CARE HOMES FOR OLDER PEOPLE
Cotswold House 178 Cotswold Avenue Duston Northampton Northants NN5 6DS Lead Inspector
Mrs Pat Harte Unannounced Inspection 13th April 2006 09:30 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 Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Cotswold House Address 178 Cotswold Avenue Duston Northampton Northants NN5 6DS 01604 751436 01604 591506 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.northampton.gov.uk Northamptonshire County Council Mrs Gabriella Katrina O`Keeffe Care Home 42 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (42), of places Physical disability over 65 years of age (5) Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. No person falling within the OP category can be admitted where there are already 42 people of OP category already in the home No person falling within the DE (E) category can be admitted where there are already 20 people of DE (E) category already in the home No person falling within the PD (E) category can be admitted where there are already 5 people of PD (E) category already in the home To be able to accommodate 1 named service user who has needs within the MD (E) category. Total number of service users in the home must not exceed 42 Date of last inspection 5th October 2005 Brief Description of the Service: Cotswold House is a residential care home providing personal care for up to 42 Elderly Residents, including 20 people with Dementia and 5 people with Physical Disabilities. The Home has an additional specific condition to provide care for 2 existing Residents with Mental Disorders. The Home is owned by Northamptonshire County Council and the Manager is Mrs. G. OKeefe. The Home is situated in a residential suburb of Duston in Northampton close to nearby shops and easily accessible by public transport. The Premises consist of a 2-storey building providing lounges/dining rooms and bedroom areas on both floors. The first floor is accessible by a lift. Single bedrooms are provided for all Residents. Residents are enabled to enjoy safe garden areas. The Home provides permanent care only and has two units specifically dedicated to the care of Residents with Dementia. The fees charged at this home are £330 per week. Extra charges are made for Hairdressing, Chiropody, newspapers and Toiletries. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. Inspection planning took one day and consisted of a full review of the Inspection record, requirements made, the Homes service history record including notifications of accidents, events and incidents, previous Residents and relatives comments received, the action plans submitted by the Provider and Manager and correspondence and contacts between the Commission and the Home. The information was collated and analysed to form the plan of inspection focusing on the outcomes for Residents. The primary method of inspection used was ‘case tracking’ which involved selecting three Residents and tracking the care they receive through review of their records, talking with them and the care staff. In addition ten Residents, six staff, two Relatives and one visiting Community Nurse, were spoken with and care practices were observed. A partial tour of the premises took place and a selection of records was inspected. Discussions were held with the Registered Manager. The Inspection took place during the morning and afternoon over a period of 6 hours and was carried out on an unannounced basis What the service does well:
The Home has a stable staff group who demonstrated their commitment to the well being of their Residents. Staff turnover is low and this means that together with the deployment of regular staff to dedicated units familiar staff are on hand to provide care for the Residents. Residents spoke very highly of the staff commenting that they were very caring, helpful and on hand to quickly respond to their needs. Residents commented on and observations confirmed that relationships between themselves and the staff group were very good. The Home’s assessment process ensures that all prospective Residents are visited and a thorough assessment carried out to that the needs of anyone admitted to the Home can be met. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 6 Staff ensure that Residents are fully involved in their care planning, including Residents with Dementia, and that respect is shown to their wishes and preferences on how the care is to be provided. The care planning process takes account of any racial, cultural or religious needs so that arrangements can be made to respect and uphold Residents wishes. Residents’ Health care needs are carefully monitored and they are enabled to see their relevant medical professionals promptly and in private. Residents confirmed that they are aware of the home’s complaints procedure and are confident to raise any issues or concerns with staff or the Manager. There have been no complaints since the last inspection. Routines were relaxed and flexible and Residents had choice in how and where they wished to spend their time. Residents’ comments included “I can get up and go to bed as I did at home” “ I can spend my time in my room if I wish.” “If I don’t feel like joining in activities I don’t have to”. Observations confirmed that staff took care to protect Residents’ dignity and privacy by ensuring personal care tasks were carried out in private. Residents commented that staff took care to ease any embarrassment and make them comfortable when intimate tasks such as bathing were carried out. Residents’ records showed that they were encouraged to remain as independent as possible and do things for themselves. Care plan instructions reminded staff that Resident’s with Dementia must be consulted, involved in and assisted to make decisions such as choosing the clothes they wished to wear. Residents’ comments on the food provision were very positive. They felt that they were provided with a good range of meals, choices were available and the catering staff were fully aware of their dietary needs and likes and dislikes. The serving of the midday meal was efficient and Residents were given help by staff where necessary to eat their meals. Records showed that weight is monitored and staff note daily nutritional intake to ensure any problems are quickly identified. Residents’ religious persuasions are respected and arrangements are made for them to receive visits from their relevant clergy in order that they may fulfil their religious observances. Residents are provided with a safe and comfortable environment and have freedom of movement including into safe garden areas. The systems for safekeeping Residents’ moneys, where necessary, were well maintained and receipts for items or services purchased by staff on behalf of Residents were carefully maintained. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 7 The Home’s Medication systems are well managed and medication is safely stored. Residents can continue to manage their own medication if it safe to do so. 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. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 8 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 Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective Residents are provided with information to enable them to make informed choices regarding their placements. The pre-admission assessment is thorough and effective in ensuring that the needs of people admitted to the home can be met. EVIDENCE: The Home’s Statement of Purpose and Service User Guide was reviewed in January 2006 to reflect a change in conditions to increase the number of places for People with Dementia care needs from 17 to 20. A new Resident spoken with confirmed that the information was supplied to her as part of the assessment process and was of help to her in making her decision to take up her placement. The admission process ensures that all prospective Residents are visited and assessed by staff from the Home to identify their individual needs and ensure that these can be met. Residents and their relatives have opportunities to visit
Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 10 the Home prior to their admission and have opportunities to discuss their needs, view the accommodation and talk with Residents and staff. Staff spoken with felt that they were given good information on their Residents needs, routines and wishes in readiness for their admission. Individual records are kept for each of the Residents and inspection of a new Resident’s records showed that the assessment process has been revised to ensure a good level of detail on the individual’s needs. Specific and recognised assessment tools are used to identify needs and risks as part of the assessment process. Records showed that Residents are provided with written contracts with copies maintained in their files. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved and consulted in their care planning. The plans provide detailed information, guidance and instruction to staff on how the individual needs are to be met with due respect paid to individual Residents’ preferences and wishes. EVIDENCE: Records showed that all the Residents care plans have now been updated to the new format introduced last year. The plans showed that care is taken to record all needs and provide staff with a good level of instruction and guidance as to how the care is to be carried through. Residents spoken with confirmed that staff involve them in the development and reviewing of their individual care plans. They confirmed that their personal lifestyle wishes were respected and that they were enabled to do things for themselves. Records showed that the timings for their preferred routines were written into the plans in the first person for example “I like to get up at
Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 12 7.00am”and “I like the staff to check on me at night”. They commented that they felt they were respected and valued as individuals by staff. Care plans also detailed tasks that Residents’ could undertake for themselves showing that they were encouraged to retain as much control over their lives and maintain their independence as much as possible. Two units within the Home are dedicated to Residents with Dementia care needs; the second unit is now ready for occupation. Dedicated, trained staff are assigned to the units to provide continuity and consistency of care and ongoing monitoring and supervision. Dementia care planning has progressed with attention paid to ensuring information gathering on Life Histories to aid staff in understanding needs and enabling them to communicate more effectively with their Residents within the timeframes of individuals. The plans again reflected consultation with individuals and showed the support needed to assist them to manage their frustrations and anxieties caused by memory loss. Records and comments from a visiting Community Nurse and Residents showed that staff react quickly to any changes in health care needs and make prompt referrals to the relevant professionals including Dentists, Chiropodists and Opticians. Residents confirmed that they were able to receive visiting medical professionals in private. The Community Nurse commented that she felt a part of the overall staff team and relationships were observed to be very good. The Home’s Medication system was well maintained with the appropriate procedures in place. The required records for incoming, administration and disposal of medication were in good order. Medication storage was safe and appropriate. Observations confirmed that staff ensure the protection of Residents privacy and dignity when carrying through personal care tasks. Sensitive attention is paid to ensuring that Residents’ wishes following death are known and documented. The Home can provide care for Residents who are dying whilst their needs can be met with the support and assistance of the Community Nursing services. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to maintain their independence as much as possible and exercise control and choice in the way they wish to lead their lives. EVIDENCE: Residents stated that routines were relaxed and flexible. They commented and observations confirmed that they were free to decide on how and where they wished to spend their time. The care plans detailed tasks that Residents could undertake for themselves showing that they were encouraged to maintain as much independence as possible. Residents were satisfied with the Home’s activity programme. Activities are provided on both a group and individual basis and include games, craftwork, quizzes and general entertainment. Residents commented and observations confirmed that staff spend time talking with them both on a group and individual basis. The development of activity programmes for Residents with Dementia is ongoing. Advice was given to creatively view behaviours to see if meaningful
Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 14 activities for individuals could be developed. For example it was clear that one Resident was used to washing her own clothes but as these were taken for laundering she had no opportunity for doing her own washing and therefore rewashed returned laundry. With support the Resident could be helped to do some of her own washing to bring her a greater sense of satisfaction and achievement as well as developing, for her, a meaningful activity. The Home has an open visiting policy. Residents confirmed that they were enabled to receive their visitors in private if they wished. Visiting Relative spoke of always being made welcome and extended hospitality. They stated that staff made time to discuss their Resident’s care needs and commented that they were kept well informed of any changes or concerns. Residents were satisfied with the food provision. They felt that staff respected their dietary needs and individual likes and dislikes and they stated that they were provided with a good range of choice. Observations of the mid day meal confirmed that the meal was nicely presented, efficiently served and that staff were on hand to assist Residents where necessary. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Home has effective systems in place to ensure complaints are listened to, investigated and acted upon and to ensure that Residents are protected from abuse. EVIDENCE: Residents confirmed that they had been given the Home’s complaints procedure which is also displayed in the Home. Those spoken with felt confident and able to raise any issues or concerns with staff. A complaints record is maintained. There have been no complaints since the last inspection but previous records show that complaints are taking seriously investigated with action taken to improve the service where necessary. Residents are registered on the Electoral roll and are given assistance to exercise their voting rights. Robust procedures for the Protection of Vulnerable Adults are in place. Staff have been provided with training in this area and demonstrated, through discussions, their full understanding of the reporting procedures. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a warm, safe, clean, comfortable and wellmaintained environment suitable for their needs. EVIDENCE: The Home has on going programme of maintenance and redecoration. Since the last inspection attention has been paid to enhancing security with the replacing of the fencing to the service area at the rear of the Home. Double handles have been fitted to all fire exists to prevent Residents with Dementia leaving the building unnoticed. Residents confirmed their satisfaction with the facilities stating that the communal accommodation was comfortable and homely. They were also satisfied that their rooms were comfortable and suitable for their needs. Observations and Residents’ comments confirmed that they are enabled to
Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 17 personalise their rooms as they wish and have their furnishings and belongings about them. Residents have access to garden areas, two of which are safely fenced so that Residents with dementia can access them whenever they wish. Standards of domestic and hygiene maintenance were good and the Home was warm, clean and comfortable. Observations confirmed that Toilet and Bathroom areas were hygienically maintained. Observations and discussions with staff showed that appropriate equipment and aids are obtained. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of trained care staff are deployed to meet the needs of current Residents. Recruitment procedures are robust and afford protection to the Residents. EVIDENCE: Residents spoken with said that the all the staff, including ancillary staff, were very kind and caring. They felt that staff understood their needs and were committed to their well being. Rotas showed that currently 5 care staff are deployed between the hours of 7.30 am to 9.30 pm with 3 carers on duty overnight. With the opening of the second dedicated Dementia care unit the number of staff on duty on daytime shifts is due to rise to 6. The deployment of staff to specific areas of the Home ensures that Residents have consistency and continuity of care from familiar carers. This enables Residents with Dementia care needs to become familiar with their carers and ensures that Residents are supported and monitored. Observations confirmed that staff responded quickly to the needs of their Residents and relationships and interaction were viewed as good. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 19 In addition to the care staff, domestic and catering staff are employed together with a Handyman. The ancillary staff provision ensures that care staff are not diverted from their care duties. Two staff members records were inspected and showed that the required clearances had been undertaken and references had been obtained prior to them commencing employment. Records of staff induction, foundation and ongoing training and updates are maintained. Records indicated that regular updates are undertaken in core areas and staff dedicated to the care of Residents with Dementia needs have received training. 60 of the staff group have now attained a relevant National Vocational Qualification. The Manager has recently reviewed the induction process in line with the Sector Skills Council guidance and has incorporated into the process training to aid staff understanding of racial, cultural and diversity needs. For example the training refers to respecting cultural / dietary practices for different races and respecting and enabling observances for different faiths. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Management of the Home is effective and in the best interests of the Residents. Safe systems are in place for the management of Residents monies and items held for safekeeping. EVIDENCE: The Manager demonstrated her ongoing commitment to maintaining the required Regulations and Standards and ensuring the Home is run in the best interests of her Residents. This is demonstrated in the fact that no requirements or recommendations have been made in this report. The Manager evidenced that she involves the Residents in the running of their home. Regular Residents meetings are held these have been adjusted so that they take place in each unit to ensure that all Residents have a voice. It was
Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 21 clear from the records that Residents opinions, comments and wishes are listened to and acted upon and that any issues raised are looked at and resolved. The Home also undertakes surveys with the results published and made available to Residents, relatives and visitors. For example the most recent survey had been analysed and the results effectively charted and made available to all on the notice board in the foyer. Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues, guide them in practice and offer support and supervision. Residents felt the Manager was readily available to them. They commented that regular Residents meetings were held and that the Manager consulted with them and sought their individual views and opinions. Residents felt that they had trust and confidence in both the Manager and the staff group as a whole. Visit reports made by the County Council’s representatives show that the Home is visited monthly with quality areas reviewed and Residents comments sought. The systems for safekeeping, where necessary, of Residents moneys were in good order. Two records inspected showed that receipts were carefully maintained for any purchases made by staff on a Resident’s behalf or charges incurred for services such as Hairdressing and Chiropody. There is an auditing system to ensure the accuracy of the individual accounts and balances. Records showed that all staff receive formal supervision addressing the areas recommended in the Care Home’s Standards. Staff commented that the back up systems ensure that they can always contact a member of the management team if necessary for advise and guidance. The approach to general health and safety was assessed as good. Fire records were well maintained indicating that the fire systems were regularly checked in accordance with the guidance given by the Fire Officer. Accident records were well maintained and showed that action was taken to prevent similar occurrences. Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 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 3 3 X 3 3 X 3 Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Cotswold House DS0000034924.V285943.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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