Inspection on 09/11/05 for Edinburgh House

This inspection was carried out on 9th November 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 but made no statutory requirements on the home.

Other inspections for this house

Edinburgh House 26/05/06

Edinburgh House 09/06/05

Edinburgh House 25/01/05

Similar services:

Chestnut Walk

Dunwood Manor Nursing Home

Excelsior

Cherwood House Care Centre

Durban House Nursing Home

Dawson Lodge

Court Lodge Nursing & Residential Home

Ferendune Court

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

CARE HOMES FOR OLDER PEOPLE Edinburgh House Sundridge Close Cosham Portsmouth Hampshire PO6 3JL Lead Inspector Clare Hall Unannounced Inspection 9 November 2005 10:00a X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Edinburgh House Address Sundridge Close Cosham Portsmouth Hampshire PO6 3JL 023 9284 1155 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) Portsmouth City Council Miss Sara Helen James Care Home 32 Category(ies) of Dementia - over 65 years of age (32) registration, with number of places Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user under 65 years of age to be admitted for a period of respite 9th June 2005 Date of last inspection Brief Description of the Service: Edinburgh House is a Portsmouth City Council run home providing a service for older persons who have dementia. The home has the facilities to accommodate up to 32 residents providing long stay residential care as well as offering respite and short stay care. The service is in one building with the accommodation on 2 floors. Each floor has two units each with its own lounge/dining area and kitchenette. Service users bedrooms are within easy reach of each lounge, and there is a designated staff group for each unit. Edinburgh House is close to the shops and is on a bus route. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken over one day. Considering client’s abilities the inspector spoke with six service users, two catering staff, one member ofdomestic staff, administrative staff and eight care staff including the homes manager. The clients were observed making full use of the facilities, taking their meals, and enjoying full use of the gardens. Questionnaire responses in respect of the service were also viewed and these included six residents’ questionnaires, ten relatives’ questionnaires and 21 care staff questionnaires. Staff were spoken with in groups and individually and observed throughout the day providing support to the clients. Feedback from three relatives was also received and a tour of the premises undertaken. What the service does well: The staff again during observation and discussion demonstrated both creativity and insight into the needs of this client group. Their approach to care has been demonstrated clearly by using the core values of choice, respect, fulfilment and rights in meeting the needs and promotion and preservation of skills, independence, freedom and risk taking. Staff were knowledgeable of the specialist needs regarding this client group and care is driven and promoted on an individual person centred basis. Comments received in respect of the service included, “I enjoy working at Edinburgh house. I feel valued and everyone works as a team”. “The management team always listen to any suggestions we have and are always approachable”. “ I feel Edinburgh House is one of, if not the best well run care home I have ever visited.” “The staff are always friendly and helpful and nothing is too much trouble from the manager downwards and my mother is very happy here” “We have always been told if a doctor has been called and what is happening”. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The provider has not addressed the concerns regarding the environment and the requirements made regarding this have not been met and will be raised again. Also the provision for alternative financial arrangements for clients has not moved forward and Portsmouth City continues to hold the funds of clients in their holding account denying them their own accounts in which to accrue interest. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 7 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. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 The information provided to the clients and relatives of Edinburgh house requires further attention and review. The home is now providing terms and conditions of residency including fees to clients. Service users are not admitted to the home without care management assessments and discussion at panel to ensure client needs can be met. EVIDENCE: It was established during the inspection in June 2005 that Portsmouth City Council were updating and reviewing the home’s service user guide. This remains unchanged and no revision of this document has been forwarded to the Commission. This will be looked at again at the next inspection. The manager stated that home’s statement of purpose still does not describe the policy on client’s personal items and the inventories of items brought into the home. It was agreed that both these documents would be reviewed at the next inspection. