CARE HOMES FOR OLDER PEOPLE
Fair Haven 23 Knyveton Road Bournemouth Dorset BH1 3QQ Lead Inspector
Jo Palmer Unannounced Inspection 10:45 26 January 2006
th 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 DS0000003937.V279928.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. DS0000003937.V279928.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Fair Haven Address 23 Knyveton Road Bournemouth Dorset BH1 3QQ 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) 01202 553503 01202 319003 Christadelphian Care Homes Mrs Wendy Avril Gibbs Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places DS0000003937.V279928.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. One named person (as known to CSCI) under the age of 65 may be accommodated to receive care. 27th September 2005 Date of last inspection Brief Description of the Service: Fair Haven is registered to provide care and support for up to 30 older people. The home is owned and managed by Christadelphian Care Homes, a registered charity that exists solely to provide accommodation to persons requiring residential and nursing home accommodation. Fair Haven however, is not registered to provide nursing care. The home accommodates mainly members of the Christadelphian community although non-Christadelphians can be cared for with permission from the trustees. Fair Haven is situated in a residential area of Bournemouth within easy walking distance of the town centre, cliff top walks and parkland. Accommodation is provided in 24 single rooms and 3 shared rooms, all rooms have en-suite facilities. There are two lounge areas, a dining room and a conservatory for resident use, t eh conservatory leads onto well-maintained gardens that are readily accessible to residents and where there are two summerhouses. A lift provides access between floors and a stair lift is also available on one of the two stairways. Fair Haven provides a good level of pastoral care and support along with 24 hour staffing, all catering and laundry services and access to local community health services such as GPs, opticians, dentists etc. DS0000003937.V279928.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection on 26th January 2006 lasted for three hours. Wendy Gibbs, registered manager was away on leave at the time of inspection, Mr Steve Webb, trainee manager assisted throughout the inspection and provided necessary information, access to records and introductions to residents. This was a brief inspection the purpose of which was to monitor progress in addressing the requirements and recommendations of the last inspection and to review practices in relation to some of the National Minimum Standards. Not all standards were assessed and the reader is referred to the report of the last inspection dated 27th September 2005, which can be obtained either from the home or can be viewed on www.csci.org.uk The inspector spoke with six residents, two members of staff, and the trainee manager, took a tour of the premises and examined relevant records. What the service does well:
Detailed assessments of prospective residents are carried out prior to them making the decision to move to Fair Haven, information is also provided in the form of a resident’s handbook (Service User Guide) that provides detailed information about the care and service available and will enable prospective residents to make an informed choice. The approach to care planning could be more systematic although the information that is available is, in the main, relevant and identifies residents care needs and how staff are to meet these. Residents are able to maintain contact and keep appointment with community based health care professionals as required. Residents confirmed that they are treated with respect and their right to privacy is upheld, residents also confirmed that they feel safe living at Fair Haven, staff were observed in their relations with residents to be courteous and considerate. Residents are confident that their concerns or complaints will be managed sensitively and effectively although a minor amendment to the complaints policy is required (see section below and requirements page) Fair Haven provides a good standard of accommodation where residents are able to live quietly and privately although are able to enjoy each other’s company in the communal areas if they choose. Bathroom and toilet facilities are easily accessible and the home is clean and well maintained.
