Inspection on 25/07/05 for Hendra House

This inspection was carried out on 25th July 2005.

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

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

Other inspections for this house

Hendra House 10/07/06

Hendra House 16/01/06

Hendra House 10/01/05

Hendra House 06/07/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Hendra House 15 Sandpits Road Ludlow Shropshire SY8 1HH Lead Inspector Terry Woods Announced 25 July 2005 10.00 th 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. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hendra House Address 15 Sandpits Road Ludlow Shropshire SY8 1HH 01584 873041 None 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) Hendra Healthcare (Ludlow) Ltd Vince Burmingham Care Home 23 Category(ies) of 1 Mental Disorder - over 65 years registration, with number 3 Mental Disorder of places 19 Old Age Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate 23 service users. 2. The home may accommodate 19 Elderly persons and 1 person with a mental disorder over the age of 65 years. 3. The home may accommodate 3 persons with a mental disorder under the age of 65 years but over the age of 60. The Commission for Social Care Inspection must be consulted with regard to all such admissions. Date of last inspection 10th January 2005 Brief Description of the Service: Hendra House is a privately owned care home registered with the Commission for Social Care Inspection to provide a service for 23 residents with older people’s needs. The home is situated in Sandpits Road, an established residential area positioned on the northwest section of Ludlow town. The Home is owned by Hendra House Healthcare (Ludlow) Limited. Mr V Burmingham, director of the company also has day-to-day management responsibility for the Home. The building, originally a private residence, has had three purpose built extensions added in its conversion to a residential home without detracting from its original character. The accommodation extends to two floors. It features communal areas to the ground floor and nineteen single and two double bedrooms on the first and second floors. Residents are able to enjoy planted out gardens and borders to the front of the building and a quiet enclosed garden and lawned area to the rear. There is a developing staff group providing residents with consistency in a warm comfortable atmosphere. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 25th July 2005 over seven hours and was carried out as a routine announced visit. A full tour of the premises took place and a sample of three staff files and three residents’ care records were inspected. Seven of the staff on duty, nine residents and three visitors were spoken during the day. What the service does well: What has improved since the last inspection? The ground floor bathroom has been completely refurbished and a new ARJO assisted bath fitted. This is now a state of the art facility with both user and carer comfort and convenience made a priority. In the area downstairs from the lounge to the first floor conservatory, all the doors have been replaced, new radiator guards fitted, new carpets and handrails to match the existing new build. New bedroom furniture has also been provided in a further seven Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 6 bedrooms since the last inspection. This reflects the home’s quest to provide a quality accommodation for all residents at Hendra House. The proprietor has now changed over to an alternative pharmacy due to constant irregularities and an unsatisfactory service being received from their previous provider. The improvements made in this area including documentation, equipment, staff training and monitoring systems well exceed the National Minimum Standard. A growing number of games and activity equipment are continually being purchased, some of which are in a larger forms both as a sight aid and for ease of play. A ‘what’s happening board’ has also been fitted for residents’ information. 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. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 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 Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 6 The home has a satisfactory and functional admissions procedure providing an effective needs assessment and evaluation of suitability for both privately funded residents and those placed by the local authority EVIDENCE: Prospective residents at Hendra House are admitted via either the local social work team, directly from hospital or through a private arrangement with no social worker involvement. In all cases, and confirmed in the three residents’ files inspected in detail, a senior member of staff visits the individual at their previous residence to complete the home’s pre admission assessment. This is to identify the person’s individual needs from the home’s perspective to ensure that an appropriate service can be provided. This process is further complemented, in some cases, by a community care assessment or a hospital discharge document. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, & 10 There is a clear and consistent care planning system in place, which provides staff with the information they require to meet residents’ needs Staff are sensitive to the individual needs of each service user and meet these in a professional manner The medication process, as a result of the changes made, has become a well organised, safe and effective service for the benefit of those in residence EVIDENCE: Hendra House continues to employ an effective and well-documented system of health, personal and social care planning for residents. Three care plans were inspected in detail with the assistance of the care manager and were seen to cover all aspects of care and lifestyle need. Residents are involved where possible in the compilation of plans to ensure that their lifestyles at the home match their expectations and preferences. Photographs are realistic of the residents’ current appearance. There is a process of review, carried out formally every two months with completed reports of outcomes and action to be taken. These were observed to be signed and dated. There is good evidence of this process within the records Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 10 kept. For example, one resident had the use of bedsides reviewed and discontinued following the outcome of a comprehensive risk assessment and education plan to ring for assistance put in place. Informal reviews are carried out monthly or as required whenever changes to care needs occur. An example of such changes is evidenced through a medication review of another resident following a visit from their GP. A notable aid for staff is the use of red ink to highlight action points to attract the carer’s attention to the most important issues. Staff involvement with the care plan review system has greatly improved communication, service delivery and provides more effective working procedures and better record keeping. The care planning system adopted and developed continues to be commendable. One resident has achieved the age of ninety-nine years and presented as extremely articulate and alert. She reflected on the kindness of staff and of the considerate way in which she is being cared for. One example given was her experience of being assisted to bathe in a relaxed and unhurried manner and being asked, “would you like to have a soak” during the proceedings. She added, “It’s the little touches that matter when you are old and the staff here are so kind”…… The proprietor has now changed over to an alternative pharmacy due to constant irregularities and an unsatisfactory service being received from their previous provider. 