Inspection on 25/04/05 for Dell Residential Home (Sudbury)

This inspection was carried out on 25th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dell Residential Home (Sudbury) 19/05/08

Dell Residential Home (Sudbury) 20/04/07

Dell Residential Home (Sudbury) 06/12/06

Dell Residential Home (Sudbury) 23/05/06

Dell Residential Home (Sudbury) 29/07/05

Dell Residential Home (Sudbury) 25/11/04

Dell Residential Home (Sudbury) 22/09/04

Dell Residential Home (Sudbury) 10/07/03

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

CARE HOME ADULTS 18-65 Dell Residential Home (Sudbury) Cats Lane Great Cornard Sudbury, Suffolk CO10 6SF Lead Inspector Jan Davies Unannounced 25 April 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dell Residential Home (Sudbury) Address Cats Lane, Great Cornard, Sudbury, Suffolk, CO10 6SF 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) 01787 311297 01787 313385 enquiries@craegmoor.co.uk Speciality Care (Rest Homes) Ltd Mrs Marianne Banks Care Home 48 Category(ies) of LD Learning Disability (48) registration, with number of places Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 25/11/04 Brief Description of the Service: The Dell is a permanent care home for adults with a learning disability. The Dell was first registered in 1987 as a core and cluster home where small groups of service users are accommodated in separate bungalows, each bungalow forming a self-contained unit. Over time, additional bungalows have been built to bring the home to the present capacity of 48. The current registered owners, Speciality Care (Reit) Homes Ltd, purchased the Home in 1995 and have agreed that the Dell has now reached its maximum desired capacity. Craegmoor Healthcare Ltd acquired Speciality Care in March 1998. Each bungalow accommodates six service users and provides its own laundry and catering facilities, communal areas and gardens. Bungalows are grouped around a central day care facility.The main kitchen and office/administration building access to the site is via a private drive. The home is situated within a quiet residential area with good links to Sudbury town centre. The buildings are modern, purpose-built unit and offer a high standard of accommodation. All service users have good-sized private bedrooms. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There had been a number of changes at the home within the last year (and following the cancellation of the previous manager’s registration by the Commission for Social Care Inspection) and the home was continuing to show positive signs of improvement. The inspector assessed 30 of the National Minimum Standards at this inspection and found a high proportion of these to be met or partially met and that the overall quality of care provided was of a satisfactory standard. What the service does well: The Dell offered opportunities for varied Lifestyles for individuals including opportunities for work, education and leisure activities. The home had strong community links regularly participating in local events. The home ensured that appropriate medical care and support was accessed with specialist care provided as required by community health care teams. The Dell had a complaints’ procedure, a whistle blowing procedure and a policy of protection of vulnerable adults. The complaints and the whistle blowing procedure were both on open display and the complaints procedure had been updated to give contact details for the Commission for Social Care Inspection. Staff have received training on protection of vulnerable adults. Mrs Marianne Banks had been appointed manager following the cancellation of the registration of the previous post holder. Mrs Banks had a good level of experience within the care sector as well as having achieved the NVQ level 4 Management of Care Services award. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 6 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. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,5 The home demonstrated how it catered for individual needs of service users and that there was a proper assessment prior to people moving into the service. EVIDENCE: The Statement of Purpose met the requirements of Schedule 1 “Information to be included in the Statement of Purpose”. It also met the requirements in recent revisions to the National Minimum Standards, Care Homes for Adults, with regard to Standards 24.2, 24.9, 25.3, 25.5, 27.2, 27.4 and 28.2 in so far as room numbers, sizes, and bathroom and toilet facilities were described. The Service User Guide was appropriate and comprehensive in relation to the service user group accommodated and their needs. Copies of assessments carried out by the placing authority at the time of referral were held on file and had been supported by further skills assessments the manager of the home had carried out. The last new admission since the last inspection was inspected and from the home’s admission policy, discussion with the manager and examination of the care plan this was appropriately arranged. The service user in question had settled in well and knew most of the other service users prior to admission from contact at the day-centre they attend together. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 9 From care plans viewed and admission details it was demonstrated that appropriate pre inspection visits had been arranged. The inspector checked that no changes had been made to this arrangement. All service users had a copy of the statement of terms and conditions between the home and themselves that specified the room to be occupied, personal support, facilities and services provided. Two service users commented that ‘I wanted to come here because the rooms (bedrooms) are nice.’ ‘My friends live in my house (bungalow) with me and people are nice—I want to stay here.’ From discussion with the manager and inspection of individual files, this also included any specialist services, and any policies or rules that may limit personal freedom. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Progress had been made on improving arrangements to ensure that the health care needs of residents are identified and met. EVIDENCE: Individual plans of care were available and appropriate arrangements had been recorded to demonstrate that all aspects of health, personal and social care needs had been identified and planned for. Plans were comprehensive up to date and reviewed within the timescale identified. Significant events in the home had been clearly recorded, daily entries into case records made, giving indication of the actual care given. This was particularly evident for one service user with mobility problems/history of falls. A risk assessment, that was regularly reviewed and updated, identified that specific and appropriate care was being given to address the potential areas of difficulty. Other service users spoken with were able to describe care needs that had been recorded in their care plans. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 11 Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,15,17 There were appropriate arrangements in place for the physical and emotional health needs of service users and these ensured that they received personal support in line with their assessed needs and preferences. EVIDENCE: Plans of Care for each service user confirmed that they have access to a range of opportunities to maintain, develop, and pursue social and recreational interests, as well as further developing their educational, emotional, and independent living skills. During the inspection it was observed that care support workers were spending time assisting residents to develop social skills and talking with them. Some service users had plans of care that were tailored to provide opportunities for one to one support. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 13 A number of people living in the home were spoken to and referred to the food being good and that there were choices for them. They were able to convey to they inspector that their own food preferences were taken into consideration. According to staff and service users visitors to the home were made welcome and encouraged at all reasonable times and this was referred to in the Statement of Purpose. A number of areas were available for use by service users when meeting with their relatives, friends and representatives. These included their own rooms and the dining area, or in the summer, the patio area of the garden. Such relationships were actively encouraged and supported by arranged meetings, offered if required. It was evident through observation and reading of care plans, that service users chose how they spent their time and that staff respected their right to make their own decisions within a risk management framework. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Progress had been made on improving arrangements to ensure all aspects of health, personal and social care needs were being identified and planned for. Some additional input from the pharmacist was recommended to improve medication administration arrangements for the administration of antibiotics. EVIDENCE: Staff members respected the privacy and dignity of service users and staff conduct in this area was defined in the home’s information available to staff on how to perform their duties. This also included a policy for personal care giving. Through discussion with both staff and service users (and observation) it was evident that the healthcare needs of the service users were being met in an appropriate and timely manner. All service users were registered with local general practitioners and have attended surgery, (if they were not too ill to do so in which instance a GP ‘house call’ would be requested/made.) Accidents and significant events in the home had been clearly recorded, daily entries into case records made, giving indication of the actual care given. This Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 15 was particularly evident for one service user with mobility problems/history of falls. A risk assessment, that was regularly reviewed and updated, identified that specific and appropriate care was being given to address the potential areas of difficulty and on the day of the inspection the GP had been called to see him and comment on the existing arrangements for his health care. Medication systems were being administered in accordance with the policy and procedure of the home. There were protocols in place which provided guidance for staff on administration of ‘as required’ medication. However the manager referred to the need for further advice from the pharmacist regarding the timing and frequency of prescribed antibiotics. Some staff were unsure when to be administering these as the instruction given referred only to ‘3 times a day’. In view of the combinations of medicine some service users taking it was agreed that further medical advice be sought on this. Discussion took place around the arrangements for the training provided to support workers for administration of medication and records were seen to show that the training was according to the home’s time-scale for this. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Complaints are handled objectively and residents were confident that their concerns would be listened to and taken seriously. However until staff recruitment procedures are made more robust all the necessary safeguards for protecting service users from abuse are not yet in place. EVIDENCE: Discussion with service users confirmed that they would talk to staff if they had a complaint. One said ‘my friend (the key-worker) would help me if I was unhappy about things here.’ Another service user told the inspector that he would talk to the manager if he was unhappy as ‘she makes it right for me.’ There have been no complaints since the last inspection. The complaint procedure was available in different formats to make it accessible to the service users. The home’s complaint’s policy and procedure had been updated to identify the role of the CSCI and the timescale of response. Not all service users were able to identify the procedure set out for complaints that the home would follow should they need to do this (because of their level of dependency). The home had provided external, independent advocacy for service users with an appropriate person to act in the role of advocate in this event. Those service users spoken with expressed their contentment with the service being provided. (see section on staffing for further information) Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,30 Minor repairs were needed to bungalows and overall security arrangements must be improved in order that service users can live in a safe and wellmaintained environment. In view of this the judgement is that this standard was not fully met at the time of the inspection. EVIDENCE: At the time of this inspection a number of service users were at home and the inspector was able to view private rooms with their consent. It was evident from this and previous visits to different service users’ rooms that these had been decorated and furnished in a style which they had chosen and which reflected their individuality; for example one room was decorated with the souvenirs and pictures of the service users football team; another room showed that the service user likes to buy and watch her own videos. Infection control was observed by separating catering, laundry, and personal care tasks, and there were supplies of disposable gloves in both houses, for staff use when carrying out tasks that could, if not undertaken correctly, present a risk. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 18 Overall the home was clean, bright, airy and well decorated with many homely touches. It was suitable for the needs of the service users who lived there and met their individual and collective needs. The manager was advised of the differences in relation to overall upkeep and maintenance of bungalows and that the higher standard should be applied across all accommodation and consistency maintained for general repair and redecoration: for example the washing machine in bungalow 3 was not repaired/working and door bells for bungalows 3,6,and 2 were not working. Bungalow 2 was exemplary in meeting the standards but as referred to above this was not consistent from bungalow to bungalow. The inspector was concerned, on visiting bungalow 6 that she could walk all around the bungalow and out into the garden area at the rear without coming across a staff member. There were 2 dependent service users there in their bedrooms without a staff member in evidence in spite of the inspector calling out repeatedly. The manager was told that this situation is totally unacceptable and immediate requirements have been made in relation to staff and security issues. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,34,35 The procedures for the recruitment of staff were not sufficiently robust and did not fully provide the safeguards to offer protection to people living in the home. EVIDENCE: The staff recruitment procedure was examined in relation to new members of staff appointed since the last inspection. There was evidence that references were requested and in the case of one member of staff a written reference was not in evidence. It was not clearly recorded on their files that each had had a satisfactory Criminal Record Bureau (CRB) check. The dates indicated that CRB s had not been received prior to them commencing their duties. One Criminal Record Bureau (CRB) check had not been returned before a member of staff started work and there was no written evidence that a POVA First check had been received when the member of staff began her induction. Both staff had previously been working outside of the UK and from discussion with the manager she was of the opinion that appropriate checks had all been completed satisfactorily for both staff concerned in accordance with the Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 20 organisation’s policy for employing staff from abroad but there was no evidence to support this. The inspector spoke to the Area Manager who was unable, at that time, to confirm that a POVA first check had been done. The inspector was told that immediate arrangements would be made to provide staffing arrangements to comply with the recruitment procedure. This meant that alternative staffing arrangements must be in place and immediate action required by management to provide alternative cover. As already referred to in the section about the environment of the home attention was focused on concerns about the ‘absence’ of the staff member from one of the bungalow’s and that dependent service users were being left unattended. The manager made immediate enquiries and took action to ensure that service users did not continue to be unattended. The inspector looked at the staff rotas and these would benefit from review of periods when only one staff may be on duty per bungalow and how ‘cover’ and additional support is being provided at such times. The home is required to provide the CSCI with more detailed information and a comprehensive staff rota (projected) for the next 2 months. There must be a review of staffing arrangements to determine whether there are sufficient numbers of staff to provide the necessary care and safeguards for all residents at all times of day. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,40,41,42 The manager had the qualifications, skills and experience to manage the service. She has been in post relatively recently and was beginning to have a positive impact on the way the service operates. EVIDENCE: The manager was able to evidence the qualifications, skills and experience to manage the service. She has been in post relatively recently and was beginning to have a positive impact on the way the service operates. Supervision was in place and having a positive effect on the way staff (told the inspector that they) felt supported. Staff expressed the view that the manager was approachable, supportive and good at her job. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 22 At the time of the inspection there were some areas found that indicated that some practices to promote the health and safety of the people using the service must be reviewed to ensure these were in place and working effectively. From observation, talking to staff and residents and from looking at the recording of care plans it was shown that there was inconsistency in the operation of care from bungalow to bungalow and this must be monitored and reviewed more closely in order to provide the higher level of care arrangements to all residents. Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x 3 x 3 Standard No 31 32 33 34 35 36 Score 2 x 2 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dell Residential Home (Sudbury) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 2 2 x I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 24 no 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. 2. Standard 34 34 Regulation 19,13 19,13 Timescale for action Two references must be obtained immediate for all staff emploed to work in the home before they start work. A criminal records bureau check immediate must be requested/received for new staff before they start work in the home. Staff recruitment procedures 1/6/05 must be in place to protect resident from potential risk of harm. All door bells must be repaired to 1/6/05 bungalows. Visitors must be appropriately 1/6/05 vetted by staff before entering bungalows and visitor books in bungalows kept up to date. The washing machine must be 1/6/05 repaired for use of the residents of the bungalow where it is sited. All areas of the home and site 1/6/05 must be appropriately monitored for risk in relation to health and safety. the homes policies for 1/6/05 safeguarding the welfare of the service users must be reviewed for consistency of application for all bungalows Requirement 3. 34 19,13 4. 5. 24 24 23 13,23 6. 7. 24 41 23 13,23,24 8. 42 13,23, Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 25 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 none Good Practice Recommendations Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 26 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ 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 Dell Residential Home (Sudbury) I54-I04 S24372 The Dell (Sudbury) V224219 050616 Stage4.doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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