DS0000003937.V279928.R01.S.doc Version 5.1 Page 6 The management structure generally supports good practice, residents confirmed that communication was good and that they regularly see the manager and trainee manager when they are able to discuss and significant issues. What has improved since the last inspection? What they could do better:
A requirement of the last inspection has been repeated concerning care planning. This related specifically to ensuring that identified needs remained current. Where a resident’s needs have changed due to failing health and increased frailty, up to date information must be available for staff reference based on assessed need and how the need should be met. This inspection identified a particular instance where an identified care strategy for pressure relief had failed and the care plan had not been updated. Further requirement has been made with regard to care planning to ensure that staff have clear instruction of the action necessary to prevent risks of infection where a resident is in receipt of wound care form a district nurse. Residents must be consulted following assessment to indicate their agreement with identified care outcomes in their care plans. A requirement of the last inspection has also been repeated regarding medication management. A system of double dispensing is still being used which compromises resident’s safety and does not ensure accountability of staff responsible for administering the medication. Whilst the trainee manager gave assurances that this would be addressed, the registered persons response to the last inspection report where the requirement was first made stated ‘this is in the process of being addressed’. The home’s complaints procedure must ensure that residents and their representatives have contact details for the Commission without recourse to staff or the home’s manager. Staff recruitment practices need to be more robust to ensure the safety of residents. All staff must be appropriately vetted prior to taking up post and evidence must be held that overseas staff are able to work in the UK. Where
DS0000003937.V279928.R01.S.doc Version 5.1 Page 7 Criminal Records Bureau certificates have not been obtained prior to the person taking up position, they must be supervised by a named supervisor at all times. Evidence must also be held to demonstrate that new staff have attained a level of competence during their induction. Staff must receive training to ensure the protection of the residents, the premises and themselves and must be familiar with the means of evacuation, fire prevention and their roles and responsibilities. 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. DS0000003937.V279928.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 DS0000003937.V279928.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 & 3. Standard 6 is not applicable. The home’s Service User Guide provides residents and their relatives with good information about the care and services provided at Fair Haven. Residents are assured prior to admission that Fair Haven is suitable for meeting their needs. EVIDENCE: A Service User Guide has been produced since the last inspection entitled ‘Handbook for your new home’. The handbook includes all the necessary information as outlined in the standards and provides residents with relevant information concerning the care and services provided at Fair Haven. Prior to the Handbook being produced, a document was available from Christadelphian Care Homes that included the Statement of Purpose and overall information about the organisation. This document is still available and is given to residents but Fair Haven’s Handbook now supplements this with information specifically about Fair Haven. Prior to admission, a prospective resident’s needs are assessed to ensure that Fair Haven is the right place for them to move to where their needs can be met. Care files seen for two resident’s recently admitted demonstrated a detailed assessment of need considering all aspects of the person’s health and welfare. There was however, no evidence of consultation with the resident. (See standard 7)
DS0000003937.V279928.R01.S.doc Version 5.1 Page 10 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 & 10 Where care plans are up to date, they provide sufficient detail in order that an informed staff group can meet resident’s needs. The effectiveness of care plans is however, let down by the failure to identify all care needs through a wellorganized review process and lack of consultation with residents to agree care outcomes. Access to health care professionals is facilitated by the home enabling resident’s health needs to be met. Medication management systems are not in accordance with Royal Pharmaceutical guidelines and do not protect residents. A kind and caring staff group treat residents respectfully. EVIDENCE: The last inspection reported that the system of resident care planning was in the process of change and a computerised system was being introduced. At this inspection this system was operational although Mr Webb confirmed that ‘paper’ files are still used in conjunction with the computerised records. Following assessment, a plan of care is formulated detailing the person’s health and welfare needs. Where appropriate, care plans refer staff to the associated care policy and procedural guidance for example, where a resident is cared for
DS0000003937.V279928.R01.S.doc Version 5.1 Page 11 in bed, the home has policies referring to the process for bed bathing and personal care routines. Care plans identify individual considerations for the resident in respect of the personal care required whilst ensuring that staff are familiar with the correct procedure, technique and equipment necessary to undertake the task. Care plans seen address residents personal care, health, hygiene, medical, mental health needs, social and spiritual needs. Care plans seen did not have a specified review date identified and in some instances, care plans had not been reviewed appropriately. One care plan seen had identified intervention for staff to follow to reduce the risk of pressure ulcers although the resident had developed an ulcer for which the district nurse was attending. In this instance, it was therefore apparent that the duties performed by staff as outlined in the care plan in respect of this resident’s pressure area care were not sufficient to prevent the ulcer forming. This resident was receiving wound care from a district