CARE HOMES FOR OLDER PEOPLE
Eshcol House 12 Clifton Terrace Portscatho Truro Cornwall TR2 5HR Lead Inspector
Lowenna Harty Unannounced Inspection 15th November 2006 09:30 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 Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Eshcol House Address 12 Clifton Terrace Portscatho Truro Cornwall TR2 5HR 01872 580291 01872 580646 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) Mark Fairhurst Mrs Gillian Fairhurst Mrs Margaret Ann Stobbart-Rowlands Care Home 31 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (14), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (4), Old age, not falling within any other category (31), Physical disability (4), Terminally ill (4) Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Up to 1 service user with dementia aged 50-60 years may be admitted. 26th July 2005 Date of last inspection Brief Description of the Service: Eschcol House provides accommodation, personal and nursing care for up to 31 older people. Four of these may have a physical disability; Four may be terminally ill, Four may have a mental illness, up to fourteen may have dementia and one adult aged 50-60 years may have dementia. The registered providers are Mark and Gillian Fairhurst. They are actively involved in the business on a day-to-day basis and employ a manager and a team of staff to assist them. There is always a qualified nurse on duty at the home. The home is located in the village of Portscatho on the Roseland Peninsula. It overlooks the sea and several rooms have spectacular sea views. The home is accessible by road and the village is within walking distance. The home has three storeys. The upper floors are accessible by a serviced lift, stairs and stair lift. There are two lounges on the ground floor and a separate dining room. Most of the bedrooms provide en suite facilities. The home is set in its own attractive grounds with parking space at the front of the building. There is level access to all communal parts of the building and the grounds and suitable facilities for people with physical disabilities to enter and move around the building independently. Fees range from £565.00- £725.00 per week. Additional, variable charges are made for (optional) hairdressing, according to information provided by the manager at the time of the inspection. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a key inspection, undertaken by two inspectors working jointly, which was unannounced. It took place on 15 November 2006 and lasted for approximately five hours. The purpose of the inspection was to ensure that residents’ needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that residents’ placements in the home result in good outcomes for them. Information received from and about the home since the previous inspection has also been taken into consideration in making judgements about the quality of outcomes for the residents living there. The inspection included interviews, some held privately in residents’ rooms and some in the communal area of the home, with residents and visiting relatives and friends. In total six residents were interviewed and two visitors to the home. Two members of staff were interviewed and there were opportunities to directly observe aspects of residents’ daily lives in the home and staff interaction with them. Other activities included an inspection of the premises, examination of care, safety and employment records and discussion with the nurse in charge of the home, who is also registered with the Commission as manager of the home. The principle method of inspection was “case tracking”. This involves interviews with a select number of residents; staff caring for them and/or their representatives, and examination of records relating to their care. This provides a useful impression of how the home is working overall. At this inspection four residents were case-tracked, with particular reference to their needs relating to their age, culture and ethnicity, religion, gender, sexual orientation and disabilities. What the service does well:
Most of the people who were interviewed during the inspection said that they had made an active decision to be admitted to the home and that they had been provided with good information about it before they moved into it. Some gave detailed accounts of how the home’s manager had visited them and discussed their needs before they visited the home. They were not formally admitted as residents until they and the home were assured it would be
Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 6 suitable for them. Most of the residents are admitted on a long-term basis, although the home does provide short-stay admissions occasionally, depending on vacancies. Information about this can be supplied, by the home upon request. Residents’ individual health, personal and social care needs are set out in detailed care plans, so that staff are aware of how they should be cared for. These are regularly reviewed and updated as their needs change. Some of the residents who were interviewed said that they are aware of the contents of their care plans and all of them agreed that they are well cared for. There are qualified nurses on duty at all times and residents have good access to external healthcare providers, such as general practitioners when they need them. There are safe and sound systems in place to ensure that residents’ medicines are properly managed so that they are kept safe and as comfortable as possible. All of the residents who were interviewed said that staff look after them well. During the inspection staff were seen to treat residents with kindness and respect at all times. Residents are offered a wide range of activities and at the time of the inspection there was a religious service in progress in the main lounge. Communion was also offered in their rooms if they preferred. Examples of activities include film shows, clothes shows, piano recitals and trips out in the car. All of the residents who were interviewed indicated that they are satisfied with what is on offer in this respect. Visitors are made to feel welcome in the home and were observed coming and going from the home throughout the inspection, so that residents maintain valued contacts. Residents who were interviewed said that they are able to make decisions about things that are important to them and gave examples of this, such as choosing whether to join in with communal activities or enjoy the privacy of their own rooms, for example. All of the residents who were interviewed said that they enjoy mealtimes and were complementary of the food provided to them. They said that they are offered a choice of food and their preferences are taken into account. One said that they appreciate being given strong tea to drink, for example. Most of the residents who were interviewed were aware of what they should do if they wish to make a formal complaint and one described the manager as very approachable in this respect. All were satisfied with the care and services provided to them and said that they had not had any reason to complain about the care or services provided to them. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 7 All of the residents who were interviewed said that they feel safe in the home and staff are well trained on what to do if they suspect a resident is being abused. Most importantly, the home is part of the local community with plenty of visitors coming and going from it so that residents are not isolated there. All of the residents who were interviewed expressed satisfaction with the accommodation provided to them at the home. Several remarked on the sea views that are spectacular and observable from most of the bedrooms and both the lounges. The home looked well decorated and comfortably furnished throughout at the time of the inspection. It was clean and tidy and staff are aware of the importance of good hygiene to prevent risks of infection spreading in the home. Most of the residents who were interviewed said that there are sufficient staff working in the home at all times and indicated that they have confidence in their abilities. There are always qualified staff on duty, including qualified nurses. They are recruited fairly and on the basis that they are suitable to work in a care setting and undertake regular training so that they keep their knowledge and skills updated. Overall, the home is well managed, in the best interests of the residents. The person in charge is well qualified and registered with the Commission for Social Care Inspection as a fit person to manage a care home. Residents are asked for their views through questionnaires and regular residents’ meetings and staff are well trained and guided on how to keep the home safe for them. What has improved since the last inspection?
