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Inspection on 30/01/07 for Cheswardine Hall Nursing and Residential Home

Also see our care home review for Cheswardine Hall Nursing and Residential Home for more information

This inspection was carried out on 30th January 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This service is very good at communicating with and listening to service users to find out what their needs are, how they would like their care to be provided and frequently reviewing the service provided to make sure it is still meeting their needs. Staff build professional relationships with service users, their families and supporters. They place responding to individual needs high on the list and tailor their training plan to meet them. The home has a sustained track record of good performance in all key national minimum standards. Service users who were able to comment stated that the staff looked after them well.

What has improved since the last inspection?

A programme of refurbishment has commenced on one of the floors. It is considered that this home is currently performing well, setting its own objectives for continual improvement.

What the care home could do better:

The manager/owner fully acknowledged the need to amend the service user guide and service user contract to meet the amended Regulations 2006. It must include the current fee levels and state whether the terms and conditions (including fees) would be different in circumstances where a service user`s care is funded, in whole, or part, by someone other than the service user. The statement of terms and conditions also needs to include the fee when a third party is paying in whole or part.The manager should record the outcome of verbal references pending receipt of written ones. The home must implement and maintain its quality assurance system which describes the extent to which the views of service users and their representatives (anonymous or otherwise) are taken into account. Through consultation the service could demonstrate that it learns from mistakes and plans for improving the service where shortfalls have been identified.

