Inspection on 10/05/05 for Kestrel House

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Kestrel House 06/10/09

Kestrel House 14/04/09

Kestrel House 15/04/08

Kestrel House 23/05/07

Kestrel House 18/04/06

Kestrel House 17/10/05

Kestrel House 08/11/04

Kestrel House 25/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Kestrel House 220 Willingdon Road Eastbourne East Sussex BN21 1XR Lead Inspector Debbie Calveley Unannounced 10 May 2005 09:00 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. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Kestrel House Address 220 Willingdon Road Eastbourne East Sussex BN21 1XR 01323 431199 01323 649420 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) ANS Homes Limited Mrs Jacqueline Taylor Care Home with Nursing 54 Category(ies) of Old age, not falling within any other category registration, with number (OP) 54 of places Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. That a maximum of fifty-four (54) service users are admitted to the home. 2. To provide care to service users aged sixty-five (65) years and over who are chronically ill and in receipt of NHS Continuing Care Services. 3. To provide care to service users aged between eighteen (18) and sixty-five (65) years who are chronically ill and in receipt of NHS Continuing Care Services. Date of last inspection 8 November 2004 Brief Description of the Service: Kestrel House is owned and managed by Associated Nursing Services. Kestrel House was purpose built in 1996 to accommodate fifty- four relocated patients that had been cared for in a local National Health Geriatric hospital. All service users living in this home have been assessed as meeting the eligibility criteria for continuing care and are funded by the PCT. The accomodation comprises of forty-eight single bedrooms with ensuite facilities and three double rooms. There is ample communal space which have recently been upgraded. Kestrel house is situated on the A22, and approximately 1-½ miles from Eastbourne town centre.There is car parking on site at the front of the home and a small garden and patio area is situated to the rear and side of the home. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 10 May 2005 at 0700 hrs and took place over seven hours. Two inspectors inspected the home and conducted informal interviews with twelve residents, four relatives and six members of day staff and four members of night staff. The inspection process consisted of a tour of the building, inspection of documentation and records, observation of breakfast and the lunchtime meal and focused on the delivery of care for nine residents. What the service does well: What has improved since the last inspection? What they could do better: The quality of the pre-admission assessment needs to be consistent to ensure that the service users meet the criteria for admission to the home. Medication should be administered and recorded safely and correctly. A health and safety matter that needs to be addressed is the response time to call bells, and the fact that the call bell cannot be heard when staff are in rooms attending to other service users. The recruitment process needs to be more robust and to ensure that two written references are received prior to commencement of employment. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 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 Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 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) 2, 3, 4 and 5 All service users’ receive a comprehensive written contract/statement of terms and conditions on admission to the home. Pre-admission assessments are completed on all service users, but the standard of the document is not consistent. EVIDENCE: Prospective service users are assessed first by the admitting consultant, who confirms the need for continuing care under their direction. The manager and senior sister are the only members of staff who visit the prospective service user in hospital and complete a comprehensive pre-admission assessment. Nine pre-admission assessments were viewed and whilst six were found to be fully completed, three were poorly completed and had no signature or date of completion. The Discharge Co-Ordinator from the hospital completes a full nursing assessment to ensure the service users smooth transition from hospital. There is a need to ensure that the service users health and mental needs can be met by the home before agreeing to the transfer. Two recent service users did not meet the category of the home in respect of their health and mental needs. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 9 The staff interviewed said that they had found it difficult to care with people with certain mental health needs. Due to a quick discharge from the hospital, it is not always possible for the relatives to be present at the pre-admission assessment, but the staff are endeavouring to promote their involvement. Two relatives stated that they were not involved in the pre-admission assessment, one relative was present when it was undertaken and was able to add some important personal details. Due to the contract arrangements made with the PCT, service users are not admitted on a trial basis, however systems in place allow a transfer to a different home if the placement at Kestrel is not suitable. The prospective service users’ relatives are encouraged when time allows to visit the home prior to the admission date. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Staff practice and documentation reflects a sound knowledge of the service users’ healthcare needs, however the documentation in place does not fully reflect the social and communication needs of service users. There has been a decline in the medication administration documentation and practice since the last inspection, putting service users at risk. EVIDENCE: A sample of nine care plans were viewed and significant improvement has been made in this area. Reviews of care plans are performed monthly and this includes the update of any risk assessment such as the pressure areas and manual handling assessment, and the update of the base line observations. There was evidence that the home maintains a close link with the hospital tissue viability nurse and treatment initiated in hospital is continued when the service user transfers to Kestrel House. The risk assessments in the care plans for individual service users have been extended to cover their complex needs. One member of the senior staff has invested a lot of time reviewing and auditing the care plans. She acknowledges that there are still some areas that need improving. Areas that were found incorrect or poorly completed were discussed with the senior nurse at the time of the inspection. These include ensuring that fluid and nutritional charts are correctly completed, that Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 11 communication care plans and risk assessments are in place and reviewed regularly with input when necessary from specialists such as occupational therapists. One relative was concerned that his wife was not given the opportunity to develop her communication skills following