Inspection on 07/07/05 for Greenford Care Home

This inspection was carried out on 7th July 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

Greenford Care Home 07/10/08

Greenford Care Home 18/06/08

Greenford Care Home 30/11/07

Greenford Care Home 26/07/07

Greenford Care Home 20/06/06

Greenford Care Home 07/03/06

Greenford Care Home 29/12/04

Greenford Care Home 12/07/04

Greenford Care Home 22/12/03

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

CARE HOMES FOR OLDER PEOPLE Greenford 260-262 Nelson Road Gillingham Kent ME7 4NA Lead Inspector Robert Pettiford Unannounced 7th July 2005 10:15 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. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greenford Address 260-262 Nelson Road Gillingham Kent ME7 4NA 01634 580711 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) Mr Cemal Osman Mrs Amanda Pryer Care Home 18 Category(ies) of Dementia (18) registration, with number of places Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 29 December 2004 Brief Description of the Service: Greenford is home to 17 service users with dementia. The home itself is situated in Gillingham adjacent to Gillingham Park, which can be accessed via the back courtyard. The home has mainly single rooms, two having en-suite facilities and day areas have a homely feel even though it is open plan in design. The main town of Gillingham offers High Street stores and a mainline railway station. The home itself is on a bus route. There is limited parking to the rear of the home. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection at Greenford took place on 7th July 2005 at 10:15am. The Inspectors agreed and explained the inspection process with the Manager. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. A tour of premises was also undertaken. The focus of the inspection was to assess Greenford in accordance to the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? What they could do better: The home needs to provide more information to service users to enable them to make an informed choice about the home. Service users and families also need to be involved in the care planning process. The storage and administration of Medication was found not to meet the required standards. Staff records were found to be poor. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 6 Improvements to the environment were seen as a priority. 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. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 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 Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 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) 1,2,3,4,5 Prospective service users have most of the information they need to make an informed choice about whether they wish to live at this home. Service users contract/terms of conditions do not provide information about the fee or who is responsible to it. Service users can be confident that their needs will be suitably they also have the benefit of a trial period at the home. EVIDENCE: The home has a Statement of Purpose and Service Users Guide. The Statement of Purpose has been reviewed and has improved, the Service Users Guide however has not been reviewed and does not contain all the relevant information. The manager was shown where the list of contents for this documents could be found. The contracts/terms conditions of residency on file did not contain the fee or who would be responsible for payment. The service users and or the family have not all signed the contracts. The documents seen did contain other relevant information. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 9 The pre assessments seen contained all of the information needed to make an informed decision as whether the home would be able to meet the prospective service users needs. The home do a large number of different assessments and these include:- Cognitive impairment, Barthel dependency, waterlow skin integrity, nutritional, and falls assessment. The home have used the assessments to formulate a plan of care. The plans detail the care provision needed but these are not recording an outcome at the monthly review or being re-formulated with the care manager/family on a six monthly basis. The home does encourage prospective service users to come to the home for the day or at least a meal, they also invite the families to visit and ask questions. All service users coming into the home do so on a 4 week trail basis, during this time the assessment continues and the service user has the opportunity to see if they are happy at the home. If at the end of this period the home feels it can meet the service users needs and the service user/family are happy then the placement can become permanent. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 Service users can be confident that their health, personal and social care needs are set out in a plan of care and are being met, however the service users/family are not involved in its formation and some detail was missing. Service users are not protected with regard to the homes policy on medication. EVIDENCE: The care plans are generated from the assessments, which are reviewed regularly. The plans detail the care and actions staff should take to ensure that the needs and wishes of the service users are met. The plans do not appear to have been done with the service users and or family and certainly none seen had been signed. The care plans themselves were reviewed monthly but no outcomes were seen recorded. The six monthly review with the family and or care manager were not evident. The daily records showed that more detail is required when documenting personal care. The staff are recording well the service users daily intake of food. Staff do need to be reminded not to use abbreviations in the daily notes recording. The service users weight needs to be monitored monthly this is not being consistently done. All service users have their own GP and district nurses visit the home when required. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 11 The home also has good links with Southlands an assessment centre for people with dementia and the psycho-geriatric nurses. All visits by out side professional happen in the privacy of the service users bedroom. Medication storage consisted of a trolley, which is too small for the amount of medication stored. This has resulted in a cupboard also being used but this is used for other purposes as well so this is not appropriate. The home uses a dosage system supplied by the chemist. Then Medication Record Sheets had been completed and showed the medication had been signed in and check when received into the building. The service users personal information that is recorded on the Medication Record Sheets was almost complete, it needed to have documented what allergies the service users has or the fact that there were none known. The trolley needed to be cleaned and medicine cups etc stored at the base of the trolley need to be kept in a sealed contain to avoid contamination. The home has no controlled medication in use at this time so storage and records were not checked. The home was not in possession of a medication fridge. Temperature sensitive medication was kept in a unlocked box in the kitchen fridge. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 12 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) Not inspected on this occasion. EVIDENCE: Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 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) 16,18 Service users know that their concerns and complaints are taken seriously. Service users are on the whole protected from the risks of abuse. However some further training was identified EVIDENCE: The inspector viewed a copy of the Home’s complaints procedures. The procedure included details of how to complain, timescales for response and information for referring a complaint to the Commission for Social Care Inspection. However some minor amendments were seen as being needed. A copy of the complaints procedure has been provided and explained to service users. The inspector viewed and discussed copies of the Home’s Policy for the Protection of Service Users and staff “Whistle blowing” procedure. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training is provided in abuse. More courses are planned to ensure all staff receive the training required to protect service users from abuse. Criminal Record Bureau Checks (CRB) have been obtained for all staff. Following discussion with senior management it was identified that there was a lack of understanding of the procedures with regard to Adult Protection and POVA (Protection of Vulnerable Adults) Protocols. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 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) 19,22,24,26 Although it was acknowledged that staff work hard to keep the home clean it does not provide a safe and well maintained environment for service users due to the level of decoration and repairs needed. EVIDENCE: A tour of the Home including a selection service users rooms with their permission and bathroom/toilet facilities along with communal areas was carried out. Many of the bedrooms were seen to be in need of re-decoration and refurbishment. Furniture within some of the bedrooms was of poor quality and in a state of disrepair. The rooms viewed did not all have radiator covers and none of them were fitted with thermostatic control valves on the sinks to control the temperature and avoid the risk of scolding to service users. None of the room had a lock either on the door or within the room which is required as per the standards. Some of the curtains in some of the rooms was falling down. Commodes in many of the bedrooms were found to be rusty and in a Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 15 poor state of repair and in need of urgent replacement. The home was in need of carrying out an audit to ensure that the furniture within the bedrooms meet with the standards Staff had made an effort to make some of the room attractive but it was acknowledged that this was limited due to lack of a dedicated budget and handyman. One bedroom on the top floor contained an overhead light which in view of the inspector was unsafe for the service user group. The communal area’s of the home were seen to be in need of some degree of re-decoration and refurbishment. Chair’s in the lounge were in need of cleaning. The manager stated that a steam cleaner would be purchased to address this. Broken glass was found in a fire door. The television reception in the main lounge was very poor at the time of inspection. The manager stated that she would get this investigated. The kitchen was found to be dirty due to tiles coming away from the wall and grout which was difficult to clean. The fire door was faulty and did not close properly. An odour was detected within the home. The manager stated that everything was being done to address this and that the homes ongoing refurbishment would address this. The home has got a procedure and policy on the control of infection and the home does have a washing machine with a sluice facility and are using the red sacks system. During the tour of the building the Inspector also saw that incontinence pads and clinical waste is collected in the appropriate yellow sacks and the bins are outside for collection by a bona fide company. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 16 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) 27,29,30 Service Users basic needs are supported by the staff that the home provides. However it was not possible to evidence if service users were in safe hands due to lack of training records. EVIDENCE: The home has a mix of management personnel, care staff. The home is currently recruiting a cook and the registered provider company is ensuring that the home has maintenance support. A copy of the staffing roster seen indicates that rotas have been prepared for the following month. The home provides two AM staff one 7-10 and three PM with two staff working nights. The rota and observations during the inspection reflected sufficient staff to support residents to participate in activities and to meet their personal needs. However the manager is requested to review staffing level to ensure that it provides roughly 330 hours of care per week and is in line with the residential forum guidelines for staffing hours with care homes. On-going training is taking place for all staff. The home has a development programmed which the Manager stated meets National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. However it was not possible to Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 17 evidence this due to the lack of any training records. The manager stated that this would be addressed as a priority. The inspector viewed details of the Home’s recruitment procedure and a number of records relating to staff members recruited. The Home undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of I.D and copies of qualification certificates, seeks written references. All staff appointments are subject to a probation period, which is subject to review. The records were found to need updating and reviewing to ensure that they contained all the information as shown in schedule Two of the Care Home Regulations 2001 Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 18 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) 36 Staff do not benefit from regular staff supervision. EVIDENCE: No evidence was available that staff are regularly supervised to ensure that the aims and objectives of the home are achieved. Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 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. 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 2 2 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 1 x x 1 x 1 x 2 STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x 2 x x Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 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 1 Regulation 4(!)(2) Requirement 4.