Inspection on 24/04/07 for Heathcote Care Home

This inspection was carried out on 24th April 2007.

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

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Heathcote 19-23 Unthank Road Norwich Norfolk NR2 2PA Lead Inspector Ann Catterick Unannounced Inspection 24th April 2007 09:00 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 Heathcote DS0000069100.V337236.R01.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. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathcote Address 19-23 Unthank Road Norwich Norfolk NR2 2PA 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) 01603 625639 01603 762356 Black Swan International Limited Manager post vacant Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th April 2006 Brief Description of the Service: The home has recently been taken over by Black Swan Ltd. Heathcote is a residential care home that provides accommodation for up to 29 elderly people. It comprises of what was previously three separate properties, which have been renovated and modified into one single property consisting of 3 floors and a passenger lift to the first and second floors. There are 5 double rooms and 19 single rooms. Several of these have en suite facilities, which includes a bath. Rooms without en suite facilities have wash hand basins fitted and toilets located outside the rooms. People who are fully ambulant, and selfcaring, are offered accommodation in the 5 single rooms on the second floor. The home has a comfortable lounge that operates as three separated areas. One part of the lounge is allocated for smoking and the other smoke free areas open on to a small patio at the front of property. There is another smaller lounge for service users and this is ideal for service users to meet with relatives and friends in private and a large dining room, which is used frequently by the service users who live at the home. Parking is available at the front of the home and the property is located close to the city centre of Norwich and to all amenities. The weekly fee for care and accommodation in the home is £347.00 Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was a key unannounced inspection and took place on the 20th April 2007 over a period of 7.5hrs and was carried out as part of a routine inspection plan. On the day of the site visit the inspector was able to speak with one of the new owners of the home, a manager from another home owned by the company, staff and residents. The manager for the home was not in the home on the day of inspection. The inspector was able to look at plans of care, policies and documents and staff files as well as have a tour of the building. Three comment cards from relatives and one from a service user were received prior to the inspection. A pre inspection questionnaire had not been received at the time of writing the report. Since the last key inspection the home has been bought by Black Swan Ltd who own other homes in the Norfolk area. At the time of the inspection they have started address some of the requirements inherited from the previous inspection and are beginning to transfer care plans, policies and other documents to the company’s forms, documents and care plan formats. Improvements have already started to take place. At the site inspection it was clear that significant improvements need to be made to the environment and improvement to the care planning system and policy and procedures need to be made. Following discussion with one of the owners of the company it was clear that their intention is to make significant improvements all round. Those staff spoken to on the day of the inspection spoke positively about the new providers and had noticed some improvements and were expecting further improvements in all areas as the new providers became more established. Several residents felt that the home had deteriorated since the time of the decision of the previous owner to sell and were optimistic about improvements that would be made by the new providers. At the next inspection it is expected that the service being provided and the environment in which residents live would have further improved significantly. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 6 Comments by made by residents. “Not many activities in the last year but the new management and owner promise that there will be more.” “Always smells clean, never a smell of urine that happens in some homes.” “New owners are lovely.” “We have been doing art and exercise classes.” “We have had resident meetings.” “We said lunch was too early and it has now been moved to 12.30 which is much better.” “I share a room but the other persons TV is very loud.” Comments made by staff “I would always report poor practice.” “Have done some training and would like to do a first aid course.” “New owner have bought a new water boiler for the kitchen and are spending money on decoration.” “Very good staff team.” “Since the take over staff are more positive.” “Work well as a team.” “Would be happy to complete NVQ training.” “The new owners are very positive.” What the service does well: The new providers have only owned the home for a few weeks. The home has had a new roof. The staff group remains stable and is feeling positive about the future. Visitors are always made welcome in the home. The atmosphere in the home is friendly and relaxed. The relationship between staff and residents is good. