Inspection on 30/06/05 for Five Oaks

This inspection was carried out on 30th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Five Oaks 21/05/07

Five Oaks 27/06/06

Five Oaks 15/11/05

Five Oaks 20/10/04

Five Oaks 03/06/04

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 FIVE OAKS 377 Cockfosters Road Hadley Wood Hertfordshire EN4 0JT Lead Inspector Teferi Degeneh Announced 30 June 2005 @ 09:30 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Five Oaks Address 377 Cockfosters Road, Hadley Wood, Hertfordshire, EN4 0JT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8449 7000 Martyn Gerrard for Scimitar Care Hotels Ltd Ms Lynnsey Mitchell PC Care Home 44 Category(ies) of OP registration, with number of places FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20 October 2004 Brief Description of the Service: Five Oaks is a private residential home owned by Scimitar Care Hotels PLC. The home is registered to provide personal care for 44 elderly people. The home is purpose built; facilities include 42 single rooms and two double rooms on three floors; service users are never asked to share a room so the double rooms are used as single rooms. There is a large lounge with interconnecting doors to a dining room, a smaller lounge, the garden room, and a sitting area in the lobby, furnished with comfortable armchairs. The three floors are accessible via two shaft lifts. There is a well-maintained garden with patio, accessible, through French windows.The home is located in a quiet residential area. At front of the building there is a parking space for staff and visitors’ cars. The home is also accessible by public transport. The Cockfosters underground station, Piccadilly line, is a few minutes’ car drive from the home. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by the CSCI pharmacist inspector and the lead inspector on 22nd and 30th June 2005. The pharmacist inspector assessed the national minimum standard relating to medication and the lead inspector examined some selected standards from the national minimum standard for older people. The inspections were based on the assessments of the files of the people who live at the home and those of the staff who work there. Other documents such as the rotas, policies, procedures, medication administration sheets and the menus were also looked at. Discussions were held with a number of the people who live at the home, with the staff, visitors and the manager. The pre-inspection questionnaire and the feedback cards completed by the registered person, relatives and people who live at the home have been assessed as part of this inspection. A guided tour of the premises has enabled the lead inspector to inspect the facilities of the home and to observe the interactions that take place between the staff and the people who live at the home. What the service does well: What has improved since the last inspection? What they could do better: The registered person needs to apply to the CSCI for a variation of conditions of registration regarding the people diagnosed as having dementia. Steps must FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 6 be taken to improve the recording and storage of medication in the home. The registered person needs to consult the people who live at the home and make appropriate changes to the quality, quantity and presentation of the meals. It is required that the registered person, i.e., the owner or a representative undertakes a visit to the home and compiles a report of the visit. A copy of the report must be sent to the CSCI inspector. The registered person must also give notice to the Commission for Social Care Inspection of the occurrence of serious incidents or accidents. A system of quality assurance must be implemented. The registered person is required to take appropriate actions to reduce and manage the risk of falling in the home. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 7 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 Standards Statutory Requirements Identified During the Inspection FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 8 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 standard(s) 3, and 4 The home’s procedure and practice of ensuring that preadmission assessments are completed for service users have enabled new service users to know and to have confidence that their needs can be met by the facilities and services available at the home. However, the category of registration and the certificate of the home are confusing to service users and they are not clear whether the home is suitable for them. EVIDENCE: The files of the five people who have recently been admitted were assessed. All these files have evidence that assessments and care plans have been completed by the home. The registered person confirmed that social workers complete assessments when people are placed at the home by the local authorities. The assessments seen were detailed covering areas such as dental, mental, social, physical and emotional needs of service users. At the previous inspection a requirement was made for the registered person to apply to the CSCI for a variation of conditions of registration in respect of service users with dementia. There was no evidence to suggest that the application has been made and the certificate of registration amended. The pre-inspection questionnaire completed by the registered person confirms that there are six people with dementia at the home. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 9 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 standard(s) 7, 8, 9, and 10 The processes of care plan reviews and risk assessments are satisfactory to ensure that service users’ needs are identified and appropriate care is provided. Service users are confident that the facilities and the staff of the home ensure their privacy and dignity. The processes for receiving, storing and administering medication are inadequate and service users’ health and safety is at risk. EVIDENCE: A number of service users’ files were randomly chosen and assessed. All of these files contained care plans which have been reviewed. It was evident from the files that care plans are reviewed monthly and are signed by service users or relatives as appropriate. Risks to service users are assessed as part of the care plans. Two relatives spoken to said that the manager and the staff listen to them and they are happy with the care provided at the home. On 22nd June 2005 the CSCI pharmacist visited the home to undertake an inspection of NMS 9 of the National Minimum Standards for Older People. The summary of this inspection is as follows: The medicines policy is complete except for two references. Firstly, the form for the assessment and agreement to medication being disguised if a service FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 10 user’s health is at risk, and secondly, that medication returned to a service user on leaving the home is to be documented and signed for by the service user, their relative or advocate. No service users were having their medication disguised at the time of the visit. There is a standard risk assessment/agreement form for service users who wish to administer their own medication. The records for the receipt, administration