Inspection on 09/09/05 for Keevan Lodge

This inspection was carried out on 9th September 2005.

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

The inspector 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

Keevan Lodge 26/04/07

Keevan Lodge 14/08/06

Keevan Lodge 10/01/06

Keevan Lodge 25/02/05

Keevan Lodge 19/07/04

Keevan Lodge 25/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Keevan Lodge 98 Clive Road Enfield Middlesex EN1 1RF Lead Inspector Rebecca Bauers Unannounced 9 September 2005 @ 12.00 noon 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Keevan Lodge Address 98 Clive Road, Enfield, Middlesex EN1 1RF 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) 020 8367 0441 Mr Sanjaye N Ramsaha for Saivan Care Services Ltd Danwantee Bundhun-Ramsaha PC Care Home only 3 beds Category(ies) of LD Learning Disability registration, with number of places Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specified service user who is over 65 years of age may remain accommodated in the home. The home must advise the registering authority at such times as the specified service user vacates the home. Date of last inspection 25 February 2005 Brief Description of the Service: Keevan Lodge is a care home registered to provide residential services for three adults with a learning disability. The home is situated in a quiet residential street close to a supermarket, restaurants and a cinema. The Enfield Town Centre is approximately fifteen minutes walk away from the home. Each bedroom in the home has a shower, a wash hand basin and a toilet. The home has a separate bathroom and a toilet on the first floor. The kitchen diner, a lounge and one bedroom are on the ground floor. The home is not accessible for people with physical disabilities. There is a large garden at the back of the home, which service users can use for sitting and relaxing when weather permits.The home was registered on 2nd August 2003 and has admitted three service users in the time it has been open. The registered manager is Ms Danwantee Bundhun-Ramsaha. The home has no vacancies. The philosophy of the home is to is “to promote a positive image of people with learning disabilities and create and maintain a homely environment conducive to the delivery of care and providing comfort”. The home has an aim of creating “a warm and supportive environment within which quality care can be delivered according to individual’s holistic needs”. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 9th of September 2005 as part of the annual inspection programme to identify progress with previous requirements and to check standards of care against the core standards. The inspection took three and a half hours to complete. A partial tour of the home took place; all three service users were spoken to independently. Care records, staff records and health and safety records were examined. Two staff were spoken to and the inspector was accompanied by the registered manager throughout. Further information was obtained from the pre-inspection questionnaire and comment cards. Three comment cards were received in total from health care professionals. Very positive comments were given with regard to the care received and the caring enthusiastic attitude of the staff team to meet the needs of the service users. What the service does well: Service users benefit from the experience of multidisciplinary working to ensure that their personal care, social and emotional health needs are met. The environmental conditions are homely and welcoming and the service users benefit from knowing that their assessed needs and aspirations are understood by staff who are supporting them in the way they prefer to promote independence. Service users benefit from fulfilling activities to enhance their lives and meet their aspirations. Service users benefit from knowing their rights and responsibilities and feeling safe in the knowledge that staff respect these. The home ensures that service users, relatives and other professional’s views are listened to and addressed to improve service provision. Service users benefit from a well-established well trained staff team who understand their needs and are provided with the support and information to work with service users in a consistent way. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 6 Robust policies and procedures are followed in the recruitment of staff to ensure service users are protected. Service users say that the staff are helpful and friendly. All service users said that they felt comfortable in the home and enjoyed the food and activities. What has improved since the last inspection? Six requirements and four recommendations were made at the last inspection. All had been met by the registered manager who must be commended. Service users who have lived in the home as permanent residents now have comprehensive individual plans which detail all areas of personal, social support and healthcare needs. These have been developed in a person centred way to ensure that the priorities of the service users come first and to ensure that staff support them consistently within clear boundaries. Detailed work place risk assessments are now in place to safeguard service users and staff. Clear agreed PRN guidelines are now in place to ensure that medication is administered when certain behaviour is exhibited by service users. All maintenance issues had been addressed to improve the living environment for service users. Staff are receiving regular documented supervision, which benefits service users in the continuity of care and addresses good practice. The registered person now notifies the Commission of all significant events effecting service users. I The registered person will be undertaking NVQ level 4 registered manager’s award this month. The service users files have been organised in a logical way to ensure easy access to information. Rota’s are now written in advance to enable staff to know in advance what they are working. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 7 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. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,4 Service users assessments are comprehensive and include individual aspirations. Service users have a long time to ‘test drive’ the home before a decision is made with regard to the appropriateness of the placement. EVIDENCE: There has been one new admission since the last inspection. The service user moved in on the 3/8/05 and is currently still ‘test driving’ the home. The service user can feel assured that his individual needs and aspirations are well documented to ensure that staff have a good understanding of his needs and to provide continuity in care. Detailed assessment and summary care plans had been obtained from the placing authority, occupational therapy assessments and the homes own detailed assessment were all available for inspection. The registered manager stated that staff are following guidelines provided by a multidisciplinary team who have been working with the service user to ensure continuity in care for the service user and to aid the transition period to a new home. A meeting has been arranged to decide the appropriateness of the placement which will be reviewed on the 16/9/05. The service user expressed his satisfaction with the home so far stating ‘ staff know what I need and like and are friendly, it’s like a family.’ Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Service users can feel confident that their assessed needs are reflected in their individual plans although a detailed individual plan is not yet in place for the newly admitted service user. Some of the service users have risk assessments in place to promote independent lifestyles. Good evidence is available to indicate that service users make decisions about their lives with staff support. Not all service users are receiving regular reviews. EVIDENCE: A restated requirement made at the last inspection for the individual plans to include all elements of standard two had been fully progressed for two of the permanently placed service users. The individual plans were detailed and included detailed support needs for health, financial, social, personal and emotional needs. There were also clear behaviour management guidelines in place that had been agreed by a multidisciplinary team. ABC charts were being utilised to identify patterns and triggers to behaviour, there was evidence that the outcomes from these charts had been reviewed and discussed with psychologists. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 11 Appropriate risk assessments were in place for two of the service users to promote an independent lifestyle. Risk assessments for the newly admitted service user still need to be developed to promote an independent lifestyle. The service user who had recently moved into the home had an initial four week induction plan in place, which included aims and objectives for the service user and actions for staff to support. This is an example of good practice during the initial settling in period and until the placement is finalised. However an individual plan must be developed with the service user to ensure that all elements of the initial assessment are included with clear support needs for staff. This will ensure continuity in care and ensure that agreed boundaries are in place in the management of any challenging needs. Two of the three service users had had reviews, one service user had not had a review in July because it had been cancelled by the placing authority an additional review date must be arranged as a priority. Daily detailed notes reflected the decisions service users make with regard to the care they receive, what they do on a daily basis and future planning for example, holidays. The daily notes were excellent and reflected many aspects of service users personalities and lifestyles. Monthly evaluation sheets provided a holistic view of the individual. The recommendation made for service user files to be organised to enable easier access to information had been progressed fully. Files had been indexed chronologically with all relevant up-to-date information available. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16,17 Service users lead their lives in the way that they choose. Appropriate leisure activities and access to the community is a regular occurrence. Service users have clarity with regard to their rights and responsibilities, which have been recognised in a multidisciplinary context. Service users enjoy a good balanced diet. EVIDENCE: Service users are still in the process of deciding what if any colleges or daycentre they wish to attend, some have attended open days, other are waiting for alternative services to become available. In the meantime service user access the community on a daily basis, for example shops, cafes, temples, cinemas and libraries. Service users tend to decide and plan their day with staff on a daily basis these decisions are documented in the daily notes. Service users spoken to said that they enjoyed their summer holiday during July. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 13 One service user indicated that there is regular family contact and a good relationship exists between the home and family. Other service users do not have contact with family members through choice or through their being no evidence of family existing. Individual plans indicated that service users rights and responsibilities are respected. Agreements are in place where service users take responsibility for replacing furniture that they have personally destroyed, or boundaries are in place for inappropriate behaviour. These had all been agreed within a multidisciplinary context. Service users had a good awareness of these agreements and as such had signed the documents to confirm their understanding. Service users are consulted with regard to food preferences this was observed during the inspection. Service users specific dietary and cultural needs are being met by the home. Records indicated that varied and balanced meals were being provided. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Service users state that they receive personal support in line with their own preferences. Good records of multidisciplinary intervention are in place including clear outcomes from appointments to ensure that follow up occurs and that service users physical and emotional health needs are monitored fully. Service users are protected by the homes medication policies and procedures. EVIDENCE: A requirement made at the last inspection for prescribed PRN medication guidelines to be in place had been fully progressed. Guidelines were held on the service users file and had been signed off by the consultant psychiatrist. Medication records were seen to be accurate with no gaps. Service users are protected by the homes medication policies and procedures. All staff have now received training in the administration of rectal diazepam. Service users said that they receive personal support in the way they prefer and that staff are caring and respectful. Personal support needs had been fully documented in the individual plans. Service users physical and emotional health needs are being well met. All service users receive support from a multidisciplinary team such as Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 15 psychologists, GP’s, community nurses and occupational therapists. Case tracking service users case notes indicated that regular health checks occur and that the full outcomes and recommendations are documented in the daily notes to ensure appropriate follow up. