Inspection on 30/04/08 for Chestnuts

This inspection was carried out on 30th April 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chestnuts 19/06/06

Chestnuts 27/09/05

Chestnuts 27/04/05

Chestnuts 07/09/04

Chestnuts 26/07/04

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

CARE HOME ADULTS 18-65 Chestnuts Yapton Road Barnham Bognor Regis West Sussex PO20 0AZ Lead Inspector Michael Gough Unannounced Inspection 30th April 2008 10:30 Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 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 Chestnuts DS0000014446.V362289.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 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. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chestnuts Address Yapton Road Barnham Bognor Regis West Sussex PO20 0AZ 01243 554679 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) www.care-ltd.co.uk Cottage and Rural Enterprises Ltd (CARE) Miss Joanne Targett Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (3) of places Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 persons in the registration category LD (persons with learning disabilities) of whom up to three (3) may be in the category LD(E) over the age of sixty five years. 19th June 2006 Date of last inspection Brief Description of the Service: Chestnuts is registered to accommodate up to six service users in the category LD (Learning Disability) aged 18 to 65 years. The establishment is situated in the village of Barnham, close to train and bus services and local shops. All rooms are for single occupancy. The service is a voluntary charity. The registered providers are Cottage and Rural Enterprises Ltd (CARE)’. The Responsible Individual is Mr Peter Williams and the registered manager is Ms Joanne Targett. Fees at the home are approximately£650 per week but this depends on the type and level of support required. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience Adequate quality outcomes. This report details the evaluation of the quality of the service provided at Chestnuts and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out in June 2006. The inspection took into account; the previous key inspection report and also information from what other people have told us about the service. Comment cards were received from 2 members of staff and 6 residents who live at the home. Included in the inspection was an unannounced site visit to the home, which took place on the 30 April 2008. Evidence for this report was obtained from reading and inspecting records, touring the home and from observing the interaction between staff and users of the service. It was also possible to speak with 2 people who live in the home, 1 member of staff and the homes assistant manager who assisted the inspector throughout the visit. The home is registered to provide support for 6 residents and at the time of the inspection there were 6 people living at the home. What the service does well: There is an effective care planning system in place and residents are supported to access the local community. The home provides care and support to enable residents to live meaningful lives and staff supports them in their day-to-day lives and they are treated as individuals and with dignity and respect. From talking with residents and from the comments received it was clear that residents were happy living at the home and that staff and residents get on well together. Care staff at the home know the residents well and were aware of individual likes and dislikes. Comments received from residents included “I am happy living at Chestnuts” and “I like the house and I love being here” and one resident commented “I like all the people I live with and the staff are great”. Residents told us that they received the support that they needed. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 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. The summary of this inspection report can Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 8 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 Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users aspirations and needs are assessed before they move into the home. EVIDENCE: The home has a policy and procedure in place with regard to admissions to the home and the assistant manager informed us that potential new residents are normally admitted from one of the providers other homes in the area. This would be when they had been identified as being able to move on, residents spoken to said that they had lived in another home before moving to Chestnuts and saw the move as a positive step. Social Service assessments are undertaken as well as the homes in house assessments. There have been no new service users since the last visit to the home and the last person to moved into the home over 3 years ago. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents assessed needs and personal goals are reflected in an individual plan of care and residents are supported to make decision about their lives with assistance given by staff. Residents are supported to take responsible risks and this allows service users to live an independent lifestyle as much as possible. EVIDENCE: Care and support plans were seen for 2 residents and these were clear and easy to follow and gave clear information for staff on what support was needed and how and when this support should be given. Both care plans seen were essential life plans and they had clear information and were person centrered, the plans had details of daily routines around the home, personal hygiene, socialisation, behaviour, care at night, likes and dislikes, leisure activities, work, education and good information about the person. All residents have key workers and they review care plans monthly with residents and any changes are discussed at monthly team meetings and implemented as required. Staff are made aware of any changes through the communication book in use at the home. All residents have had a 6 monthly Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 11 review and an annual review with social services; families are invited to attend reviews, as are any other interested parties. Residents were supported to make decisions about their day to day lives and staff were observed interacting with them and taking their views into account, there was evidence in care plans of residents preferences for when they would like to get up and go to bed and there was information, which showed that residents had been offered choices and also detailed the choices made. We were informed that residents views are listened to and taken into account, those residents spoke with and those who completed surveys stated that they were able to make their own decisions and that staff respected this. However one comment from a resident stated that “ I am not able to stay home alone so I sometimes have to do things I might not want to i.e. go shopping or swimming when I would rather stay at home” a member of staff confirmed that this was the case and was due to the fact that at times there were not enough staff to enable the residents to stay at home as there was only one member of staff on duty. Both residents who were case tracked had risk assessments in place and these gave details of the assumed risk the support required and the action to be taken to minimise the risk. We found that residents had a number of risk assessments in place when no risk had been identified, for example one resident had a risk assessment in place for moving and handling and this was because of a problem the resident had some time ago when her leg was in plaster, this risk assessment was still in place even though the plaster had been removed and the resident was fully mobile. The home needs to review all risk assessments for residents to ensure that those that are in place are needed and are up to date. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and supported to be part of the local community and to be involved in appropriate activities. They benefit from support to maintain social contacts and daily routines at the home respect their rights and responsibilities. Meals at the home are flexible and residents benefit from a healthy diet. EVIDENCE: None of the residents have expressed an interest in gaining any form of employment although the assistant manager is booked on a course, which is designed to provide support for residents who would like to seek employment. 3 of the residents go to college for arts and crafts, cookery and also literacy and numeracy. 1 resident carries out voluntary work in a local charity shop one day per week. The residents at the home take part in a range of different activities and these are tailored to the individual. Activities include swimming, cinema, games, videos, community walks, trampoline, trips to pubs and cafes and shopping. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 13 Residents spoken to and those who completed surveys said that there was always something to do and that they liked going out into the local community. As stated earlier in the report 2 residents who completed surveys told us that at times they had to do things that was not their choice because there were insufficient staff on duty to allow them to remain at home whilst other residents went out. The home has a visiting policy and family and friends are welcome at any time. Residents are encouraged and supported to maintain family links and staff support them to visit their parents if they wish to do so. Staff were observed interacting with residents and their preferred form of address was used. Residents who we spoke to made it clear that they were very happy at the home and it was clear that the residents and staff get on well together. All residents in the home has weekly tasks to encourage them to be involved in the day to day running of the home and routines in the home respected residents rights to be involved as much or as little as they wanted. Mail is given to residents unopened and staff support them with their mail if required. Menus at the home are made up each week by the staff after a menu planning meeting with the residents. The likes and dislikes of residents are taken into account as is their nutritional needs. They are offered a choice of cereals and toast at breakfast, with the main meal being at lunchtime. The evening meal is normally a snack type meal and residents are able to make their own drinks and snacks at anytime and staff will provide support if needed. The menu is flexible and allows for change at short notice and this gives residents the opportunity to choose a take away if they wish. Residents spoken to said that the staff were good cooks and that they enjoyed the meals at the home. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support in the way they prefer and their physical, emotional and health needs are met. The homes policies and procedures with regard to medication provide protection for residents. EVIDENCE: Personal support is given flexibly and residents care plans give clear information to staff on how they would like their personal support to be given, support is normally verbal prompts but staff will give extra support if needed. There is a mix of both male and female staff and each resident has a key worker and residents have been involved as much as possible in their selection. Personal support is given in private and the preferences of residents on who they prefer to give them the support they need is respected. The home has a policy on cross gender care and if at all possible same sex care is offered and given. All of the residents at the home are registered with the same GP surgery, however they have different GP’s. Residents visit a local community dentist and optician as required and a visiting chiropodist calls every 6 – 8 weeks. Residents are able to access other health care professionals such as district Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 15 nurse’s, occupational and speech therapists, a continence adviser and physiotherapists through GP referrals as required. The home has a medication policy and all staff have received training in the administration of medication. The home uses a monitored dose system for medication and records were inspected and found to be accurate and up to date. One resident is able to self medicate and there are clear procedures laid down and the resident has secure storage for their medication. The homes medication cabinet was checked and this was suitable for its current purpose, however the home does not currently hold any controlled drugs. The law concerning the storage of controlled drugs has recently changed and the home was reminded that should there be a need for any controlled drugs to be held at the home, they must be stored in a proper Controlled Drugs Cupboard. A proper Controlled Drugs cupboard is one, which meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a clear and accessible complaints procedure, which includes timescales for the process and residents can be confident that their views would be listened to and acted upon. The home has policies and procedures to help protect residents from of abuse, however the practices regarding their finances do not fully protect them. EVIDENCE: The home has a clear and accessible complaints procedure, and this was in an accessible format for residents and this contained all of the required information and gave details of how to contact the CSCI. The homes completed AQAA and stated that there have been no complaints made to the home since the last inspection and the assistant manager confirmed this. Residents and staff members spoken to were aware of the complaints procedure. All staff receive training with regard to adult protection and POVA as part of their induction and refresher training is carried out annually. The home has a copy of the West Sussex Multi Agency Guidelines and also has a whistle blowing policy. Staff members spoken to confirmed that they had received training and were aware of their responsibilities in this area. Financial procedures were checked and resident’s benefits are paid directly to the organisations headquarters and residents receive their personal allowance in cash each week. 2 residents manage their own finances and are provided Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 17 with lockable storage. The other 4 residents have their finances managed by staff, each has their own cash box and savings account and clear records are kept and receipts are kept for any large transactions. All of the residents at the home receive Disabled Living Allowance (DLA) and this is also paid directly to the organisations head office, there was no record of this recorded at the home and the 2 residents who are able to manage their own finances did not appear to be receiving their DLA. The assistant manager did not know where this money was kept, how much money was held for each resident or how it was administered. The registered persons must ensure that there is a clear record of all monies held by the organisation on behalf of residents and these records must be kept at the home, they must also ensure that any money held for individuals is kept in an account in the name of the service user to which it belongs. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely and comfortable environment and the home is clean and hygienic and free from offensive odours. EVIDENCE: A tour of the home was conducted and the home is laid out over 2 stories. There are six bedrooms one of which is en-suite, 2 bathrooms with WC and there is also a separate WC. There is a large kitchen and a large lounge/dining area. All areas of the home were clean and furniture and fittings were of good quality and homely in appearance. The service was clean and hygienic and there were no offensive odours. Residents spoken with were proud of their home and said that they were very happy living at Chestnuts. There is a separate laundry, which has washable floors and walls. There is a domestic washing machine that can wash clothing at appropriate temperatures. Residents do their own laundry and each resident has a set day, however they are able to use the laundry at any time if they need to. The home has an infection control policy and staff have received training in this area. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home needs to keep staffing levels under review to ensure that at all times there are sufficient staff on duty to meet the needs of residents. Staff employed at the home have the competencies and qualifications required to meet residents needs and they are supported by trained staff. EVIDENCE: The home employs a total of 4 care staff and they have all completed a minimum of NVQ level 2. There is no domestic staff employed at the home. The staff rota was looked at and this showed that there is a minimum of one staff member of duty at all times, we were informed that of the 4 care staff one is the registered manager and one is the assistant manager, this leave 2 other care staff and one of these is due to leave shortly. Although residents spoke with said that there was always a staff member around comments in a 2 surveys returned by residents said that they had to do some things with the other residents rather than stay at home because there was only one member of staff on duty. On the day of the inspection the homes manager was not available, therefore it was not possible to view recruitment records at this visit, as records were kept Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 20 locked away for confidentiality reasons. The inspector did speak with the assistant manager who said that all staff had undertaken suitable recruitment checks and the homes completed AQAA also confirmed this. There is a training co-ordinator employed by the organisation who provides training for all staff employed at the home. Staff undertake induction training, which is based on “skills for care” guidelines and is linked to NVQ, and this is completed within the first 6 weeks of employment. Mandatory training is carried out in; moving and handling, fire safety, medication, first aid, health and safety, food hygiene and infection control. Additional training is also carried out for managing challenging behaviour, continence, learning disability, care practices and NVQ training. Staff members spoken with and those that completed surveys confirmed that they had received a good induction and said that there was regular training sessions at the home. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of care staff is taking the manager and her assistant away from their management roles and this could potentially put residents at risk. The homes quality assurance procedures need to be further developed to ensure that the home seeks the views of residents and other interested parties are taken into consideration. The homes policies and procedures promote and protect the health safety and welfare of staff and residents. EVIDENCE: The manger of the home was not available at the time of the inspection, however she has been in post for over 3 years. The last inspection report stated that the manager was focussing on being “hands on” dealing with the Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 22 immediate needs of residents and this has not changed. The homes staff rota showed that the registered manager and the assistant manager were on the rota for caring duties and there were no management hours allocated for the registered manager or the assistant manager. The home has regular residents meetings and staff meetings once per month and these provide some information on how the home is meeting its aims and objectives, however the views of relatives and other interested parties such as care managers and health care professionals are not sought. Staff have received training in health and safety issues and policies were in place to support good practice. The homes fire logbook was up to date and the fire risk assessment was dated March 2007. Certificates were available for annual testing of equipment and services. Fire equipment was last tested on 2/4/08, Gas equipment tested in January 2008 and private electrical equipment on 23/1/08. Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 23 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 X 2 3 3 X 4 X 5 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 3 X Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 24 No 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 16(2)(l) 20(1)(a) Timescale for action To ensure that residents finances 31/07/08 are protected the registered persons must ensure that there is a clear record of all monies held by the organisation on behalf of residents including DLA payments. These records must be kept at the home; they must also ensure that any money held for individuals is kept in an account in the name of the service user to which it belongs. In order to ensure that the 15/06/08 needs of residents are met at all times the registered persons must ensure that there are sufficient numbers of staff on duty at all times to meet the needs of the residents and this must be kept under constant review. So that the home can measure 31/07/08 how well the service is meeting the needs of the residents – there must be an effective system of quality assurance that reviews the quality of the service at regular intervals. Requirement 2 YA33 18(a) 3 YA39 24(1)(3) Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 25 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 Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Chestnuts DS0000014446.V362289.R01.S.doc Version 5.2 Page 27 - 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!