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 10 Clients do have other relevant information available and information packs are kept accessible in the client’s rooms and in the communal areas. Also in the main lobby of there home there is an abundance of literature available to relatives regarding counselling services, advocacy services and other relevant topics from charities like Age Concern. The previous inspection report was clearly available to residents and their representatives at the front desk and on the notice board. It was established that there was only one client who did not have a representative and it was stated that she does have some capacity and is able to give informed consent. Relatives spoken with acknowledged information is available to them in respect of the home. Since the last inspection one third of all clients have been issued the new terms and conditions of residency and these were seen signed and secured on client files. Service user files demonstrated care management assessment details and following discussion with senior staff it was established that should a client be referred from secondary care establishments then the home has its own assessment documents which were viewed. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 The home’s philosophy of care ensures that residents are treated with respect, that their dignity is preserved and that their choices are respected. Staff value resident’s privacy, dignity, choice, rights and independence. The mental health needs of the clients have now been incorporated in detail in service user care plans. EVIDENCE: Staff were observed completing and updating the care plans throughout the day. Four plans were reviewed and case tracked to the care being provided. These identified that significant improvements have been made for the assessment and recording of client needs in communication and identifying mental health issues. Descriptive interventions are now recorded to meet identified individual needs. Plans describe adequate details relating to interventions for communication, memory loss, disorientation, and change in personality and challenging behaviours and they reflect the use of non-verbal techniques for effective communication. The plans did reflect good physical care needs with detailed interventions. A commendable improvement was the recording of the service users non-verbal cues for pain. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 12 The manager and staff are working very hard to update all the clients’ records to this standard and a number of care assessment tools are under trial in this process. The feedback from six resident questionnaires indicated that they are all very satisfied with the care provision at Edinburgh House. Two stated they would like to go out shopping and attend church more and one stated she would like to see an optician. One service user specifically stated she is very happy the way things are, especially having the home’s cats come to see her. Of the 10 relatives questionnaires, there were an abundance of positive and complimentary comments regarding the service and the staff. No areas of concern were identified. One stated “I have always found everybody very kind, friendly and welcoming. They treat dad with courtesy, respect and friendliness.” Another said “My mum has been in Edinburgh House for twelve years and I have nothing but praise for the management”. Since the last inspection further improvements were noted for the safe identification of clients in the administration of medicines. It was identified that the home does require a new up to date drug reference. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Significant improvement has been demonstrated for the recording of service users choices and preferences. EVIDENCE: The routines of daily living were observed throughout the day and it was clearly evident that residents activities’ made available are flexible and varied to suit service users’ expectations, preferences and capacities. Staff were sympathetic to the noise levels, needs of the clients on an individual basis. Staffs were also observed seeking the opinion of residents to having the television on and how loud it was and to providing reading materials. Residents were enjoying the gardens and making use of their private space to sit quietly. Relatives and visitors were also seen freely moving around the home. On the day of the visit the residents were observed enjoying the presence of the home’s cats and birds. Service users were observed having the opportunity to exercise their choice in relation to: • leisure and social activities; • food, meals and mealtimes; • routines of daily living; • personal and social relationships. Activities participated in were seen being recorded. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 14 One service user, visited in her room described her day and how she chooses what she does and how she spends her day. She was well dressed in clothes she was particularly fond of and had on her favourite jewellry. She described how considerate the staff were and there was a hot cup of coffee brought to her room, which she thought was wonderful. Staff spoken to demonstrated an understanding of the needs of this particular client group. Discussions with one carer identified how she promotes activities and stimulation on a 1:1 basis. She was observed being very creative and knowledgeable regarding the individual needs of clients. Even while talking with the inspector she demonstrated respectful, supportive and appropriate acknowledgment in response to the demands made on her by the clients during the discussion. Numerous craft supplies were seen available at the home and it was established that the home belongs to a craft bank. Following a nominal fee the home can have access to numerous materials that are used for clients when undertaking craft activities. The manager did discuss with the inspector that the staff hope to offer more activities and support to clients in view of the care staff being increased. Staff did comment that they would like the opportunity to go out more with service users. The development of the activities provided in the home, including specialist support