Inspection on 28/07/05 for Dunelm Nursing Home

This inspection was carried out on 28th July 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dunelm Nursing Home 26/04/07

Dunelm Nursing Home 19/01/06

Dunelm Nursing Home 28/02/05

Dunelm Nursing Home 06/10/04

Dunelm Nursing Home 19/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Dunelm Nursing Home Grove Road Chadwell Heath Romford Essex RM6 4XJ Lead Inspector Jackie Date Unannounced Inspection 28 July 2005 09:00 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 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. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dunelm Nursing Home Address Grove Road, Chadwell Heath, Romford, Essex RM6 4XJ 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) 0208 597 0429 0208 559 0938 Redbridge Community Housing Ltd (RCHL) Mrs Margaret Lutchmiah CRH Care Home 12 Category(ies) of LD Learning disability (12) registration, with number of places Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28 February 2005 Brief Description of the Service: Dunelm is a 12 place care home that provides nursing care for adults with learning disabilities. It is one of a number of homes run by RCHL, a not-forprofit organisation. The home was in the grounds of a hospital but this has now been closed and a residential estate is being built. Most of the residents have profound learning disabilities and additional physical disabilities. Residents have little or no verbal communication skills, and limited ability to make decisions about their lives. The home was purpose-built and the ground floor is accessible to wheelchair users throughout. The first floor has an office and staff area. The ground floor has two units each with five bedrooms (one shared) and a large lounge/dining area. The kitchen is between the two units. At present 10 people live at the home. Bedrooms are decorated and personalised, according to the residents likes. Some of the residents attend day services. The home has 2 minibuses and residents go out quite a lot. Activities and physiotherapy are provided in the home. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted for about five hours and took place during the morning and early afternoon. It was the first of the two inspections that each home must have during the inspection year. Five staff and all of the residents were spoken to. All of the communal rooms, the kitchen and some of the bedrooms were seen. Care and other records were checked. In addition to this the inspector had previously visited the organisation’s head office to view staff records. What the service does well: What has improved since the last inspection? The manager and staff team continue to work to provide a good service for the residents and to meet each persons needs. A better second minibus has been purchased and this gives more opportunity for residents to go out. New flooring has been fitted in some areas of the building and some of the rooms have been painted. Therefore the environment continues to get better. The sensory room has been refurbished and new equipment purchased. Residents therefore get more opportunity for relaxation and sensory activities. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 6 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. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 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 Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 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) 2, 3, 4 and 5 Information is available to enable the staff team to meet residents’ needs. When there is a vacancy information is obtained to enable the staff team to decide whether or not the home can meet prospective residents needs. Prospective residents and their relatives can spend time in the home to find out what it would be like to live there and to enable the resident to make a choice about living in the home, within their capacity to do so. Residents and their representatives are still not provided with a written and costed contract/statement of terms and conditions and therefore may not always be clear about what they are entitled to. EVIDENCE: The organisation has an admissions procedure that includes the gathering of information and assessments. It also contains details of how a prospective resident would be introduced to the home. Assessments are done before residents move into the home. They are made by trained nursing staff and detailed information about individuals needs and preferences are also gathered. Prospective residents are invited to visit the home and to gradually build up from short visits to overnight stays. Each resident has a detailed care plan that contains information about what they can do, their likes and dislikes and what help and support they need. The Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 9 staff team know residents well and know what they can do, their likes and dislikes and what help and support they need and can meet these needs. The residents are unable to comment on what it is like to live in the home, but they all appeared to be happy and relaxed. The residents have a contract between themselves and the Housing Association/provider. However the three previous inspections have required that the organisation must provide a fully costed contract/statement of terms and conditions to each resident. This was not available in residents’ files. After the inspection the manager said that although this piece of work has not been carried out the organisation have now developed a format for this and it will be completed in the near future. In view of this the date for completion of this piece of work has been extended but if this requirement is not met the Commission will consider enforcement action to ensure compliance Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 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) 6, 7 and 9 Residents’ plans focus on their individual needs and abilities and contain detailed information so that staff can meet their needs. EVIDENCE: Each resident has a care plan. These are very detailed and give clear information about each persons strengths, needs, likes and dislikes. Healthcare plans are also in place and these detail healthcare and nursing needs. The degree to which residents can be involved in the development of the plan is very limited due to their profound learning and communication difficulties. Each resident has a daily log and the staff record details of what the person has done, what care has been provided and how the individual has been. Residents have a key worker and also a named nurse. The care plans had been reviewed and relatives had been invited to these reviews. There are risk assessments in place. These identify risks for the residents and indicate ways in which the risks can be reduced to enable the residents’ needs to be met as safely as possible. For example the support a resident needs when using a hydrotherapy pool Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 11 Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 