Inspection on 16/11/05 for Lawrence Court Care Home

This inspection was carried out on 16th November 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

Lawrence Court Care Home 09/06/08

Lawrence Court Care Home 13/06/06

Lawrence Court Care Home 19/05/05

Lawrence Court Care Home 02/12/04

Lawrence Court Care Home 11/05/04

Lawrence Court Care Home 27/02/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Lawrence Court Nursing Home Allendale Road Byker Newcastle Upon Tyne Tyne & Wear NE6 2SB Lead Inspector Unannounced Inspection 16th November 2005 09:30 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 DS0000000400.V257931.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. DS0000000400.V257931.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lawrence Court Nursing Home Address Allendale Road Byker Newcastle Upon Tyne Tyne & Wear NE6 2SB 0191 276 0017 0191 2760296 lawrence.court@fshc.co.uk 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) Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care Limited) Post Vacant Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places DS0000000400.V257931.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th May 2005 Brief Description of the Service: Lawrence Court is a purpose built care home with nursing located in Byker. It is situated on the same site as another care home owned by the same company. The home provides nursing care for 23 older persons and the ground floor and provides social and personal care for 23 older persons on the first floor. The two floors are accessible via stairs and a passenger lift. There are two lounges and one dining room on each floor and there are designated smoking lounges. All of the bedrooms are single en suite and there are adapted bathing, showers, and toilet facilities throughout the home. The lower ground floor is not readily accessible to residents. This floor has the staff room, kitchens and laundry services. The home has an accessible garden area and there is ample car parking. The home is close to local shops and leisure facilities and is on a local bus route. DS0000000400.V257931.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over one day. The home has been without a registered manager since the summer and the company have appointed a new manager as of 7th November 2005. The home is in the process of varying the registration and the residents who have nursing needs have been transferred to the sister home, which is situated, on the same site. The eighteen residents remaining in the home have been transferred to the first floor and the ground floor is unoccupied. None of the residents currently require nursing care and the home no longer has qualified nursed employed. The Commission has not received any written proposals regarding the changes that have happened or any further proposals about the future registration of the home. The inspection focused on the current management and care services in the home and the outstanding requirements that have not been met from the previous three inspections. The inspector looked round all parts of the home and inspected a number of records. Five residents, one visitor, six staff were spoken to throughout the day. What the service does well: Residents spoken to liked the staff and living in the home. They said that “they look after me” “the food is good and there is plenty of it”. One visitor said they are always made welcome and they had no concerns about the home. The care plans show that residents are fully assessed before they move into the home and they are encouraged to visit the home before deciding to stay. The staff worked hard to ensure that the residents’ privacy and dignity were maintained. The meals are varied and nicely presented and residents can choose what they eat. DS0000000400.V257931.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Over the last eighteen months the home has not had stable management. The previous manager commenced in December 2004 and left in June 2005. Since then the deputy has managed the home with support from the manager from the home on the same site. A new manager has been appointed as of 7th November 2005. She has yet to make application to be registered with the Commission. The home is in the process of varying the registration, however no formal applications have been made about the proposed changes. This must be done as soon as possible. The new manager needs to progress with the changes being made and address the outstanding requirements from previous inspection reports. The care staff previously have been directed and supervised by qualified nurses, they now need to have appropriate specialist and updated mandatory training to be able to care for all the residents needs. The social and mental health care needs of individual residents must be recorded and the care plans improved so that all staff know what do for each resident. DS0000000400.V257931.R01.S.doc Version 5.0 Page 7 Protection of Vulnerable Adults training needs to progress so that all staff know what to do should there be any suspicion or allegation of abuse. The internal maintenance checks must be carried out and fire records kept up to date. Whilst some redecoration and minor improvements to the building have taken place, further work must be done to make sure the home is safe, comfortable and suitable for the residents. 