Inspection on 18/10/08 for Kirlena House

This inspection was carried out on 18th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kirlena House 19/11/07

Kirlena House 20/07/07

Kirlena House 19/05/06

Kirlena House 21/02/06

Kirlena House 09/08/05

Kirlena House 23/11/04

Kirlena House 21/09/04

Kirlena House 12/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Kirlena House 18 Kennington Road Oxford OX1 5NZ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ruth Lough     Date: 1 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Kirlena House 18 Kennington Road Oxford OX1 5NZ 01865730510 Telephone number: Fax number: Email address: Provider web address: enquiries@auditcare.com Name of registered provider(s): Name of registered manager (if applicable) Mr Vedenath James Audit Type of registration: Number of places registered: Mr Vedenath James Audit,Mrs Ellen Audit care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The total number of persons that may be accommodated at any one time must not exceed 12. Date of last inspection Brief description of the care home Kirlena House is a registered care home for older people accommodating up to 12 residents. The home is located near Oxford in the village of Kennington, close to shops and transport facilities. The house itself is detached, with a patio area and large attractive garden at the rear. There is one shared bedroom and ten single bedrooms all but one of the rooms have en-suite WC and hand basins. There is lift access to the first floor. The ground floor lounge overlooks the garden and there is a separate dining room. The home provides 24-hour support through the care staff and does not provide nursing care. Kirlena House is the smaller of two homes privately owned by the same Care Homes for Older People Page 4 of 29 Over 65 3 12 1 0 0 0 Brief description of the care home proprietors and in close proximity to each other. The home shares its policies and procedures with its sister home, Mon Choisy. The current range of fees is between £464 and £555 per week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection process generated from the adequate findings identified at the last assessment of the quality of the service by the commission in July 2007. This inspection process included reviewing information provided by the service before a one-day visit to the home. During the day the records for care planning, recruitment, and administration of the service were assessed. The people who use the service were consulted about their opinion of what is provided, through surveys and during the day. Care Homes for Older People Page 6 of 29 From this visit it was found that there were a few areas that will need to improve as to protect the health and promote the privacy and dignity of the people they support and three requirements were made to reflect this. A small number of good practice recommendations were given at the time of the inspection and can be found in the body of this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users needs are thoroughly assessed before they are offered a place in the home. Evidence: The assessment records for two people living in the service were reviewed as see if the individuals needs are identified before they are admitted. Both had come to live in the home within the last ten months, one had been admitted for a period of respite support while their main carer was unable to care for them. The records did show that the home used the referring information from the social service assessment process and from the individual and their families before carrying out their own assessment. From the two records reviewed it was apparent that the key areas of the individuals needs are looked at including, their mental state, physical mobility, and any personal risks before a decision is made to admit them. Care Homes for Older People Page 10 of 29 Evidence: Some of the records for the assessment and care planning for one individual were not available at the commencement of the inspection visit. These we found to be in the process of being updated to reflect the current care needs of the person concerned and made available to inspection in the latter part of the day. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All aspects of the individuals health, personal, and social care needs are identified and how they are going to be met is planned for. Evidence: The people who we spoke to during the day did indicate that they thought that their needs were being met and that they were looked after well. The care planning records that were reviewed were detailed informative documents that provided the key information of how to meet the needs of the people concerned. The instruction to staff was clearly written and included the personal choices and wishes of the individual. The risks for mobility, nutritional status and their dependency needs are all monitored regularly and any changes noted and action taken to reduce or eliminate them. Additional records are added to the core documents to monitor on a monthly basis the quality of the changes to the person in regard to key areas of their care planning and Care Homes for Older People Page 12 of 29 Evidence: the quality of the record keeping carried out by staff. Staff write clearly about the outcomes for the person of the days activities for them, giving a good picture of their mental and physical state. Any interaction with a medical or healthcare practitioner is recorded in detail and records are kept of planned routine treatments for dental, opticians, or chiropody consultations. The home has a monitoring process in place for falls and ensures that if required, an Occupational Therapist is consulted when concerns are raised about mobility. The records and storage for medication administration carried out were