Inspection on 15/04/08 for Kestrel House

This inspection was carried out on 15th April 2008.

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

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

Other inspections for this house

Kestrel House 06/10/09

Kestrel House 14/04/09

Kestrel House 23/05/07

Kestrel House 18/04/06

Kestrel House 17/10/05

Kestrel House 10/05/05

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 Kathy Flynn Unannounced Inspection 10.50 15th April 2008 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kestrel House Address 220 Willingdon Road Eastbourne East Sussex BN21 1XR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01323-431199 01323 649420 potterde@bupa.com www.bupa.co.uk BUPA Care Homes (ANS) Ltd Debra Mary Potter Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54) of places Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is fiftyfour (54). Service users must be older people aged sixty-five (65) years or over who are chronically ill and in receipt of NHS Continuing Care Services. 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. 23rd May 2007 Date of last inspection Brief Description of the Service: Kestrel House is owned and managed by BUPA. The accommodation comprises of forty-eight single bedrooms with ensuite facilities and three double rooms. There is ample communal space, which has recently been upgraded. Kestrel house is situated on the A22, and approximately 1-1½ 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. The service provides all residents with a copy of the service users information pack and a brochure as part of the admission process. Copies of inspection reports and the homes Statement of Purpose are available in the reception area of the home. Fees charged as from 1 April 2007 in accordance with the contract with the Primary Care Trust is £582.69. Additional charges are made for hairdressing, toiletries, chiropody, newspapers and outside activities. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection was carried out on the 15th April and took place over eight hours. The inspection included a tour of the home, a review of pre-admission assessments, care plans, staff records and training, medication records, activities, and menus. There were 38 residents at the home during the inspection. Twelve of the residents were spoken with and two visitors to the home were happy to discuss the support provided. The manager, deputy manager, and the staff on duty discussed the care and support they provide at the home. The Annual Quality Assurance Assessment (AQAA) was completed by the manager, within the required timescale, and identified areas where improvements are planned for the benefit of residents. The reader should aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 use the term ‘service user’ to describe those living in care home settings. However for the purposes of this report those living at Kestrel House will be referred to as ‘residents’. What the service does well: Kestrel House offers residents and homely place to live, the environment is clean and residents are able to personalise their rooms with their own possessions if they wish. Communication between residents, relatives and staff was relaxed and friendly, and residents appeared comfortable during the inspection. Residents spoken with said the staff ‘are very good’ and they provide the help they need. Visitors were equally positive and said they are always made welcome when they are at the home. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, and 3. Standard 6 is not applicable. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Appropriate preadmission assessments are not completed for all people admitted to the Kestrel House, consequently the home may not be able to meet the residents individual health care needs. EVIDENCE: There are 54 beds at Kestrel House and these are all contracted to the Primary Care Team (PCT), with admissions to the home coming mainly from the hospital. Six of these beds are allocated to the hospital for post-operative patients who are unable to go home, because they are recovering from leg fractures and are non-weight bearing. The manager and deputy manager advised that preadmission assessments are carried out for all but emergency admissions to the home. However a Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 9 preadmission assessment had not been completed for a resident admitted under the six bed scheme for post-operative patients, the care plan was not up to date, the transfer aid required to move this resident safely had not been identified consequently, as recorded in the daily record, staff used the wrong aid. The importance of the preadmission assessments was discussed during the review of some care plans, from the information available it is clear the home is unable to meet the primary care needs of some of the residents. This has been an ongoing issue and has been discussed during previous inspections. The concern is that external health providers are putting pressure on the home to accept patients from hospital inappropriately. A requirement has been made for the development and introduction of an effective preadmission assessment, to ensure the home meets the individual primary care needs of prospective residents before they are offered a place. Information should be obtained from all individuals concerned with the care of prospective residents, for example relatives and GP’s, to make sure a full picture of their health care needs is obtained. The service users guide should be updated to include all relevant information about the homes procedures for making complaints. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning system provides a picture of residents needs and staff are able to offer support based on the information available. However residents with mental health needs may not be best supported in this home, because the nursing and support systems used do not cater for this group of people. EVIDENCE: A new care planning system has been introduced at Kestrel House, it provides a considerable amount of information about individual residents needs. Staff have worked hard to introduce this and those spoken with said they like the new system. The plans include the appropriate risk assessments for moving and handling with details of the aids required and the number of staff that should assist; pressure relieving aids for beds and chairs; falls assessments with any action to prevent this, including the use of bed barriers to protect residents. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 11 In addition each resident has a map of life, in effect a life story with details of their families, work experiences, spiritual interests and hobbies. A daily log is recorded to show the particular support and care the residents receive. There is evidence that the care plans are reviewed on a regular basis and that relatives can be involved in the development of the care plans, and the reviews if they wish. However at the time of the inspection it was noted that some residents have specific needs that the home cannot meet. This is because they have mental health problems and the staff are not trained to assist this group of people. The manager and deputy manager confirmed that they have contacted the PCT about one of these residents, and are hoping that a home that have staff with the necessary skills can be found. The importance of offering rooms only to individuals whose needs the home can meet were discussed in detail. It was clear that if the staff are not trained to look after people with mental health problems then the care plans will be insufficient to meet their specific needs, in effect person centred care may not be provided. In addition care may not be provided in a way that encourages each person to be involved in decisions about their care, even if they lack capacity. The nutritional needs of each resident are assessed on admission and residents are weighed monthly. However it was noted that a resident had lost a considerable amount of weight when admitted to the home and there was no evidence that this had been identified as a problem, or any action taken to address this. This resident is one of those identified as having mental health problems and therefore requires specialist responses to specific health care needs. The manager and the nurse on duty advised that any weight loss is addressed as part of the system they use. Links with allied health professionals including the Tissue Viability Nurse and the Macmillan Nurse are in place, and a physiotherapist visits the home 3 times a week to see post-operative residents. Appointments are made for residents to see chiropodists and opticians if required. Residents are registered with the GP practice that made the successful tender with the PCT, residents do not have a choice, and are not able to remain registered with their own GP while they are at Kestrel House. The home has policies and procedures for the receipt, storage and administration of medicines. Medicine administration records charts (MAR) were viewed and these were completed appropriately. Staff were noted to keep the medicines secure when administering them and a photo of each resident is available with the charts. The manager confirmed that the concern raised at Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 12 the last inspection regarding delivery of medicines to the home has been addressed. Communication between residents, relatives and staff was relaxed and friendly. Residents spoken with said the staff are very helpful and they usually have a joke and laugh with them no matter what they do. They also said that staff are very supportive and provide personal care that makes sure their privacy is protected. However residents and visitors said that staff were always very busy, they ‘rush and do the work’ and ‘don’t have time to talk unless they are helping us’. A concern was raised, by a relatives, regarding the support offered at the home for residents who require palliative care, in that the support may not meet their individual needs, even though the Palliative Care group from the hospice visits the home weekly. The manager advised that she will be working as the co-ordinator for the Gold Standard Framework for end of life care, which can be used alongside the Liverpool Care Pathway the home currently use, to provide an ongoing care package for residents with palliative care needs. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A varied programme of activities is provided for residents to participate if they wish. The meals at the home are varied, offering choices and meeting the specific dietary needs of residents. EVIDENCE: The home offers a varied programme of activities, for groups and individuals, depending on what the residents prefer. These are arranged throughout the week including weekends. An activities group, made up of residents and relatives meets regularly to discuss the activities that have been offered, and to plan what will be available for the next month. Residents spoken with said they really enjoyed the cream tea the previous week, with a relative acting as a waitress and a friend as the butler, who also read poetry and ‘really made it very enjoyable’. The fete at the weekend, which offers links with the local community, was also supported well by residents and visitors to the home. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 14 During the inspection a group of residents enjoyed musical bingo, bingo, a demonstration of painting by a fellow resident and hangman, in the lounge. The residents were relaxed and helping each other with the bingo games. The activity person has been working at the home for over a year and said he enjoys the sessions very much and has learnt a lot from the residents. There are no restrictions on visiting to the home, visitors are welcome at any time and can stay as long as they like. Visitors spoken with said they were always made welcome and some spend most of each day at the home. The staff at the home said residents can make choices about all aspects of their lives and residents who expressed an opinion said that they could decide what time to get up and where they spend their time. Relatives spoken with said the care and support offered to the residents is good, although staff seem to be very busy. The meals are good, two choices are offered for the main meal, although the cook explained the residents can have anything they want, ‘it is their home so they should be able to choose what to eat and change their minds if they want to’. Pureed meals are provided, with the vegetables and protein mixed separately, and staff assist residents as required. Residents and relatives spoken with said the food is good and they can choose what they want. A resident said that the food is very good, but despite what she orders at supper time she is usually given something different, it happens regularly enough for her to record this in the homes survey. At supper time on the day of the inspection the resident was not given what she ordered, she was given the meal that had been ordered by staff for the resident who had previously been in that room. The main concern with this issue is that some residents do not have the capacity to tell staff that they are being given the wrong meal, and if as with this resident the staff give out the wrong food day after day, staff are not taking any action to prevent this, or they do not regard it as a problem. The manager confirmed that any comments residents make in their own survey are acted upon, and she expects the staff to deal with issues like this as soon as they are aware of them. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes complaints policy, which is included in the service users guide, is not up to date and does not give clear information for residents and relatives. Training in adult protection is provided for staff to protect residents. EVIDENCE: The service users guide should be updated and the complaints policy reviewed to show how residents and their relatives can make complaints, and whom they should complain to. This should include the PCT who is responsible for placing residents in the home, and clear information about the involvement of the Commission for Social Care Inspection. The concerns raised during the inspection were discussed at the time with the manager, who confirmed she would be addressing these with the staff concerned. Staff failure in dealing with or referring any concerns raised by residents of relatives was identified as an area that needs to be improved in the Annual Quality Assurance Assessment (AQAA), completed by the manager before the inspection. A requirement has been made requesting the development and introduction of a system for staff to follow regarding concerns and complaints made by residents and relatives. This should also Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 16 address how staff should change their care practices to ensure incidents of concern are not repeated. Training in the protection of vulnerable adults is provided for staff. Those spoken with have attended the training and are aware of what action to take if they have any concerns. The manager confirmed that the home follows the safeguarding adults procedures in line with the updated East Sussex and Brighton and Hove protection of adult guidelines, in addition to the policies produced by BUPA. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Kestrel House provides a comfortable and homely environment for residents. Training in the control of infection is provided for staff to protect residents. EVIDENCE: Kestrel House is a purpose built home with 38 single and 3 double residents rooms, with en-suite facilities of sink and toilet. The home is well maintained with ongoing repairs and refurbishment. At the time of the inspection the home was clean and residents and visitors appeared comfortable. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 18 A shaft lift enables residents to have access to all parts of the home and aids are provided to ensure staff can support residents safely. These include hoists, stand aids, assisted baths and toilets. There is a main lounge and dining room on each floor, and attractive gardens to the rear that are used by residents when the weather permits. There are parking spaces to the front of the building for visitors. Training in the control of infection is provided for staff. Those spoken with said they had attended the training and were aware of the correct use of gloves and aprons to protect residents. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff training is provided to ensure the staff are aware of their responsibilities and can meet the residents needs. However there has been a high turnover of staff during the last 6 months and this may affect the level of care provided. EVIDENCE: The manager and deputy manager advised that there are sufficient staff working at Kestrel House to meet the needs of the residents. However a number of relatives and staff said the staff were always busy and did not seem to have the time to talk to residents unless they were providing personal care. The residents did not complain about the personal support offered but stated that the staff were busy. Considering the varied demands on the staff, with regard to the admission of residents whose primary care needs the home cannot meet, a core team of staff is essential to ensure that the home is able to offer a basic level of nursing and care for all residents admitted there. A requirement has been made regarding the provision of staff at the home. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 20 All new staff are required to complete induction training in line with Skills for Care, work books are provided by BUPA for them to use, and further training is encouraged including National Vocational Qualification (NVQ) courses. Staff spoken with had completed the NVQ level 2 in care and another was just about to start. The home does not meet the minimum requirement of 50 staff with NVQ level 2 or its equivalent. This is due to staff turnover and not to a failure of the home to provide opportunities for staff. Robust recruitment procedures are used with two references and POVA checks prior to employees starting work at the home. CRB checks may be completed when the staff are working through their induction training, and the manager confirmed that staff do not work with residents without supervision until all the checks have been completed. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style encourages the involvement of residents, relatives and staff in the running of the home. Training is provided for staff to ensure the health and safety of residents is protected. EVIDENCE: The manager has been in place for three years, she is a registered nurse and has completed the Registered Managers Award. Her management style encourages residents, relatives and staff to be involved in how the home is run, and there have been a number of groups set up to encourage this, Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 22 including the activity group. In addition residents meetings and staff meetings are used to discuss any areas of concerns and potential improvement. The manager has a good understanding of the improvements that have to be made regarding admissions to the home and staffing and is looking at how these can be addressed. A quality assurance and monitoring system is used to obtain feedback from residents and relatives, residents were completing surveys at the time of the inspection, and the expectation is that any concerns raised will be resolved as soon as possible. The home does not take responsibility for residents finances, receipts are kept for any additional payments for example for hairdressing, and these are externally audited to protect residents. The home provides mandatory training for staff in moving and handling, fire training, first aid and infection control to ensure the health and safety of residents is protected. Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 OP3 Regulation 14(1) (a)(c)(d) Requirement An effective pre-admission assessment is to be developed and introduced to ensure that places at the home are only offered to individuals whose primary care needs can be met by the home. Care plans to be reviewed and updated as required to ensure the needs of the residents are identified and staff are qualified to provide the care. The complaints policy to be reviewed and updated to include information about whom complaints can be made to, and appropriate training to be provided for staff to ensure they act on any concerns or complaints raised. Staffing levels to be reviewed in line with the assessed needs of residents, to ensure that there are sufficient numbers to provide care and support for residents. Timescale for action 26/05/08 2. OP7 12 (1)(20 26/05/08 2. OP1 OP18 OP38 5, 22, 18 (1)(c)(i) 26/08/08 3. OP27 18 (1)(a) 26/05/08 Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kestrel House DS0000014006.V361059.R01.S.doc Version 5.2 Page 27 - 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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