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. DS0000000400.V257931.R01.S.doc Version 5.0 Page 8 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 DS0000000400.V257931.R01.S.doc Version 5.0 Page 9 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): 2,3,4,5 The contracts or statement of terms and conditions ensure the rights and obligations of the resident and the provider are clear. The admission process is detailed which ensures individual needs are assessed. Without suitable training there is no assurance that the staff can meet the residents assessed needs. EVIDENCE: The home is now providing contracts or statements of terms and conditions for residents. The home is in the process of varying the registration of the home and there have not been any new admissions. There are detailed admission documents available for completion before any residents are admitted to the home. DS0000000400.V257931.R01.S.doc Version 5.0 Page 10 The staff spoken to say they had not received any specialist training to meet residents individual needs. This includes caring for residents who have dementia or have some challenging behaviours. The newly appointed manager confirmed that residents would be able to visit the home before making any decision to move in on a permanent basis. DS0000000400.V257931.R01.S.doc Version 5.0 Page 11 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 The care plans do not set out the detail needed to ensure residents social care and mental health care needs are met. The lack of detailed training and record keeping for the administration of medicines has the potential to place residents at risk. Care is given in ways that promote residents’ privacy and dignity. EVIDENCE: Each of the residents has a care plan, which is completed following admission. The care plans are based on the care managers and the home managers assessment. The staff confirmed that all of the care plans are being updated as the residents who need nursing care have been transferred to the sister home. This means that the residents who live in the home have been assessed as needing social and personal care. The care staff are now responsible for the record keeping in the home. The plans showed that risk assessments are available and the care plans are regularly reviewed and updated. The plans lack details about residents social DS0000000400.V257931.R01.S.doc Version 5.0 Page 12 care needs and there was little detail regarding how staff dealt with residents who showed behavioural problems or were aggressive. There was evidence from the care plans and from discussion with staff that GP’s, district nurses, opticians and chiropodists are involved in the residents care. There are policies and procedures available for the administration of medicines. The care staff now have this responsibility however not all staff have received training. An audit was not possible as there was no record of medicines received or disposed of. The pages in the Controlled Drug book did not have the name of the resident or strength of the medication recorded. The staff were observed to knock on doors before entering and all personal care was carried out in privacy. The staff knew all of the residents well and the relationships were friendly and professional. DS0000000400.V257931.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14,15 Social activities do not provide stimulation and interest for residents living in the home. Staff promote individual residents right to maintain independence for as long as they are able. The dietary needs of residents are catered for with a varied selection of food, which meets residents taste and choices. EVIDENCE: Since the last inspection the activities person has left. There are some activities planned for residents but on the day of inspection there was little social or leisure activity. Residents mainly sat in the lounges watching television or stayed in their room’s only coming out at lunchtime. The care plans do not show what resident’s individual needs are or how these needs can be met. There is information available regarding how to contact advocacy services should residents or their relatives wish to do so. The residents have brought personal items with them making their rooms individualised and homely. DS0000000400.V257931.R01.S.doc Version 5.0 Page 14 Staff confirmed that the residents can access their care plans, however not all plans had residents and their representative agreement. The home has a four-week menu, which offers choices for each meal. Residents are asked what their choices are for the day and the staff records this on a menu sheet. The lunchtime meal offered two choices of main course and dessert. The tables were appropriately set and the residents said that they enjoyed their meal. Hot and cold drinks were offered throughout the day and snacks are readily available. Comments from the residents included “the food is fine, I get plenty to eat”. Since the last inspection the teatime menu has been reviewed to take individual preferences into account. DS0000000400.V257931.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The complaints process is satisfactory with some evidence that complaints are listened to and acted upon. The staff’s understanding of Protection issues is not clear placing residents at possible risk of harm. EVIDENCE: There are policies and procedures in place, which give details of how and to whom to complain. All concerns and complaints are taken seriously and are clearly recorded. There are no complaints currently in the home. There are policies in place for the Protection of Vulnerable Adults, however there is little evidence to show that staff have received training and that the internal training links into the Local Authority Guidance. There has been one POVA incident since the last inspection, which was dealt with and resolved by the Local Authority. DS0000000400.V257931.