—(1) The registered person shall compile in relation to the care home a written statement (in these Regulations referred to as “the statement of purpose”) which shall consist of— (a) a statement of the aims and objectives of the care home; (b) a statement as to the facilities and services which are to be provided by the registered person for service users; and (c) a statement as to the matters listed in Schedule 1. (2) The registered person shall supply a copy of the statement of purpose to the Commission and shall make a copy of it available on request for inspection by every service user and any representative of a service user. 5.—(1) The registered person shall produce a written guide to the care home (in these Regulations referred to as “the service user’s guide”) which shall include— (b) the terms and conditions in respect of Timescale for action 07/10/05 2. 2 5(1) 07/10/05 Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 21 3. 7 15(1) 4. 9 13(2) 5. 19 23(1) 13(4) accommodation to be provided for service users, including as to the amount and method of payment of fees; 15.—(1) Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the service user’s needs in respect of his health and welfare are to be met. 13.—(2) The registered person shall make arrangements for the recording, handling, safe keeping,safe administration and disposal of medicines received into the care home. Regulation 17(1)(a) Schedule 3 (k) a record of all medicines kept in the care home for the service user, and the date on which they were administered to the service user; 23.—(1) Subject to regulation 4(3), the registered person shall not use premises for the purposes of a care home unless— (a) the premises are suitable for the purpose of achieving the aims and objectives set out in the statement of purpose; and (b) the location of the premises is appropriate to the needs of service users. 13.—(4) The registered person shall ensure that— (a) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety; (c) unnecessary risks to the health or safety of service users 07/10/05 07/10/05 07/01/06 Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 22 6. 24 16(1) 7. 26 16(1) 8. 27 18(1) are identified and so far as possible eliminated, 16.—(1) Subject to regulation 4(3), the registered person shall provide facilities and services to service users in accordance with the statement required by regulation 4(1)(b) in respect of the care home. (2) The registered person shall having regard to the size of the care home and the number and needs of service users— (c) provide in rooms occupied by service users adequate furniture, bedding and other furnishings, including curtains and floor coverings, and equipment suitable to the needs of service users and screens where necessary; 16.—(1) Subject to regulation 4(3), the registered person shall provide facilities and services to service users in accordance with the statement required by regulation 4(1)(b) in respect of the care home. (2) The registered person shall having regard to the size of the care home and the number and needs of service users— (j) after consultation with the environmental health authority, make suitable arrangements for maintaining satisfactory standards of hygiene in the care home; (k) keep the care home free from offensive odours and make suitable arrangements for the disposal of general and clinical waste; 18.— (1) The registered person shall, having regard to the size of the care home, the 07/01/06 07/01/06 07/01/06 Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 23 9. 29 19(1) statement of purpose and the number and needs of service users— (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users; 19.—(1) The registered person 07/10/05 shall not employ a person to work at the care home unless— (a) the person is fit to work at the care home; (b) subject to paragraph (6), he has obtained in respect of that person the information and documents specified in— (i) paragraphs 1 to 6 of Schedule 2; (ii) except where paragraph (7) applies, paragraph 7 of that Schedule; (iii) where paragraph (7) applies, paragraph 8 of that Schedule; and (c) he is satisfied on reasonable grounds as to the authenticity of the references referred to in paragraph 5 of Schedule 2 in respect of that person. (2) This paragraph applies to a person who is employed by a person (“the employer”) other than the registered person. (3) This paragraph applies to a position in which a person may in the course of his duties have regularcontact with service users at the care home or with any other person of a description specified in section 3(2) of the Act. (4) The registered person shall not allow a person to whom paragraph (2) applies to work at Version 1.30 Page 24 Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc the care home in a position to which paragraph (3) applies, unless — (a) the person is fit to work at the care home; (b) the employer has obtained in respect of that person the information and documents specified in— (i) paragraphs 1 to 6 of Schedule 2; (ii) except where paragraph (7) applies, paragraph 7 of that Schedule; (iii) where paragraph (7) applies, paragraph 8 of that Schedule, and has confirmed in writing to the registered person that he has done so; and (c) the employer is satisfied on reasonable grounds as to the authenticity of the references referred to in paragraph 5 of Schedule 2 in respect of that person, and has confirmed in writing to the registered person that he is so satisfied. (5) For the purposes of paragraphs (1) and (4), a person is not fit to work at a care home unless— (a) he is of integrity and good character; (b) he has qualifications suitable to the work that he is to perform, and the skills and experience necessary for such work;(c) he is physically and mentally fit for the purposes of the work which he is to perform at the care home, and (d) full and satisfactory information is available in relation to him in respect of the following matters— (i) each of the matters specified in paragraphs 1 Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 25 to 6 of Schedule 2; (ii) except where paragraph (7) applies, each of the matters specified in paragraph 7 of that Schedule; (iii) where paragraph (7) applies, each of the matters specified in paragraph 8 of that Schedule. 6) Paragraphs (1)(b) and (5)(d), in so far as they relate to paragraph 7 of Schedule 2, shall not apply until 1st April 2003 in respect of a person who immediately before 1st April 2002 is employed to work at the care home. 7) This paragraph applies where any certificate or information on any matters referred to in paragraph 7 of Schedule 2 is not available to an individual because any provision of the Police Act 1997 has not been brought into force. 10. 11. 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 Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Greenford H56-H06 S29057 Greenford V225009 070705 Stage 4.doc Version 1.30 Page 27 - 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. 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