nurse although there was no care plan available for staff to follow detailing the action necessary in the event of the wound site needing attention or how to reduce the risks of introducing infection i.e. should the dressing come off or get damaged or soiled. A system of medication management is in place that is not recommended. A system of double dispensing is used where medication is taken from its original container and placed into pots marked with each resident’s first name for the following day, this results in trays of pots of unmarked medicines being left for each resident’s next four doses. At the time of administration, a member of staff then take the pots with the unmarked medicines to the resident named on the pot and signs the record to indicate their accountability for having given the correct medication. This system of double dispensing of medication was in place at the last inspection and a requirement was made in this respect which has not been addressed although the registered persons responded to the inspection stating that Fair Haven was ‘in the process of changing over to a monitored dosage system’ although the system would require more space which this was being looked into. Mr Webb confirmed during this inspection that the system change over was imminent. Royal Pharmaceutical Guidelines state: Section 4.2 For a care home member of staff to administer a medicine it must have a printed label containing the following information: •Service users name. •Date of dispensing. •Name and strength of medicine. •Dose and frequency of medicine. Section 6.2.3 Medication should never be removed from the original container in which a pharmacist or dispensing doctor supplied it until the time of administration. The best way of administering medicines to a service user is directly from the
DS0000003937.V279928.R01.S.doc Version 5.1 Page 12 dispensed container, medication can be placed in a small pot after removing it from the dispensed container as a way of hygienically handing it to the service user. Medication should never be secondary dispensed for someone else to administer to the service user at a later time or date. Residents spoken with confirmed that a kind and caring staff group treat them respectfully; staff and residents were observed in their interactions to have mutually courteous relationships. DS0000003937.V279928.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): None of these standards were directly assessed during this visit although through meeting with residents it was evident that they consider their social, leisure and spiritual needs to be well met by the home. The last inspection reported these standards as met. For more detail, the reader is referred to the inspection report dated 27 September 2005. EVIDENCE: DS0000003937.V279928.R01.S.doc Version 5.1 Page 14 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 The complaints policy assures residents that any concern will be dealt with appropriately although residents are let down by the fact that the procedure does not refer them directly to the Commission. Standard 18 was not assessed during this visit; the last inspection reported the standard as met. EVIDENCE: The home’s complaints procedure is contained in the new ‘handbook’, (Service User Guide) the policy informs residents that their concerns will be taken seriously and details the expected response time for the resident to receive a satisfactory conclusion. The policy states that where a resident is unhappy with the outcome, they may contact the ‘appropriate Care Commission office – CSCI/CSWI/CC’ and that the manager will provide the address. The address for the Commission for Social Care Inspection, Poole Local Office must be contained in the procedure and be available to residents who may wish to approach the Commission directly should they not feel comfortable raising concerns directly with the home. Reference to CSCI/CSWI/CC must be explained to ensure that residents know the correct authority to approach. Residents spoken with confirmed that they would feel comfortable approaching staff in the home if they had any concerns or complaints. Mr Webb confirmed that no complaints had been received. DS0000003937.V279928.R01.S.doc Version 5.1 Page 15 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): 21, 22, 24 & 25 Fair Haven provides clean, well-maintained premises where residents have access to comfortable accommodation in their private rooms and in communal lounge and dining room space. Bathrooms and toilets provide adequate facilities. EVIDENCE: A recommendation of the last inspection has been addressed with regard to a ‘vacant/engaged’ sign being positioned on a ground floor bathroom door, which cannot be locked as the bathroom has an external fire door and is used as an escape route. Bathrooms and toilets are sited around the home conveniently for access from the lounges, dining rooms and resident bedrooms although all resident bedrooms have en-suite facilities. A new emergency call system has been installed since the last inspection and each resident has access to a call point in his or her room. Residents spoken with confirmed that if they have to use their alarm bell, staff respond rapidly. DS0000003937.V279928.R01.S.doc Version 5.1 Page 16 Of those residents room visited, all were appropriately furnished and carpeted and residents confirmed that they were able to bring some of their own furnishings. Residents are also able to personalise their rooms to their own taste with pictures, ornaments and other homely touches. The home was appropriately lit, ventilated and a reasonable temperature for the time of year and weather conditions. Radiators and pipe-work have been guarded to prevent accidental scalding and residents confirmed that they were warm enough. DS0000003937.V279928.R01.S.doc Version 5.1 Page 17 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 & 30 Staff recruitment procedures are not robust and potentially put residents at risk. Induction training is provided to ensure staff have the appropriate skills to care for the resident group although there is no evidence of attainment levels. EVIDENCE: The recruitment file for a recently appointed member of staff was examined. The file held an application form detailing the persons work history and qualifications and two references had been obtained. Caution is needed to ensure that a reference is obtained form the applicant’s previous employer; in this instance, an agency employed