10 staff members have benefited from the attendance of ‘the intermediate certificate in the safe handling of medicines’ training. MAR sheets are used to record administration. These were observed to be well kept and up to date. A purpose built lockable refrigerator with a visible temperature gauge fitted is available to store drugs requiring this facility. A record is kept of daily temperature checks. The inspector observed the senior carer on duty administering medication at lunchtime. She was able to talk through the process confidently and report on the effectiveness of the new system. The improvements made in this area including documentation, equipment, staff training and monitoring systems well exceed the National Minimum Standard Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 The home provides a good quality lifestyle for the people in residence. Meals at Hendra House are of a good homely type offering both choice and variety and catering for special dietary needs. EVIDENCE: The owner continues to improve the daily activities organised on site at Hendra House in consultation with the residents. This ensures that residents have every opportunity to give their views on what activities they would like to have introduced. A growing number of games and activity equipment have been purchased, some of which are in a larger forms both as a sight aid and for ease of play. These include dominoes and playing cards with large spots, bingo cards in easy to mark frames, draughts, noughts and crosses, skittles and scrabble. Other group activities provided include exercises, ‘sing alongs’ and occasional tea dances and community visits to events or areas of interest. A daily record is kept of residents’ involvement in activities as part of the quality-monitoring tool. Staff reflected on encouragement and attempts to involve residents more recognising that with some this is extremely difficult and is an area that they need to continually persevere with. The local vicar attends monthly to give Holy Communion. It is understood that a pianist often accompanies her to play the organ and facilitate hymn singing. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 12 Visitors are encouraged and residents are supported to maintain links with families and friends. There are no restrictions on visiting times, which extend to 10.00pm daily. Relatives visiting on the day confirmed this and reported that they were always made welcome and settled in with a cup of tea. Wherever possible residents are helped to exercise choice and control over their lives. The inspector sampled an enjoyable lunchtime cooked meal. The home has a rolling menu covering a three-week cycle continues to provide a diet of varied and traditional food. Residents were observed being assisted with their meal where needed and treated with respect. A full refurbishment of the kitchen took place during 2004 with safety, quality and improved working conditions in mind. All appliances and equipment have been replaced including infection control systems. An adjacent food storage facility has also been constructed. This contains new chrome plated and stainless steel food storage shelves and two upright freezers with external temperature displays. A food stock rotating system is in place together with the labelling and dating of frozen items. The cook on duty has been in post for sixteen years and reported her continuing satisfaction with the new working environment. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 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, 17 & 18 The home has a satisfactory complaints system and there is evidence that residents feel that their views are listened to and acted upon The arrangements for the protection of residents from abuse are satisfactory EVIDENCE: All residents receive a copy of the home’s ‘comments, suggestions and complaints’ document, at the point of admission, which contains a useful flow chart setting out the procedure graphically. Feedback from family members confirmed that the complaints procedure was brought to their attention at the time of their relative’s admission. The complaints record folder and log contained no entries and there have been no complaints received at the Commission for Social Care Inspection office during the last year. The home has subscribed to ‘CareAware’ advocacy services to which residents have access as required. The organisation is an advisory service specialising in issues relating to long-term care for older people. There was however no evidence presented of the service having yet been used. The home has a policy concerning adult protection and the prevention of abuse. The Whistle blowing procedure is an integral part of the induction process and the staff interviewed confirmed their knowledge of this procedure and were able to confidently talk through it. Staff have attended ‘Protection of Vulnerable Adults’ training provided by Shropshire County Council and training for new staff is arranged as necessary. A copy of the latest edition of the Protection of Vulnerable Adults Procedure is available at the home. There have been no incidents of abuse although instances have occurred concerning a third party member of public, which affected two residents. This Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 14 followed an initial complaint to the home by a resident identifying the abuse and the member of public concerned. Both the police and the POVA team were involved and records demonstrated good management of the situation by the proprietor for the benefit and protection of the residents involved. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 15 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, 20, 22 & 26 The home continues to provide a comfortable, safe and constantly improving quality environment for those in residence. EVIDENCE: The owner has completed phase two of a three-part refurbishment programme, which has contributed to bringing the home up to a high standard over the past two years. This included a state of the art kitchen, adjacent food storage facility and new laundry. An extension in phase one to the ground floor at the rear of the property removed one existing bedroom and added four new en-suite rooms. Further developments to commence in the spring of 2006 include further en suite bedrooms, alterations to the smoke room facility, a new fire escape to replace the existing wooden structure and a new build extension to the front veranda area to provide more extensive dining facilities, a treatment room for Doctors and District Nurses and an easily accessible Care Manager’s office. More recently a new ARJO assisted bath has been fitted at the ground floor level. This is a state of the art facility with both user and carer comfort and convenience made a priority. In the area downstairs referred to as zone 1 all the doors have been replaced, new radiator guards fitted, new carpets and Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 16 handrails to match the existing new build. This reflects the home’s quest to provide a quality accommodation for all residents at Hendra House. Residents and visiting family members were pleased to share their views on the developments with the inspector and welcomed all the improvements being made to make life more comfortable for everyone. One resident specifically reflected on her refurbished en suite facility and the easy to use lever handles which are fitted to her sink taps. “This shows the homes consideration for people that have difficulty in turning ordinary taps on and off” she said “and they are so easy for me to use”. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 17 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, 28, 29 & 30 There is an effective and well-supported staff group with the skills and knowledge to enable residents to enjoy a quality of life that meets their individual requirements and aspirations. EVIDENCE: The ratio of care staff to service users is determined according to assessed need and according to the rota there are generally four staff on duty during the morning, three late afternoon / evening and two on duty over night. The manager, a care manager, 4 senior care assistants, two part time domestic staff and two part time cooks plus an assistant on rota, support the care staff to provide an effective service for the residents. The home operates a thorough recruitment procedure for the protection of those in residence. Staff files are well presented and complete as per National Minimum Standards requirements. Contents seen included induction documentation, application form, two written references, Criminal Records Bureau check, medical questionnaire, confidentiality clause, a training record a copy of the staff members birth certificate and passport where available and a recent photograph. All staff receive a statement of terms and conditions and a copy of their job description to clarify their particular role. An impressive staff training achievement record is kept demonstrating the homes commitment to achieving a competent work force. Staff spoken to confirmed the training opportunities available to them. They also shared their interest through the CSCI’s on-site survey in attending specialist knowledge courses that are usually provided to senior staff only. This was noted by the Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 18 manager who will be amending current identified training needs in consultation with junior staff to inform the future training plan. It is commendable that 11 members of staff have completed NVQ level 2, 3 have completed NVQ level 3 and 3 are working towards this award. One member of staff also holds the NVQ level 4 award. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 19 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) 33, 34, 35, 37 & 38 The manager has a good understanding of the areas in which the home needs to improve with strategies in place to achieve results. There are satisfactory systems in place to monitor the service provided at the home with genuine service user involvement. The manager is developing and maintaining a well-supported staff group in the home’s quest to constantly improve the service to meet residents’ aspirations. There are very good systems in place to ensure that residents’ health, safety and welfare are promoted and protected. EVIDENCE: Mr Vince Burmingham, director of the company has day-to-day management responsibility for the Home. He has completed the registered managers award and the NVQ level 4 programme in management and care. He constantly Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 20 demonstrates his skills as a competent manager, which is clearly reflected in the performance of the home. The home is able to demonstrate how staff are encouraged to take ownership and responsibility of decision making at a level relevant to their roles. Valued recognition is also apparent of both individual and team contributions towards improving the performance of the home. This was made clear in conversations with staff members and also noted in the Investors in People assessment document, which preceded the home’s attainment of this award. The home has a development plan in place. This identifies an on going process of actively monitoring the service being provided to residents at Hendra House. Examples of good practice were noted with regard to quality satisfaction surveys for residents, relatives and staff. These are carried out twice per year on a rolling two monthly schedule. The survey requests comments on all areas of the home including the accommodation, care facilities, meals, complaints and choice about lifestyle. There is evidence of analysis of the results and of positive outcomes for the home. An overall satisfaction is noted which is also reflected in the CSCI feedback forms. Family and residents’ meetings are also carried out twice per year. One visiting family members said that she welcomed these and thought that the ‘Hendra Herald’ publication was also a useful and interesting item now in its fourth edition. It continues to be considered that providing a quality service to residents at Hendra House is at the forefront of the home’s aims and purpose. A comforts fund has been set up with accounts administered independently from the home by two staff members and one relative. A constitution has also been compiled and regular six monthly meetings occur with feedback presented at the relatives’ meetings. There is a signed agreement in place detailing how residents who handle their own financial affairs have their personal allowances managed and paid over. The owner is also the appointee for a small number of residents. Formal bookkeeping is in place for all residents who are assisted by the home. There is a written ledger kept and signed by two staff after all transactions. The document contains columns for credit in, deductions for fees if applicable, payments to the resident, current balance and signed and dated. The figures were cross-referenced with the ‘SAGE’ ledger kept on the computer system. The remaining residents are supported by their family to manage their benefits. It is noted that all financial records kept by the home are of a high standard and professionally managed. There is a comprehensive management plan in place at Hendra House to promote, protect and monitor the health, safety and welfare of residents and staff. Health and safety records are well organised and risk assessments addressing all required aspects were observed to be in place. A staff-training plan is in operation both ongoing and at the induction stage addressing safe working practices and using a risk assessment approach. An impressive Employee Achievement Record continues to be kept which confirms courses completed by staff over the past two years. This is complemented by an ‘Identified Training Needs’ matrix for 2005, with individual staff and the input required, noted. Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 21 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 3 x 3 x x x 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 3 3 4 4 4 4 4 x 4 4 Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 22 no 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 Regulation Requirement Timescale for action 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 Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn SHREWSBURY SY2 5DE 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 Hendra House E56 E01 S29315 Hendra House AI V217019 250705 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!