reviewed as to assess if safe practices are in place to protect the people living there. The home uses a NOMAD, Dosset box, system provided by the local pharmacy and has safe storage facilities for the medication in the home. They use a monitoring system to record the passage of any item brought into the home and returned to the pharmacy as to ensure that safe practices are carried out. None of the current residents undertake any responsibility for self-medication. The MAR(Medication Administration Record) charts that they use for noting the administration of drugs given are use effectively and appropriately. One area they could improve is to separate each chart per individual and provide a photograph of the person concerned as to add extra support to staff to give the right medication to the right person. The manager provides medication training in the induction programme for new senior staff. The topic of the choices and wishes each person has about the care and support they would want at the end of their life and following their death has been approached in the initial care planning carried out. The providers have recognised that this is an area of care that they want to improve and have initiated training in palliative care for some of the staff. Care Homes for Older People Page 13 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are able to continue with their lives as best as they are able, and in accordance to their wishes. Evidence: The provision of activities, especially those with dementia or short term memory loss, was identified in the last inspection process as an area they could improve. We looked in the care records and sought the opinion of the residents and staff during the day to see what changes have been put in place. The interests, hobbies, and religious preferences of the people they support are identified in their assessment of need and parts of the care planning. This now has recently been further enhanced by staff carrying out seeking greater information about the individual through contact with family and friends with a personal history. This has enabled them to gain better knowledge about the person and we were informed they now intend to develop a more individualised activity plan that meets their personal interests and abilities. Care Homes for Older People Page 14 of 29 Evidence: Since the last inspection there is an Occupational Therapist who visits weekly to undertake a Chair exercise programme to encourage movement and physical activity. One resident did express her enjoyment of this and added, Does make your arms ache, though! Additionally, some of the staff have recently attending training to this, outside the visits by the OT, as to be able to offer this more frequently. They have also purchased information about activities for people with dementia or short term memory loss to enhance staffs abilities of what they can provide. Through further discussion with some of the residents in the home, they did express that they thought there was enough to do. One did say that they were quite happy to read, do some colouring, and listen to what was going on around them. Others said they enjoyed some of the celebrations going on. The day before had been a special birthday of another resident, so plenty of people had come to visit the home. Information provided by the staff in the home and on display on notice board indicated that there were events, such as barbeques, visits by local groups, such as the church for a regular service with the residents. The meals and menu planning is carried out through gradually learning about personal choices, the enjoyment of the meals provided and any dietary needs. A new menu plan has been created and a copy of this was made available to view and showed that there is usually two choices of main meals on offer each day and if required alternatives can be found. Usually during the week the main meals are prepared at the larger sister home, Mon Choisy, that is close by and transferred to the home. Breakfasts, evening meals and at weekends, the care staff in the home are responsible for preparing the meals. Personal choices, alternatives required, and comments about the meals provided are noted in the records in the kitchen to monitor if the meals meet approval and the needs of the residents. Residents are encouraged to meet in the dining room for the main meals of the day and at present all of the people living in the home seem to enjoy this. However, they are able to eat their meals elsewhere, such as their rooms or in the lounge should they wish. Comments about the meals from residents did confirm they liked what was provided and that if they did want what was on offer they could have something else. Care Homes for Older People Page 15 of 29 Evidence: Staff provided information that none of the people living in the home wanted assistance with eating their meals, only required a little prompting. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service can be confident that any concerns that they may have are listened to and that there are systems in place to protect them from any possible harm or abuse. Evidence: The complaints procedure is provided to residents in the Statement of Purpose and Service User Guide and is on display in the home. The service has not had any complaints or concerns made to it since the last inspection process. But has the necessary documents to record and show the management of a complaint should it be made. The commission has not been in receipt of any concerns, complaints, or information about the service during this period, either. A letter complimenting them about the effort made by the staff in the home for a birthday celebration had just been received by the home. Residents confirmed during the day that they felt confident that they were listened