CARE HOMES FOR OLDER PEOPLE Cheswardine Hall Nursing And Residential Home Cheswardine Market Drayton Shropshire TF9 2RJ Lead Inspector Pat Scott Key Unannounced Inspection 30th January 2007 09:45 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 Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.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. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cheswardine Hall Nursing And Residential Home Address Cheswardine Market Drayton Shropshire TF9 2RJ 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) 01630 661316 01630 661316 stephen@cheswardinehall.com Mr Stephen George Poole Mrs Anne Poole RN Mrs Anne Poole Care Home 48 Category(ies) of Dementia (1), Old age, not falling within any registration, with number other category (26), Physical disability (21) of places Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 48 service users, of whom up to 48 may be Older Persons, 21 may be persons with a Physical Disability, and 1 may be suffering from Dementia. The home must comply with the Staffing Notice as issued by the Shropshire Area Health Authority dated 18th August 1994. 24th January 2006 2. Date of last inspection Brief Description of the Service: Cheswardine Hall was built about 1880 in the style of a large country house, set in beautiful private grounds with a small lake. The Home provides residential and nursing care for a maximum of 48 older people. It is owned and managed by Stephen and Anne Poole, both of whom take an active part in the daily operation of the Home. The Home’s furniture, décor, fixtures and fittings reflect the character and opulence of the house. Cheswardine Hall makes its services known to prospective service users in: The Statement of Purpose and information pack which also contains the inspection report. Fee rates are reviewed annually and service users are notified one month in advance. Additional charges to service users are clearly detailed within the information and the terms and conditions. Current fees range from £480-£830. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: quality audits, staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the owners, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? What they could do better: The manager/owner fully acknowledged the need to amend the service user guide and service user contract to meet the amended Regulations 2006. It must include the current fee levels and state whether the terms and conditions (including fees) would be different in circumstances where a service user’s care is funded, in whole, or part, by someone other than the service user. The statement of terms and conditions also needs to include the fee when a third party is paying in whole or part. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 6 The manager should record the outcome of verbal references pending receipt of written ones. The home must implement and maintain its quality assurance system which describes the extent to which the views of service users and their representatives (anonymous or otherwise) are taken into account. Through consultation the service could demonstrate that it learns from mistakes and plans for improving the service where shortfalls have been identified. 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. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.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 Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Key Standard 3. Key Standard 6 is not applicable to this service National Minimum Standards 1.2 Prospective service users and their representatives have most of the information needed to choose a home which will meet their needs They have their needs assessed and a contract which tells them about the service they will receive. EVIDENCE: Prospective service users are given the opportunity to have a trial period of time in the home. The manager/owner provides them with information and helps them to feel comfortable in their surroundings. A service user commented that they had been able to ask about life in the home. They stated they had been made to feel very welcome and treated as an individual. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 9 Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective service user. Records show that the staff team are qualified and experienced to work with the needs of the service users. Documentation and training logs also show that specialist areas of work have been explored and that staff have access to detailed guidance and training materials. E.g. Updates in palliative care are regularly arranged. The home provides a statement of purpose (SOP) that clearly sets out the objectives and philosophy of the service supported by a service user guide that summarises the SOP and provides good clear information about the home. The guide is precise in what the prospective service user can expect and gives a good detailed account of the quality of the accommodation, qualifications and experience of staff, how to make a complaint and recent CSCI inspection findings. It does not yet comply with the changes in the Care Home Regulations as amended in September 2006. It must include the current fee levels and state whether the terms and conditions (including fees) would be different in circumstances where a service user’s care is funded, in whole, or part, by someone other than the service user. One service user was spoken with who had previously been in the home for respite care. She had since become a permanent service user and stated that she had wanted to stay and that the transition to long-term care had been made as easy as possible. She stated that the terms and conditions of residency had been clearly explained to her. Admissions are made to the home after a full needs assessment has been undertaken. The home is then able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the statement of purpose. For people whom are self funding and without a care management assessment the assessment is always undertaken by the manager/owner. Evidence seen in care files confirms that the assessment is conducted professionally and sensitively and has involved the family or representative of the service user. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Key Standards 7.8.9.10 The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: From talking to staff and management the service has a strong belief that it is essential to involve service users in the planning of care that affects their lifestyle and quality of life. Each service user has a plan that has been agreed with them. The plan also includes a risk assessment element. Service user comments include: “I am well looked after, the staff are very friendly”, “When I wake up in the morning I have my breakfast in my room and I don’t get dressed until I am ready to do so. Staff respect this”. The home ensures that each service user’s plan is reviewed regularly and involves the service user and family where feasible. The plan is updated and the necessary action taken to respond to any changes. Service users receive Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 11 clear feedback on all decisions and actions that affect the placement and their individual care. The service is aware of current policy issues and topical reviews of care for older people, and works to transfer this into the daily work with residents e.g. the home liaises with the hospice. Service users have right of access to health and remedial services. Staff make sure that those service users who are fit and well enough, have regular appointments and visit local health care services, supported by family, care staff or volunteers. The health care needs of those service users too frail to leave the home are managed by visits from local health care services. Service users’ personal aids are well maintained and the home provides the necessary aids and equipment to support both staff and service users in daily living. Service users have individual health care plans that give a comprehensive overview of their general health and acts as an indicator to changing health needs. Service users have the choice to shower or bath when they wish, and are supported and facilitated to be independent in their personal hygiene. Care staff are trained to meet the health care needs of the service users and have access to training in health care matters. The home works to an efficient medication policy supported by procedures and practice guidance. Quality audits conducted by the manager confirm that practice reflects policy. The aims and objectives of the home reinforce the importance of treating service users with respect and dignity and these values were seen to be applied to all aspects of their life and are fundamental to the philosophy of care of the home. Attention is given to ensuring privacy and dignity when delivering personal care. Recruitment of staff takes into consideration the need to employ a varied and balanced staff group. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. 