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): 19,20,21,23,24,25,26 The standard of the home currently does not provide a well-maintained environment for residents and there are potential hazards regarding safety and infection control. EVIDENCE: Since the last inspection the residents needing nursing care have been transferred to the nursing home, which is on the same site. All of the residents needing social and personal care have been transferred to the first floor of the home, leaving the ground floor unoccupied. The new manager said that a full refurbishment of the home was to commence, however a planned refurbishment and redecoration programme with timescales for implementation has not been provided. There are several outstanding requirements, which have not been met. Many of the lounge chairs and occasional furniture is showing signs of wear and are scuffed and stained. The carpet in the smoking room has numerous cigarette burns, the bedroom furniture is worn and shabby and several of the DS0000000400.V257931.R01.S.doc Version 5.0 Page 17 wardrobes are free standing. Several of the carpets are many years old and are worn. The grouting around the sink units has been repaired since the last inspection. The sink units remain difficult to clean with poorly fitting doors. The tiling in the shower rooms is in poor condition and not easily cleaned. The shower room upstairs has dirty tiles and the seal between the floor tiles and vinyl is lifting. All of the bathroom and toilet floorings are also in poor condition. The assisted bath seat has not been cleaned and has a layer of old soap scum ingrained on the back. There remain problems in the laundry with splits in the vinyl flooring and the plinth remains split. The walls have been redecorated since the last inspection. The in house maintenance records have not been kept up to date. The water temperatures have not been checked or recorded to prevent risks of scalding. On the day of inspection the standard of cleanliness had improved and generally the home was clean and odour free. Communal toiletries were being stored in the shower room on the first floor. DS0000000400.V257931.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): 27,28,29,30 The home is adequately staffed given the current numbers of residents. The procedures for the recruitment of staff are satisfactory and offer protection for residents living in the home. The arrangements for training of staff and the provision of specialist training are not satisfactory to ensure residents’ needs are met. EVIDENCE: Since the last inspection the home now only provides social and personal care. Currently the ground floor is empty and there are 18 residents living on the first floor. There is a new home manager who is supernumerary and works full time. The first floor unit is staffed with 1 Senior Carer and 2 care staff during the day. Overnight there is 1 Senior Carer and 1 carer. The administrator has transferred to another home within the group and the activities persons position is vacant. There are domestic, laundry, chef, kitchen assistants and a maintenance person employed in the home. DS0000000400.V257931.R01.S.doc Version 5.0 Page 19 The previous manager had begun to review all of the staff files to ensure the required 2 references; Criminal Record Bureau checks and proof of identity were available. The files examined were satisfactory. The training files still contain basic information about training in safe working practices and any specialist training that is necessary to enable staff care for residents assessed needs. The NVQ training, which was suspended, has recommenced although 50 have not reached NVQ level 2 in care. There was evidence that staff have received moving and handling training. DS0000000400.V257931.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,33,35,36,38 After a period of instability and lack of management there is now a manager who is aware of the issues that need to be addressed and improve within the home. The current systems for consultation are not satisfactory with little evidence that residents’ views are sought or acted upon. The procedures for safeguarding residents’ finances are not robust to protect their best interests. The staff are satisfactorily supervised There continues to be issues in the maintenance of the building, record keeping and training of staff that pose potential hazards to health and safety of residents. DS0000000400.V257931.R01.S.doc Version 5.0 Page 21 EVIDENCE: The previous manager had been in post for 6 months and since the summer the home has been without a registered manager. The company has appointed a new manager who has been employed since the 7th November 2005.She has not completed application to the Commission to become the Registered Manager. The home is undergoing proposed changes from providing nursing care to providing personal and social care including Dementia care for older people. Currently there is no quality assurance system in place that involves residents and their representatives. There is still a central personal allowance account that is non-interest bearing. Records are available for all personal allowances with receipts for all transactions. The home has opened individual bank accounts for named residents. Staff supervision is in place with records available. The session’s covers care practice, any individual staff need and future development. The accident recording was satisfactory with monthly analysis carried out. Contract maintenance certificates were available and up to date. Training in moving and handling has taken place since the last inspection. Further training in infection control, food hygiene, fire and health and safety has yet to be completed for all staff. The fire training and records do not detail the actual training given and the records were difficult to follow. The Environmental Health Officer has carried out an inspection and the home have actioned all of the issues raised. DS0000000400.V257931.