her illness, which had caused her to lose her ability to speak. On consulting her care plan there was no plan in place to evidence how staff communicated with her and no aids were found in her room to enable her husband and family to communicate. A second relative spoken to was concerned that her grandmother was not being “encouraged” to remain as independent as she should be for the short time she was in the home. Her care plan did not accurately reflect that she was for rehabilitation before being placed in an alternative home. She was being nursed in bed and staff were not encouraging her to get up for meals or for personal care. A service user with the help of a communicator from the Stroke Society, told the inspector that she was very pleased with the care she received that she was encouraged to be independent and could not ask for better support. The husband of another service user said that he had been consulted with his wife’s plan of care. Evidence was seen of service user and relative consultation with the care plan formation. The clinical rooms were found to be clean, tidy and well stocked. Policies and procedures for administration, receipt, storage and disposal of medicines are accessible to all staff and are updated as required, but not followed. Records in the medication administration record charts were on several occasions incomplete. There were gaps for when a medication was missing in the blister pack and therefore it is unclear if the medication had been administered. One was a Class 2 controlled medication. There were many items printed on the medication administration record charts, which had long since been discontinued. Medication direction changes were annotated on the chart without a signature and date. Tippex was found on some medication administration records. Policies and procedures for administration, receipt, storage and disposal of medicines are accessible to all staff and are updated as required. Throughout the inspection the staff were observed to ensure that service users dignity and privacy were maintained. A service user told the inspector that staff were “really lovely” and looked after her really well. Another said he was looked after really well and staff were always “polite and kind”. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. The home offers’ a life style which meets the majority of service users expectations and preferences. The dietary needs of service users are well catered for and offer a balanced and varied selection of food that has been updated in line with the personal likes and choices of service users. EVIDENCE: The previous activity co-ordinator has recently resigned and the post has been filled for twenty hours a week. Planned activities are scheduled at present Monday to Friday 1- 4 pm. The other five hours are spent on a one to one basis and include letter writing. There were no records available for viewing as yet as the new activity co-ordinator wanted a fresh start. Five service users’ views on the activities offered were complimentary, three services have made the choice not to attend the activities. There is evidence of representatives of different faiths visiting the home and three service users mentioned they had received communion. There is open visiting and service users are encouraged to invite friends and relatives to visit. The feedback from service users regarding choice and control of their lives was mixed. One service user said he had been sitting up since breakfast at 8.30 am Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 13 and was still waiting at 10.30 am for assistance to get washed and dressed. He also said that he used to go to the dining room for lunch, but was left sitting there from 11.30 am until 1pm, and so now stays in his room. Two service users in the dining room at 11.00 am said they always sat here to enjoy the garden view and were never late for lunch! Another service user said that she was always consulted about how she spent her time, could choose when she got up and went to bed and what she wanted to eat. The kitchen was found clean and well organised. The chef and his team work well together and when interviewed were able to describe and provide documentary evidence of the specific dietary requirements of service users. There was evidence that an alternative choice for all meals was available and that fresh fruit is also readily available. The meal served at the time of the inspection was appealing, wholesome and nutritious. Staff were seen assisting less able service users in a dignified manner. The dining rooms have recently been redecorated and new flooring is in place. All the service users spoken with were complimentary of the food offered and of the choice they were given. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 14 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 and 18 The home has a satisfactory complaints system in place to manage complaints. The staff have an understanding of the vulnerability of service users which is supported by appropriate training. The present recruitment process does not protect service users from abuse. EVIDENCE: The complaint book was viewed and there have been no complaints made to the home since mid 2004. Service users and relatives spoken to have knowledge of the complaint procedures. There have been two anonymous complaints made to the CSCI concerning poor care practice since the last inspection, these were investigated and found to be not upheld. An Adult Protection strategy meeting was held in February 2005 and was investigated under the guidelines of adult Protection, and areas of poor documentation and practice were identified, up-held and addressed. A complaint policy and procedure is in place and the staff spoken to were aware of the importance of documentation and of the timescale in investigating a complaint. The home has policies and procedures in place for the Protection of Vulnerable Adults and Whistle Blowing. These are regularly updated. A copy of the East Sussex Multi-Agency Guidelines on the Protection of Vulnerable Adults was available in the home. Three members of staff were able to discuss the policy in detail and were aware of the importance of whistle blowing. The staff confirmed that they receive training in Adult protection. The home does not have any involvement in residents’ finances. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 15 Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 16 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, 23, 24, 25 and 26. Recent upgrading has significantly improved the appearance of this home creating a comfortable and safe environment for those living there and visiting. Systems have been put in place to ensure the home is clean, pleasant and hygienic. EVIDENCE: The home was purpose built and designed with input from the Health Authority. There is level access to all parts of the home, the size of the corridors and rooms are spacious to allow safe movement of chairs and wheel chairs. Each floor has a dining room and two separate lounges, the dining rooms have recently been upgraded and redecorated and now presents as homely and pleasant. The lounges are next to be redecorated. The activities room is creatively designed and well stocked and is assessable to all service users. Garden areas are attractive, well maintained and assessable to wheelchairs. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 17 A redecorating and maintenance programme is in place and has been adhered to since the last inspection. The service users bedrooms have been redecorated and are furnished to meet their individual needs and preferences. Some service users have individualised their room with pieces of furniture and personal paintings. Bedroom doors are not routinely provided with locks but service users are being offered the choice of one and risk assessments are in place regarding this. A lockable drawer with a key is routinely provided. The three rooms used as shared accommodation have privacy curtains. Two relatives spoken to had been asked and encouraged to bring in photographs and personal items and there was evidence of this practice throughout the home. Call bells were found out of reach of service users at times and it was discovered that when staff are busy in rooms performing care, they cannot hear other service users ringing the bell for assistance. It is asked that the system be reviewed to enable this issue be resolved. The standard of cleanliness has been maintained to a good standard since the last inspection. Sluice areas were clean and gloves and aprons are freely available. The home has all relevant policies and procedures in place concerning infection control. Laundry facilities are available in-house and provide a good service. There was positive feedback from service users about the standard of the laundry service. Some communal furniture in the lounge area are in need of deep cleaning and this was included in the feedback to the senior nurse and must be reviewed. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. Staffing levels are adequate for the needs of the service users. Service users are supported by a team of trained and competent staff. Since the last inspection the standard of vetting and recruitment practices have declined with appropriate references not being in place and potentially leaving service users at risk. EVIDENCE: The staffing levels were seen to be sufficient for the needs of the service users on the day of the unannounced inspection. Four night staff were informally interviewed and said that they felt that the numbers of staff on duty for each floor was adequate at night, 2 trained nurses and 4 carers, and that they were able to give a good standard of care. One staff member said that if they needed more staff for a particular reason it would be provided. The day shift was one member short due to sickness and feedback suggested that there is still a problem with staff sickness. The morning shift was seen to be busy and some call bells went unanswered for approximately 5-6 minutes. Two service users said they had been waiting for some considerable time to be attended to. However the staff continued to work hard and despite being one staff member short carried out their duties with good humour and competence. A service user said that he thought the staff were really good and even when rushed they looked after him well. The recruitment process for four new members of staff were examined and were found incomplete as not all of them had two written references prior to Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 19 commencement of employment. There was also no evidence of verbal references’ in their file. Criminal Record Bureau checks had been completed on all staff. There is evidence of an established induction-training programme and this is completed over 6-12 weeks. Two new members of staff confirmed that they currently on the induction training. Foundation training has been commenced through a recognised agency. Staff continue to be offered the opportunity to attend study sessions that are related to the care of the service user in the home, and staff interviewed spoke of the training opportunities given to them at the home. A staff-training list was provided on the day and is seen to be varied and provides opportunity for staff to develop their skills and covers the mandatory sessions required. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 20 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) 35 and 38 Service users’ finances are handled appropriately. The call bell system in place at present does not safeguard the well-being of service users’, placing them at risk. EVIDENCE: Appropriate records are maintained in relation to personal allowances and were available for inspection. The home’s policy states that they do not get involved with financial affairs of their service users. A relative or an appointed solicitor deals with all service users financial affairs. All staff are kept updated on the Health and Safety policies, the manual is available to all and clearly written. The staff are issued with certificates yearly for Manual Handling, twice yearly for Fire Safety and Food and Hygiene. The accident forms for service users was seen and were correctly completed. Not all service users’ were found to have access to a call bell and this was found in the communal areas as well as in their bedrooms. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 21 Response to call bells were slow and on three separate occasions a call bell was displayed and unanswered for over five minutes. It was discovered by talking to staff that unless they are in the hall or by the nurses station they can not hear the call bell. It is asked as a matter of priority that the call system in place is reviewed to ensure the safety and well-being of service users. Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x x x x 3 x x 2 Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 8 Regulation 13 (1) (b) 17 (1) (a) Schedule 3 Requirement Timescale for action 10/07/05 2. 8 3. 9 4. 29 5. 6. 7. 36 38 3 That service user’s psychological health and social needs are monitored regularly and preventative and restorative care provided. That appropriate risk assessments are in place.( previous timescale of 17/01/05 not met). 13 (1) (b) That records concerning service 17 (1) (a) users nutritional intake and schedule needs are kept accurate and up 3 to date. 13 (2) Medication administration record charts must reflect current medication and must be a true and accurate record. 7, 9, 19, 5 that two written references schedule relating to the person are 2 obtained before commencement of employment. 18(2) That staff receive regular supervision which is recorded and placed on their staff files. 13(4) 23 That all call bells are in an (2) (n) accessible position. That the call bell system is reviewed. 14 (1) (a) That the pre-admission (b)15 (1) assessment is correct and of a good standard. 10/05/05 10/05/05 10/05/05 10/07/05 10/05/05 10/05/05 Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 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 Kestrel House H59-H10 S14006 Kestrel House V217394 290405 Stage 4.doc Version 1.20 Page 25 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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