practice in this area. There was detailed information about care tasks and assistance the person needed. In one instance where an individual’s health had deteriorated this had been well documented and notes made about discussions with the person about their care. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 11 Reviews are held on a regular basis. Risk assessments had been completed and these had been reviewed. One individual had been receiving care from district nurses and home’s staff in relation to pressure sore and poor skin condition; however, there was no risk assessment about her particular skin care needs to include how risk could be alleviated or managed. Care plans had been signed by the individual as were care reviews. One person I spoke to said how she had discussed with care staff “the help I needed”. Mobility and Handling Profiles had been completed. Of note was how care plans reflected individuality with past histories and personal fact files. Also included were Daily Living likes and dislikes and in one instance personal goals had been identified with the individual as part of their care plan review. The people who live in the home have access to community health services and records showed where individuals had received services such as chiropody, dental treatment and optician. One individual had been referred for speech therapy. Individuals are treated by the community nursing services where this is necessary. A comment from a district nurse stated that they felt what the home does well is “contacting district nurse for any problems or concerns the residents may have” and that “a communications book has helped in raising concerns about patient care” (from ‘Have Your Say’ questionnaire). The home has also identified a particular member of staff who ensures where individuals need assessment due to continence difficulties links with the continence advisor. There were 4 “Have Your Say responses from general practitioners; all were satisfied with the overall care in the home and two commented, “I am very pleased with the standard of care at Charlton” and “staff seem very caring and trying to do their best for the clients”. All of the respondents confirmed that the home “communicates clearly and works in partnership” “able to see patients in private” and that “staff demonstrated a clear understanding of the care needs” of people who live in the home. Arrangements for managing medication were looked at and I was satisfied that the necessary storage arrangements are satisfactory. Administering records were looked at and showed that accurate recording had been made. In addition controlled drugs were recorded in controlled drug register and signed by two members of staff as required. Returns of medication are recorded and signed for by the pharmacist or their representative. Only one resident was currently managing their medication and a risk assessment had been completed to identify any potential risks to the safety of this individual by their self-administering their medication. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 12 In talking with a number of residents it was clear that they all felt that staff treated them with respect: “[they] treat us as we would want to be treated” and “I am always happy with the way staff treat me and give me the help I need”. I also observed staff assisting residents and this was always done in a sensitive and supportive way. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: The home provides a good range of activities including board games, bingo, quizzes, cards and dominoes. Days out are also organised and in minutes of residents meeting suggestions had been made as to where to go for the day. A member of staff is available to organise activities in the home. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 14 On the day of this inspection staff had organised exercise and bingo. A small group of residents also met for afternoon tea. A St. Georges Day party had been arranged and other parties and events are organised at which relatives and friends are invited. In talking with people who live in the home they all spoke positively of the entertainment and activities: “there’s always something going on” “I never get bored” Eleven of the “Have Your Say” respondents said there was “always” activities arranged by the home they could take part in with 4 saying “usually” comments included “I love playing bingo and word games” “I like the trips the home provides”. In the home’s quality questionnaire an individual had commented that “entertainment is excellent” and a relative that the “the entertainment the staff put on are great”. Staff felt this was one of the strengths of the home and certainly I felt there is a very strong effort to make this aspect of life in the home an important one. I spoke to a relative who was visiting the home she said how she had visited the home regularly at differing times of the day and had always found staff “all very friendly” “always made to feel welcome” and “always able to ask how her relative was” and felt she was kept informed about his health and wellbeing. The home has open visiting and again when I asked individuals about their visitors they said how staff “always friendly”. All relative respondents to “Have Your Say” questionnaires said that the home “always” helped their relative to keep in touch and “always” kept up to date about their relative. In talking with people who live in the home they all spoke positively about their ability to “choose how I spend my day, “its up to me what I do”. When asked about any routines they felt there were none “other than mealtimes we get up when we want and go to bed when we want” “my day is my own”. I spoke to one individual about this she needed help to get up in the morning but again she said that “its up to me when I get up I just say and its no problem, staff all very good”. I spoke to a number of individuals about the food provided in the home and there were a number of positive comments: “always good food here” “good choice of food” “I enjoy my food here”. Twelve of the “Have Your Say” respondents said they always” like the meals in the home with 3 saying “usually”. One individual commented “they are great meals and I always give my appreciation to the cook, as they cook excellent meals”. I joined residents for dinner and found the food well presented and all individuals were given a choice. The atmosphere in the dining room was unhurried with staff giving assistance in a sensitive way to those that needed help with their meal. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear procedures and policy enabling individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: I spoke with a number of individuals about what they would do if they were unhappy about something their responses were “I would speak up if unhappy the manager is really special, go and chat with her” “I would go and tell member of staff”. One individual when asked said there was “an official form to complain”. I also asked if they felt they would be listened to and something done the response was always yes “they listen to us”. No complaints had been made since the last inspection. The home has an Adult Protection Policy and staff have undertaken Adult Protection training. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and hygienic environment for the residents and staff. People who live in the home generally have good access however this could be improved so that individuals have independent access to garden area. EVIDENCE: In walking around the home it was very evident that there is a high standard of cleanliness and individuals I spoke to residents who confirmed how the home is always clean and free from unpleasant odours as on the day of this visit. This was also confirmed in questionnaires, all respondents saying the home was “always” fresh and clean. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 17 It was also very evident that the owners and managers have made a real effort to provide a homely environment with attractive lounges, dining room and gardens. This was commented on by a number of residents “its so homely here” was a typical comment. Relatives also commented “there is always a homely atmosphere”. Effort has clearly been made to make the home as bright and homely as possible with corridors being attractively decorated and bathrooms as previously noted in this report of particular note in their warm and appealing environment. Generally the access within the home is good with level access and lift available however access to the garden is poor and is not level or ramped to the extent that individuals can access the garden independent specifically wheelchair users. I discussed this with the manager as well as the open access to the rear of the home that potentially could pose a risk of intruders to the home or indeed residents who may use this area. There is also a potential risk to those individual who have some confusion of disorientation who may leave the home without being noticed. The manager told me that she was thinking of enclosing the garden area close to the home, this would improve security and provide a safe enclosed area for residents. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: I looked at the staffing rotas for a 4-week period. They confirmed that there are 4 staff on duty am (7-2,8-3) 2 pm 3-10 and 2 waking night staff. As part of establishing care needs and care hours a monthly dependency assessment is undertaken. For April this showed 5 individuals high needs, 17 medium needs and 8 low needs equalling a requirement for 534 care hours with available hours being 568. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 19 The Staff Development Action Plan indicated that 7 staff have NVQ 2, 6 NVQ 1 with 4 staff undertaking NVQ 2. Staff told me that the training provided was very good and available training included Dementia Awareness, Introduction to Mental Health (6 staff members had completed), Nutritional Awareness, Depression In Older People (10 staff booked to undertake), and Deaf Awareness. Records confirmed that staff had completed the required mandatory areas of training: Moving & Handling, First Aid (all night staff had completed this training), Fire Health and Safety, and Adult Protection. Recruitment records were looked for recently recruited member of staff and showed that the necessary procedure and practice had been followed: full application showing employment history, 2 written references, Criminal Record Bureau check (CRB) POVA check. I also signed off a number of CRB certificates as having been seen. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good opportunities for residents and others to express their views about the service they receive. The practices of the home help to make sure that the health, safety and welfare of residents and staff is protected. EVIDENCE: Ms R. Brain has 8 years managerial experience and extensive experience working in a care environment; she has NVQ 4 Registered Managers Award. Staff described her as “friendly and approachable” and importantly people who live in the home all spoke of her very positively; “I can always go to see her”, “she’s always there if we want her”. I found her open and willing to discuss constructively the issues raised from this visit. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 21 The home has an external Quality Assurance undertaken by an independent organisation. A resident’s survey of 10/11/06 found 95 satisfaction with the care provided in the home. I did not examine in detail how the quality assurance system operates and will do so at the next inspection. Resident’s meeting are held regularly and minutes showed they had been used to inform people who live in the home of any changes and seek suggestions and comments about life in the home. Individuals had raised issues around the menu and activities in the home. In addition the issue of heating in the home had been discussed relating to the fact that radiators cannot be independently controlled only in the sense that they can be set to be off or on but no temperature control. An individual had raised this with me and I was told by member of the management staff this is something that is being looked into and it was hoped that changes could be made through fitting of thermostatic valves. I looked at the compliment book that is available and some comments from relatives included: “We are delighted with mum’s progress” “good atmosphere in the home” “Lovely welcoming atmosphere” “Congratulations on the lovely atmosphere you create here” “Highest possible standards of care” “Mum is thriving in this warm and friendly atmosphere all round health is so much better” Some comments from relatives “Have Your Say” questionnaire: “All the staff are very caring. There is always a homely atmosphere and all staff are very approachable. I couldn’t wish for my relative to be anywhere better” “All Charlton staff are wonderful and hard working, my relative has been very happy at Charlton.” Health and Safety records were examined and showed the necessary maintenance and checks of equipment had taken place: Fire Equipment 18/08/07, emergency lighting 29/11/07, Lift 13/04/07, hoists, parker bath 22/01/07. Gas Safety certificate issued 23/02/07. Fire drill records and briefings showed that staff had completed the required frequency of fire drill and weekly fire alarm tests are undertaken, as are monthly emergency lighting tests. Fire risk assessment had been completed. Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 X X X X X 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 3 X 3 X X X X 3 Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 5 (a) Requirement Timescale for action 30/05/07 2 OP8 12 (1) 3 OP20 13 (4) (a) 23 (2) (a) (n) Terms and Conditions or Contract to have statement that any increase in fees will be notified at least one month in advance to be accompanied by a statement of the reasons for such an increase. 30/05/07 The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of people who live in the home. (This relates to identifying those individuals who are at risk of developing pressure sores through a risk assessment and recording actions to take to alleviate risk and appropriate intervention) 30/09/07 The registered person shall ensure that the physical design and layout of the home meets the needs of the people who live there and suitable adaptations are made and that all parts of the home are free from hazards. (This relates to improving access to the garden from dining room) Charlton DS0000035466.V334600.R01.S.doc Version 5.2 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 Charlton DS0000035466.V334600.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Charlton DS0000035466.V334600.R01.S.doc Version 5.2 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. 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