to should they have any concerns or worries. The home has policies and procedures in place for staff to follow should any concerns Care Homes for Older People Page 17 of 29 Evidence: of possible abuse or harm be identified. They are provided with the necessary training within their induction programme and at periods after this. From the sample of training records we reviewed it was identified that it was at least four years since there was any recorded training for one member of staff without the topic being revisited in their training programme. From information obtained by speaking to the staff member concerned and from other information provided it was apparent that they are kept up to date with any changes to legislation or guidance. However, this is not shown in the employment training records. The commission has not been in receipt of any information about safeguarding concerns at the home. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are provided with an environment that is generally well maintained but still has areas to improve to ensure that their comfort and physical wellbeing is promoted. Evidence: A number of the residents we spoke to said that the liked their bedrooms and enjoyed the garden of the home. The home was purpose built approximately twenty years ago and is situated in a residential area of the village of Kennington and is very much part of the local community. For the purpose of this inspection, we reviewed the facilities both private bedrooms and the communal areas to see what the quality was, that it is maintained appropriately, and meets the needs of the people living there. Generally the home is maintained well with routine maintenance and safety checks carried out. They also have a gradual programme of renewal and refurbishment of some of the fixtures and furnishings of the home. A recent improvement has been to update some of the chairs in the dining room. Care Homes for Older People Page 19 of 29 Evidence: There are some improvements they must implement to protect the well being of the residents. One area of concern was the use of linen hand towels in the communal toilets and bathrooms. This is not good practice, as it does not minimise the spread of infection, as would the use of disposable paper towels. Additionally the laundry room did not have any liquid soap or paper towels for staff to wash their hands after handling dirty laundry. The domestic was in the process of cleaning this room during the inspection and acknowledged that these would be replaced as soon as possible. Other areas where they should improve is the standard of the screening in the one shared room this was seen to be inadequate and left gaps at both ends of the rails when fully extended. This will not protect the privacy and dignity of the people in the room when personal care is being carried out. Some of the mattresses of the beds were exposed as they were in the process of being made by staff and it was identified that one was stained in places, although covered with a plastic cover. Also some of the divan beds had soiling on the material of base of the bed, which would be unpleasant for the residents to see and could be a source of infection. Generally some of the hygiene around the bed bases should be improved as some of the metal framed beds were dusty and had soil marks. They should also look at the quality of the bed linen such as sheets and pillowcases as the small sample seen showed that some were very thin, had stains upon them and didnt fully fit properly. They could also improve the comfort of the resident by providing material mattress covers to protect their skin from the necessary but uncomfortable plastic protection on the beds. Throughout the home there appeared to be a lack of towel rails and adequate facilities for personal toiletries in en suites, which must make it difficult for residents and staff to use. The use of paper towel dispensers and fitments to place the liquid soap would make the space in the en suites a little more user friendly. These observations were passed back to the provider during the visit. The toilet seats in some of the rooms although looked clean were stained from long term use of bleaches and cleaning solutions. Some of the commodes in the rooms had rusting frames and torn covers on the padding, which puts the resident at risk from skin damage and infection, as they are difficult to keep clean. New commodes have been placed in some of the rooms and the providers representative did state that there were more to distribute around the home. Care Homes for Older People Page 20 of 29 Evidence: We could see during the day that residents clothing looked as if it was cared for well. They confirmed that this was so, they were pleased with how prompt it was returned, and one resident said, Always smells nice. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skill mix of the staff ensures that the needs of the people in the home will be met. Evidence: The residents we spoke to thought that the staff were friendly and helpful. The staff we met during the day appeared to have a good rapport with the people they support and approached them respectfully and patiently. During the last inspection process in November 2007 there were a few areas of the recruitment and employment practice that didnt ensure that sufficient information had been obtained about staff. These were mainly in the quality of the completion of the sampled application forms and the service making sure that employees had had returned satisfactory Protection of Vulnerable Adults First and Criminal Records Bureau checks before starting in the home. From information provided on the day of this visit to the service there had been no new employees recruited to the home since the last inspection. Therefore, these areas could not be