Inspection on 11/01/07 for The Cedars Care Centre

This inspection was carried out on 11th January 2007.

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

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

Other inspections for this house

The Cedars Care Centre 14/05/07

The Cedars Care Centre 16/11/05

The Cedars Care Centre 27/06/05

The Cedars Care Centre 24/01/05

The Cedars Care Centre 12/06/04

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 Cedars Nursing Home 12 Richmond Road New Barnet Hertfordshire EN5 1SB Lead Inspector Margaret Flaws Key Unannounced Inspection 11th 12th January 2007 20:30p 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 Cedars Nursing Home DS0000010419.V307753.R02.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. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedars Nursing Home Address 12 Richmond Road New Barnet Hertfordshire EN5 1SB 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) 020 8364 8839 020 8364 8583 Cedar Gardens Care Limited David Adams Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Specific service user: One specific service user who is under 65 years of age and has mental health needs may be accommodated in the home. This condition will need to be reviewed at such time as the service user attains the age of 65 years or vacates the home. 16th November 2005 Date of last inspection Brief Description of the Service: The Cedars Nursing Home is a care home registered for a maximum of 45 older people who require nursing care. It is one of a number of care homes owned by Cedar Gardens Care Limited. The present owners have owned the home since 1999. The aim of the service is to provide quality nursing care in a supportive environment. The home is a large detached two storey house. There are thirty five single bedrooms and five double bedrooms located across the ground and first floors. All the bedrooms have en-suite facilities. Air conditioning is provided in the home. There is a shaft lift serving the ground and first floor. The communal areas, including a dining room and two interconnected lounge areas, are on the ground floor. There is a well maintained garden with a patio area to the rear of the home. There is also a small parking area at the front of the home. The home is situated in New Barnet, a short distance from the Great North Road and in a quiet residential area. It is about a mile from shops and other community facilities located in High Barnet. Fees for the home are £610-£860. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days and was undertaken over one evening and one day by Inspectors Margaret Flaws and Inspector David Hastings. The inspection included a tour of the premises, interviews with staff, service users and relatives, observations of activities in the home and inspection of service user, staff and other home records. The Registered Manager and the Administrator assisted throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Thirteen requirements were made at this inspection, including one immediate requirement. Five medication requirements were given. Staff should record on the MAR chart that a service user is in hospital rather than leaving the space blank; they should not use tippex on the MAR charts and allergies should be recorded in the MAR chart for each individual. The room in which oxygen is stored needs a warning on the door. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 6 One immediate medication requirements were given. Where service users have difficulty in communicating, staff must clearly record individual pain indicators on their MAR chart. All call bells must be well maintained and accessible to all service users when they are in their bedrooms. Automatic door closures must be fitted to rooms where doors are still kept open with bean bags. Staffing levels must regularly reviewed to ensure that they are well matched to dependency levels. The home must ensure that all staff received medication training and staff who administer medication must have appropriate training annually; night staff training should be as comprehensive as that delivered to day staff and at the same level and frequency. Staff supervision has been patchy recently and needs to be more frequent and available to all staff. The home also requires a policy for dealing with needle stick accidents. 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. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 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 the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users can be confident that their needs will assessed prior to admission and that they will be provided with the degree of information they require to decide on the suitability of the home. EVIDENCE: There were twenty nine service users in the home on the first evening inspection (two were in hospital). One new service user was admitted to the home on the second day of the inspection, bringing the numbers up to thirty service users. The home has several contracts with local authorities (the main contract is with the London Borough of Barnet) and the Primary Health Care Trust. There are also a substantial proportion of private service users. The home has had a high number of admissions since the last inspection. Two recent pre-admission assessments were checked and these provided a sound basis for care planning. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 9 Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 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 and 10 Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. Service users’ personal, health and social care needs are set out clearly in care plans and documentation is sound. Staff spoken to were knowledgeable about the service users’ needs. Service users can exercise choice as they wish. However, service users cannot be confident of protection from the home’s medication procedures. EVIDENCE: The health care plans of eight service users were inspected and several service users spoken to. Care plans examined were comprehensive, contained a variety of risk assessments, screening tools and specific needs assessments. A new format is currently being introduced for care plans. The home provides a broad range of care, including respite, palliative and terminal care. Two service users were receiving palliative care during the inspection. The home is introducing forms to assess additional needs, such as wishes in the case of death. This is an important process to have in place, given that many service users are very unwell when they are admitted to the home. