Inspection on 17/10/06 for Coombe Hill And Blenheim Lodge Nursing Home

This inspection was carried out on 17th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Coombe Hill And Blenheim Lodge... 26/09/07

Coombe Hill And Blenheim Lodge... 31/01/06

Coombe Hill And Blenheim Lodge... 16/02/05

Coombe Hill And Blenheim Lodge... 07/09/04

Coombe Hill And Blenheim Lodge... 28/01/04

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Ashlong House

Norbury Crescent (30)

Henry Nihill House

Birchwood

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

The Infirmary

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

CARE HOMES FOR OLDER PEOPLE Coombe Hill And Blenheim Lodge Nursing Home 1-3 Adelaide Road Surbiton Surrey KT6 4TA Lead Inspector Margaret Lynes Key Unannounced Inspection 17th October 2006 10:15 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 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.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. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coombe Hill And Blenheim Lodge Nursing Home Address 1-3 Adelaide Road Surbiton Surrey KT6 4TA 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) 0208 399-3388 0208 399 8771 Titleworth Ltd Vacant Care Home 40 Category(ies) of Dementia - over 65 years of age (31), Learning registration, with number disability (9), Old age, not falling within any of places other category (31), Physical disability (9), Sensory impairment (40), Terminally ill (40) Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: Coombe Hill and Blenheim Lodge are situated close to Surbiton town centre. There are good bus and train links to surrounding areas and central London. The home is in a residential area and the River Thames is within fifteen minutes walking distance. The home offers care for persons who have physically disabilities aged eighteen and upwards, within a designated unit. Other categories of care provided for include learning disability, mental disorder and sensory impairment, along with nursing care. There are a variety of activities on offer for service users, such as cinema, shopping and day centres. The home has a heated exercise pool, although it is out of action at present. The home has a landscaped garden with areas where service users can talk with their family and friends in private or enjoy some solitary time. Visitors are welcome at any time. Overnight accommodation can be arranged by prior agreement for visitors. The Registered Persons have produced a Service User Guide, which includes information on the aims and objectives of the service. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over the course of some 9 hours, and consisted of examination of documentation, a tour of most parts of the premises, discussion with service users and meeting with some of the staff. All of those who assisted in the Inspection are thanked for their efforts and input. The previous, unannounced inspection, which took place in December 2005, indicated that just two of the eight requirements made at the home’s main inspection earlier that year remained unmet. They related to the need to ensure that all medication documentation was up to date; and the need to ensure that regular checks (by a competent person) of the portable electrical equipment could be evidenced. On this visit, it was determined that both of these outstanding requirements had been met. This inspection resulted in 15 new requirements being made. What the service does well: What has improved since the last inspection? What they could do better: Given that this visit has resulted in 15 new requirements, there are clearly some areas where improvement can be made. These new requirements relate to the need to improve pre-admission assessments and health care documentation; to ensure all staff treat service users with respect; the need to ensure the home conforms to fire safety standards; the need to ensure that the premises remain as free from risk as possible; the need to effect some relatively minor repairs to the home, and ensure all areas are free from odour; the need to review staffing levels, staff training and staff recruitment. As mentioned overleaf, while this list seems substantial, it should also be noted Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 6 that the failings in these areas, in the main, only related to isolated examples. The issue of most concern relates to the lack of qualified staff on duty. This needs to be rectified as a matter of urgency. 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. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.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 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. It was felt that while most of the pre-admission documentation was satisfactory, this could not be said for all of this vital paperwork. This means that it is feasible that service users will be offered a place without having had their individual needs fully assessed. This in turns means that the home may not be able to meet all of the needs identified post-admission. EVIDENCE: The files of six service users were examined. All but one contained adequate pre-admission information. The one file that was not deemed satisfactory did contain an in-house pre-admission assessment form, but it had contained little information. In order to prevent any further upheaval for service users, it is beholden on the home to ensure that it has sufficient information about a potential client before a placement is made. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. It was felt that the service user plans examined satisfactorily set out each resident’s individual health, personal and social care needs. This means that the care team should be fully aware of the specific care to be given, and service users can be reassured that the staff team are aware of their needs. The lack of correlation between some of the health care records (with particular regard to residents’ weight) meant that the Inspector could not evidence that all steps were being taken to ensure the well-being of those service users whose weight notably decreased over a relatively short period of time. The medication records for Blenheim Lodge were examined and found to be in order. This means that staff are adhering to the medication policies and procedures and thus protecting service users from possible adverse effects of wrongly administered drugs. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 10 Although generally staff were seen to liaise with service users in a pleasant, friendly and respectful manner, there were two occasions where the Inspector felt that service users were not treated with as much respect as they should have been. EVIDENCE: The care plans for six service users were examined. Each one had been individually written and adequately covered the personal, health and social care needs of the resident concerned. While most of the health documentation was well recorded, well presented and detailed, it was noted that in some instances service users had lost a notable amount of weight over a relatively short period of time, and there was no evidence as to what action had been taken to investigate this. While staff were able to more than adequately describe what they had done, this action must be evidenced in writing. It was also noted that one of the files inspected did not contain a pressure area assessment. Staff acknowledged that this was an oversight. At the last inspection it was noted that once again the medication records were inaccurate. On this visit however, the records that were examined were found to be correct. As mentioned overleaf, the staff team were seen to interact with the service users in a friendly, pleasant and familiar manner. There were two instances however, when the Inspector felt staff were not as respectful as they could have been. One occasion related to a carer standing over a service user to feed them at lunchtime, rather than sit down with them; while the second incident related to a carer coming up behind a service user and suddenly start to wheel them out of the lounge – without any explanation or warning, and while the service user was in conversation. Although these were isolated incidents, it is nevertheless important that all carers are aware of the need to act in an appropriate manner at all times. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. As was mentioned in the inspection report for the previous year, the home provides a variety of activities, both internally and externally. These appeared to satisfactorily meet the needs of the service users – both recreationally and spiritually. Visitors are encouraged to call. The lunchtime meal was observed and appeared to be well prepared and appetising. With one exception service users said that they found the food to be good. EVIDENCE: The home has a mix of younger and older residents, and this mix appears to work well. The former group has its own distinct unit but they are occasionally to be found sitting in the main communal area with the older residents. As was mentioned in the summary to this report, particular attention was paid to Blenheim Lodge on this visit, and it was pleasing to note the efforts made to encourage and support the residents to be independent and foster personal and social relationships. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 12 Although the food was not sampled on this visit the Inspector was able to surreptitiously observe the midday meal. It was well presented and it was pleasing to note that in almost every instance (see comments re Standard 10) staff displayed patience and understanding when helping residents with their meal. There was just one dissenting voice with regard to the food provided. The comments from this particular service user were passed on to the senior staff (with the service user’s agreement). Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. 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 in place adequate policies and procedures with regard to complaints and adult protection. This means that provided they are followed, they should offer protection to service users, and reassurance to them and their families/friends that any complaints will be appropriately dealt with. EVIDENCE: There have not been any recorded complaints since the last inspection. It was noted in the complaints procedure that the wrong address for the local CSCI office had been given. It would be helpful if this could be amended. There has been one adult protection issue since the last inspection. This did not relate to concerns about the home per se, but rather to external influences that the home were concerned could have a negative effect on a service user. The home ensured that all appropriate avenues were examined, and the necessary adult protection referrals made. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 14 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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was generally well-maintained, clean, and homely. This means that it was felt that the home offered a safe environment for its residents. EVIDENCE: A tour was made of most of the building. Generally it was found to be clean, well furnished, warm and comfortable. Some four requirements have been made with regard to the environment. These are all relatively minor issues and the home should have no difficulty in meeting them. There was an odour noted in two of the bedrooms, but otherwise the home was found to be pleasant and hygienic. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 15 The home is well-adapted to cater for the needs of its residents, and although the hydrotherapy pool was temporarily closed, this is an enviable facility. The unit catering for the younger adults was adequately equipped so as to enable them to move about as freely and independently as possible. On walking around it was noted that there were a considerable number of bedroom doors wedged open – generally with a rubber wedge, but in one instance with the foot rest from a wheelchair. This is contrary to fire safety and will be further referred to in Standard 38. It was also noted that a number of the emergency call bell cords were very short and thus not easily reached. It would be a simple matter to replace the cords. Again – this will be referred to in Standard 38. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 16 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): 27-30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Analysis of (1 week) of the rota indicated that the number of qualified nurses on duty consistently fell below that expected in a home of this size. It was also again noted that some staff work excessively long shifts. This means that service users are being placed at unnecessary risk due to the lack of nurses. It also means it is unlikely that carers working the long shifts can provide a continuously good level of service, which in turn means that mistakes are more likely to be made. The home has not, of late, been able to maintain its level of training for staff, which means that it is feasible that the care provided to service users is not quite of the quality it could be. After examination of a number of staff files, the Inspector felt that service users were not being adequately protected by the home’s recruitment procedures. EVIDENCE: The rota examined showed that there were two qualified nurses on the morning shift, with one on duty in the evening and one at night. In a home of Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 17 this size the expectation would be that there would be 3 qualified nurses on duty in the morning, and two on during the afternoon/evening and at night. While on all but one shift the number of carers was acceptable, these numbers were sometimes made up by staff working 13 hour shifts. This has been commented on in previous reports and while senior staff do their utmost to ensure that the staff working these long shifts take adequate breaks, it cannot be considered good practice to have staff regularly work such lengthy hours. Due to the departure of the registered manager, who was also responsible for staff training, the human resources officer freely acknowledged that some work needed to be done to get training for staff back on track. This would include the introduction of a Skills for Care based induction programme, and the pursuit of NVQ courses so that the percentage of staff with this latter award could begin to approach that expected of homes by the end of last year. The staff files examined showed that all of the staff in question had commenced work with just a POVA 1st, and that the home had not waited for the full CRB disclosure to be returned. While the Commission acknowledges that there may be extreme instances where the well-being of service users will be put at risk if a new member of staff cannot start work, this practice is not recommended. It was also noted that the files examined did not contain a declaration of health, neither did they contain a recent photograph. One of the files was also found to only contain one (instead of the required two) written references. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 18 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): 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. As the home is currently without a Registered Manager it was not possible to assess Standard 31. Quality assurance systems were in place to monitor the performance of the home. This means that the registered person and the care team are able to determine where improvements are needed, which results in a service that is being run in the best interests of the service users. Service user finances were looked after by senior staff, with the computerised records being accessed only by one specific senior. In this way service users financial interests were safeguarded. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 19 Due to issues regarding fire safety and the inaccessibility of some of the emergency call bells, it was not felt that the health, safety and welfare of both service users and staff was being fully promoted and protected. EVIDENCE: The home has a number of systems in place to monitor the overall quality of the service provided. These include fortnightly discussion with each of the service users to determine their satisfaction with their room, the food/drink provided, nursing and general care, activities, the home in general, time to bed/rising time and to ask if they felt anything could be improved. Records relating to service user finances are maintained on a computer. The senior staff can provide any service user with petty cash, which is then reconciled with their account. Where items have been purchased on residents’ behalf, staff are expected to, and do, provide receipts. The last inspection report contained a requirement to evidence that portable electrical equipment had been regularly maintained. This requirement has now been met. With the exception of the fire alarm and emergency lighting tests, the other maintenance documentation that was inspected on this visit was satisfactory. The fire alarm tests were only apparently being carried out at infrequent intervals, and not even once a month. The fire safety logbook states that the emergency lighting will be tested monthly – however the last test was in July. The Commission expects emergency lighting to be checked on a regular basis, however it is also felt that the home should follow its own procedure. It is expected that the fire alarms be tested weekly. As has been mentioned earlier, a considerable number of bedroom doors were found to be wedged open. This is contrary to fire safety, and should a service user wish their door to remain open then the registered person must arrange for appropriate devices to be fitted. It was also noted that some of the emergency call bell cords were either very short or not in evidence. Staff explained that some of the service users would not be able to use a call bell, and thus the cords were removed for safety. They were advised that if this were the case then it needed to be documented in the relevant care plans/risk assessments. Where there are cords, those that are very short and thus not easily reached need to be replaced. It had previously been noted at this home that some substances hazardous to health had been left in reach of service users. A lock was subsequently fitted to the storage cupboard. On this visit, however, the lock was not in use, thus negating its presence. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 20 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 2 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 2 X X X X X X 2 STAFFING Standard No Score 27 1 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 1 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 21 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 OP3 Regulation 14 Requirement The registered person must ensure that all new service users are fully assessed prior to admission. The registered person must ensure that staff evidence all action taken with regard to service users health issues. The registered person must ensure that all service users have a documented pressure area assessment. The registered person must ensure that the staff team treat all service users with respect at all times. The hole in the wall behind the door in bed F4 needs to be repaired. All bedrooms should be fitted with a bedside lamp (unless there is a health & safety reason as to why this is not appropriate. This then should be documented in the service user’s risk assessment). The door to bedroom F9 needs adjusting so that it can open/close freely. DS0000026251.V316719.R02.S.doc Timescale for action 17/10/06 2 OP8 13 17/10/06 3 OP8 13 17/10/06 4 OP10 12 17/10/06 5 6 OP19 OP19 23 16 17/11/06 17/12/06 7 OP19 23 17/11/06 Coombe Hill And Blenheim Lodge Nursing Home Version 5.2 Page 22 8 9 OP26 OP27 16 18 10 OP29 19 11 OP30 18 12 OP38 23 13 14 OP38 OP38 13 13 15 OP38 23 All parts of the home must be kept free from offensive odours. The registered person must ensure that the home is sufficiently staffed at all times, and that staff do not routinely work excessively long shifts. The registered person must ensure that new staff provide all of the documentation listed in the Regulations. The registered person must ensure that staff have access to training relevant to their work, including a suitable induction and NVQ courses. The registered person must ensure that bedroom doors are not wedged open. If the occupant wishes their door to be kept ajar, then a suitable, approved, door-closing device must be fitted. The registered person must ensure that all emergency call bell cords are within easy reach. All staff must ensure that the cupboard housing COSHH substances is kept locked at all times. The registered person must ensure that fire alarm tests are conducted weekly, and that emergency lighting checks are carried out in accordance with the homes own procedure. 17/10/06 17/10/06 17/10/06 17/12/06 17/11/06 31/10/06 17/10/06 17/10/06 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 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 23 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V316719.R02.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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