There were some noted improvements in the way prospective residents are assessed, so that their individual needs, wishes and circumstances are accounted for better. This means that their subsequent care plans can be much more personal to them as individuals. There is improved consideration of their life histories, cultural backgrounds and religion, for example, so that they can be made as comfortable as possible in the home. The home has recently improved the systems in place for advanced care planning and has information about this available to residents and visitors to the home. There were noted improvements with regard to medicines management at this inspection and records appeared to be fully up-to-date and accurate so that residents are more protected from medication errors. The manager described how there have been improvements to the assessments of residents’ nutritional needs, which have involved catering staff so that they can enjoy improved quality of food.
Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 8 There was improved evidence at this inspection, that the home has safe systems to protect residents from abuse. This includes checks made on new staff, by law, to demonstrate that they are suitable to work with vulnerable adults in a care setting. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 9 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 Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 Quality in this outcome area is good Admission to the home is on the basis of an assessment so that prospective residents can be confident it will be suitable to meet their needs. The home does not provide intermediate care but will accept people for short-term admissions and has suitable facilities for this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the residents who were interviewed confirmed that they had made an active decision to be admitted to the home and said that the admission process included an assessment of their needs so that they could be assured it would be suitable for them. The manager and staff who were interviewed confirmed that admission is on the basis of an assessment and prospective residents and their relatives are encouraged to provide as much information about
Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 11 themselves as possible, so that the home has a “life story” on which they can personalise subsequent care planning. This was evident in the records inspected. The manager demonstrated a good knowledge of the diverse backgrounds and needs of the residents who were case-tracked, which was confirmed in interviews with them and their records. There is consideration of peoples’ religion and cultural background during the assessment process, for example and information is sought about their disabilities so that care plans can be appropriately tailored for them. Needs relating to their age, gender and sexual orientation are also taken into account, with appropriate sensitivity. Risks relating to any history of falls and specific behavioural problems are also taken into account. The home’s statement of purpose clearly states that the home does not provide specialist rehabilitation or intermediate care services although it will accept people for short-term and respite care. Facilities available in this respect are clearly set out in the information provided to prospective residents. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. Residents health, personal and social care needs are clearly set out in individual care plans so that they and staff working with them are aware of how their needs should be met. There are good systems in place to ensure that their healthcare needs are met and safe and sound systems to manage their medicines so that they are protected from the effects of medication errors. Residents are treated with respect and due regard for their dignity so that they enjoy a good quality of life in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 13 Some of the residents who were interviewed were aware of their care plans and all had detailed written records of their needs and how they should be met on their personal files. The manager said that the home is currently undertaking advanced care planning under the gold standard framework, which has led to improvements in the care planning process. There was documentary evidence that care plans are regularly reviewed and updated as residents’ needs change. Residents who were interviewed indicated that their healthcare needs are met well. The manager said that there are qualified nurses on duty at all times and the home has good links with local external health providers. Records on residents’ personal files verified this. All the residents and visitors who were interviewed confirmed that they staff care for them well. Staff were observed to treat residents with kindness and respect at all times. Bathroom doors are lockable and bedrooms can be supplied with door locks upon request. Staff were observed to knock before entering residents’ bedrooms. There are clear written guidelines for staff on the safe handling of residents’ medicines and residents have the option of managing all or some of their own medicines themselves. One of the residents who was interviewed retains one of their medicine items and manages this well. All staff who handle residents’ medicines are trained. Records of administration appeared to be up-to-date and accurate and the home has suitable storage facilities for medicines. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. Residents’ social, cultural, religious and recreational interests are accounted for and their needs met so that they enjoy a good quality of life in the home. Relatives and visitors are made to feel welcome in the home so that residents maintain valued contacts and do not feel isolated in the home. Residents are encouraged and supported to make decisions so that they maintain control over aspects of their lives that are important to them. They are provided with wholesome, home prepared meals so that their nutritional needs are met and they enjoy their food. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents’ assessment and care planning information demonstrates that their social, cultural, religious and recreational interests are taken into consideration. The home’s manager and staff were able to provide examples of
Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 15 the activities available to them and this was verified in the daily care records that were inspected. At the time of the inspection there was a religious service in progress in the lounge and residents were able to receive communion in their own rooms if they preferred. Residents who were interviewed expressed satisfaction with the programme of activities available to them and gave examples of the things they enjoy. The home’s manager and staff who were interviewed said that relatives are welcome in the home, which residents who were interviewed confirmed. Visitors were observed coming and going, unrestricted, from the home during the inspection. They are able to receive visitors in the privacy of their own rooms if they wish. Residents who were interviewed said that they are able to make decisions about things that are important to them, such as whether to take part in social activities in the lounge or remain in their own rooms and when to get up and go to bed for example. A staff member who was interviewed said that care planning improvements have led to increased consideration of choice for residents. Residents’ assessment, care planning and daily care records indicate that their choices and preferences are well accounted for and respected. All of the residents who were interviewed said that they enjoy the meals provided and said that they are offered a choice. A staff member said that their nutritional needs are assessed and external support from specialist nutritionists is provided, if necessary. Residents’ assessment and care records note their food likes, dislikes and preferences, so that menus can be planned accordingly. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. The home has good systems in place to enable residents to make complaints so that they can be confident they will be listened to and the issues they raise will be taken seriously. There are systems in place to protect residents from abuse so that they can feel safe in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that there have not been any formal complaints since the previous inspection. New residents are provided with copies of the home’s formal complaints procedure in their information packs upon arrival in the home. All of the residents who were interviewed said that they are satisfied with the care and services provided to them in the home and most knew how to go about making a complaint if necessary. Staff who were interviewed demonstrated a good knowledge of the home’s complaints procedure. There are formal systems in place to protect service users from abuse, including written guidance for staff and access to training internally and externally to the home. The manager said that several staff members have attended the local multi-agency training for the protection of vulnerable adults
Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 17 from abuse. There are records to show that staff are recruited on the basis that they are suitable to work with vulnerable adults in a care setting. All of the residents who were interviewed said that they feel safe in the home. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. The home is pleasant, comfortably furnished, well decorated and safe so that residents enjoy a good quality of life in a homely environment. The home is kept clean and hygienic so that residents are protected from the risks of cross-infection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home looked well decorated and well furnished throughout at the time of the inspection. One of the rooms was being redecorated at the time of the inspection. The manager and staff who were interviewed confirmed that maintenance tasks are undertaken promptly, as and when they become necessary. Residents expressed satisfaction with the accommodation provided
Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 19 to them and confirmed that they can personalise their own bedrooms in accordance with their own tastes. Residents who were interviewed said that the home is kept clean and it appeared clean and tidy throughout at the time of the inspection, which was unannounced. The manager described the systems in place to maintain good hygiene, including written procedures to guide staff, access to training in infection control and provision of suitable equipment to maintain good hygiene. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. There are sufficient staff, employed in a variety of capacities so that residents’ needs are met. There are sufficient numbers of qualified and trained staff so that resident’s needs can be met effectively. Staff are recruited fairly and on the basis that they are suitable to work with vulnerable adults in a care setting so that residents can feel safe in their care. Staff undergo regular training to update their knowledge and skills so that residents can have confidence in them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the residents who were interviewed said that there are sufficient staff on duty at all times to meet their needs. Staff were observed working in different capacities such as catering and domestic work, care work and nursing so that they are able to work effectively with the resident group. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 21 There is a qualified nurse on duty at all times in the home and 90 of the care staff are qualified to NVQ 2 or above, according to the home’s manager, which is in excess of the national minimum standards. Staff records that were inspected verified this. Staff who were interviewed during the inspection confirmed that they had been fairly recruited and that checks had been made of their suitability to work with vulnerable adults in a care setting. Records inspected verified this. Staff who were interviewed during the inspection said that they have good access to ongoing training so that they maintain and develop their knowledge and skills. The manager said that the home has an Investors in People award and staff records that were inspected provided evidence of their induction and ongoing training. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 35 Quality in this outcome area is good. The home is well managed for the benefit of the residents. There are formal systems to ensure that their best interests are taken into account in the planning and development of the service. There are systems in place to ensure that the health, safety and welfare of residents is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 23 The home’s manger is qualified and has been registered as a fit person to be in charge, by the Commission. She was able to describe recent training she has undertaken to update her own knowledge and skills. Staff and residents expressed confidence in her abilities. The manager described formal systems in place to measure the quality of the services the home provides. This includes questionnaires to residents and people who have an interest in the home and regular formal meetings with residents, when they can express their views and concerns. Evidence was available in the form of the home’s published annual development plan. Staff who were interviewed said that they have good access to ongoing training to ensure that they know how to keep the home safe for residents. Training records inspected verified this. A selection of health and safety records were inspected including the home’s fire safety risk assessment and records of equipment tests and checks, which were up-to-date and complete. Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 24 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 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X 3 X Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Eshcol House DS0000009264.V318862.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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