Inspection on 17/07/07 for Derwent Cottage

This inspection was carried out on 17th July 2007.

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

Derwent Cottage 16/07/08

Derwent Cottage 08/08/06

Derwent Cottage 11/10/05

Derwent Cottage 07/06/05

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Derwent Cottage 27 Eastgate Seamer Scarborough North Yorkshire YO12 4RB Lead Inspector Pauline O`Rourke Unannounced Inspection 17th July 2007 09:30 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 Derwent Cottage DS0000061996.V343625.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 Adults 18-65. 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. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Derwent Cottage Address 27 Eastgate Seamer Scarborough North Yorkshire YO12 4RB 01723 866146 01723 866147 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) Milbury Care Services Limited Mrs Andrea Whitehall Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 4 service users in category LD or LD(E), some or all of whom may also have physical disabilities Date of last inspection Brief Description of the Service: Derwent Cottage is registered to provide accommodation to 4 younger adults who have a learning disability and/or a physical disability. Andrea Whitehall is the Registered Manager and Milbury Care Services Limited owns it. Derwent Cottage caters for adults with a learning disability and associated health and behavioural problems including some challenging behaviour. All the accommodation is accessible and it is set in grounds that are available to all the people in the home. All the bedrooms are single occupancy with ensuite facilities. There are two communal areas and one of these is also used as the dining room. It is close to the village centre and local facilities and amenities. There is easy access to public transport to and from neighbouring towns and villages A Statement of Purpose and Service User Guide are available in the home and these are also available to relatives on request. The fee level advised at the time of inspection was around £1760 per week depending on assessed needs and level of care required. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence for this report. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment form. Comment cards returned from four healthcare professionals, three relatives and one social care professional. A visit to the home carried out by one inspector that lasted for five and a half hours. During the visit to the home staff were spoken with. Care records relating to three people, three staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Derwent Cottage for the people living there. The manager was available to assist throughout the visit for feedback at the close. What the service does well: The people who live at Derwent Cottage have to tell someone of the help they need. This information is used to make a care plan. The care plans used are detailed and tell the carers everything from how people like to get up, go to bed, what they like to do during the day and how it is best to communicate with them. These care plans are reviewed every two months by a member of staff known as a key worker. Feedback from one family said ‘we did not really know what care …would have. The reality is he is well looked after and up to now are pleasantly satisfied. If they do not have the skills they get in the professional help and set up and attend relevant skill course. The other residents have completely different needs to ...and they too are treated as individuals and have their needs attended to. I had no prior knowledge of the existence of such happy, homely and caring establishments, which is very well run with superb staff. They seem the right people in the right job’. Another relative said ‘they let me know about the care by phone or when I see them. Derwent takes care of my …., they make her happy’. Those people who live at Derwent Cottage have a full programme of activities and they enjoy going out shopping, to the East Riding Activity Club, local disco, use of a sensory room and to the local pubs. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 6 The staff go through a strict recruitment process to make sure they have the skills to help the people in the home and to ensure they are safe to work with vulnerable people. The staff also have access to training to improve their skills and they receive support form the manager. During the visit the interactions observed between staff and the people who they care for were relaxed, and respectful. Feedback received from professionals said ‘Carers excellent at identifying health problems. They advocate for service user for service users to ensure they receive appropriate treatment. Staff receive excellent training and the manager identifies further training as necessary’ and ‘they are flexible and adaptable which has been particularly noticeable as the client I have placed with them has fluctuating needs’ and ‘staff seem to be very skilled and have sought additional training to support specific needs’ 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. The summary of this inspection report can be made available in other formats on request. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who decide to use this service have the information needed to ensure their needs can be met. EVIDENCE: Milbury Care Services Ltd has a proven admissions policy and this ensures that a multi disciplinary assessment is undertaken prior to any admission. A recent admission to the home went through the admissions process. The manager received an assessment and visited the person who requires support and their family prior to any visits made. The process usually involves a series of visits and short stays to determine whether the placement is suitable. A trial period is then planned and the length of this trial is dependent on the needs of the individual. However in discussion the carers of the new person decided the admission should be permanent from the beginning. The assessment process takes in to account the wishes of the established people in the home and in this case their reactions are being observed on a day-to-day basis. A care manger said ‘information was gathered from the hospital, the family and all other professionals involved. Their needs are very complex. All the care staff pursued additional training instantly as their medical needs dictated. An Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 9 extremely good service has been provided with careful and methodical planning completed quite quickly.’ The case files were seen of the new person and established people contained comprehensive assessments, detailed daily recording and evidence of regular reviews of the care plans. Staff spoken with said that they had enough information when someone was admitted to the home to provide the support they require. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are able to make decisions on a day-to-day basis about their lives and this allows them to remain as independent as possible. EVIDENCE: All the case files seen contained a detailed care plan outlining the support and guidance required by the individual concerned. They also contained information about how each person communicated and staff were observed using spoken language, makaton a simple sign language, pictures and touch in their dealings with the people. Evidence was available to show that they are reviewed on a regular basis. Staff were knowledgeable about the people they are caring for and each person has several key workers. It is the key workers responsibility to ensure the care plan is reviewed. Feedback received from a relative said ‘The other residents have completely different needs to Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 11 our relative and they too are treated as individuals and have their needs attended to’. Feedback received from other health professionals includes ‘I have found the staff in Derwent Cottage careful to assess the patient seek advice appropriately and also question decisions if they are not fully explained. This leads to a greater understanding of health care needs of the individual as well as good advocacy’ and ‘Staff are not afraid to ask for help and advice. Extra training –especially in specialist areas i.e.: epilepsy to keep updated is always useful. Each client is respected as an individual with their own likes, dislikes, problems etc’. People were seen during the visit making their own choices about what they wanted staff to do for them. Staff have developed an understanding of the communication methods used by them and these are clearly identified in the care plans. Occasions where a person may refuse to do something were highlighted and the plans reminded staff that they could refuse to do anything if they wish. A daily diary is maintained for each person that informs the staff and the review process. Everyone had up to date risk assessments in place in relation to their individual needs and their differing daily living abilities. These documents are reviewed regularly incorporating specialist assistance when necessary. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to make decisions about their daily life and staff provide appropriate support and encouragement for them to remain independent. EVIDENCE: Each person has an activity folder outlining a personal profile of likes and dislikes. A daily calendar is kept showing what they do each day. The activities available are pertinent to the individual and a health professional said ‘Each client is respected as an individual with their own likes, dislikes, problems etc’. The activity files show that people access external activities as well as activities in the house. The key workers know the likes and dislikes of people and activities planned are based on this knowledge. Feedback from a relative said ‘they have an excellent rapport with our relative, there is an extensive range of activities for him and have really “got to know him” and Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 13 realise his needs.’ And ‘They let me know about the care by phone or when I see them’ and ‘We know we can visit/ring any time’ People were seen accessing the community for walks and they do access the local pubs and shops. Transport is available to take people in to town. Staff assist people to visit families where appropriate. The care plans showed each person’s personal preferences and choices in terms of retiring and rising, personal care and freedom of movement. These were only compromised by the need to be ready for day care transport or to attend appointments. A variety of food was offered and the staff felt they catered for every need. Staff were observed to assist with lunch and with drinks during the morning and afternoon. Any assistance was given in a quiet, dignified and unobtrusive way. Special crockery and cutlery were readily available. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s health and personal care needs are met on an individual basis. The staff employ the principles of respect, dignity and privacy in all interactions with the people in the home. EVIDENCE: The case files seen contained detailed information about the level of support people required with their personal care. They are detailed and evidence was available to show they are reviewed on a regular basis. The associated health professionals said that the manager is good at recognising when the staff require extra support especially as the needs of the people are complex and changing. They also indicated that the staff provide good care and understand peoples needs and act on the recommendations of the health professionals. Staff were observed treating the residents with respect and endeavoured to maintain their dignity at all times. The case files also contained detailed health information and contained evidence that they access specialist health care when necessary. Feedback Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 15 received from a health care professional said ‘Carers excellent at identifying health problems. They advocate for service user for service users to ensure they receive appropriate treatment. Staff receive excellent training and the manager identifies further training as necessary. They manage some very challenging individuals follow advice from health care professionals and actively seek support.’ Another one said ‘Liaise with health professionals regarding client’s needs.’ Notifications received from the service when someone needs attention form the hospital also indicates that proper support is sought with health care issues. Medication is dispensed from the original containers and the storage and administration records seen were satisfactory. All staff that dispense medication have received training in The Safe Handling Of Medicines. This training is followed up with in-house supervision and support. There is a controlled drugs register in place and the records seen were accurate and up to date. The controlled drugs were seen to be stored securely. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected EVIDENCE: There is a complaints policy in place and this is available to the people in the home and their families. It is available in a variety of formats depending on the needs of the person it is provided for. Feedback received from families indicated that they were happy with the way everything is at the moment but if they were unhappy with anything then they would contact the manager. An Adult Protection protocol is in place and staff were aware of their responsibilities under this procedure. Staff have received training through LDAF training. It is also available through a new training matrix installed through the computer system and this allows staff to work at their own pace. The manager also reinforces the training in the monthly staff meetings. Staff were aware of the necessary actions they must take if they suspect any form of abuse has occurred. All staff are thoroughly vetted before they start work to ensure they are suitable to be working with vulnerable people. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Derwent Cottage is an adapted property opened as a care home some years ago, originally for older people. It has been adapted and upgraded to offer accommodation to a maximum of four service users with learning and associated physical disabilities. The property is located near to the village centre and within easy travelling distance of the town of Scarborough. Public transport passes close to the house. The premises are set in their own secluded and private grounds with no external indication that the property forms a care home. Level access was achieved to each external door. Fixtures, fittings, fabrics and furnishings were all domestic in nature reflecting the registered provider’s wish to create a non-institutional environment. Everyone living in the home had their own bedroom with ensuite facilities. The bedrooms had been Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 18 personalised to reflect the personality of the individual and where necessary had specialist equipment provided. The premises were maintained in a good condition internally and externally and were clean and odour free. Throughout the visit people were seen to access all areas of the home no matter what their method of mobilising. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported by well-trained staff in sufficient numbers that they are seen as individuals and the care provided is pertinent to their needs. EVIDENCE: Staff files seen contained all the necessary documentation required to ensure that they are suitable to work with vulnerable people. A new member of staff said that the recruitment process had been thorough and she had not started her employment until her Criminal Records Bureau disclosure had returned. The files also contained evidence of supervision and training completed by the staff. The staffing ratio is 1:1 and this level of cover is always provided during the daytime, with 14 hours a day provided extra by the funding authority. Staff felt that the staffing levels were adequate to meet the social and physical needs of the people in the home. All staff have completed their mandatory LDAF training and there are currently seven members of staff who have been registered on a National Vocational Qualifications level 2 in care. Other training available to staff is through El Box; this is a computer Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 20 programme that allows staff to access different training and to do them at a pace that suits them. Staff said that the new system was easier to access as it allowed them to complete the training at work. A training matrix is provided on an annual basis and this allows for the training to be planned. Staff are expected to identify their own training needs and to develop their leadership skills. The manager then organises training in line with their personal development plan. Feedback from health professionals confirmed that when necessary specialist training is provided for an individual person using the service. ‘Staff are not afraid to ask for help and advice. Extra training –especially in specialist areas i.e.; epilepsy to keep updated is always useful.’ Interactions observed between staff and people in the home throughout the visit were seen to be friendly, respectful and mindful of a persons’ individuality and the need for privacy. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed home where the administration of the home is based on openness and respect. This allows them to retain their individuality and independence. EVIDENCE: The manager operates an open door policy and this was seen during the visit, with people easily coming to the office. She tries to work two days a week with the carers so that she can keep in touch with the people in the home and the staff. She continues to keep her training up to date and is supported by two seniors in her management role. Staff said that the manager was approachable and quickly organises training and will try to resolve any difficulties within the staff group quickly. She holds staff meetings on a Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 22 monthly basis and a quiz is held at the end to check peoples’ knowledge about the service and associated issues. The quiz held during the visit included questions such as the names of the care managers of the people in the home, the name of the Commission of Social Care Inspection inspector, and technical details to do with equipment. The manager said that she finds these useful and helps identify gaps in an individual’ s knowledge. The manager has a development plan for the year; this includes person centred planning with the key workers expected to maintain and look to develop peoples’ skills and interests. Questionnaires are sent to families and other health and social care professionals annually to get feedback from them. The area manager also visits every month and completes a report along with staff meeting records. These all feed in to an annual meeting to look at what can be developed for the whole service. This in turn leads back in to training for staff and what opportunities can be organised for the people who live in the home. The manager looks after the personal monies for people and the records seen were accurate and up to date. The manager ensures that all the equipment in the home is well maintained and evidence was seen to confirm that this happens. All the people in the home have personal risk assessments relating to their activities in and out of the home. Risk assessments are also in place for health and safety around the environment. All accidents and incidents are recorded and when necessary reported to the Commission of Social Care Inspection. Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Derwent Cottage DS0000061996.V343625.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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