Inspection on 23/09/08 for Greenways Residential Home

This inspection was carried out on 23rd September 2008.

CSCI found this care home to be providing an Good service.

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

Greenways Residential Home 14/10/09

Greenways Residential Home 24/05/06

Greenways Residential Home 18/10/05

Greenways Residential Home 02/06/05

Greenways Residential Home 09/12/04

Greenways Residential Home 28/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Greenways Residential Home 6-8 Victoria Road Southwick West Sussex BN42 4DH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Edward McLeod     Date: 2 3 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Greenways Residential Home 6-8 Victoria Road Southwick West Sussex BN42 4DH 01273591573 Telephone number: Fax number: Email address: Provider web address: clarkbrenda80@yahoo.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Brenda Clark Type of registration: Number of places registered: care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 15. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Greenways is a care home registered to provide personal care and accommodation for up to 15 older people. The property is detached and is situated in a residential area close to the centre of Southwick. Shops and other local community facilities are nearby. The majority of private accommodation is arranged on two floors. The upper floor can be accessed by a passenger lift, however four bedrooms on the middle mezzanine floor can only be accessed by steps. The majority of rooms are for single 0 Over 65 15 Care Homes for Older People Page 4 of 28 Brief description of the care home occupancy and have en suite facilities. Communal space consists of a lounge/dining room, a conservatory and there is a garden and patio to the rear of the house. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection visit was arranged to assess the homes compliance with key standards of the national minimum standards for care homes for older people and with the requirement made at our previous inspection visit. Our planning for this visit included obtaining CSCI survey form responses from four people living in the home and four of the care staff. We also obtained from the owner, Mrs Clark, the homes annual CSCI self-audit questionnaire (the AQAA). Information from these sources has been used in the preparation of this report. In planning for this visit we also reviewed the outcomes of our previous inspection visit on the 24th May 2006 and our annual service review dated 9th October 2007. Care Homes for Older People Page 6 of 28 The inspection was carried out by one inspector who was on the premises between the hours of 9.30 a.m. and 2.30 p.m. on the 23rd September 2008. At this visit we spoke with four people living in the home, two members of staff and the owner Mrs Clark. We sampled two sets of care plans and admission records, and two sets of staff recruitment, supervision and training records. We also observed interactions between staff and people receiving a service, and a lunch sitting. We sampled other records including complaints and health and safety records. Mrs Clark advised us that the care home fees range from 338 per week to 400 per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay. Evidence: The three people living in the home who responded to our CSCI service user survey Care Homes for Older People Page 10 of 28 Evidence: told us they had received enough information on the service to enable them to make a decision about coming to live in the home. The owner Mrs Clark has told us that a copy of the social services care plan or care management assessment is obtained to help inform the decision making, and that a pre-admission assessment is undertaken. Mrs Clark advises us that the pre-admission assessment has been updated to include dental health needs, television and telephone and other special room requirements. People are invited to visit, meet staff and discuss their care needs before they enter the home. We looked at two sets of pre-admission assessments and found that peoples needs were being assessed, and an assessment was being made if the home could meet their needs. We looked at two sets of residents contracts which told us that people are being provided with a contract that tells them their rights and responsibilities and the fees payable. This information could made more useful to people receiving a service by including in the contract a summary of who pays what part of the fee, as advised in the National Minimum Standards for care homes for older people. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. Peoples right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. Evidence: During this visit we looked at two sets of care plans, which included good information Care Homes for Older People Page 12 of 28 Evidence: to guide staff on what support they would be providing for the person. Care plans are being regularly reviewed and updated. Staff told us in their CSCI surveys that they receive updates from managers on the care to be provided. Service user surveys told us that people believe they receive the care and support they need, and that staff listen to them and act on what they say. Staff we spoke to gave us examples of how care plans are carried out - for example one persons anxiety is managed by supporting them in receiving phone calls and visits from their family. People living in the home told us that they are receiving all the support they need from staff. The four people living in the home who responded to our CSCI survey told us they always receive the medical support they need. Comments made included if staff are unable to help they contact the visiting nurses. Care plans we looked at and staff we spoke with indicated that people are accessing the medical support they are in need of. Discussions with staff indicated that no-one in the home suffers from pressure areas, and staff were aware of how they would support someone who did have red areas or pressure sores. Staff told us that the home arranges transport for hospital appointments and that the family is notified when the appointment is arranged and when it has been carried out. During our visit we looked at the medication returns book, the arrangements for storing medication, and observed medication being given and then recorded for one person. We noted on training records that staff are receiving training in administering medicines. The homes annual CSCI self-audit questionnaire (the AQAA) tells us that residents are able to take responsibility