reassessed fully. What they did provide was copies of the proposed updated application forms as to ensure that the necessary information is completed. However, a full evaluation of the whole of the recruitment process will only be able to Care Homes for Older People Page 22 of 29 Evidence: be carried out when new staff are employed. The records for the employment of two members of staff working in the home were reviewed. This was see what training, supervision and appraisal is place for these individuals as to ensure that they are fit for the roles they had been employed for. The records were detailed and all supervision or meetings with individual staff, training attended and appraisals are all noted. From information provided is was established that of the staff team the majority of them apart from one have either commenced on or achieved at least an NVQ 2, two members of staff have attained an NVQ 4. There are a number of experienced qualified nurses employed in the home, although they do not have current registration for this country. However, their knowledge and skills could be seen in the quality of the written information and development of the care planning records that were reviewed. There is a continual training programme in place that has included the core health and safety topics and as previously seen in parts of this report, some more specialised and applicable to the needs of the people living in the home. The have included, Chair Exercises, Palliative Care, Nutrition and Health, and Challenging Behaviour. They have planned for staff to attend training on The Mental Capacity Act. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run by an experienced manager and provider and has an established, consistent team, of staff. The gaps in some provision for the environment and processes in place for the control of infection that have a direct impact on the people they support and does not show that the service is always run in their best interests. Evidence: The management and the staffing team have not changed since the last inspection process. We were informed by the provider that the Registered Manager has the required qualifications of an RMA ( Registered Managers Award) and is a qualified nurse and social worker. However, documentary evidence was not made available to support this or what they have done to maintain their knowledge pertinent to their role since the last inspection of the home. Care Homes for Older People Page 24 of 29 Evidence: The home has carried out a recent survey process with the residents, their relatives, and professionals who come in contact with the service. The information from this was being collated but not ready to use within this assessment of the service as to support that the business planning incorporates the outcomes from this. Some of the other quality assurance systems in place include the reviews of care planning support and records, supervision of staff, and meetings for relatives, residents, and staff. Information provided in the Annual Quality Assurance Assessment, self assessment document did state that there are audits carried out on the premises, some of which were seen. However, the evidence of what was found in some of the rooms during this inspection did not support that this process is robust enough. This was in regard to the provision of screening, bedding, and the poor condition of some of the commodes. The home keeps small amounts on money on residents behalf to pay for hairdressing, chiropody, and some toiletries as and when they are required. A sample of these records, were reviewed as to establish if these practices are carried out in the best interests of the person concerned. The records showed that any transaction is recorded with supporting receipts and is checked every week to ensure that the records reflect the processes carried out. Staff are provided with the necessary information and training for safe working practices in the home. This has included infection control training both within the induction programme and in subsequent updates. The concerns about the use of linen towels in the communal toilets and not ensuring that paper towels and liquid soap are always available does not reflect fully that they have a good understanding of what should be in place. The fire records of the home were reviewed as to sample what practical procedures they have in place and what systems they have to ensure that staff have a good knowledge of what to do should a fire occur. The records showed that there are regular fire drills and testing of equipment. Advice was given to remove much of the past documentation from the fire records as to not confuse staff with what is in place and currently relevant to the home. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 24 16 That bed linen and 24/11/2008 mattresses placed on the service users beds should be of a good quality and fit for purpose. You should ensure that you can provide mattresses and bedding that are fit for purpose and comfortable to meet the needs and fraility of the people living in the home. 2 24 16 There should be adequate screening between beds in the shared bedroom. The privacy and dignity of the people who share bedroom accommodation should be protected by screening that fully shields them from view of others. 24/11/2008 3 26 13 Adequate facilities should be 24/11/2008 put in place such as paper towels and liquid soap for people to use in the bathrooms, toilets, and and Care Homes for Older People Page 27 of 29 other areas where they may need to wash their hands. This should be in place to ensure that the risks to peoples physical health and wellbeing is not compromised by weak control of infection measures in the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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