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Service users feel that they are listened to by staff and that they can discuss any issues and know that they will be dealt with. Service users are protected by the homes adult protection procedures and by confident staff who have been trained and deemed competent in the identification and reporting of allegations of abuse. EVIDENCE: Service users spoken to said that they felt that staff were easy to talk to and that at any time they felt able to say if they were unhappy about something. None of the service users wished to make a complaint during the inspection. Records confirmed that there had been no complaints since the last inspection. All staff had received adult protection training and those interviewed were knowledgeable with regard to the correct reporting procedures if an allegation was made by a service user. Service users are protected from abuse, neglect and self-harm by the homes adult protection policy and procedure. Records of money records were kept for service users, in some cases relatives had said that the home did not need to keep receipts for amounts spent below twenty pounds. This agreement had been documented on the service users file. Other service users have accurate money records that are checked periodically by the registered manager this includes savings books. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30 Service users benefit from living in a comfortable homely, clean environment. EVIDENCE: Requirements made for maintenance issues to be rectified had been fully progressed. A light shade had been put in the upstairs bathroom and the windowsill had been painted. All light bulbs that had not been working had been replaced. The car battery in the front garden had been removed and both freezers had been defrosted. The home was well decorated and comfortable. The back garden had been fully renovated and the service users had planted many colourful flowers in the garden. Service users were seen enjoying the summer sun in the garden. Service users were knowledgeable with regard to the importance of using sun cream to protect themselves from burning. The home is clean and hygienic. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,36 Service users are currently benefiting from appropriately trained and well supported staff within a staff team with high morale. EVIDENCE: A requirement made at the last inspection for staff to receive supervision every two months had been fully progressed. Four staff files were examined and found to contain documented supervision records. Staff spoken to confirmed that they received good support from the manager and that they had regular supervision. Staff files demonstrated that staff are well trained to meet the needs of service users all staff had completed all statutory training and more than half the care staff had achieved NVQ level 2 in care, two staff were undertaking NVQ level 3. Staff spoken to were knowledgeable with regard to service users needs. Particular reference was made to positive multicultural working given the diversity of service users and the staff team. Staff described staff morale as good and very family orientated with the emphasis on ‘person centred working, respect and treating service users as they would like to be treated themselves’. A recommendation made for the registered person to write the rota in advance of it running out so that staff are clear about the hours they will be working the Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 19 following week had been fully progressed. The rota had been completed for a month in advance. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,42 Service users benefit from a well organised manager, which is reflected in the ethos and leadership of the home. Staff morale is high. The health, safety and welfare of service users are protected in the sense of ensuring all relevant safety checks are carried out. However fire doors are not being kept shut to safeguard service users in the event of fire. In addition the home does not have emergency lighting in place. EVIDENCE: A requirement made for the Commission to be notified of any significant event affecting the wellbeing of a service user had been fully progressed. The home has clear protocols in place for staff to make notifications. A restated requirement made for a work place risk assessment to be in place that identifies and documents clear actions to minimise risk including a fire risk assessment had been fully progressed. These documents were seen and were satisfactory to safeguard the welfare of service users and staff. However whilst looking around the home it was noted that several of the fire doors had Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 21 been propped open. This is not good practice, fire doors must be shut at all times or automatic closing devices must be fitted so that in the event of a fire the doors automatically close. It was noted that during a recent fire inspection by external contractors it was recommended that emergency lighting be fitted, this recommendation must be complied with to safeguard service users and staff in the event of a fire. A recommendation made for clear achievable objectives to be identified in the business plan had been progressed. The business plan was seen and contained objectives for achievement. A recommendation made for the registered manager to obtain NVQ level 4 in management had been progressed. The registered manager will be commencing the course this month, this will also include the assessors course. Service users benefit from a well run home. The registered manager has a good understanding of the service users needs and staff benefit from and open management style where ideas and values can be shared equally. All relevant health and safety certificates were seen to protect service users and staff. Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Keevan Lodge Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 1 x 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 23 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 6 Regulation 15(1) Requirement The registered person must ensure that the newly admitted service user has a detailed individual plan in place that covers all aspects of personal, social support and health care needs as set out under standard 2. The registered person must ensure that the service users multidisciplinary review that is over due takes place with the placing authority. The registered person must ensure that the newly admitted service user has detailed risk assessments in place as part of an independent lifestyle. The registered person must ensure that no fire doors are propped open. Fire doors must be shut at all times or suitable self closing devices must be fitted to safeguard service users and staff. The registered person must ensure that emergency lights are fitted within the home as per the recommendations made by an independent fire inspection agency. Timescale for action 1/10/05 2. 6 15(2)(b) 1/11/05 3. 9 13(4) 1/10/05 4. 42 23(4) 1/11/05 5. 42 23(4) 1/12/05 Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 24 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 Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 25 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Keevan Lodge 20050909 Keevan Lodge X00023 UN Stage 4 S34275 V245027 G59.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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