CARE HOMES FOR OLDER PEOPLE
Creedy House Nether Avenue Littlestone on Sea New Romney Kent TN28 8NB Lead Inspector
Christine Grafton Unannounced Inspection 21st April 2008 09:10 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 Creedy House DS0000070666.V361326.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. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Creedy House Address Nether Avenue Littlestone on Sea New Romney Kent TN28 8NB 01797 362248 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) creedy@1stchoicecarehomes.com www.1stchoicecarehomes.com 1st Choice Care Homes T/A Creedy Number 1 Ms Anita O’ Neill Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only (PC) - to service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) 2. Older People with Physical Disabilities (PD). The maximum number of service users to be accommodated is 44. Date of last inspection N/A as New Service Brief Description of the Service: Creedy House is a large detached building in the small town of Littlestone, within walking distance of the sea and local shops, with other amenities nearby. There is a regular bus service to Ashford, Dymchurch and Hythe. It is a three-storey building with a large well-maintained garden, disabled access and some parking. All bedrooms are singles, ten of which have an en-suite facility. A shaft lift provides access to the first and second floor. Communal areas comprise of three lounges and two dining rooms, plus a library on the first floor. The home provides care for up to 44 people who are in need of nursing care and palliative care, but also has some people who have residential care needs. The home’s statement of purpose and service users’ guide contains information about the services provided and a copy is given to each resident. The most recent CSCI report is made available in the entrance hall. At the time of this inspection, weekly charges were in the range of £320:63 to £824:02, with additional charges for hairdressing, chiropody, newspapers and some toiletries. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes.
This was the home’s first inspection since a change of ownership in October 2007. The report takes account of information received since then, including a visit to the home. An unannounced visit took place on 21st April 2008 between 09:10 hours and 16:35 hours. The visit included talking to the manager, area manager, staff, residents, and observing the home routines and staff practices. Some records were looked at and we looked round the home. Information sent to us by the manager prior to the visit, in the form of the home’s annual quality assurance assessment, has been used in the planning of the visit and to inform judgements made. At the time of the visit there were 32 people living at the home. The atmosphere in the home was welcoming and relaxed. What the service does well:
People considering whether to move into the home are given an informative guide, which tells them about the service and the care they should expect to receive. The home makes sure that peoples needs have been fully assessed before they move in so that they receive the right support and care. Each resident has a personal plan of care that assists staff in providing consistent care. Staff know how to support residents in the way that they want so that their needs are met. Staff treat residents with respect for their dignity and encourage choice. Residents expressed that the staff are helpful and attentive. Residents have opportunities to take part in various group activities. The activities coordinator also spends time with them individually, helping to make sure they do not become bored and providing them with some stimulation. The home’s dining areas provide residents with very pleasant surroundings where they can enjoy their meal times. Residents are offered choices and a healthy and balanced diet is provided. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 6 Residents know that if they have a concern, it will be listened to and dealt with promptly. The home provides a variety of specialist equipment to make sure that the individual needs of residents are met in a comfortable and safe way. The home has good laundry facilities and provides a good service. A resident commented: “the laundry service is extremely good here”. Practices to maintain hygiene and prevent the spread of infection within the home are also good, making sure that residents live in a clean and safe environment. The home monitors its own performance, regularly checking all aspects of the quality of its service. This helps make sure that residents’ best interests are promoted. What has improved since the last inspection?
This is the first inspection under the new ownership, but it is clear that in the six months since they took over, many changes have been made to improve outcomes for residents. These have been stated in the home’s annual quality assurance assessment and observations and discussion with management at the visit have confirmed that a significant number of improvements are well under way. These include: The homes’ documentation has been reviewed and changes introduced that will help improve outcomes for residents, by making sure that it is clear, staff know what to do and things do not get missed. Improvements have been made to the care plan format to make it more person centred around the individual, so that people are treated as equals and their diverse needs are recognised. Staff have received training on person centred care and are now starting to work with the new documentation and are putting the principles into practice. They have increased the number of activities on offer and the monthly newsletter has been developed so that residents and relatives know what has been planned for each month. As a result of listening to relatives, a new suggestions box is being introduced, as relatives wanted a means of leaving their suggestions at the home when the manager is absent. The activities co-ordinator now works on Saturday mornings, as well as during the week, to liaise with relatives. Improvements have been made, and are continuing, to the general environment within the home, including: redecorating bedrooms, providing
Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 7 new furniture, equipment and carpets. The refurbished areas provide a very pleasant and homely environment for residents to live in. The staff-training programme has been developed and includes a new induction programme to make sure that staff get the relevant training to enable them to meet residents’ needs. The new training focuses on developing staff competency to deliver improved outcomes for residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 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 Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People considering moving into the home are given all the information they need to decide if it is right for them. They have an assessment that tells staff about them and the support they need. They are only admitted if the home is sure that their needs can be met. EVIDENCE: People living in the home are given their own copy of the home’s statement of purpose and service users’ guide. This tells them what they should expect from the home and gives them a good indication of the daily routines. The guide is well written in a good font size and includes information on how to make a complaint. A resident confirmed they had a copy of the guide in their room. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 10 The pre-admission documentation used to assess new residents was looked at as part of the case tracking. The home also uses the assessment undertaken by the care management team. This provides the information necessary to decide whether or not the home can meet the person’s needs. A full assessment is then completed on admission and covers all aspects of their health and personal care needs. A new care plan format is currently being introduced that is person centred and contains a personal profile. This helps to reflect people’s equality and diversity needs, such as religion or belief, sexuality and disability. The care plans identify a whole range of care needs, including risks and contain guidance for staff to address needs. Two of the residents spoken to said how staff had helped them to settle into the home and that they are well looked after. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having their own care plan that provides staff with the information needed to make sure that their health, personal and social care needs are met. They are protected by the home’s policies and procedures for dealing with medicines. Personal care is offered in a way that promotes privacy and dignity. EVIDENCE: The person centred care plans look at all aspects of care and the support needed by the residents. They are easy to follow with clear and precise guidance for staff. They contain details of contacts with healthcare professionals, such as doctors, physiotherapists and the podiatrist.
Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 12 Daily records contain relevant details, providing a picture of the person as an individual. Risk assessments are well recorded and provide residents with adequate protection. There was evidence of health and personal care needs being met and this was confirmed in discussion with staff and residents spoken to. Care plans are regularly reviewed and updated as needs change. This ensures that they receive consistent care. Where residents have been assessed as at risk of developing pressure ulcers, appropriate pressure relieving equipment has been provided. Tissue viability is monitored and wound care plans put into place as necessary. Each resident has a named nurse and key worker to ensure that all needs are met. Good medication procedures and practices are followed. The medication administration sheets were well recorded. A couple of issues were discussed with the deputy manager, which they said they would look into. Medication storage is good, with secure metal cupboards and drugs trolleys. The medication room is small, but the home is looking at improving this to create more space, so that everything can be kept together in one area more easily. Staff were observed interacting well with residents, showing respect for their privacy and dignity. Residents were nicely dressed in their own clothing. A resident was pleased that their blouses are always ironed, saying, “The laundry service is extremely good here”. Residents spoken to expressed that the staff are helpful and attend to their needs. Staff have received training on person centred care. The personal profiles that are being developed will help to ensure that any issues relating to equality and diversity are picked up and used to inform the care plan. Residents’ communication needs are dealt with well and evidence of good practice was observed. Staff were seen using good body language and communication skills when interacting with the residents. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home will support them to follow their own personal interests and provide them with opportunities to take part in activities to suit their needs. Residents benefit from the relaxed mealtimes, the nourishing and balanced diet, with choices provided, served in attractive surroundings. EVIDENCE: The home employs an activities co-ordinator who works four afternoons during the week, plus Saturday mornings. She does both group and individual activities with residents and liaises with relatives. Outside entertainers visit regularly and a blossom trip has recently been arranged. Several residents confirmed they are able to make choices in their daily lives, following their own routines and pursing their own interests. Some residents choose to spend their time in their bedrooms and others choose to spend their time in the various communal lounges.
Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 14 Religious needs are identified in the care plans and services are held in the home. The home has an open door visiting policy. Daily records show contacts with families and friends and the visitors’ book shows lots of visitors to the home. A monthly newsletter keeps people informed about what is happening in the home. Community contact has been identified in the home’s annual quality assurance assessment (AQAA) as an area for improvement. Details of advocacy services are included in an information file kept by the visitors’ book. Menus have been recently reviewed and provide two choices for dinner and tea. The lunchtime meal was observed in the large dining room, which is spacious, with plenty of room for residents in wheelchairs. Tables were laid with new damask tablecloths and napkins. Food was attractively presented and served hot. Specialised diets are catered for and there is close liaison between the nutritional support assistant and the cooks. When residents need assistance with feeding this is managed discreetly by the staff and in an unhurried manner. When necessary residents are provided with aids to assist them in eating. Several residents spoken to said that they enjoy their meals. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that any complaints will be listened to and acted upon; and they will be protected by the home’s procedures and practices to safeguard them from abuse. EVIDENCE: There is a clear complaints policy and procedure that is included in the service users’ guide given to every resident. A copy is also available in the information file kept by the visitors’ book. Residents spoken to know who to speak to and had no complaints about the home. They all said that the staff are approachable and respond if they have a worry. Good complaints records are kept and the company area manager audits complaints monthly. The manager has recently raised a safeguarding vulnerable adults alert and it is being investigated following the home’s protocols. The home has kept us informed about any significant events affecting residents’ welfare and actions taken to protect them. The staff-training matrix displayed in the manager’s office indicates that the majority of staff in the home have received protection of vulnerable adults training. The manager confirmed that training will be ongoing, and that staff will be expected to update their training as necessary.
Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24 & 26 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are benefiting from the recent investment to improve the décor and furnishing, creating a comfortable and more pleasing environment to live in. The home is providing a range of specialist equipment and adaptations to enhance residents’ safety. Good practices are in place to maintain hygiene and prevent the spread of infection within the home. EVIDENCE: The new providers have embarked upon a redecoration and refurbishment programme that is well under way. They have a clear action plan, starting
Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 17 with residents’ bedrooms. A tour of most parts of the home showed that a number of bedrooms have been completely refurbished, with new décor, carpets, blinds and furniture. New features include: some pedestal washbasins, fitted wardrobes, or new free-standing ones, new drawer units, new armchairs and eight new profiling beds that have recently been delivered. Several more bedrooms were in the process of being re-vamped and the small dining room is currently being upgraded. All residents occupy single bedrooms and a number of residents expressed how much they like their rooms and how comfortable they are. The home has a variety of specialist equipment to meet residents’ needs, including: four mobile hoists, a stand aid hoist, over-bed hoists and specialist baths. The manager stated that nine more overhead hoists have been ordered. This helps to improve safety for both residents and staff. There are still some signs of wear and tear, but the AQAA sets out the intention to complete most of the refurbishment programme over the next twelve months. From evidence seen at this visit, the home has demonstrated its commitment to improve and it is therefore likely that this will be achieved. The home has a well-equipped laundry room, with two new washing machines and two new tumble driers. A resident commented on the home’s good laundry service. The home was clean and fresh and procedures to prevent the spread of infection within the home include: the provision of liquid soap and paper hand towel dispensers in all the appropriate areas for hand washing. Staff were observed carrying out their duties following good hygiene procedures. The home has a contract for the disposal of clinical waste. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the numbers and skill mix of staff on duty will be sufficient to meet their needs and they will be protected by the home’s recruitment procedures. EVIDENCE: The staff rota indicates that during the morning shift there are usually two nurses plus six carers on duty and in the afternoons, one nurse and five carers. The manager is supernumerary and works weekdays. In addition there are sufficient housekeeping and catering staff on duty throughout the whole week. Weekend staffing levels usually consist of five carers throughout the day, with the same nursing cover as on weekdays. Residents spoken to said that staff are attentive and meet their needs. One staff member commented that the home is well staffed. Observations and discussions during the visit indicate that there is enough staff on duty to meet the needs of the current residents. Care plans contain dependency assessments, which are regularly reviewed. The results of these are to be collated to give a picture of the overall
Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 19 dependency levels. The keeping of an up to date staffing calculation matrix helps to ensure that staffing numbers are adjusted to meet residents’ changing needs. Staff are deployed to work on each of the three floors. The AQAA states that when staff have completed training for person centred care they aim to introduce team nursing. At the moment staff are allocated to an area on a daily basis and work in pairs. The AQAA indicates that the majority of care staff have achieved their National Vocational Qualification (NVQ) in care level 2 or above. The staff-training matrix displayed in the office indicates that staff have completed a variety of courses with updates planned. This makes sure that staff receive the specialist training they need to ensure that they have the skills, knowledge and capabilities to care effectively and safely for the residents. A new in-depth induction training package is currently being introduced that is linked to the Skills for Care specification. Existing care staff are working through this as well as new staff. The manager also intends to develop and record the induction and orientation programme for the qualified nursing staff. The manager has also developed ways to check staff competencies after they have received training. Evidence of this was seen with regards medication knowledge and administration. Two staff files were viewed and contained most of the required paperwork. This includes: a full employment history, references, protection of vulnerable adults (POVA) register checks, criminal records bureau (CRB) checks and qualification checks. Files also contain evidence of training completed. This means that residents are protected because staff have been properly vetted before they start to work at the home. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is managed in a way that safeguards residents’ best interests, promoting and protecting their health, safety and welfare. EVIDENCE: The manager is a registered general nurse and has recently completed the last component for her registered managers award. She has the relevant experience of working with the elderly and has been in post since October 2006, being the registered manager since November 2007. The deputy manager is a registered nurse experienced in the care of elderly people. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 21 The AQAA is well completed and contains all the information we asked for. It shows the changes that have been made and identifies where improvements are needed. It gives some indications of how they are going to achieve this. It shows recognition of equality and diversity, prioritising individualised care and the training of staff on person centred care. The home has a quality monitoring system in place that includes seeking the views of residents, relatives, care managers, doctors and community nurses. Questionnaires had recently been sent out and some have been returned. Monthly quality audits are completed, including looking at care plans and medications. The area manager carries out monthly visits and writes a report on the conduct of the home. Where the home looks after residents’ personal spending monies, good records are maintained and receipts kept to safeguard residents’ financial interests. Staff receive regular formal supervision. The new induction paper is being used to highlight training needs. Once completed, a training programme is to be developed for each staff member to meet their needs. This will make sure they have the knowledge and competence to do their jobs properly, with the focus on improving outcomes for residents. Policies and procedures are in place to ensure safe working practices. Staff attend a range of mandatory health and safety courses and the manager has a good understanding of risk assessment. The AQAA indicates that all the relevant checks and inspection of equipment and systems have been completed. No safety hazards were observed on the tour of the building. Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 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 2 x x 3 x 2 x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 Creedy House DS0000070666.V361326.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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