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 X 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 1 1 X 1 2 1 2 STAFFING Standard No Score 27 3 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 2 3 X 2 DS0000000400.V257931.R01.S.doc Version 5.0 Page 23 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 OP4 Regulation 18(1)(a) Requirement The home must ensure that the staff have the experience, skills and qualifications to deliver the services and care that the home offers to provide. The care plans must set out in detail how the social and psychological needs of residents will be met. The care plans must be available to the residents and where possible be agreed and signed by them. The home must ensure that residents psychological health is monitored and preventative care provided. The home must provide appropriate activities and exercise according to residents assessed needs. The home must ensure that all medicines received, leaving the home or disposed of are accurately recorded. All controlled drugs must be accurately recorded in the register. Staff administering medicines must have accredited training. DS0000000400.V257931.R01.S.doc Timescale for action 01/03/06 2. OP7 13(4) 15 (1)(2) 01/03/06 3 OP8 13(1) 16(1)(2) 01/03/06 4. OP9 13(2) 17(1)(a) 01/03/06 Version 5.0 Page 24 5. OP12 12(4)(b) 14 16 6. OP18 12,13 7. OP19 13,23 8 OP20 16(1)(2) 23(2) 9. OP21 23 10. OP23 16(1)(2) 11. OP24 16,23 The home must ensure that residents are given opportunities for stimulation through leisure and recreational activities in and outside the home, which suits their needs, preferences and capacities. Information about activities must be circulated in formats suited to their capacities and residents interests recorded. Progress with training for all staff on Protection of Vulnerable Adults, physical restraint and dealing with aggression. OUTSTANDING FROM 18/04/04 Provide and implement a redecoration and refurbishment programme for the home. Replace worn, damaged furniture and lounge chairs. Replace damaged sink units in the dining rooms. Replace the smoking room carpet. OUTSTANDING FROM 12/08/04 The home must ensure that all furnishings in communal rooms are domestic in style and of good quality and suitable for the range of interests preferred by the residents. OUTSTANDING FROM 2/12/04 Deep clean or replace the flooring in the shower room opposite room 28. Assess all the bathroom and toilet floorings and where flooring cannot be cleaned or repaired it must be replaced. OUTSTANDING FROM 02/12/04 The home must provide in rooms occupied by residents’ adequate furniture, bedding and other furnishings including curtains and floor coverings to meet their needs. The worn bedroom furniture must be replaced. Wardrobes require fixing to the wall to DS0000000400.V257931.R01.S.doc 01/03/06 31/01/06 31/01/06 31/01/06 31/01/06 31/01/06 31/01/06 Version 5.0 Page 25 12. OP25 13. 14. OP26 OP26 15. OP28 16. OP30 17. OP31 18. OP33 19. OP35 20. OP38 prevent toppling accidents. OUTSTANDING FROM 19/05/05 13(3)(4) The home must ensure that staff test and record water temperatures before residents are bathed or showered to prevent scalding. Weekly maintenance checks must be carried out and recorded. 13(4) The residents’ personal toiletries must not be shared and be stored in their own rooms. 12,13,16 The laundry flooring must be impermeable and easily cleaned. The flooring requires replacing OUTSTANDING FROM 02/05/04 18(1) The home must ensure that a minimum ratio of 50 trained members of staff (NVQ level 2 or equivalent) is achieved by end of 2005. There must be at all times suitably qualified competent and experienced staff working at the home and the home must ensure they receive training appropriate to the work they are to perform. 24 All staff must receive training in safe working practices and specialist training to ensure residents’ assessed needs are met. OUTSTANDING FROM 19/05/05 9(1)(2)(b) The manager must progress with (i) 10(3) her application with the Commission to become registered. 24(1)(2) The home must establish a (3) quality assurance and quality monitoring system based on the views of residents. 20(1)(2) The home must ensure that (a)(b) residents have their personal money in separate interest bearing account. 13,16,23 All staff must have statutory training updated with records kept. DS0000000400.V257931.R01.S.doc 31/01/06 31/01/06 31/01/06 31/01/06 31/01/06 01/02/06 01/04/06 31/01/06 31/01/06 Version 5.0 Page 26 OUTSTANDING FROM 02/12/04 21. OP38 13(3)(4) 23(4) The home must ensure that all maintenance checks are carried out with records kept. Water temperatures must be recorded to ensure temperatures do not exceed 43C.The fire training and drills must be recorded. 31/01/06 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 DS0000000400.V257931.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 DS0000000400.V257931.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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