Inspection on 18/07/05 for Dane House

This inspection was carried out on 18th July 2005.

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

Dane House 16/07/07

Dane House 29/05/06

Dane House 14/12/05

Dane House 06/12/04

Dane House 01/06/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Dane House 52 Dyke Road Avenue Brighton East Sussex BN1 5LE Lead Inspector Debbie Calveley Unannounced 18 July 2005 07:00 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 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. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dane House Address 52 Dyke Road Avenue Brighton East Sussex BN1 5LE 01273 564851 01273 507161 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tamaris Healthcare (England) Ltd Mrs Tracey Fiona Davis Care home with nursing 25 Category(ies) of Old age, not falling within any other category registration, with number (OP) 25 of places Physical disability (PD) 5 Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the maximum number of service users to be accommodated is twenty-five (25). 2. That service users are sixty-five (65) years or over on admission. 3. That service users may also have a physical disability. 4. That a maximum of five (5) service users may have a physical disability and be aged between forty-five (45) years and sixty-five (65) years on admission. Date of last inspection 6 December 2004 Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Dane House is a converted family house situated in a residential area of Hove. The home is registered to provide nursing care for twenty-five service users in the category of old age. A variation to the category has enabled the home to provide care for up to five service users with a physical disability. Dane House is a large detached property, with a conservatory to the rear of the house leading to a pleasant rear garden with a pond and good quality garden furniture. The accomodation offered consists of nineteen single bedrooms, ten with ensuite facilities, three double bedrooms, two with ensuite bathrooms. There are ample communal bathrooms with adaptions for the disabled, the lounge area is large with dining tables at one end, leading in to the conservatory which has comfortable chairs. There are other quiet areas on the ground floor with chairs which can be used by the residents. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 18 July 2005. It commenced at 7.30am and was conducted over six hours. There were eighteen residents living in the home on this day. The methodology of the inspection included a tour of the building, inspection of documentation and records, the delivery of care for ten residents and informal interviews with ten residents, one relatives and four members of staff. What the service does well: What has improved since the last inspection? What they could do better: The care planning and documentation in respect of the residents is identified as a concern as it does not reflect accurately the work staff do to meet the residents needs. The danger of not maintaining accurate records is always that staff may not provide safe and consistent care and that changes in needs cannot be tracked. At the present time feedback from the residents indicates that the activities provided are not well attended and do not stimulate the residents, an activity Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 7 programme needs to be developed to include activities that will be enjoyed and looked forward to by all the residents. Staffing levels at this inspection were found insufficient to meet the needs of the residents. Staffing levels need to be assessed against the specific needs of the service users. Shortfalls regarding documentation in the medication administration charts were identified and discussed. Correct recording and administration of medication is necessary to ensure and promote the health and safety of residents. 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. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4 and 5. The comprehensive Statement of Purpose and Service Users Guide give prospective residents the information required to enable them to make an informed choice about where they live. A contract/statement of terms and conditions is not in place for all residents. A pre-admission assessment is undertaken on all prospective residents before admission to ensure the home can offer them the care they require, however not all were fully completed, signed and dated. Visits to the home by prospective residents and their family prior to admission are encouraged so they can meet staff and fellow residents before making a decision. EVIDENCE: The comprehensive Statement of Purpose and Service Users Guide give prospective residents the information required to enable them to make an informed choice about where they live. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 10 There is still a need to introduce a new contract of terms and conditions under the new ownership of Four Seasons. Service users admitted to the home in the past eighteen months have not received a contract; there is a letter in use, which acts as an agreement of terms until the new contracts are in place. This means they do not have full knowledge of the services available to them. One resident said he had received a letter explaining the terms and conditions eight months following admission to the home. This is not satisfactory, as he now does not want to sign it now, as he does not agree with certain areas. A contract needs to be provided and signed on admission to the home to formalise what has been agreed. A senior member of the staff completes a pre-admission assessment using the homes assessment tool Two assessments were seen fully completed, but three were incomplete and did not give a full explanation of reasons for admission. It was confirmed by two residents that their family were involved in the assessment. The assessment is undertaken at the residents’ place of residence, and input from other relevant professionals is sought when and as required. From information seen in the pre-admission assessment there was evidence of residents being admitted to the home that were out of the registered category, this needs to be reviewed to ensure that the home and staff can meet the needs of these residents. Five of the ten residents spoken with said they remembered visiting the home before admission, which had made them feel they had the choice. One resident said that it had helped her “make her choice by visiting two homes in the area”. One visitor said she had “toured all the homes in Hove before making a final decision and that it had been beneficial to visit to meet the staff and feel the atmosphere of the home”. One resident said “she had just found herself here, but knew her daughter had chose the best home for her”. Another said she had not been well enough to visit before her admission. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10. There is no clear or consistent care planning system in place to adequately provide staff with information they need to satisfactorily meet service users needs. It is not possible to evidence that the health needs of service users are met. The home has failed to improve their procedures for the administration and recording of medication thus placing service users at risk and harm. EVIDENCE: Nine care plans were viewed and did not fully meet the identified needs of the residents. It was noted that the positive outcomes observed at this time are still dependent upon staff knowledge and memories rather than full and detailed recording. One resident, in the home for just under one month did not have a care plan in place at all. Her needs are complex and staff need to be aware of them and have a plan of care in place to ensure her needs are met. An immediate requirement was made at the time of inspection in respect of this. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 12 The care plans did not identify all aspects of the individual’s needs in respect of wound care, identified nutritional problems and social needs. The daily log records in residents rooms are not being completed on a regular basis by the identified key worker and whilst senior staff record events in another folder kept in the office, inconsistencies were found and there was no clear record available that evidenced the care being given. There was no evidence in the care plans inspected to suggest that residents or their representatives were consulted about the care process. Six of the residents spoken too, did not remember discussing the care plans with the staff. A relative spoken to said they “were kept informed of the care given, but had not been involved in any aspect of the care planning”. The clinical room was found clean and tidy, the cupboards and fridge were also clean and found to be well stocked but not over crowded. The senior nurse was completing her medication round at the commencement of the inspection. On viewing the medication administration charts numerous gaps were found, which were discussed with the manager. There was also some confusion over instructions of some identified entries, which need to be followed up with the G.P and pharmacist. Verbal orders need to signed and dated by the staff member receiving the instructions so any queries can be tracked. Throughout the inspection it was observed that residents were treated with dignity and respect. A resident remarked that” she felt the staff respected her feelings and that she never felt she was a nuisance, and she had been able to bring her cat with her”. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 and 15. The arrangements for leisure and social activities inside and outside of Dane House provide limited opportunity for mental or physical stimulation. The home encourages and enables residents to maintain contact with their families and friends, by having an open door policy and a welcoming reception. Residents are helped to exercise choice and control over their everyday lives. The dietary needs of residents are well catered for and offer a balanced and varied selection of food that has been updated in line with the personal likes and choices of residents. EVIDENCE: There is evidence of an activity programme, which is displayed in communal areas of the home. No activities took place on the day of the inspection. The feedback from residents was mixed and one resident “commented that the only time he had been out of the home since his admission was for a Christmas do” and he felt that he was declining in mobility and was bored. This resident was discussed with the staff regarding his social needs. Two residents said that they did not attend the activities and that it was their Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 14 choice. They said they preferred to stay in their room. One resident said that he spent most of his time reading and felt that the exercise class was not for him. One other resident said she felt she was getting lazy. From the feedback received from residents, it was the predominantly the male residents who felt that the activities did not meet their requirements. It was confirmed by talking to residents that the routines of daily living have a degree of flexibility; residents can request meals at a different time if they are going out and in their preference for getting up and for going to bed. One area that was discussed as needing more autonomy and choice is that certain residents wanted to have more baths. There is open visiting and one relative said they were welcomed to the home, whenever they visited. Residents are able to handle their own finances if they wish to, and if they are able. In every bedroom there is a lockable facility to safeguard valuables. All residents are made aware of an advocacy service provided by Age Concern. Two residents were aware of this service. Furniture and other belongings are welcomed by the home if the resident wishes to bring them with them. Certain rooms have been personalised. The chef personally visits all residents with the following days choices. The menus demonstrated choice and variety and were indicated a well balanced diet. The menus rotate on a four weekly basis and change according to the seasons. Fresh fruit is offered. The residents were forthcoming in their views of the food, and the majority said the choice was good and the food was always tasty. One resident remarked that “ the food is good but never hot enough” he eats his meals in his room”. Three residents said they “choose their meal, but don’t always remember what they chose”, but said “the food is okay”. The dining area is pleasant and well furnished with natural light and the tables are positioned to create a congenial atmosphere. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 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 standard(s) 16, 17 & 18. Policies and procedures are in place for dealing with complaints which are assessable to service users and their representatives. Arrangements for protecting service users are satisfactory at this time, protecting them from possible risk or abuse. EVIDENCE: A policy and procedure is in place for dealing with complaints and this is also outlined in the statement of purpose and service users guide. The manager is aware of the timescales set down for dealing with complaints and a complaints register is available. The Adult Protection policy in the home was found to be up to date and staff interviewed were knowledgeable about the systems in place to protect vulnerable residents. There is on-going training for all staff in Adult Protection. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 22, 23, 24, 25 & 26. The home provides a comfortable, clean and safe environment for those living there and visiting. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the resident’s personalities and interests. There is specialist equipment in the home for residents’ use to maximise their independence, however call bells need to be in reach of residents. EVIDENCE: Dane House provides a comfortable, safe and well-maintained environment for the residents. The residents are encouraged and enabled to personalise their rooms with furniture and pictures, and this was evident during the visit. All personal items are listed in the individual care plans. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 17 Residents are offered the choice of having a lock and key for their bedroom, risk assessments are in place for this. All residents have a lockable facility for the storage of personal items and valuables. Two residents said they felt this increased their independence by keeping personal papers themselves rather than handing everything over to the home. There is an ongoing maintenance programme and the home was found well decorated and maintained. The home provides adequate attractive communal space. The communal rooms are well used and provide adequate communal space. The lounge area was found warm, comfortable and homely. The dining area was both clean and well-decorated, and the garden and patio areas have both wheelchair access and seating. There are toilet, washing and bathing facilities to meet the needs of the service users. Including showers and assisted baths. Specialised equipment to encourage independence is provided e.g handrails in bathrooms, hoists, wheelchairs and lifts to all areas of the home. The corridors are wide enough for the self propelling of wheelchairs. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Beds and chairs were seen to be placed appropriately for maximum benefit of those wishing to read. Water temperatures are controlled and monitored monthly and a record kept. Random temperatures were taken and were of the recommended level. Four residents said they were encouraged to bring in items of furniture and pictures and also mentioned their families were always bringing in new photographs and pictures. Two residents proudly shared some photographed memories of the war and their families. Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection. One resident said,” everyone is very nice and the place is kept clean”. Good practice by staff was observed during the day and there were gloves and aprons freely available in the home. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30. The staffing levels in place on the night and day of the unannounced inspection were inadequate to meet the assessed needs of the residents. The arrangements for the induction of staff are good with the staff demonstrating a clear understanding of their designated roles. Staff are provided with training pertinent to meeting the needs of the residents. EVIDENCE: The night shift at Dane House is staffed by one trained nurse and one carer. Due to the layout of the home and the needs of the service users at this time, the number of staff on the night shift is not considered sufficient. One staff member said “out of the eighteen residents, four were high dependency needing a lot of care, it’s a struggle and we do not have the time to do the little things that matter for the residents”. She also said that it was difficult to supervise staff. The morning shift consisted of one trained nurses and three carers, again due to the needs of the residents the staffing was seen to be insufficient. One member of staff said that “it was difficult to give residents the time they required, especially as one resident was very unwell and was dying”. The staff worked very hard to fulfil their role. One resident said that “the staff don’t have time to talk like they use to” and she misses the socialising that she used to enjoy. One resident said that he often had to wait for up to twenty minutes Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 19 to be attended to, another said that the home was short of staff. One staff member said that it was really hard to provide the care in the mornings due to the high needs of residents and not enough staff. Staffing levels need to be adjusted according to the changing needs of the residents. All new staff receive an induction and foundation training in line with the National Training Organisation and staff training is on-going. Three members of staff said that the training in the home is “very good, lots of it” and that they receive regular supervision. The staff were able to discuss training sessions they have received and that when residents have an illness that they have not dealt with before, they receive training pertinent to that illness. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36, 37 & 38 All staff receive formal supervision at least six times a year and this promotes good practice and provides a support system for staff. There are policies and procedures in place that safeguard residents’ rights and best interests. The environment and working practices of the staff protect and promote the residents health, safety and welfare needs. EVIDENCE: The home runs a training programme that is suitable for the staff and for the needs of the residents. Training events are displayed on key notice boards in the home to ensure all staff are aware. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 21 Staff are supported by the manager on a daily basis and more formally through supervision. Staff spoken to confirmed they received supervision and annual appraisals. They are in a written format and copies are kept in the staff files. The staff confirmed and the staff training records show that all staff are kept updated on the Health and Safety policies, the manual is available to all and clearly defined. Staff were able to discuss the training they received and said that they were kept up to date with changes to policies in connection with fire safety and health and safety. The staff are issued with certificates yearly for Manual Handling, twice yearly for Fire Safety and Food and Hygiene. The home has a comprehensive set of policies and procedures, which govern the running of the home. All relevant legislation and procedures are in place in respect of Health and safety. Good practice in respect of health and safety was observed throughout the inspection. Due to the busy shift, there was some delay noticed in responding to call bells and call bells need to be in reach of residents at all times. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x Version 1.30 Page 23 Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 5 (1) (b) Requirement That all privately funding service users receive a contract including the terms and conditions of the home. That the pre admission assessment is correctly completed, signed and dated. That a comprehensive plan of care is generated from a comprehensive assessment is drawn up for/with each service user, and it is reviewed at least once a month. That a care plan for a specific service user is put in place. That all documentation in respect of residents health needs are kept up to date and reviewed regularly. Medication administration record charts must reflect current medication profile and must be a true and accurate record. That an activity programme is devised to ensure all service users social needs are met. That staffing levels are increased so as to meet the assessed needs of service users. Timescale for action 30 September 2005 18 August 2005 30 sepember 2005 2. 3. 4 7 15 (2) (b) (c) 12 (1) 4. 5. 7&8 7&8 6. 9 15 (2) (b) (c) 13 (1) (b) 17 (1) (a) Schedule 3 13 (2) 18 July 2005 18 July 2005 18 July 2005 30 September 2005 18 July 2005 Page 24 7. 12 8. 27 16 (2) (m) 23(2) (h) 12 (4) (b) 18 (1) (a) Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 38 Good Practice Recommendations That an audit for to call bells is commenced. Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 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 Dane House H59-H10 S13976 Dane House V221625 210605 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!