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 11 All service users were visited and spoken to briefly in their rooms on the first evening, along with those who were in their rooms at the time of the inspection the next morning. Those who were able to speak to the inspectors said that they were comfortable and most said able to contact staff easily if they needed to using the nurse call system. Two service users were not happy with response times and two call bells required adjustments: these were pointed out to the nurse in charge and a requirement is given. The home has introduced a new procedure for checking and recording the service users’ ability to use the call bells. Staff said that they checked bedbound service users every fifteen to thirty minutes. These visual checks were then recorded on a form in the bedrooms. There were some gaps in checking times (mainly during busy periods in the day) but generally it was clear that monitoring was taking place. Several care related requirements from the previous inspection have been met: falls are now clearly recorded; risk assessments are more detailed and care plans are more regularly reviewed, including night care plans. Eight service users had pressure sores, all acquired while in hospital. The home works closely with the Primary Care Trust Tissue Viability Nurse to improve wound healing for these service users and staff are trained in pressure area care. Where medical photography is used, permission is now clearly documented, meeting a requirement from the last inspection. Medication procedures and records were examined with the assistance of a clinical staff member. Several requirements were given. One immediate requirement was given. One service user with communication difficulties had not been given prescribed painkillers for over one month and no indicators of pain were recorded. The home is required to ensure that, where service users have difficulty communicating, staff clearly record individual pain indicators on the MAR chart. Staff had left gaps on the MAR chart when service users were in hospital and used tippex: staff must record hospitalisation using a ‘H’ instead of leaving the chart blank and they must not use tippex to make changes. Allergies must be recorded in the MAR chart for each individual. When medication is received, this must be accurately recorded, with information on whom the medication is for, what is received, including quantity. The person receiving the new medication must sign these details. The room in which oxygen is stored must have a warning on the door. All other medication counts and records examined in this audit were accurate. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 12 Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. The home offers service users a good choice of activities and opportunities for family involvement. However, these activities are mainly targeted at the more active and mobile service users. Improvements are needed in meeting the needs of service users who are bedbound or who spend most of their time in their rooms. The food is of very good quality, highly nutritious and plentiful. EVIDENCE: During the inspection, several activities, mainly quizzes, games and singalongs led by the activities coordinator took place in the lounge. However, because a number of service users are either bedbound or choose to spend time in their rooms, the home needs to review the way activities are provided for them. A requirement is made. Most relatives surveyed or spoken to said they were happy with the activities provided but some requested more active and stimulating activities. Several service users were observed to choose to go to bed late or get up later than others. Those spoken to said that they were happy with the degree of choice and control over their lives available to them. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 14 Lunch was served buffet style in the lounge. There was a choice of fish and chips or roast pork. The food was healthy and tasty. Several diets were catered for appropriately. The chef is committed to providing good quality meals and produces a regularly changing menu in consultation with service users. Menus include a daily cooked breakfast, a three course lunch and soup, salad and sandwiches in the evenings. The inspector toured the kitchen with the cook. The fridges were full of fresh vegetables, there are regular deliveries of fresh fish and other quality food supplies. Fridge and freezer temperatures are checked and recorded daily. They were within range. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Service users can be assured that complaints will be appropriately investigated and followed up; that adult protection policies and procedures are in place and that staff are trained to put these into practice. EVIDENCE: One complaint has been received by the home since the last inspection, which is still in the process of being addressed. Documentation relating to this complaint was examined which demonstrated that good process was being followed. The complaints book evidenced that complaints are appropriately followed up and investigated. Part of this inspection involved investigating an adult protection allegation made anonymously to CSCI. No evidence was found to substantiate this allegation. All staff regularly receive adult protection training, most recently in December 2006. The Registered Manager delivers this training, having completed a Train the Trainer course. All staff interviewed could describe very accurately how they would deal with allegations or incidents of abuse and could give examples of what constituted abuse. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. The environment for service users is generally comfortable, clean and pleasantly attractive. This includes both service users’ bedrooms and communal areas. Service user’ safety would be better protected by the installation of automatic door guards. EVIDENCE: The inspectors made two tours of the home during the inspection, one in the evening and one the next day, visiting all areas except the gardens. The overall environment is generally pleasant, with several large communal spaces. The Registered Manager described plans to redecorate several parts of the home, which are in need of refurbishment. Bedrooms are comfortable, well furnished and highly personalised by the service users. Bathrooms and toilets were in good order and a new bath has been put in. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 17 Two rooms had their doors propped open with bean bags, a procedure which has been reviewed with the Registered Manager in the past. These doors require automatic door closures and a requirement is given. The home was clean, hygienic and generally free from offensive odours on the night and the next day of the inspection. The kitchen was also inspected and was clean. Kitchen staff receive regular job specific training. Cleaning staff were observed working in the home throughout the inspection. The laundry was inspected and was in good order. A new washing machine was purchased since the last inspection. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. The home needs to review its staffing to ensure it has the right numbers of staff on duty at all times to meet the service users’ needs. The service users are protected by a sound recruitment process and training programme. EVIDENCE: All staff on duty on three shifts and visiting the home for a meeting were interviewed as part of this inspection, a total of fifteen staff, as well as the Registered Manager and Administrator. An Activities Coordinator worked with the service users in the lounge on the second day of the inspection. Some staff and relatives raised the issue of staffing levels and the effects of staff changes. While the home had a decreased occupancy at the time of the inspection, concern was expressed about the amount of time available to staff to spend with the service users and attend to their needs, particularly as the home has service users with high dependency levels and complex needs. It is required that the home put a clear system in place for assessing service user’ dependency and matching staffing levels to these identified dependencies, particularly given that the home provides care to service users with complex and changing needs, including palliative and terminal care. Staff records, including the records of three new staff, were examined. New staff had pre-employment checks, including CRB or POVA First clearances, completed and on file, along with evidence of identification and references Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 19 obtained. Registered Nursing staff also had records of their current PIN numbers with the UKCC. The home has a good staff training programme and certificates are kept in the staff files. There is a good, up to date staff training matrix which gives an easy to follow overview of staff training received. Since the last inspection, staff have been trained in fire safety, moving and handling, manual handling, food safety, supervision, COSHH, managing challenging behaviour, food hygiene, risk assessment, nutritional needs, continence promotion, footcare, PEG and naso-gastric feeding. There is a strong clinical training programme, which includes management of syringe drivers and other pumps, wound, leg ulcer and pressure ulcer management, stroke training, catheter care and phlebotomy training. Seven staff are studying for or have completed either NVQ2 or NVQ3. Some night staff, including nursing staff in charge at night, have not received the same level of training as day staff. It is required that the training of night staff be reviewed and their training in core areas of their work updated. Some staff had not had annual medication training and it is required that all staff receive medication training annually, at a foundational level for care staff and in depth for clinical staff with medication responsibilities. A requirement made at the last inspection, that staff receive diabetes training, was discussed with the Registered Manager. He said that it is has been very difficult to find a company that offers this training but showed the inspectors a letter that confirmed a booking for training for up to twenty staff this month. The requirement is met. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Service users are consulted on their views and their financial interests are protected. Staff supervision needs to improve to better support staff. Health and safety is generally well protected in the home. EVIDENCE: The home is run by the Registered Manager, who is supported by a new Head of Care, and an Administrator. The home measures quality by surveying relatives. The last quality survey took place in Oct 2006 and recorded service user and relatives’ views. Staff supervision records were examined and staff asked about how often they receive supervision. The provision of supervision is patchy. The manager said that some new staff have been trained to provide supervision. It is required Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 21 that all staff receive formal, one to one supervision at least six times per year and that this be appropriately recorded. Service users’ financial records were sampled and were in good order. Incident and accident records were in order. They mainly recorded falls by service users. However, when a staff member had a needle stick injury, appropriate actions taken to deal with this were recorded but the home does not have a policy and procedure for needle stick injuries. This is required. Health and safety certificates were checked and were in order. Fire alarms had been recently serviced; certificates obtained for emergency lighting, electrical PAT testing, legionella checks, gas safety and electrical safety. The home has current Employers Liability Insurance. An Environmental Health Inspection on October 2006 required that the home undertake a risk analysis, which has been done. Fire safety records were also checked and found to be in order. Alarms are regularly tested; fire drills carried out and fire equipment tested. Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 23 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. 1 Standard OP9 Regulation 13(2) Requirement Timescale for action 28/02/07 2 3 OP9 OP9 4 5 OP9; OP38 OP9 6 OP19 7 OP12 The Registered Persons must ensure that the MAR sheet is marked appropriately if a service user is in hospital. 13(2) The Registered Persons must ensure that tippex is not used on the MAR sheet. 13(2) The Registered Persons must ensure that allergies are recorded on the MAR sheet for each individual. 38(1); The Registered Persons must 13(2) ensure that the room with oxygen has appropriate signage. 13(2|);12( The Registered Persons must 1) ensure that staff clearly record pain indicators on the MAR chart for service users who cannot communicate. 13(4) The Registered Persons must ensure that all call bells are in a good state of repair and accessible to all service users in their rooms. 16(2) The Registered Persons must ensure that they review activities provided to service users who spend most of their time in their rooms. DS0000010419.V307753.R02.S.doc 28/02/07 28/02/07 28/02/07 17/02/07 28/02/07 31/03/07 Cedars Nursing Home Version 5.2 Page 24 8 OP19 13(4) 9 OP27 18(1) 10 OP30 12(1); 18(1) 18(1) 11 OP30 12 OP36 18(1) 13 OP38 12(1) The Registered Persons must ensure that automatic door closures are fitted to rooms still using beans bags. The Registered Persons must ensure review staffing levels to ensure they are well matched to the dependency levels of service users. The Registered Persons must ensure that night staff receive the same level of training to that offered to day staff. The Registered Persons must ensure that all staff receive medication training, and that staff with medication responsibilities receive in depth training annually. The Registered Persons must ensure that all staff receive formal, documented, one to one supervision at least six times per year. The Registered Persons must ensure that there is a needle stick policy in place. 31/03/07 31/03/07 30/04/07 30/04/07 30/04/07 30/04/07 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 Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Southgate Area Office 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 Cedars Nursing Home DS0000010419.V307753.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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