for their own medication where appropriate, and that medication reviews are recorded. Training records we looked at told us that staff who administer medicines have received training in this. Care Homes for Older People Page 13 of 28 Evidence: The manager told us she carries out random checks on medication records to ensure good practice is in place. One person we spoke to said she was aware she had the choice of whether she held her medicines or these were held by staff, and she told us she preferred to have staff hold her medicines because she may forget to take her medicines otherwise. One person told us in their CSCI survey that Im always given medication on time and as prescribed. The AQAA tells us that staff knock on the persons door before entering, that staff respect peoples privacy and dignity when assisting with going to the toilet and bathing, and that medical examinations are undertaken in the persons own room. One member of staff told us we try to keep people independent. Most people dress themselves, if not we go though choices and clothing with them. A resident we spoke to during our visit told us that he likes to do things for himself and staff recognise this and only offer assistance if asked. Staff in the home including the manager have attended bereavement training to assist in their care of people with a terminal illness. A member of staff described to us how one persons care was carried out during the last months in their life, which included support for relatives and the personal care being done entirely by two carers who knew the person well. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks at a time and place to suit them. Evidence: Mrs Clark advises us that since our previous visit more time has been devoted to doing activities with residents and that playing games has helped keep people alert and active. Mrs Clark tells us that residents were asked what activities they would like staff to Care Homes for Older People Page 15 of 28 Evidence: provide, and that scrabble and card games were suggested and these have been made available. Staff and people we spoke to during our visit told us that activities in the home include bingo, music, movement, board games, videos and reminiscence. People we spoke to said they enjoyed visiting the local shops and watching cricket on the nearby green, and Mrs Clark told us that staff have begun taking people out to the shops and for a coffee. One member of staff told us that on Saturdays games usually take place and on Sundays an old film is shown. Staff told us that bringing a local newspaper in for the residents to read often encouraged conversation. Care plans we sampled indicate what peoples interests are, and staff we talked to gave us examples of how they support people to follow their interests. People are being supported to maintain contact with their relatives and friends, and evidence for this was found in the daily records which we sampled during our visit. Mrs Clark advises us that a menu board has been introduced and menus are discussed at residents meetings. People told us in their CSCI survey forms they like the meals provided, with one person telling us that the cooking is tops, not just isolated meals but all the time. We observed a lunch sitting on the day of our visit. We sampled records which are being kept of meals provided, and these indicated that a choice of meals is being provided at all meal times. People who needed assistance with cutting their food were receiving this. Staff told us that no-one living in the home at present requires a specialist diet. The meal was unhurried, and people who wanted a second helping received this. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. Evidence: People living in the home are provided with the homes complaints procedure. The four people living in the home who responded to our CSCI survey told us they knew who to speak to if they were unhappy, and that they knew how to make a complaint. One person said in their survey that any complaints I make are dealt with quickly. We sampled three complaints in the homes complaints records, and found that the complaints had been appropriately investigated and resolved. The four staff who responded to our CSCI survey told us they knew what to do to take forward concerns raised. Care Homes for Older People Page 17 of 28 Evidence: Mrs Clark tells us in the AQAA that all staff have attended training in safeguarding vulnerable adults and are aware of the procedures for this which should be followed. Training records we sampled confirmed that staff were undertaking safeguarding training. The manager advised us that there have bee no safeguarding concerns in the home since the previous inspection. We spoke to one member of staff about how staff respond if a persons behaviour is difficult. The member of staff said it was important not to lose patience but be kind. The member of staff gave an example of how staff have learned to reassure and calm one person when they are becoming restless. The manager told us in the AQAA that people are given the choice of going out to vote or sending a postal vote in national and local elections. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People stay in a safe and well maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. Their room feels like their own, it is comfortable and they feel safe when they use it. Evidence: We found that the home is providing comfortable and homely accommodation for the people living there, and that it is being kept in good order and the garden was being tended on the day of our visit. The decoration and furnishing in the home is being improved, and since our last visit the home has had a spring clean, carpets have been replaced in five bedrooms, and there has been decoration and replacement of curtains in some bedrooms. There is a system in place for room safety checks to be done and for routine maintenance work to be attended to. Care Homes for Older People Page 19 of 28 Evidence: Mrs Clark told us in the AQAA that plans to improve the premises include redecoration, carpet cleaning, and trees and bushes to be cut back to increase access to the garden for residents. We visited seven bedrooms and all the communal areas in the home. We found that people were being supported to personalise their bedrooms and make them their own. All bedrooms have en-suite facilities. At the previous inspection a requirement was made that the hot water temperatures at outlets in the home be monitored. Mrs Clark told us that adjustments had been made to hot water temperatures in the home, and hot water temperatures are now being recorded. She told us that staff record bath temperatures before the person goes into the bath. We looked at the records made for hot water temperatures, and hand tested hot water in two bedrooms. We found that hot water temperature levels which will prevent the risk of scalding are being provided, and the previous inspection requirement was assessed as met. Kitchen cleaning and general cleaning rotas are monitored by the manager, and in the kitchen we found that the Safer Food system of food hygiene recording is being used. We looked at the laundry room and found that peoples laundry is kept separate after washing. There is a separate sluice room for use if needed, but Mrs Clark advised us this is not often used. People told us in their CSCI surveys that the home is kept fresh and clean. All areas of the home visited during our visit were found to be fresh and clean. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from managers. Evidence: The four staff who completed CSCI survey forms told us that there are sufficient numbers of staff on duty. One person wrote that there were always required staff on duty. Illness is always covered by staff. On the day of our visit we found that there were enough staff on duty to provide people with the assistance they needed, and for people to be assisted in a calm and unhurried way. We sampled two sets of recruitment records for staff who have been employed in the home since our previous visit. We found that the required checks and references had been obtained, and new staff Care Homes for Older People Page 21 of 28 Evidence: are being provided with induction training and support such as supervision to assist them in getting to know the people in the home and the policies and procedures to be followed. Staff we interviewed told us they enjoyed working in the home, that the manager is supportive, and staff meetings are helpful. The four staff who completed CSCI survey forms told us they had completed CRB checks before starting work in the home, and that their induction training covered everything that they needed to know. Mrs Clark told us that five of the care staff have now achieved the National Vocational Qualification (NVQ) in care at level 2 or 3, and that managers have supported staff to complete this training. One member of staff told us in their CSCI survey form that NVQ has taught me a great deal but I know I can rely on my manager to explain any queries. During our visit the manager said that NVQ training had given staff better insight into the job. The four staff who completed CSCI survey forms told us that they felt they had the right support and knowledge to carry out their work. Mrs Clark told us in the AQAA that the home provides 80 training places per year, and recent training attended by staff has included food hygiene, diabetes, and care plan recording. Mrs Clark told us during our visit that the training needs of the individual member of staff are discussed in supervision sessions, and supervision records sampled confirmed this. We sampled training certificates for two members of care staff, and found that people had undertaken recent training in topics such as fire safety, administration of medicines, health and safety, skin care, and safeguarding vulnerable adults. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. Evidence: During the visit we spoke to Mrs Clark, the owner of the home, about the manager vacancy in the home. Mrs Clark told us that she had cancelled her registration as manager of the home as she had appointed another person to become manager. The person was not able to Care Homes for Older People Page 23 of 28 Evidence: take up the post due to an injury, and Mrs Clark said she has therefore continued to manage the service and provide continuity for staff and people living in the home. Mrs Clark told us that she would be advising the Commission in writing of the plans for the future management of the home, and is aware that there is a need of a manager to be registered for the service. Mrs Clark advised us that she has continued to update her training and knowledge, and her recent training has included a course in bereavement. The AQAA tells us that residents receive questionnaires about their views on the service once per year. After questionnaires sent out in March 2008, Mrs Clark told us that the response was that people living in the home felt they obtained a very good service which they were happy with. There were no issues requiring further action. Improvements made in the home after consultation with residents has included the introduction of a menu board and more varied activities including trips out. Mrs Clark told us that residents meetings are held every 3 months, and we sampled the record of the residents meeting held on 15/9/08. The notes record that several people talked about some of their individual food preferences, for example one person requested mustard on the table at meals. During the lunch we observed that mustard was being provided. Other things which people wished to be checked or changed were recorded in the notes and one person living in the home told us that things (are) always dealt with promptly. Mrs Clark tells us in the AQAA that the manager has little involvement in the personal finances of the service users, although secure facilities are provided for the safekeeping of money and valuables. During our visit we sampled one set of records for a person who has small amounts of money held by the home manager. We found that transactions were recorded and receipts were available for inspection. We found that the home was taking action to ensure that peoples money is safe - for example by assisting one person to arrange for a solicitor to act as their power of attorney. Care Homes for Older People Page 24 of 28 Evidence: We looked at supervision records for two care staff and found they were receiving regular staff supervision which was including discussion about their training needs. Mrs Clark tells us in the AQAA that health and safety legislation is kept up to date with environmental risk assessments undertaken and regular fire training for all staff. The training certificates for two staff which we looked at told us that staff are receiving training in health and safety topics such as fire training, food safety, manual handling and health and safety. Mrs Clark told us that staff go through the fire procedures with residents, explaining what will happen in the event of a fire. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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