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6 People who use the service experience adequate quality outcomes in this are. We have made this judgement using a range of evidence, including a visit to this service. Residents have their own assessment documentation and the new providers are transferring this over to their own format as soon as possible. It is planned that all residents will be issued with a contract and statement of their terms and conditions. As the service is new to the providers this plan could not be evidenced and therefore the outcomes in this area remain unchanged. EVIDENCE: The new providers have made initial changes to the Service User Guide and will review this as time goes by. The home has very recently been taken over by a new company and the new providers are in the process of reviewing and transferring all information about residents over to their own format. The company has other homes in the area and are known to have comprehensive and safe systems in place. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 10 Residents will not be admitted to the home without having their needs assessed. The manager would also ask for any other relevant information from health and care professionals. They new providers are aware of the requirement to ensure that all residents receive contracts and will provide these to all new residents who are admitted to the home. Intermediate care is not offered in this home. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have plans of care that show how care needs are to be met. There are gaps in information and care plans do not fully protect service users from harm or give staff all of the information needed to care for residents in a full person centred way. Not all aspects of the medication practice are safe and could but residents at risk of harm. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 12 EVIDENCE: Since the last key inspection a concern was received by the Commission with regard several areas including care planning for residents. A random inspection took place in the home and the concerns around care planning were substantiated. This was at the time of change of ownership. The new providers have a company format for care planning and are in the process of putting this in place. At the random inspection a requirement to ensure that risk assessment were carried out and held in the care plan of anyone exhibiting challenging behaviour was made. This has not taken place although some comment about the concerns was made in the running records. The timescale for action is the30/06/07. A requirement has been made in this area. Care plans, in the old format, were inspected on the day of inspection and they did not include all of the information needed. The format was not clear. Care plans included a photograph and initial care plan with reviews but these were limited and not kept up to date. Some areas of risk were identified in care plans but no clear risk assessment and plan was in place. For example it states in one care plan that a resident “wanders all the time,” but not plan of care or risk assessment identifies how to safely meet the needs of this resident. It was acknowledge that the new providers are in the process of reviewing care plans but this process is yet to be completed. The timescale for action is the 30/06/07 and this requirement is still outstanding. A requirement has been made in this area. On the day of inspection the Controlled Drug Book (CDB)was on the desk in the office and it was noted that when cross referencing with the medication administration record (MAR) medication had been given and signed for on the MAR sheet but not signed for in the CDB. The Controlled drug that had been administered on the morning of the inspection had not been signed for on either book. A requirement has been made in this area. Other areas of practice around the care of administration appeared to show safe practice. Medication training for staff has been arranged for 08/05/07. Residents said that staff treated them with respect and that their privacy was respected. The interaction between staff and residents on the day of inspection supported this view. This view was also supported by the comments received in the comment cards returned to the Commission. Heathcote DS0000069100.V337236.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience adequate quality outcomes in this are. We have made this judgement using a range of evidence, including a visit to this service. Residents are beginning to have more opportunity for activity and occupation as the new providers are developing social activities and interests that will meet the individual preferences of residents. Visitors to the home are always made welcome. People who use the service are offered good quality food in a pleasant environment. EVIDENCE: Residents said that little goes on in the home and activities had generally lessoned since the time the previous provider decided to sell the business. Several resident were knitting and one suggested that the only reason she knitted was that there was little else to do. Some residents said that since the new providers had been in place they felt more was going to be provided to them. There were going to have regular residents meetings and felt that their view would be listened to. The new providers have plans to develop the social opportunities for service users and hope to have these resident led. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 14 An anonymous concern had been received suggesting that some residents were got up early than they may want to by night staff. All of those service users spoken to said that they could rise and retire when they chose. Staff confirmed this. The residents were pleased that since the new providers had taken over they were now having a hairdresser on a weekly basis, as this had not been taking place. Residents said that visitors were always made welcome in the home. The main menu was seen and was varied and balanced offering a good variety of nourishing food. The new provider hope to engage residents in the development of menus to ensure their preferences and choices are taken into account. The inspector joined residents at lunchtime. The dining area was an attractive and pleasant place to eat and lunch was a relaxed unrushed affair with those service users needing assistance being offered this in a caring and dignified way. Heathcote DS0000069100.V337236.