the staff member although the referee was given as a member of staff at a care home where the worker had been placed. A copy of an e-mail was held that had been sent from Christadelphian Care Homes head office confirming that a satisfactory CRB* check had been made. This was received by the home three weeks after the person started employment. There was no evidence that a check had been made against the POVA* record. There was no copy of a work permit or visa on file indicating that this employee was able to work in this country. A blank copy of the home’s induction programme was seen which was held in accordance with National Training Organisation workforce training targets for care staff. Mr Webb confirmed that the member of staff recently appointed had undergone a brief in-house induction, which included orientation to the home, information about the home’s policies, and procedures and residents care issues. There was no evidence of the workers attainment during the formal induction process. The registered persons are reminded that the Induction
DS0000003937.V279928.R01.S.doc Version 5.1 Page 18 standards have been reviewed; to keep abreast of changes to the induction programme and the Core Common Standards, the registered persons are referred to the skills For Care (formerly TOPSS) website at www.skillsforcare.org.uk *CRB – Criminal Records Bureau POVA - Protection of Vulnerable Adults, a record of names of people held by the Secretary of State who have been considered unsuitable to work with vulnerable adults. DS0000003937.V279928.R01.S.doc Version 5.1 Page 19 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): 32 & 38 Residents benefit from a well-organised management structure at Fair Haven which is open and inclusive and where they are able to contribute and participate. Infrequent staff fire training compromises the health, safety and welfare of residents. EVIDENCE: Residents spoken with confirmed that the management arrangements of the home were good and that they were kept informed through regular meetings and discussions of any changes or developments. A representative of Christadelphian Care Homes visits Fair Haven monthly to report on the conduct of the home to other of the trustees, copies of the reports of these visits are held on file at the Commission. These reports evidence that the management approach to the home is inclusive as the views and opinions of residents and their representatives are sought.
DS0000003937.V279928.R01.S.doc Version 5.1 Page 20 Records were examined relating to the testing and maintenance of the homes fire warning system, emergency lighting and fire fighting equipment, these were satisfactory. Staff fire training certificates were seen and Mr Webb confirmed that the last training for staff was in March 2005 by an external training provider. It is expected that day staff receive training at six monthly intervals and night staff three monthly to ensure they are up to date with procedures for evacuation of the premises (a procedure that can change as residents needs change) and are up to date and reminded of the principles of fire prevention, common causes of fire, the function of fire doors and the buildings automatic detection system, good housekeeping. And their role and responsibilities in an emergency. DS0000003937.V279928.R01.S.doc Version 5.1 Page 21 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 X X X 3 3 X 3 3 X STAFFING Standard No Score 27 X 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X X X X 1 DS0000003937.V279928.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Care plans must be reviewed regularly to ensure that identified needs remain current and that where a person’s needs have changed, up to date information is available to ensure staff have clear direction regarding how to meet those needs. Time-scale 30/11/05 not met, this requirement is repeated for the second time. Additionally, this inspection requires that where intervention identified on care plans is not working, i.e. regarding pressure relief, reviews are timed appropriately and staff intervention tasks are changed to reflect the new tasks identified that are based on recognised good practice guidance. Where a service user is in receipt of wound care from a district nurse, the home must establish a plan of care, based on advice from the district nurse, to identify the action necessary to reduce the risks of introducing infection should the dressing become damaged between the nurses visits.
DS0000003937.V279928.R01.S.doc Timescale for action 1 OP7 15 31/03/06 2 OP7 15 31/03/06 Version 5.1 Page 23 3 OP7 15 4 OP9 13 5 OP16 22 6 OP29 18 7 OP30 18 The registered persons must evidence, where appropriate, that the resident and/or their representative has been consulted about the care outcomes as identified in care plans. Medication must only be administered to residents from original, marked containers. All medicines must be identifiably marked with the name of the medicine, the dose and the name of the person fro whom it is prescribed. All administration records must be signed. Timescale 30/11/05 not met, this requirement is repeated for the second time. The written complaints procedure must include the name, address and telephone number of the commission for social Care inspection. Reference to other authorities must be explained. New staff must only be employed following receipt of a satisfactory CRB and POVA check. The registered persons must obtain a POVA check prior to the person starting work. Where a CRB certificate takes longer to obtain, the person can start in post but must work only with a named supervisor until a satisfactory CRB certificate is obtained. Overseas staff must provide evidence of their eligibility to work in this country in the form of a work permit and visa, a copy of which must be held on file. The registered persons must be able to ensure, and evidence, that all newly appointed staff attain a satisfactory induction period in the home in accordance
DS0000003937.V279928.R01.S.doc 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 Version 5.1 Page 24 8 OP38 23 with National Training Organisation specifications. All staff must receive fire safety training, which is to be six monthly for day staff and three monthly for night staff. 31/03/06 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 DS0000003937.V279928.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000003937.V279928.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!
