Inspection on 31/10/05 for Kallar Lodge

This inspection was carried out on 31st October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kallar Lodge 21/06/06

Kallar Lodge 09/08/05

Kallar Lodge 15/02/05

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

CARE HOMES FOR OLDER PEOPLE Lake Rise 75 Gregory Road Chadwell Heath Romford Essex RM6 5RU Lead Inspector Helen Fontaine Unannounced Inspection 31 October 2005 10:00 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 Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 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. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lake Rise Address 75 Gregory Road Chadwell Heath Romford Essex RM6 5RU 020 8270 6750 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) London Borough of Barking & Dagenham Ms Carol Ann Darkins Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2005 Brief Description of the Service: Lake Rise Residential home offers 24-hour residential care to 37 people over the age of 65 years. The home also provides intermediate care. The accommodation is split between three floors and has a passenger lift. The accommodation is linked to the remaining sheltered accommodation complex, which has been a cause of concern, as the home’s lift is shared with the tenants of the sheltered accommodation complex who therefore have access to the residential home. The first and second floor each have their own communal lounge and kitchen area. In addition to these communal areas there is a large lounge on the ground floor, which is used for social events and as a private visitors’ room. All rooms are single with an en-suite toilet and washbasin. All rooms are spacious, airy and bright and have TV points and a call system in place. The rear garden is with disabled access to the grounds and there are car-parking facilities at the front of the property. The home is located within a residential area close to local services and facilities, which are easily accessible by car and public transport, as is the M25 and A12. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Lake Rise took place over four hours and was carried out as part of the yearly inspection programme. This was the second statutory inspection visit to the home; over the course of the two visits, all core standards have been assessed. Many requirements were made at the time of the last inspection, the timescale of which has passed, so these have been re-stated with a new timescale. An additional Requirement was made at this inspection, with regard to fire doors being propped open. Further information about unmet requirements can be found in the relevant standard. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the revised timescale will lead to the Commission for Social Care Inspection considering enforcement action to secure compliance. The Inspector looked around all parts of the building and a number of records were inspected. A number of Service Users were spoken to, the Manager assisted with the inspection and Senior Residential Care Officers were also present. What the service does well: What has improved since the last inspection? What they could do better: An additional Requirement was given at this inspection, with regard to fire doors being wedged open. The home does need to make sure that it complies with the fire regulations and does not place Service Users at risk. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 6 It is of concern to the Commission that so many of the requirements (10) from the last inspection have been repeated in this one. A further 5 are also repeated from the inspection prior to that ( that is, February 2005), thus for 3 consecutive inspections. Unless the registered persons take urgent and robust action to address these shortfalls, the Commission is likely to take enforcement action. The home does have a number of service users who have developed dementia since moving into the home. If the home intends to admit service users with a diagnosis of dementia in the future, they must have been registered by the Commission to have this category of registration. The home’s Statement of Purpose still remains as it was at the last inspection, as it still does not document how the home will meet the needs of Service Users who have developed dementia since moving into the home. The requirement for the manager to confirm in writing to new Service Users that it can meet their needs is repeated from 2 previous inspections. The home need to do more in relation to care planning, ensuring they are reviewed, updated as needs change and key areas such as religious needs being evidenced that they are being met. Additionally, wishes upon Service Users death needs to be documented. The homes records need to show how they can meet the needs of those Service Users who have developed dementia since moving into the home. There is still an ongoing problem whereby the home can be accessed by people who live in the adjourning sheltered housing complex. This has been ongoing for some time and the registered persons must inform the Commission what action they are taking to remedy this. A number of requirements regarding the physical aspects of the home have been repeated – these include that the home’s communal bathrooms undergo a redecoration, the carpet in room 48 is replaced, water temperatures to be checked and logged before each Resident is bathed and for all the bathrooms to be provided with paper towels, liquid soap, swing bins, to reduce the risk of infection. 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. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 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 Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 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 the following standard(s): 1, 3 and 4 Service Users are not being given enough information to be able to have an informed choice about where to live. The home is not doing their own initial assessment before Service Users move into the home. EVIDENCE: The homes Statement of Purpose still remains as it was at the last inspection, as it still does not document how the home will meet the needs of Service Users who have developed dementia since moving into the home. The file of the newest Service User in the home was looked at and there was no assessment done by the home. There was a Care Managers assessment and the Manager did produce the homes own Pre-admission assessment form, but the Manager said they have not started to use this yet. The new preassessment covers communications, mobility, continence, eating and drinking, religion, cultures, social and personal care, washing/bathing/dressing, medical and the client’s view of moving into the home. The Care Managers assessment did have the Service Users signature on the assessment and the new form would give the Service Users and their relatives the information they Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 9 need. However, the home must confirm to new Service Users how it can meet their needs- this is a repeated requirement. The home must evidence how it can meet the needs of the Service Users developing dementia. The home is not registered to admit service users with a diagnosis of dementia, prior to their admission. If the home intends to admit service users with dementia in the future, it must apply for registration with the Commission for this specific category. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10 and 11 Service Users care plans do not provide clear, comprehensive information on individual care and support needs. This can place Service Users at risk. Service Users do not self medicate, but are protected by the home’s policies and practices. Personal care is offered in a way that protects residents’ privacy, dignity and promotes their independence. The home has made limited progress on establishing residents’ wishes over the issue of death and dying. EVIDENCE: During the inspection Service Users individual care plans were looked at and on the front sheet was their name and photo. The care plan included daily routine, personal, physical, emotional, mental and healthcare needs. One Service User’s care plan with a section on religious and spiritual needs, had that the Resident was taken to Church on Sunday. However, the Manager said that they have not gone to Church for sometime and the Service User spoken to said they could not remember the last time they went. The home does need to make sure that the Care Plans are kept up to date and key aspects, such as religious needs evidenced in daily records. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 11 The review dates on the care plans, were written on the side or the bottom, but there was no evidence that these plans were being updated with changing needs. There was also no evidence that the Service User had been involved in the reviews or had any knowledge what was written on their care plan. Healthcare is monitored and prompt referrals are made to external healthcare professionals as required. During the inspection a Service User was unwell and staff were observed to be contacting the GP surgery, requesting a visit. During the inspection medication was looked at, no Service User in the home self-medicates although it was noted that each of the rooms had facilities for medication to be stored. The Medication Administration Records ( MAR sheets) were looked at, along with the admittance and disposal of medication sheets; all of these were completed appropriately. All the Service Users medication is kept in blister packs and other medication is stored appropriately. Staff were observed treating the Service Users with respect and their privacy was upheld. Individual choices of dress and appearance is respected and personal care is provided in private. Residents’ rooms were lockable and they had the choice to lock their rooms and keep the key on them, or leave the room unlocked. The home has a policy and procedure for death and dying, but the care plans looked at did not detail the Service Users wishes. One Service User spoken to was very quickly and clearly able to inform the inspector of their wishes about where they wished to be buried. The home does need to make sure that they cover this issue with each Service User, preferably on the Pre-admission assessment. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 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 the following standard(s): 12, 13 and 15 Social activities are organised for the Service Users but the home is not meeting the social needs of those with dementia. The home does provide wholesome and appealing balanced diet, which is served at times convenient to the Residents. EVIDENCE: The home now has in the main hall and on other notice boards around the home, notices about activities. One notice was advertising the Christmas Bazaar. The Residents meeting minutes seen and documented the home’s fete in July, with a request for a trip to the Zoo. During the inspection the Manager made contact with another agency about a dementia group they ran, with either the opportunity for the Service Users to attend or setting up a similar