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service receive good quality outcomes in this are. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes complaints procedure and the new providers are to use the company documentation that informs and empowers those who wish to make a complaint or express a concern. Residents will be protected by the policy and procedures put in place by the new providers. The new procedures were in the process of being put in place at the time of the inspection. EVIDENCE: The Commission received an anonymous concern on the 06th March 2007 and completed a random inspection on 07th March 2007. The concerns were: • A staff member talking to residents in an inappropriate manner. • A resident who had continence difficulties had cigarettes withheld to encourage the difficulty to improve. • A senior staff member was boisterous in her manager and used poor communication. All of these matters were investigated and the concerns were substantiated. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 16 These matters occurred around the time of the new providers being in post. All concerns have since been addressed and the new provider is developing new systems to ensure this does not happen again. The complaints procedure is made available to staff and residents and makes up part of the Service User Guide. Residents said they would know who to speak to if they had a concern or complaint. The new providers will be putting their own complaints policy and procedure in place. The new providers will be putting into place their own policy for safeguarding adults and will ensure that all staff receive training in this area. All staff spoken to said that they would always report poor practice. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23 and 26 People who use this service receive poor quality outcomes in this are. We have made this judgement using a range of evidence, including a visit to this service. Residents are living in an environment that does not fully meet their needs or promote their well being. The new providers have plans to significantly improve the environment. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 18 EVIDENCE: The new providers are in the process of creating an annual development plan. A general day-to-day maintenance book is used to identify day-to-day maintenance needs. The new providers have inherited an environment that has significant shortfalls and needs significant improvement to bring it up to a good standard. An annual development plan is in the process of being created. The new providers have put on a new roof and have plans to double-glaze all windows. There are plans to improve the garden and make a safe garden patio area. Plans to create a new laundry and develop a smoking area away from the main lounges. Other significant refurbishment and redecoration is planned. Bedrooms are of a reasonable size and all residents in single rooms were satisfied with their accommodation. One resident who shared a room was not doing this through choice and it was clear that as the two residents sharing the room had differing needs and preferences this was not an ideal situation. A requirement has been made in this area. There was no room divide or curtain to enable privacy for the occupants. A requirement has been made in this area. The smoke from the smoking area of the open plan lounge area wafted throughout the home and had significant impact on all of those in this vicinity. The smoke in the atmosphere of the home was impacting upon the health needs of residents, staff and visitors. A requirement has been made in this area. The new providers plan to make the garden available for residents. This had not been completed at the time of the inspection. The timescale of action is 30/09/07. A requirement has been made in this area. Not all radiators have been covered or are of low surface temperature, however this is something that the new owners plan to do. The time scale for this is 30/09/07. A requirement has been made in this area. The new providers have made an application to Norfolk County Council for an improvement grant. It is expected that the new providers will make significant improvements to the environment in the coming months. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service receive adequate quality outcomes in this are. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for by a staff group who have a mixture of skill and experience who aim to care for residents in a way that promotes dignity and privacy. There is further opportunity to develop the skills and experience of the staff group to improve the care that is provided to residents. EVIDENCE: Residents spoke positively about staff and staff were observed to work with service users in a caring supportive way and the interaction between them was good. Residents said that they were treated with respect. Positive comments were received about staff in the comment cards returned. Staff felt that there was usually enough staff on duty to meet the needs of the residents. The management were in the process of recruiting some more staff at the time of the inspection. Staff have received some training but during the time that the previous owner was selling the business less training took place. The new providers are to create a training profile for all staff and ensure that all staff have had the mandatory training and other relevant training is offered on a regular basis. Some staff have NVQ and other are wanting to complete this training. A requirement has been made in this area. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 20 Three staff files were inspected and included evidence of interview, references and evidence of POVA and CRB being applied for. The providers will change the staffing filing system over to the company format. Two staff meetings have taken place since the new providers have owned the home and staff appeared positive about future training and support. The company has its own format for the new induction standards and will make sure that this is followed with all new staff. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 People who use this service receive adequate quality outcomes in this are. We have made this judgement using a range of evidence, including a visit to this service. Residents are living in a home that has recently been bought by a company that has a reputation for improving services. The manager of the home is new in post, although not new to the home. The management in the home is improving. It is expected that significant improvements will be made to the home, by the new providers. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 22 EVIDENCE: The home had been for sale for some time and this has had an impact on the management support within the home. Black Swan Ltd now owns the home and the proprietor’s take an active role in the management of the home. The company has recently appointed a new area manager for the company who will offer day to day support to the managers within the company when needed. The company has a reputation for improving the services they purchase. The home has a new manager who was not in the home on the day of inspection. She was previously the deputy and has had significant experience of working in the home. She is completing her Registered Manager Award. Staff spoke positively about the new manager saying that she was approachable and supportive. Staff also spoke positively about the new providers saying that some positive changes had started to happen in the home. Some quality assurance has taken place in the past and the new providers have already begun to complete their own. Supervision has not been taking place on a regular basis. The new providers will have their own system for ensuring that formal supervision takes place. The time for action in this area is 30/05/07.A requirement has been made in this area. Money that is looked after in the home for residents was audited and there was good practice in this area. Policies and procedures are in place and these are being transferred to the company policies and procedures. Incidents and accidents are recorded and a new file for general risk assessments is being created. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 23 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 2 2 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 2 2 x x 1 x x 2 STAFFING Standard No Score 27 3 28 2 29 30 x 3 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 x 3 2 x 2 Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 13.4 Requirement Timescale for action 01/06/07 2 OP7 15 3 OP9 13.2 Risk assessments should be completed for all residents who are exhibiting challenging behaviour and all residents who are affected by the challenging behaviour of other residents. This will ensure that the needs of individual residents will be met and how to meet these needs is recorded. All residents should have a care 01/07/07 plan that identifies all of their health, personal and social care needs. This will ensure that all residents needs are identified and the information is available to ensure that these needs will be met. When medication is administered 01/07/07 to residents a clear audit of how many medicines remain should be clearly recorded. This will ensure that the home is aware of all medicines that are in the home at any one time. Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 25 4 OP9 13.2 5 OP20 13.4(c) 6 OP20 23.2(a) 7 OP23 23.2(e) 8 OP23 23.2(e) 9 OP25 13.4 10 OP30 18.1 11 OP36 18.2 The records kept by the home with regard the administration of controlled drugs are completed according to guidelines at the time of administration. This will ensure safe practice in this area. Those residents who do not smoke must have a smoke free communal environment to ensure the smoke from the smoking area does not impact on their health and well-being. This will ensure that the smoke from smoker’s cigarettes will not have a negative impact on residents who do not smoke. The garden area should be accessible to residents. This will ensure and additional communal space for residents. Residents should not have to share a bedroom unless they choose to do so. This will ensure that resident’s choices and preferences are respected and adhered to. If residents choose to share the bedroom should have a room divide to ensure privacy. This will ensure some privacy. The radiators in the home should be guarded or be of low surface temperatures to ensure no unnecessary risk to residents. Staff need to complete all relevant training that enables them to carry out their role. This will ensure that residents are cared for by a staff group who are appropriately trained. Staff working in the home should received formal supervision at least 6 times a year. This will ensure that staff are supported in their role and continue to offer good care to residents. 01/06/07 01/09/07 30/09/07 01/07/07 01/07/07 30/09/07 01/09/07 01/06/07 Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 26 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 Heathcote DS0000069100.V337236.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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