Inspection on 07/02/06 for Emerson Court

This inspection was carried out on 7th February 2006.

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

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

Other inspections for this house

Emerson Court 14/10/09

Emerson Court 27/10/08

Emerson Court 28/06/06

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Emerson Court 129 Wingletye Lane Hornchurch Essex RM11 3AR Lead Inspector Mr Roger Farrell Unannounced Inspection 7th February 2006 12:20 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 Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 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. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Emerson Court Address 129 Wingletye Lane Hornchurch Essex RM11 3AR 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) 01708 442 351 01708 437 338 Mr Peter George Warmerdam Mr Peter George Warmerdam Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 June 2005 Brief Description of the Service: Emerson Court is a privately owned care home for older people that now offers seventeen places, fifteen of which are in single rooms. Some bedrooms have en-suite wcs. It is a is a large detached property on a corner plot with forecourt parking. The buildings layout means that it is not suitable for people who use wheelchairs or have significant problems with mobility. In November 2005 the registered manager bought the home. A lack of investment by the previous owners means that parts of the premises are quite tatty, including the state of the exterior decoration. It is set well back from a busy road, in a pleasant residential area not far from the shops and transport links of central Hornchurch. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 12.20 and 4.45pm on 7 February 2006. Peter Warmerdam started as the manager in October 2004 following a lengthy period during which senior care staff had been obliged to take on responsibility for the day-to-day running of the home. At that time there was considerable concern about the home, principally linked to how it was being operated as a business by the owners. The Commission took first stage legal action on some key areas of concern, such as accessing business accounts, hygiene standards and fire safety arrangements. Inspection reports over a couple of year’s set out how this home was not meeting the minimum standards, such as a lack of investment in maintaining and modernising the building. This covered basic expectations such as providing an adequate bathroom and carrying out the work asked for by fire safety inspectors. When Peter Warmerdam started as manager over a year ago the home was in crisis due to cash-flow problems. However, a consistent positive factor is that this home has been able to rely on a core of dedicated staff who continued to make sure residents’ day-to-day needs were met. There was a loss of trust in the owners, and staff were aware that the home was up for sale well ahead of being told by the former owners. Against this backdrop of strained relationships, the new manager, assisted by two deputies sought to maintain the home’s viability and ensure safe working systems. Although it took longer than anticipated, Peter Warmerdam became the owner on 30 November 2005. The last inspection of the home was an announced visit in June 2005. There were a series of meetings and contacts with the former owners about their plans, and the Commission’s concerns about the operation of the home. Peter Warmerdam maintained a good record of keeping the Commission informed regarding operational issues and his negotiations to purchase the home. This included confirming the maximum level of occupancy, saying that all bedrooms except one would be used as singles, and being specific about the use of communal rooms. Most of the core standards were covered at the last visit. A copy of that report is available at the home, or can be seen on www.csci.org.uk. At this recent visit Peter Warmerdam gave an overview of the transition from the previous owners, and the improvement plans he is developing. In turn, the inspector outlined the changes due to be introduced in April in the way homes are inspected. This places an increased responsibility on managers and owners to show how they are making sure the service meets the legal standards. They have now received a letter spelling out these changes. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 6 The main focus of this recent visit was to check on compliance with the 13 requirements listed in the last report. As appropriate, some general points from the last report have been carried forward. What the service does well: What has improved since the last inspection? Peter Warmerdam’s first year as manager was out of necessity largely concerned with ensuring the viability of the business. His registration as owner represents a fresh start for this home. He recognises that considerable ‘catching-up’ needs to take place in order to confidently demonstrate that Emerson Court is meeting the necessary standards monitored by the Commission – and in order to meet the expectations of residents, their families and social workers who arrange places. Some of the requirements in the last report were specific to issues with the previous owners, such as making available financial accounts and listening to the views of staff. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 7 Initial improvements carried out since the change of ownership include replacing linen and towels; decorating a couple of bedrooms; rebuilding the side canopy, and some external painting. Replacement laundry equipment was installed last year, and more recently other appliances such as a freezer and dishwasher have been bought. The main conclusion is that this home now has a committed manager/owner who is planning investment to improve the building. He can continue to rely on deputies and a staff team eager to see improved the facilities and prove that they provide a high quality of care. 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. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 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 Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 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, 4 and 5. There was a problem with the former owners being vague about some key information in the main documents. Updates done by the new owner give better specific details, such as how many staff are on duty and the size of bedrooms. A check on how assessments are being carried out showed that adequate information is being collected at an early stage. This is being used to draw up the initial care plans. EVIDENCE: Homes must have a main legal document called a ‘statement of purpose’ that says which category of resident they can care for; describe the facilities and level of service provided; and set out the values they promise to promote. A revised ‘statement of purpose’ was included as part of the new owner’s application. This is helpful as it confirmed the maximum number of registered places as 17; sets out the size of bedrooms and communal rooms; and acknowledges that the home is not suitable for those who have problems with mobility, including needing a wheelchair. It also says that it will accept residents for short stays. Helpfully, it gives other more specific detail compared to earlier versions, such as spelling out the level of staff cover. Each resident has also been given a copy of the updated ‘service users’ guide’. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 10 The national minimum standard (NMS) stresses the need to carry out detailed assessments. This is to make sure the home can meet a person’s needs, and also ensure sufficient personal details are recorded at an early stage. What needs to be covered is listed under Standard 3.3 in the NMS. The inspector looked at the file of the last resident to move in. The manager had completed a five-page tick-list and brief comment assessment. This person was paying their own fees, with no involvement from a social worker. There was a report from the resident’s last care home along with a transfer letter, and a two-side nursing assessment from ward staff. The main care plan sheets covering eleven headings had been completed. Another positive point was that an initial review had taken place the previous day with the person’s son and daughter, and the manager had already typed up the minutes. The out-of-date reference has been removed from the ‘contract of residence’. The five residents who pay their own fees have a copy of the contract. Copies of all the standard contracts used by councils who use the home are available. Havering Council pay for about half the residents. They carried out their own checks in January 2006, a month before this visit. The inspector said the manager needs to make sure sufficient information is recorded, particularly where there are not background reports or assessments from a social worker. However, based on the files seen at this visit, these standards are again scored as met. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 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. There has been a slow but positive improvement in the way practice files are arranged. However, the findings in June were disappointing as the files were not being kept in sequence and there were gaps. The smaller sample seen at this recent visit were better, meaning that Standard 7 is now rated as met. EVIDENCE: Setting up and maintaining a system of service user files that meet current standards has been a gradual process in this home. In particular, last year the inspector positively acknowledged the progress that had been achieved by the previous acting manager and the team. Notably, many of the ‘care-plan’ sheets were well expressed and contained good specific detail on the practical help needed. Samples seen at this visit were arranged in accordance with the front index sheets. This included the main care-plan sheets, and a Bartel Chart scoring a general dependency level. There is a section of contacts with medical staff, including a GP tracking sheet. Risk-assessment are quite basic. However, the file of one person seen recently raised the issue of her not calling for assistance when she got up during the night. A floor pressure pad had been bought as a means of alerting night staff. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 12 Descriptions of care needs given by a deputy showed a sharp knowledge of individual care needs. A copy of the last inspection by the Commission’s pharmacy inspector is available with notes by one of the deputies showing how the recommendations were tackled. Medication is stored in a trolley kept in the carers’ office off the main lounge. A temperature record has now been started. Medication is supplied by a local independent pharmacy in monitored dose cassettes with printed recording sheets. The pharmacist provides a two-part training session, and only staff who have completed this course give out medication. The pharmacist also does checks on the medication system. Indeed one such audit had occurred earlier on the day of this inspection, the feedback being that arrangements were satisfactory. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 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 and 13. New initiatives are being taken to make sure residents are offered chances to be involved in leisure and social activities. EVIDENCE: The manager and deputy gave an overview of routine activities, and each resident’s contact with family and friends. One of the seniors now takes a lead as activities organiser, being ‘off-rota’ one afternoon a week. The manager said that he would prepare and send the inspector a resume of social events, such as visits by entertainers. A clergyman visits once a month to lead prayers and hymns. About two thirds of residents have regular visits from their families. Descriptions were given regarding a couple of instances where family contacts need to be monitored. A Polish befriender now visits one resident who does not speak English and has no family from his country of origin. At his last visit the inspector joined the residents for lunch. All comments by residents about the standard of meals were favourable. One comment was – “It is very good. Always well cooked…Yes, there is choice…you are asked about preferences.” Another person added – “I would agree, items are well prepared, and the meat is tender.” A further comment was – “They know I like fish. I am asked if I want it coated or steamed.” As on previous occasions, staff were Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 14 seen to be responsive to individual needs, and encouraging one person who was slow having his main course. At teatime a wide range of options were offered for this lighter meal, residents telling the inspector that this is normally the case. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. The inspector is satisfied that complaints are taken seriously, including less serious matters. The manager and team have a good awareness of the their responsibilities, and the guidelines that must be followed if a concern is raised about the wellbeing of a resident. EVIDENCE: Details on making complaints are on display, and this is covered in the service users’ guide. The complaints book shows that staff record matters raised with them, including those of a relatively minor nature, and that these are followed through. In one instances it was recorded that a relative was offered a letter explaining the outcome, but they had said this was not necessary. Most recent entries were about minor building faults that could be tackled by the handyperson. The manager is aware of the steps to follow if there were a suspicion of abuse. This includes having available a copy of ‘No Secrets’, and the local protection policy and procedure. All staff have signed to say that they have been briefed on these procedures, and give good responses when asked about this area, including on the ‘whistle blowing’ expectation. This matter is due to be covered again in supervision. The manager needs to brief staff on the role of the General Social Care Council, and the phased programme of registration. All staff must be given a copy of the GSCC’s code of practice. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. The previous owners had a poor track record of keeping this building up to standard. Their approach was one of ‘patch-up and make do’, carrying out some essential work only when inspectors have started legal action new owner is developing an improvement plan to make sure the facilities catch-up with modern standards and expectations. EVIDENCE: The last owners showed little motivation to maintain the building in a manner that meets modern expectations of quality, or improve working arrangements. For instance, the exterior of the building needs attention as paint is peeling and woodwork shows signs of rot. However, A survey carried out ahead of the change of ownership found no structural faults. Last year the manager insisted on some essential replacements, such as new laundry equipment, replacement dining chairs, and levelling the floor in one bedroom - yet the building shows lots of signs of a failure to invest in basic upkeep and improvement. The new owner discussed with the inspector how he was prioritising work. This included completing some internal paintwork, Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 17 notably replacement doors that had been left unfinished. The next major task was to refit the kitchen, and replace the flooring in the ‘service area.’ A couple of bedrooms had been redecorated, and others would be done as part of a rolling programme. He agreed that by the end of April 2006 who will have drawn up an improvement schedule. This would list essential work, followed by medium-term upgrading. He also had broader longer-term ideas, such as withdrawing the last shared room, and reintroducing the front small lounge as a replacement single bedroom. Additional communal space would be achieved by adding a conservatory to the existing large lounge. This plan will be discussed at the next key visit. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 29 and 30. As stated earlier, the consistent strength of this home is that it has a strong core of committed care assistants and senior staff – most of whom have been in post for many years. About half of the team have completed, or are undertaking the main NVQ award. The manager can now show that he is carrying out better checks before new staff start. EVIDENCE: At the last visit the manager and owners were served with an ‘Immediate Requirement Notice’ for failing to carry out the necessary checks on staff. They were told that not having the documents asked for in Regulation 19(4)/Schedule 2 would result in further legal action, which can include prosecution. Soon after that visit the manager did an audit of all staff files, identifying the gaps and introducing a tracking sheet, and gave an undertaking to follow-up each item. At this visit the inspector was shown a tracking matrix, last updated a couple of weeks earlier. He also checked the files of the most recent staff to join the team. This showed that this matter is now satisfactory, including doing fresh CRB checks. There was such a check for the person who had started the previous week. Therefore the requirement on this important standard is now entered as achieved. The manager gave an overview of training and qualifications. The ‘staff details’ sheet shows that the home has now achieved the 50 target for qualified care staff. That so many staff have completed their professional qualification against the backdrop of uncertainty that existed last year is a further sign of Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 19 their resourcefulness. One of the deputies was instrumental in making sure this result was achieved In turn the manager restated his commitment to support NVQ training. One person was currently doing NVQL2; and four were doing L3, including the two deputies. The inspector also saw a series of training log sheets on core topics such as fire safety; first aid; safe food handling; manual handling; risk assessment and general health and safety. These list when each person has watched the training video, and completed a test paper on that topic. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 38. The manager is making sure that all the necessary safety checks are booked, and gave commitments that all the confirming certificates will be readily available. One senior takes a lead on internal safety checks, and her records are very well arranged and up-to-date. EVIDENCE: One of the senior care workers takes a lead on in-house safety checks. There is a well set out fire log showing regular equipment checks, drills, and contractor servicing of the alarm system and extinguishers. Her record of general safety checks shows the same high standard. However, the main electrical and gas, certificates had just lapsed, but renewal visits had been booked. A check on the water supply was also scheduled. There was a current lift certificate. The handyperson was carrying out the safety checks on electrical appliances. There is now a maintenance book that is used to report defects for the handyperson to tackle. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 21 The last inspection of the premises by a fire safety inspector was in October 2004, with satisfactory conditions reported following the work they had asked to be completed. In November 2004 an environmental health report identified 24 items needing improvement. A follow-up visit concluded that arrangements had improved, but repeated the need to replace flooring in the kitchen and service area; and install a dishwasher and fit a new sink. The manager confirmed that these works would be completed within a couple of months. A resident and relatives survey had recently been circulated. The inspector said that he would like to see an analysis of the returns at the next visit. How residents are helped with their money will be checked at the next visit. Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Items 1 to 3 are carried forward. 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(5) Requirement Timescale for action 30/05/06 2 OP19 16(2); 23(2) 3 OP38 13(4) 4 OP12 16(2)(m) Carry out all the improvements set out in the environmental health reports, including providing suitably sealed flooring in the kitchen and service areas. Prepare a premises improvement 30/05/06 schedule. This should set out a programme covering the decoration, renewal of fabric and replacement of furniture and equipment. This must include target dates for completion, and cover in order of priority: bedrooms; the main lounge; the dining room; the small lounge/diner; the smoking room; the kitchen and tea-preparation area; the laundry; the bathroom; the shower-room; wcs; the staff work station; and the exterior of the building. Arrange for a competent person 30/05/06 to test the water supply system, including precautions against the development of Legionella, and have a report of these checks available. Have available a record of the 30/05/06 activities and social events DS0000066195.V283380.R01.S.doc Version 5.1 Emerson Court Page 24 5 OP18 18(4) 6 OP38 13(4) provided, and a record of residents that took part. Provide all staff with information on the role of the General Social Care Council, and make sure each person is given a copy of the code of practice. Have available up-to-date certificates and documents covering the following areas: • Five year electrical safety certificate; • Checks of electrical appliances; • Corgi gas certificate. 30/05/06 30/05/06 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 Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford 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 Emerson Court DS0000066195.V283380.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!