group at the home. However at the time of the inspection, there were no additional activities organised for those Service Users with Dementia. One Service User spoken to talked of their love of knitting and how their family member helped them to make knitted blankets for them to use. The Resident said that their family come and see them once a week and during the inspection other Service Users family members were seen coming and going from the home. During the tour of the home the kitchen was seen and it was observed that the fridges and freezers and the store cupboard were well stocked with food. The Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 13 meal that was being prepared and did smell very appealing and during the tour of the building menus were seen in each area. One member of staff was observed writing on a board, what the main meal of the day would be and the choices, which were varied. Service Users spoken to all said that the food was very good; one Resident specifically commented that the food was good and that they were putting on weight. Each of the areas of the home had a kitchenette area, here the breakfast and teas were prepared and the main meal is prepared in the main kitchen. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 The home has a clear policy and procedure for complaints that Service Users are confident will be listened to. The compliant procedure does not contain details of the Commission, so could mean service users or their representatives are prevented from making representation to the Commission regarding their concerns. The Service Users are protected from abuse by the home and trained staff. EVIDENCE: The home’s complaints policy and procedure are set out by the London Borough of Barking and Dagenham, as are their policies on Adult Abuse. The issue of updating the complaint procedure to meet the regulations still remains, as it does not contain details of the Commission for Social Care Inspection. and will be part of the arranged meeting with the Commission of Social Care Inspection. The complaints book was looked at, there was only one complaint for April 05. There were also a number of compliments and staff said that they received a lot of verbal compliments. One Service User talked to was very clear that any concerns they had would be listened to and was confident that any complaint would be investigated. Staff do receive training in Adult Abuse and there is the Local Authority robust policy, procedure available to the home. Staff files looked at showed that a number of staff had received training and the Manager said that they had been on an Adult Abuse trainer’s course. The Manager said that the home does Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 15 have a training video on Adult Abuse and another member of staff commented that the staff appreciated this more than the course they had been on. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 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 the following standard(s): 19, 24, 25 and 26 Service Users benefit from living in a warm, clean individually personalised and communal accommodation. The welfare of residents’ and staff is put at risk due to access areas, which are shared with the sheltered accommodation complex. There are some areas of risk due to infection control issues. EVIDENCE: The home was very airy, clean and free from offensive odours. Each of the Service Users had a large bedroom with en-suite facilities in each. The home had previously been warden-controlled flats and the room previously had a kitchen as well as a small bathroom. With the kitchen removed and the bathroom made smaller, this has left a really large room making it very personalised and suitable to have visitors in during visits. During the inspection some empty and some of the Residents rooms were looked at with their permission. These were all light and airy, with the Service Users personal effects around them. In one Residents room visited, a member of their family was visiting the Service User and very much enjoying each other’s company. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 17 Another Service User had their collection of dolls and pictures and made knitted blankets for the bed and chair. The issue of the condition of the bathroom floors and fittings remain and need repairing. Communal bathrooms lacked hand washing equipment, paper towels and soap, thus increasing the risk of infection. Again, these matters are carried forward from the last inspection. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 Service Users are supported by the number of staff and all staff are trained and competent to do their jobs. EVIDENCE: During the inspection the staff rota was looked at and there was a high level of staff on the duty rota, with one rota for the care staff and one for the Manager and Seniors. In addition to the regular staff there was the availability of bank staff, if and when regular staff were off. The training schedule was looked at and the Manager is very keen to make sure that all staff receive training. There are currently 14 staff that have completed their NVQ 2 with more completing in December. The other training undertaken were, Medical Emergencies, challenging behaviour, lifting objects, dementia awareness (1), abuse awareness, principals of good practice and a number of other courses. All the staff seen during the inspection and the tour of the home were observed to be competent at their jobs. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 36 and 38 The home does undertake good consultation with Service Users, their families and friends. The home is not giving staff regular supervision but does do yearly appraisals. The safety of Service Users is not being protected with regard to fire doors being blocked open. Although the detail of standard 31 was not assessed, the competent management of this home is being compromised by the level of legal requirements repeated from previous inspections. EVIDENCE: The home is undertaking surveys to relatives and residents, this consultation was seen taking place during the inspection. However, the comments were not seen and need to be included in a quality assurance report and provided to Service Users, and the Commission. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 20 The supervision schedule was looked at and although the schedule has been established and the Senior present said they had done supervision, there was no documented evidence that supervision was taking place regularly. The staff, along with the Seniors and Manager, receive annual yearly appraisals in line with the Local Authority policies and procedures The minutes of the residents meeting were seen and they indicated the home was acknowledging resident views and wishes. During the tour of the home it was noted that a number of fire doors, especially the doors to the Service Users rooms were wedged open. It was of concern to overhear the maintenance man asking for more wedges to be bought, to wedge further doors open. Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 1 X 1 1 X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 3 1 X X X X 2 2 2 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X 2 X 1 Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES 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 1 Regulation 5(1)(A)to( f) Timescale for action The Statement of Purpose and 31/12/05 Service User’s Guide must contain all the information required in relation to the Regulations. Both documents must specify how they can meet the needs of the Residents with dementia and what Service User groups the home caters for. This Requirement is repeated from the previous 2 inspections. The Registration application 31/12/05 must specify the Service User groups, which the home can admit. This Requirement is repeated from the previous 2 inspections The Manager must confirm to 30/11/05 new Service Users, in writing that it can meet their needs. This Requirement is repeated from the previous 2 inspections The Registered Person must 30/11/05 ensure that monthly care plan reviews are completed. These are to be signed and dated. This Requirement is repeated from the previous inspection. The Registered person must 30/11/05 DS0000040415.V262479.R01.S.doc Version 5.0 Page 23 Requirement 2. 1 4(1)(c)Sc hed1(6)&( 8) 3. 3 14(1)(d) 4. 7 15(2) 5. Lake Rise 8 15(2) 6. 10 & 37 7. 11 8. 12 9. 16 10. 19 11. 19 12. 24 ensure that care plans are updated when needs change and service users are involved, wherever possible 15&17(1)( The Registered person must a)Sch3.3( ensure that care staff q) demonstrate how individuals’ lifestyle, wishes and choices have been made by recording appropriately in the daily report log. This Requirement is repeated from the previous inspection. 12(2) The Service User’s wishes concerning the arrangements after death are discussed and carried out. This Requirement is repeated from the previous inspection. 4(1c)S1(6 The home must demonstrate 8)16(2)(m that it is able to provide for the n) needs of the Service Users with dementia in relation to activities and daily living if they remain living in the home. This Requirement is repeated from the previous inspection. 22(7)(a) The complaints procedure to be updated in accordance with the regulations. This Requirement is repeated from the previous inspection. 12,13,16, The health, safety and welfare of 21,23 the Service Users and staff must be paramount, therefore, the home must not be accessible via the sheltered housing accommodation. This Requirement is repeated from the previous 2 inspections. 23(1)(2) The homes communal bathrooms (a) undergo a redecoration programme. This Requirement is repeated from the previous inspection. 16(2)(c) The carpet in room 48 is replaced. This Requirement is repeated DS0000040415.V262479.R01.S.doc 17(1)(a) 31/12/05 31/12/05 31/12/05 30/11/05 31/12/05 31/01/06 31/01/06 Lake Rise Version 5.0 Page 24 13. 25 13(3)(4) (a)(c) 14. 26 16(2)(j) 15. 33 24 16. 36 18(2) 17. 38 4 from the previous inspection. All water temperature’s to be checked and logged before each resident is bathed where the bath does not have a pre-set valve fitted. This Requirement is repeated from the previous inspection. All bathrooms are provided with paper towels, liquid soap, swing pedal bins to reduce the risk of infection. This Requirement is repeated from the previous inspection. A report of all quality care surveys with Residents and Relatives, must be provided to Service Users and to the Commission for Social Care Inspection when complete. This Requirement is repeated from the previous 2 inspections. The Registered Person shall ensure that persons working at the care home are appropriately supervised at least six times a year. This Requirement is repeated from the previous inspection. The Registered Person shall take adequate precautions against the risk of fire, with regard to fire doors being wedged open. 30/11/05 30/11/05 31/01/06 31/01/06 30/11/05 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 Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lake Rise DS0000040415.V262479.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!