for this client group, will be looked at further during the next inspection. The notice board was advertising forth-coming events including a Christmas fete anda Christmas party and relatives meetings. The minutes from previous relative meetings were also on display. The inspector toured the home’s kitchens. All food records and cleaning schedules were completed. The storeroom was clean and well organised and well stocked. The home had a food hygiene inspection undertaken on 6/10/05.The recommendations were for minor redecoration of doorframes and other wood work where chipped. On further discussion there has been no date arranged for this to be addressed. The kitchen staff demonstrated that they have information on fortifying food, vitamins and minerals and meal plans for diabetics. They also have reference materials for number of differing cultural and religious diets and guidance on food preparation. Service users were observed taking their lunch and one client was seen being provided with an alternative choice of pasty and chunks of vegetables and potatoes to suit a finger food diet in view of her abilities. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 15 It was established that the homes cooker can be unreliable. It is over eighteen years old was said to be the oldest cooker in all of the Portsmouth City Homes. This item needs to be included in the homes 2006-2007 plan for replacement as it has already broken down twice this year and the home also provides food not only for some 32 residents but also for the adjoining Day Centre. Food records and meat temperatures were complete. All feedback from service users and relatives was very positive regarding the meals supplied. Staff did raise concerns that they did not feel that there was enough fresh fruit and vegetables supplied. The care staff stated that the service users have their fruit bowls in each unit filled up once a week but they did not feel this provided a good enough supply and that the clients were not getting their five portions daily. The manager agreed to address this and seek opinions at forthcoming meetings. This will be discussed further at the next inspection. One service user explained that “my choice is for jam, bread and butter for my breakfast, which I have, when the others have cereal”. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has implemented a complaints procedure logbook, which identifies the audit trail, and log of the complaints received and staff have access to relevant adult protection procedures. EVIDENCE: There is a complaints procedure accessible in the homes information documentation held in the resident’s room and communal areas and since the last inspection the Home has devised a complaints log. Relatives and service users spoken to stated they would report all complaints to the manager. The home does have all the relevant policies and procedures in relation to the protection of vulnerable adults. Areas of abuse were discussed with staff members and a good understanding was demonstrated. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,23,24,26 Previous requirements raised in relation to the environment have not been addressed. The communal environment is suited to the needs of clients though the bedrooms lack space. EVIDENCE: There is a general five-year plan for the home but this does not indicate specifics in regards of continuing redecoration of wear and tear and replacement and renewal. Concerns raised following the inspection undertaken in June 2005 regarding the homes environment were that, • • • The external grab rails need redecorating Toilet/bathroom floors are in need of replacement The staircase to the back of the home has wallpaper hanging off the ceiling and the floor is bare concrete. This area needs attention. DS0000044195.V254948.R01.S.doc Version 5.0 Page 18 Edinburgh House • An area in the garden was assessed by health and safety and requires work to make it safe. These areas have not been addressed and requirements made will be raised again. Four of the thirty service user’s rooms are undergoing redecoration and recarpeting. All the homes bedrooms are now single though the conditions of registration remain at 32 in case the service wishes to admit a married couple. These rooms do vary in size. A number of rooms are limited in size, which limits the furnishings in these rooms. The minimum standard of furnishings cannot be provided, as this will restrict the floor space. Resident’s rooms are personalised but the resident is limited to the amount of possessions due to the space provided. Residents described the home as clean and did not have concerns regarding the cleanliness. Portsmouth City are currently reviewing infection control procedures and this will be looked at further at the next inspection. One resident visited in her room described how nice her room was, “so nicely furnished with its own hand basin and beautiful bed”. She stated how the bin was emptied every day and how clean the room was kept by cleaning staff. Staff were observed wearing their own individual hand gels. Discussion and a tour of the premises demonstrated that colour, layout and décor were sympathetic to the clients needs. The gardens are large and service users were seen making full use of them. The manager stated that new bedding plants would be purchased for service users who enjoy gardening to plant for the winter. The home provides separate toilet and staff rest rooms. There is also a training room on the ground floor. A tour of the premises indicates there is enough storage space. The home provides four living units catering for up to eight service users. They provide living /dining/kitchenette facilities and service users were observed freely wandering between the units if they wished. The set up of these small clusters appears complementary to the philosophy of the type of living suited to clients accommodated at home. One service user was observed washing and drying up the dishes. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 The staffing levels have been increased but must also remain flexible so as to meet the varying demands of this client group. Staff recruitment files are now held on the premises. The staffs now receive an initial induction, which is specifically tailored to the working in the establishment rather than the organisation. EVIDENCE: There are four units provided for which accommodate seven/eight residents and there has been only one member of staff to each unit. Since the last inspection the care hours have been increased by 115 hours and this allows for an additional member of staff to float across all four units and during lunch times the units have an additional two members of staff. The manager stated she envisages the staff being able to incorporate more individual tailored activities with the increase in numbers of staff and more support for clients requiring supervision during mealtimes. Staff and records confirmed that service specific and necessary mandatory training is undertaken. Records also indicated the implementation of a home based induction which allows for staff to be orientated to the specific client group and their associated needs whilst in their period of being shadowed. Staffs were observed interacting with residents using appropriate techniques and during discussion it was very evident they were very knowledgeable to the needs of this client group. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 20 It was stated by the manager that in view of the clients’ needs agency staff are not employed and it was observed in the minutes of a relatives meeting that relatives voiced their approval that the home had not used agency staff for over two years. It was recognised that clients with dementia have specialist needs that require staff with appropriate skills and training. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34, Portsmouth City Council is still holding client monies in holding accounts, disadvantaging the residents. Significant efforts have been made by staff to seek service user and relative opinions in respect of the service. EVIDENCE: The manager of the home holds an NVQ 4 in management and the NVQ 4 in care. It has also been established that she has undertaken a number of courses to further develop her managerial skills and professional development. Course undertaken included the certificate in social care management, First aid, Quality assessment, depression in older adults, health and safety foundation for managers, various IT systems training and three courses in specific relation to the field she works in. These include dementia care best practice, creative approaches and working with people with dementia. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 22 The manager has developed, since going on a quality course for people working with clients with dementia, a quality-monitoring questionnaire. This questionnaire has been produced based on the information the manager gained on the course. The manager stated that the information gained through the questionnaires every six months should over a period of two years cover every aspect of the home. This is commendable. The service is still holding client monies in city holding accounts. Portsmouth City Council was stated to be addressing this in June 2005 but it has been established during discussion that the co-ordinator for this transition is no longer in post. This will require further discussion with the PCC. Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x 2 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 4 1 x x x x Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23(2) b Requirement A plan of action must be provided to address the homes programme for the redecoration and refurbishment of the home, internally and externally on an ongoing (monthly) basis. This programme must demonstrate that the redecoration refurbishment and renewal is undertaken and addresses the concerns identified in the report, continuously and not just in the long term plan. This requirement has not been met and has been raised for a second time The concerns which must be addressed by the provider are; • The external grab rails need redecorating. • Toilet/bathroom floors are in need of replacement • The staircase to the back of the home has wallpaper hanging off the ceiling and the floor is bare concrete. This area needs attention. • One dining table is in need Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 25 Timescale for action 30/01/06 of replacement /adjustment as it wobbled considerably when lent on and could potentate spills/hazard. • An area in the garden was assessed by health and safety and requires work to make it safe. • The homes cooker needs to be replaced. • minor redecoration of the doorframes and other wood work where woodwork is chipped in the kitchen. An action plan stating the dates that these works will be undertaken must be submitted to the Commission. 2 OP35 20(2)a Service users finances must not 30/01/06 be held in the Portsmouth cities holding account. A plan of action and completion to having this situation rectified by the provider must be forwarded to the Commission. 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 Edinburgh House DS0000044195.V254948.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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