and disposal of medication are satisfactory except that medication prescribed by the hospital and brought in for service users by relatives is not being received on the administration charts. The storage of medication was satisfactory but the area where medication is stored was found to exceed 25oC in hot weather. The only Controlled Drug being prescribed at the time of the visit was temazepam and this is kept in a Controlled Drug cupboard. The administration is recorded and witnessed by another member of staff but on paper charts. Medication training has taken place via long distant learning courses for all staff who administer medication. Some of this took place two years ago. Discussions with the registered person and an observation of some rooms indicated that service users are provided with telephones. The staff spoken to gave satisfactory descriptions of how they ensure service users’ privacy and dignity. For example, they said that they would ask people for their preferences of how to be supported and always make sure that doors are closed when providing personal care. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 11 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 standard(s) 12, 13, 14, and 15 A wide range of activities is provided by the home ensuring that service users are occupied. A satisfactory system is in place to enable service to obtain items of their choice while having a responsibility for their own finances. The home and the staff have created conducive atmosphere for service users to have visitors in private. The arrangements for developing and reviewing the menu are not satisfactory and the needs of service users in respect of quality and quantity of meals are not met. EVIDENCE: The home has an activities co-ordinator. The registered person confirmed that an entertainer comes to the home and the staff provide social and leisure activities such as quizzes, bingos, board games and skittles. On the day of the inspection a number of service users were observed enjoying an entertainment. Programmes of activities were available for inspection. Most relatives who completed the feedback cards were satisfied with the care provided at the home but one person commented: “there could be at times more stimulation for the more able [people]….” Seventeen relatives who completed feedback cards ticked the boxes in the column of “Yes” confirming that the staff welcome them to the home and they are able to see service users in private. A relative wrote: “There is always a smiling member of staff to welcome when I ring the front door bell – usually three to four times each FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 12 week.” The two relatives spoken two on the day of the inspection were satisfied with their visits and the services of the home. The home does not manage service users’ finances. Discussion with the registered person and some service users indicated that an arrangement is in place where service users are invoiced for items (for example, newspapers, toiletries, etc.) they buy while living at the home. This arrangement is part of an agreement between service users and the home. Both the registered person and the service users spoken to said they are happy with the arrangement and they have not encountered any problems with the system. It was evident in the files that records are kept of service users’ possessions. The home has a four weekly rotating menu. It was understood from discussions with the registered person that the menu has not been reviewed for a long time. The majority of service users said they are happy with the food. A relative commented that the “food is only average”. On the day of the inspection most people appeared to have enjoyed their lunch but some people hardly finished their meals. The presentation of the meals and the atmosphere in the dining room were appropriate and relaxed. The staff were present to provide assistance as required. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 13 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 standard(s) 16, and 18 The process of complaints are satisfactory and service users can be confident that their concerns can be listened to and necessary actions taken. The staff of the home have the skills necessary to identify and deal with abuse. These have reassured service users that they are protected from all forms of abuse. EVIDENCE: Written evidence seen and discussions with service users confirmed that service users are able to report their concerns and complaints to the registered manager or the provider. At the time of the visit a complaint by a relative was being investigated by the registered provider. Most of the people who completed the feedback card ticked the “NO” box confirming that they were not aware of the home’s complaints procedure. However, they noted that if there was a need to make a complaint they would easily find out how to make a complaint. At the previous inspection a requirement was made for the registered person to ensure that all staff receive adult protection training in line with Enfield Council’s adult protection policy and procedure. The registered person confirmed that only two staff have attended training in respect of the protection of vulnerable people from abuse. However, it was evident from the home’s induction package and discussions with the staff that the staff are aware of what constitutes an abuse and the procedures to follow to deal with a real or a suspected abuse. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 14 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 standard(s) 19, and 26 The home has a high standard of cleanliness, facilities and equipment, which have ensured that service users live in a safe and comfortable environment. EVIDENCE: All parts of the home were clean, tidy and well maintained. The two relatives spoken to confirmed that the home was always clean and there was no offensive smell whenever they visited. On the day of the inspection a handy person was fitting one of the backdoors to enable wheelchair users to access the garden. It was obvious from the tour of the premises that facilities and equipment have been provided to ensure service users’ health and safety. The passenger lifts, which have been regularly maintained, have programmes, which allow them to give sufficient time to people when getting out and moving away from them. There is a satisfactory infection control policy. The laundry is equipped with a modern washing machine, in which foul laundry can be washed at an appropriate temperature. The home has a generator, which automatically turns on if and when there is an electric supply failure. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, and 30 The number and experience of the staff team in this home are satisfactory to meet service users’ need. However, the home has made little progress in ensuring that all staff have a satisfactory CRB check. This has created a situation where service users feel that they are not protected and their health and safety is put at risk. EVIDENCE: Three members of staff were individually interviewed and another three care staff were observed and spoken to. All these staff demonstrated satisfactory knowledge and experience of supporting older people in a care home. They said they are well supported by the management in providing a high standard of care. The staff were observed interacting appropriately with the people at the home during lunch time. The service users spoken to said they are happy with the staff. The relatives spoken to and those who completed the feedback cards were positive about the staff. For example, some relatives wrote in the feedback cards as follows: “Staff are very nice and caring”. Another relative stated: “The best asset of this home are the lovely staff who make [a service user] feel at home and cared about.” The documents and discussion with the registered person showed that there are twenty-six care staff, two domestics, two part-time cooks, a laundry assistant and a handy person employed at the home. The rotas showed that there were seven care staff and a manager on duty during early and late shifts. Three waking night staff covered night shifts. A health and safety officer is employed by the Company that owns this home to organise training for the staff. The training plan indicated that some, not all, of the staff have FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 16 undergone training in basic food hygiene, fire prevention, care practice, first aid, safe handling of medicines, infection control, and dementia. However, records showed that all the staff have had an induction. Five new care staff have been employed since the last inspection. The files of these staff showed that each of them has two written references and a satisfactory CRB check. A requirement previously made regarding the lack of CRB certificates for two existing employees is still outstanding. The registered person said both care workers have made applications to the CRB; however, the result has been delayed because of an alleged missing of some evidence. The manager confirmed that both care staff work only during the day under supervision. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, and 38 Despite the availability of appropriate facilities and the existing arrangement of checking and servicing them, service users remain at risk of falling. The systems for monitoring and reporting of the quality of services and the occurrence of significant issues are poor and service users do not know if they can comment on the quality of the services and if the CSCI is notified of incidents. EVIDENCE: The people who live at the home, the staff and visitors who were spoken to said the manager is approachable and easy to talk to. Discussions with the registered manager revealed that staff meetings take place regularly. There is a policy on equal opportunity and the staff spoken to gave examples of how they ensure equal opportunity in the care home. At the previous inspection the registered person was required to carry out unannounced visits to the home on a monthly basis in line with Regulation 26 of Care Homes Regulations 2001. This has not yet been implemented. The registered person said quality FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 18 assurance questionnaires have been developed as a tool for gathering the views of stakeholders. The registered person has yet to distribute the relevant questionnaires to all the stakeholders and develop a strategy to ensure that the feedback obtained as a result of the process of the quality assurance system is acted upon. There are appropriate facilities such as two passenger lifts, rails, and hoists for use by people with a physical disability. Portable electrical appliances have been checked on 16/3/05 and the home’s fire appliances and fire alarms were serviced in May and June 2005 respectively. The temperature of the water is regularly monitored and recorded. Records showed that emergency lights, fire detectors, fire call points and door releases are regularly checked. Twentythree incidents and accidents have been recorded since the previous inspection. Most of these incidents related to falls of some service users. It was evident from files that risk assessments have taken place for service users and call alarms are fitted in all bedrooms. The registered person has not notified the CSCI of the occurrence of these incidents/accidents. FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 x 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 2 2 x x x x 2 FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 4 Regulation Requirement Timescale for action 31/8/05 2. 9 3. 9 4. 5. 9 15 9(1)(2)(3) The registered person must apply to the CSCI for a variation of conditions of registration in respect of the two service users with dementia. Assessmensts and care plans of the service users must be submitted with the application form. Timescales of 31/12/ not met 13(2) The registered person must ensure that the temperature where medication is stored is maintained at 25 degree Celcius or below. 13(2) The registered person must work with the pharmacist supplying the home to ensure that all the contents of the Nomad Box are labelled clearly on the back of the box. 18(1) The registered person must ensure that medication training is up dated regularly. 16(2) The registered person must consult service users and provide them with adequate, suitable, wholesome and nutritious food which is varied and properly prepared and available at such times as may reasonably be required by service users. G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc 15/8/05 31/8/05 31/10/05 31/7/05 FIVE OAKS Version 1.20 Page 21 6. 29 17(2) Sch. 4.6; 19(1)(2)S ch 2 7. 32 26 8. 33 24(1)(a) (b)(3) 9. 38 37 10. 38 12(1); 13(1); 17; 26 The registered person must ensure that staff have all necessary documents and that Regulation 19 and Schedule 2 including the maintaining of all records (Schedule 4.6) of the Care Homes Regulations 2001 is complied with in respect of all staff working at the home. Staff currently employed without CRB check must only work under supervision until their satisfactory CRB certificates are obtained. The registered person must carry out unannounced visits to the home on a monthly basis in line with Regulation 26 of the Care Homes Regulations. A copy of the written report must be sent to the CSCI and a copy must be held in the home. Timescales of 20/11/04 not met. The registered person must put in place effective quality assurance and quality monitoring systems, which seek the views of service users, visitors and professionals. The outcome of the surveys must be published and made available to all parties including the CSCI. (Timescales of 1/3/05 not met). The registed perswon must give notice to the Commission for Social Care Inspection without delay of the occurrence of any incident, accident or any injury to a service user. The registered person must take appropriate actions to prevent or reduce the high number of falls and ensure that service users are safe at all times. The registered person must updated the CSCI Inspector regading the number of falls on a monthly basis. 10/8/05 31/8/05 31/10/05 21/8/05 15/7/05 FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London, N14 6HA 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 FIVE OAKS G59 S10660 Five Oaks V221566 30.06.05 Stage 4.doc Version 1.20 Page 24 - 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!