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, 13, 14, 15, 16 and 17 The residents are supported to take part in activities and to be part of the local community. Residents are supported to keep in contact with their relatives. Residents are given meals that they like and that meet their needs and individual preferences. EVIDENCE: The residents all have profound disabilities and very high support needs. They are extremely dependent on staff. Some of the residents attend local day centres and others are supported to access activities by the staff team. One of the residents has a one-to-one worker to support her in activities. The residents go out a lot during the week. This includes shopping, bowling, swimming, cinema, and hydrotherapy. The home has the use of two adapted Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 13 vehicles and a driver/handyman is employed. Residents go out to places of interest in the community or out for lunch. On the day of the inspection two of the residents went to use the sensory room of the local day centre. The sensory room in the home has been refurbished and new equipment purchased. It includes a ball pool, bubble tubes, music and other sensory equipment. Staff said that most of the residents really enjoy using this room. An aromatherapist visits every two weeks and some of the residents have aromatherapy sessions. One key worker has contacted the Asian Womens Network to register one of the residents but unfortunately theres a waiting list at present. Residents are taken to different places to worship as required. This includes the church, the mosque and the temple. The staff team are to be commended for the range of community activities offered to the residents and for their ongoing efforts to extend these further. Several families and relatives are involved with the home and “ the friends of Dunelm” has been set up for some time. Fundraising and social activities are organised by them. On the Sunday before the inspection the family of one resident organised a barbecue for everyone. When the inspector arrived at the home most of the residents were still getting up and having breakfast. The residents all had different things for breakfast and the staff said that this was because of their different likes. Residents had different plates and cutlery according to need. One member staff said that if you offer one of the residents a choice he will smile at the one that he wants, for example tea, coffee or water. Some residents were given their food by the staff. Menus are based on staffs knowledge of residents’ likes, dislikes and needs. Fresh vegetables, meat and fish are used rather than processed food. The residents cannot always eat large pieces of hard fruit and therefore the cook buys soft fruits when available and also makes fruit salads. One of the residents has a gluten-free diet. Another resident receives their food via a PEG feed tube directly into the stomach and the nursing staff are trained to deal with this. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 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 and 20 Residents receive personal care that meets their individual needs and preferences. The staff team support the residents to get the healthcare that they need. Medication is appropriately administered by the nursing staff. EVIDENCE: The residents all require a lot of support with their personal care and details of the help that they need and how they prefer to be supported are in their support plans. For example “offer a bath or shower”, “ wash hair twice a week”. All of the residents are registered with a local doctor and specialist help is received when needed. Staff take residents to all of their medical appointments. Residents’ files have details of nursing assessments and health care issues and show that residents have regular access to health care professionals. Records are kept of medical appointments and these show that residents have checks from the optician, dentist and when needed the chiropodist. A physiotherapist visits the home twice each week and provides physiotherapy to the residents that need this. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 15 None of the residents can self medicate and medication is administered by trained nurses. Medication is appropriately and safely stored in a locked cabinet and medication administration records are kept. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 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 and 23 There is a complaints procedure that would be followed in the event of any complaints being made. Staff are aware of issues of abuse and work to protect residents from abuse but not all of the staff have received training in this area. EVIDENCE: There is a complaints procedure and this is displayed in the home. However due to the degree of their disability is unlikely that any of the residents would be able to make a complaint without support. Views of the service will be sought from relatives and representatives prior to the next inspection. The organisation has produced a detailed adult protection policy that tells staff the actions to take in the event of abuse/suspected abuse being discovered. Staff spoken to were aware of the issues of abuse and aware of their responsibility to residents. However some staff said they had not received any adult protection training. Others said that they had and also that it forms part of the LDAF (Learning Disability Award Framework) and the NVQ training. All staff must receive adult protection training. All of the residents need help with their finances and do not have the capacity to understand about the concept of spending or saving money. Records are kept of financial transactions. Some residents’ financial affairs are managed by their families. Others are managed the head office. Residents’ monies Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 17 were not checked as part of this inspection. However the organisation does carry out financial audits and copies of this were available at the home. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 18 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, 26 27, 28, 29 and 30 The residents live in a clean and comfortable home that has suitable aids and adaptations for their needs. EVIDENCE: Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 19 The house is near to the local shops and bus routes. There are two units in the home and the communal space in each consists of a large lounge/diner. There is also a kitchen, laundry room and a garden. The ground floor of the building is accessible for wheelchair users throughout. Two residents share a large bedroom and the rest have single rooms. These are decorated and furnished to meet individual needs and likes. Special beds had been purchased for the residents that need these. The flooring in the communal areas and the hall had been recently replaced. The communal areas are large and quite difficult to make homely. However the staff team continue to put a lot of effort into improving the environment with soft furnishings, flowers and plants and photographs. There are two offices upstairs. There are enough baths, showers and toilets and these are adapted to meet the residents’ needs. At the time of the inspection the home was clean and free from offensive odours. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 20 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) 33, 34, 35 and 36 The Commission for Social Care Inspection cannot be confident that service users are supported and protected by the organisations recruitment practice, including the recruitment of bank and agency staff. Staffing levels are sufficient, and staff receive the necessary training, supervision and support, in order to meet residents’ current needs and provide a good service for them. Residents are supported by a staff team that know them well and who are committed to providing a good quality service. EVIDENCE: An inspection of a sample of personnel files at the organisations head office showed that not all of the required checks on staff could be demonstrated to have taken place. This was of particular concern, as many of the files inspected related to staff who have joined the organisation in the past year, and for whom the recruitment process should have been robust, as matters regarding recruitment have been discussed previously with the organisation. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 21 The staff team have experience of working with people with learning disabilities and staff on duty said that they had received a lot of training since they started work in the home. This has included epilepsy, manual handling, LDAF (Learning Disabilities Award Framework) and NVQ. They were clear about their duties and responsibilities towards the residents. The staffing on the early shift is one team leader (a qualified nurse) and four support workers. The late shift has one team leader (a qualified nurse) and three support workers. At night there is one team leader (a qualified nurse) and two support workers. A driver handyman, a cook and a cleaner are also employed. At the last inspection there was not enough evidence to confirm that staffing levels were sufficient to meet residents needs at all times. In particular during the late shift. However since then this issue has been discussed with the staff team and as a result of this a cook is now on duty for three hours on Saturday and Sunday. Additionally, one of the residents, who had very high support needs, died earlier this year. Staffing levels are now sufficient to meet the residents’ needs. Staff meetings and staff supervision have been taking place regularly, providing staff with the opportunity to discuss problems and to be involved in the development of the service. Staff spoken to say that they receive good support from the manager and from each other. Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 22 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) 37, 38, 39, 41, 42 and 43 The home is well managed and provides a safe environment for the residents. However the organisation has not been robust in maintaining staff records or ensuring that policies and procedures are relevant to this service. This could potentially place service users at risk. EVIDENCE: The manager has substantial experience of services for people with learning disabilities. She is an enrolled nurse, a registered learning disabilities nurse and has obtained a Certificate in Management Studies and a Postgraduate Diploma in Health Service Management. Staff are involved in the running of the home and the staff team discuss any developments and changes. The quality of the service provided to the residents is monitored by the home manager and by the organisation. The service manager carries out monthly monitoring visits to assess how effectively the home is operating to meet its Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 23 stated aims and objectives, and reports are written. These indicate the action to be taken when deficiencies are identified. Copies of these reports were available in the home and copies are sent to the Commission. In addition to this the organisation carries out a quality audit each year. All of the required residents records are kept but as stated previously an inspection of staff records held at the head office found that staff records as required by Schedule 2 of the Care Homes Regulations 2001 were not available in all staff files. The organisation has been advised that this issue must be addressed and have given commitment to audit staff files and address the problem. All of the necessary health and safety checks are carried out and a safe environment is provided for the residents. The previous two inspections have required that the registered person must ensure that a costed business development plan is available for the home. This has not been done but staff said that they have discussed issues for the development plan in supervision sessions and at staff meetings. After the inspection the manager said that although this piece of work has not been carried out the organisation have now developed a format for this and it will be completed in the near future. In view of this the date for completion of this piece of work has been extended but if this requirement is not met the Commission will consider enforcement action to ensure compliance Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 24 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 x 3 3 3 2 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 3 x 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 4 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dunelm Nursing Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 2 3 2 Version 1.40 Page 25 G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Yes 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 YA5 Regulation 4, 5 Requirement Each resident must have a written and costed contract/statement of terms and conditions. (Previous timescales of 30 June 2004, 31 December 20004 and 31 May 2005 not met). The registered persons are required to ensure that their recruitment procedure is robust and in line with regulation. All staff must receive Adult Protection training. The registered persons are required to maintain records for the protection of service users in line with Schedule 2 of the Care Homes Regulations 2001. For new staff before appointment and for existing staff. The registered person must ensure that a costed business at an development plan is available for the home. (Previous timescales of 31 January 2005 and 31 May 2005 not met). Timescale for action 31 October 2005 2. YA34 19 On going 3. 4. YA23 YA41 13 17 31 December 2005 30 September 2005 5. YA43 25 31 October 2005 Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 26 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 Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Dunelm Nursing Home G55_S0000025952_Dunelm_V241321_280705_Stage 4.doc Version 1.40 Page 28 - 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!