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. All Key Standards Service users are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet service user’s expectations. Service users receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: The routines of the home are planned around the service users needs and wishes. Systems enable the service to be flexible and changed to meet individual wishes. Service users spoken with had the confidence to discuss what makes them happy and comment where improvements can be made. The home takes service users daily feedback seriously and makes changes where possible. Staff were seen to listen to service users and make considerable effort to provide a flexible service, which enables them to enjoy a better quality of life. Sufficient staff resources are provided to allow time for activities and stimulation. Some group activities take place but there is also an emphasis on one to one time. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 13 When service users have particular interests every effort is made by staff to help the service user maintain their interest and keep up any community involvement. Service users stated that family and friends feel welcome and know they can visit the home at any time. Staff were seen to make time to talk to visitors. The design of the home provides seating areas within the communal areas of the home where service users can entertain their visitors, in addition to the privacy of their own room. It is clear that the home encourages individuals and groups from the community to visit the home. The home is able to offer service users information and telephone numbers for contacting independent people who will act as advocates on the service users’ behalf where the service user prefers the help of an independent person. Service users have the choice to bring an amount of small goods with them on admission to the home and are encouraged to keep personal items which are important to them in their own room. The home believes that service users should always be aware of any information held and written by the home, and have the right to read any documents they wish and staff try to promote this. An experienced cook is responsible for providing quality nutritional meals that meet the dietary needs of the service users. Service users enjoy the flexibility of meal arrangements and enjoyed being able to eat in their own room if they wished. Regular drinks are available and staff will always make a cup of tea at any time when asked. Service users spoken with stated that the quality of the meals is very good. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. 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. Key Standards 16.18 Residents have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. EVIDENCE: The service has a complaints procedure that is up to date, clearly written, and is easy to understand. Service users spoken with said they would know who to talk to if they wanted to make a complaint. No concerns have been raised within the home since the last inspection. Training of staff in the area of protection is regularly arranged by the home. Service users state that they are very satisfied with the service provision, feel very safe and well supported by staff that have their protection and safety as a priority. The promotion of the individual’s rights is central to the aims and objectives of the service. The home’s documentation refers to the rights of the individual. Staff are skilled and understand the importance of actively promoting individuals rights. Systems are in place to ensure that service user’s rights are respected and enjoyed by service users in all areas of their life. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Key Standards 19.26 The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The owners and staff encourage service users to see the home as their own home. It provides a very well maintained, safe, comfortable, attractive home which has all the specialist equipment and adaptations needed to meet individual service users’ needs. As well as a good selection of general aids such as hoists and variable height beds, the home also ensures that equipment is individualised for each service user and all staff members are trained in the safe use of aids and equipment. Records show that service users are assessed for their need to have equipment or aids before they move into the home and these are provided to Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 16 them on admission. There is evidence in the care plans that the home meets the changing needs of service users promptly. The rooms are very well planned and have on-suite facilities and are above the average size. The fixtures and fittings are of a high quality, well maintained and adapted to meet the wishes of the present service user. Service users seen in their rooms stated that they were satisfied with the cleanliness and décor. There is a selection of communal areas, this means that service users have a choice of place to sit quietly, meet with family and friends or be actively engaged with other service users. The bathrooms are comfortable and easy to use and include a selection of different ways to bathe, for example assisted and unassisted showers and baths and there are a number of toilets strategically placed around the home. The home was well lit, clean and tidy and smelt fresh. Clinical waste is properly managed and stored. Call bells are left within reach of residents and these are responded to promptly. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. 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. All Key Standards Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. EVIDENCE: Services users commented that they have confidence in the staff that care for them. Management encourage staff members to undertake qualifications and recognise the benefits of a skilled, trained workforce. Mandatory training is provided following employment which is recorded within staff personal files. The service has a good recruitment procedure that clearly defines the process to be followed. This procedure is generally followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of service users. One staff recruitment file was seen which was still awaiting written references although the manager/owner stated that verbal ones had been received. The outcome of this was not recorded. Another file showed that all checks had been carried out before the person commenced employment at the home. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 18 One recent member of staff recruited confirmed that the service was clear about what was involved at all stages and was robust in the following of its procedure. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. 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. Key Standards 31.33.35.38 The management and administration of the home is based on openness and respect. Implementation of its quality assurance system will confirm that practice reflects the policies, procedures and guidance of the home. EVIDENCE: The service has a good record of meeting relevant health and safety requirements and legislation and conducts its own audits to ensure compliance with policies e.g. medication. Records are of a good standard and are routinely completed. Fire records were sampled and were in order. The service has a formal system to provide a quality assurance and monitoring process through service users satisfaction questionnaires and feedback. However, there is no evidence that this formal process has taken place. The owners are present on a day to day basis and converse with service users Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 20 regularly about the service in the home. Service users spoken with said that they have a good rapport with the owners. By implementing their quality assurance system and recording the outcomes, the provider will be able to demonstrate that it learns from mistakes and plans for improving the service where shortfalls have been identified. The home has all the necessary insurance cover in place to enable it to fulfil any loss or legal liabilities. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 4 X 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 2 X 3 X X 3 Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 5A Requirement Timescale for action 31/03/07 2 OP2 51(b) 3 OP33 24(1)(2)( 3)(4)(5) SI No. 1493. The Care Standards Act 2000 (Establishments and Agencies)(Miscellaneous Amendments) Regulations 2006. The registered person shall amend the service user guide to provide the detail required by the amendment Regulations 2006. SI No. 1493. The Care 31/03/07 Standards Act 2000 (Establishments and Agencies)(Miscellaneous Amendments) Regulations 2006. The registered person shall include the fee level in the terms and conditions where a service user’s care is funded in whole or in part by someone other than a service user. SI No. 1493. The Care 31/07/07 Standards Act 2000 (Establishments and Agencies)(Miscellaneous Amendments) Regulations 2006. The registered person shall implement and maintain its established quality assurance system. The system shall provide for consultation with service users and their representatives. Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.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. 1 Refer to Standard OP29 Good Practice Recommendations The outcome of verbal references should be recorded. Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.R01.S.doc Version 5.2 Page 25 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 Cheswardine Hall Nursing And Residential Home DS0000022241.V296971.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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