Inspection on 30/01/08 for Lindisfarne

This inspection was carried out on 30th January 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lindisfarne 11/07/08

Lindisfarne 25/04/07

Lindisfarne 31/10/06

Lindisfarne 15/02/06

Lindisfarne 23/09/05

Lindisfarne 21/02/05

Lindisfarne 29/07/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Lindisfarne Church End Leverington Cambridgeshire PE13 5DB Lead Inspector Joanne Pawson Unannounced Inspection 30th January 2008 11:00 Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 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 Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lindisfarne Address Church End Leverington Cambridgeshire PE13 5DB 01945 464817 01945 464817 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) Caretech Community Services Limited vacant post Care Home 10 Category(ies) of Dementia (3), Learning disability (10), Physical registration, with number disability (10) of places Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three named service users with dementia under 65 years of age Date of last inspection 25th October 2007 Brief Description of the Service: Lindisfarne is a bungalow for adults with learning and physical disabilities situated at the edge of the village of Leverington, two miles north of the market town of Wisbech. There are ten single bedrooms and a large lounge and dining room. There are two shower rooms shared by two bedrooms each, and the other bedrooms have their own ensuite toilet and washbasin. There is a kitchen, laundry room and two further bathrooms as well as an office and staff changing room. Gardens surround the bungalow and there is a large parking area at the rear. The home has two vehicles, one which has disabled access. The home is close to the village shop and the church. Peterborough, with its wide range of shopping and leisure facilities is a half hour drive away. Fees are from £1,319 to £2,075 per week according to the level of disability and support needed. Residents fund their own social activities including admission for their carer if required. They pay for their own holidays, any extra day services beyond those as part of their care plan, personal clothing and hairdressing. CSCI reports are kept in the office and are available to service user representatives on request. There is also a copy of the latest report near the car park entrance to the home. The manager does not currently actively discuss the report and its contents with the residents as the level of their disability makes the report format difficult to understand. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This unannounced inspection was carried out by two inspectors on the 30th January 2008 using the Commission For Social Care Inspection’s methodology. We walked round the bungalow, spoke with residents, staff and the acting manager, and looked at some of the records kept by the home. We also observed the staff working with the residents in the lounge and dining area whilst we looked at care plans. Since the last key inspection in April/June 2007 we have carried out quite a lot of regulatory activity relating to Lindisfarne. We were very worried by the results of that inspection, and were not satisfied with the response we received from the provider when we sent them the report. We arranged to meet with representatives of Caretech on 01/10/07. Following this meeting, the manager was suspended and decided to resign. We carried out a random unannounced inspection on 25/10/07 and 26/10/07, and a random inspection on 17/12/07. In the report following the December inspection we wrote, “There were twenty-two requirements made at the inspection in April/June 2007. We assessed eleven of those when we inspected the home on 25th October 2007, and were very concerned that seven of the eleven had not been met. At the inspection on 17th December 2007 we found that none of the five requirements we assessed had been met: four of which were those where timescales had been extended on 25th October 2007. We are seriously concerned at this failure to meet requirements, and therefore failure to improve the lives of the people who live at Lindisfarne. If we do not see improvements at our next inspection, we will seek legal advice with a view to taking further enforcement action.” In December 2007 Caretech appointed a new manager, Karen Smith. We refer to her as the ‘acting manager’ throughout this report as she has not yet applied to CSCI for registration. What the service does well: What has improved since the last inspection? Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 6 Some of the requirements made at the last inspection have been partly met but still need further work to meet full compliance. These include requirements for adequate care plans and suitable activities for the residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service experience adequate quality outcomes in this area. Some assessments are carried out so that people can decide if they want to use this service. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Assessments are usually undertaken by the home’s staff, and usually new residents would go through a transition period, with a series of visits to the home until they felt ready to move in. However, the last two people to be admitted to Lindisfarne had been admitted in emergency situations so the preferred transition had not happened. This was not the fault of the home or its staff. One of the new residents, admitted in August 2007 had been living in a care home in another county. A full assessment of his current needs had not been undertaken by his care manager, nor by Caretech. Staff from Lindisfarne had visited him at his home and had acquired copies of his care plan and other Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 9 documents so that they had some up to date information about him on which to base a care plan. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 People who use this service experience poor quality outcomes in this area. Care staff do not always have the information they require to meet the residents’ needs in a consistent manner. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: We looked at care plans for three residents. The first resident had complained of discomfort, and staff had noticed swelling around his shoulder. He had been taken to hospital where an X-ray had shown he had a fractured shoulder. One of the care staff working with this person on the day of the inspection said that he was not sure how it had happened but that the resident was ‘falling out of bed nearly every day’, which could have caused the injury. However there was no record in the resident’s daily records of him falling out of bed. There was no risk assessment about the resident Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 11 falling out of bed, or how the risk of this could be minimised, including whether he had been assessed for bed rails. This person’s care plan had been reviewed there was no detailed guidance for staff on how to offer care to this person following his fracture. The second care plan we looked at contained a risk assessment about the resident smoking. However there was nothing in this resident’s care plan about the fact that he smoked or what support he needed from staff to be able to do this. We saw a resident banging his head on a door and the wall during the inspection. Some of the staff seemed not to know how to deal with this. One member of staff borrowed a guitar from another resident and sat on the floor with the resident and played the guitar. The resident responded to this and stopped banging his head. The care plan for this resident stated ‘ I often shout and bang my head on the walls if I am frustrated or you are not understanding me’. Although this issue had been identified there was no guidance what staff should do when this happened, and no mention that playing the guitar might help. We were concerned that it appeared from the records that no other strategies had been tried and recorded, in order to relieve this person’s frustration. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 People who use this service experience adequate quality outcomes in this area. People are not offered enough opportunities to take part in activities they enjoy. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The care plan for one resident stated that he liked football, rock’n’roll, going to the pub, bowling, reading the paper, watching DVD’s and going to farms. However his activity record for January showed that his activities were limited to six shopping trips, a haircut and an arts and crafts visit. Residents are encouraged to take part in house hold activities: one resident’s care plan stated ‘encourage me to dust my room. If I am not well enough to participate I might still like to watch’. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 13 We saw one of the residents in the kitchen watching a member of staff cooking the lunch. The staff member told us that the residents take it in turns to help with the meals. The staff member stated that the staff take it in turns to write the menu, taking into consideration the likes and dislikes of the residents. There is a local shop near the home which residents walk to with staff assistance. Two people attend organised day activity three times a week. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 People who use this service experience adequate quality outcomes in this area. Medication is not always signed for when given this could place the residents at risk. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The records show that residents have access to specialist health professionals such as dentist and opticians when needed. The pre-printed charts to record the administration of medication had a number of examples of medication not being given as prescribed and no indication that these medications should only be given when needed. Creams, lotions and drink thickener had not been signed as given. One of the residents had holes in his trousers which meant that his continence pad could be seen through the holes. One resident was sitting in a wheelchair Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 15 and we saw a member of staff move her to another room without the staff member asking her or explaining where she was going. One resident was trying to move around in his wheelchair and a member of staff took the brakes off for him so that he could move around. About five minutes later an agency member of staff walked into the room and put the brakes on the resident’s wheelchair to stop him moving around without explaining to him what she was doing and why. Staff told us that the residents can choose what time they go to bed and get up. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 People who use this service experience good quality outcomes in this area. Safeguarding issues are dealt with appropriately. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a complaints procedure. Following the previous key inspection, when the procedure was not adequate, the manager sent CSCI a revised copy. At this inspection we did not check whether this revised copy was available: this will be checked at the next inspection. We saw incident forms that related to one resident harming another resident. The acting manager could not remember if the incident had been reported to the Adult Protection Team. The Area Manager had put a post-it note on the form asking if the incident had been referred, but neither the area manager or the acting manager had followed this up. There was no system at the home to record or check whether incidents have been referred. Further investigation after the inspection confirmed that the incident had been appropriately reported: this had been done by the acting manager. We asked the acting manager if she was absent would the staff be aware of whom they should report any suspected abuse to. She stated that she had told them but couldn’t say if they were aware. The acting manager must ensure that staff are aware of the correct procedures to follow. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 17 Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 30 People who use this service experience poor quality outcomes in this area. Lindisfarne does not offer a homely environment. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: A tour of the home found: • many of the bedrooms were being used to store large amounts of incontinence pads; • most of the beds looked very uninviting with creased sheets and duvets hanging out of their covers; • one bedroom had no curtains up and had a blanket up at the window which gave the room a very shabby appearance; • one of the ensuite toilets was full of boxes of pads and the toilet and washbasin could not be seen, let alone used; Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 19 • • • • one bed had what looked like blood on the mattress protector and down the side of the bed; there was faeces on the outside of the toilet in one of the shared ensuites; one duvet cover had a different name on it to whose bedroom it was in; there were several areas in the home which seemed to have damp patches on the walls. Staff had worked hard in one of the bedrooms, which had recently been decorated and new bedding and curtains purchased. However the curtains were hanging off the hooks and there was electrical flex and a plug hanging from the curtain pole, so the overall effect was ruined. One of the bedrooms had an extra heater in it. The staff explained that the bedroom has always been cold as the radiator does not give out enough heat to warm the room. Several of the bedroom floors were dirty and one had what looked like rice on it. There was dirt and rubbish in the corner of one room, and behind another chest of drawers which had been pulled away from the wall. The radiator cover in one of the bedrooms was broken and would not have stopped someone from having contact with the radiator, which could pose a risk. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 People who use this service experience good quality outcomes in this area. Staffing levels are adequate to meet the needs of the residents. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There were seven members of staff plus the manager on duty. This is an improvement from our previous inspections, although we were disappointed to learn that the person employed to clean the home had left. This means that the support staff still have all the cleaning, cooking, laundry and so on to do, as well as supporting the residents. Only two of the staff on duty were permanent staff members and the other four were agency staff. The agency staff stated they had all worked in the home before and one of them had applied to become a permanent member of staff. One agency staff said she had worked at Lindisfarne for a while, left to go somewhere else, and then had requested to come back to Lindisfarne. The acting manager stated that they had recently recruited four new members of staff and had two interviews on the day of the inspection. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 21 The acting manager explained that although some of the residents were funded for a set amount of one to one staffing these hours were not allocated for a specific resident on the rota. We observed a staff handover and talked to the staff group about their views of the home. The staff were aware that there had been issues with the previous inspections and asked us how they could improve the care for the residents. The staff commented that they don’t have input into the care plans on a regular basis. The support staff stated that they are not being taught properly how to fill in some of the company paperwork, however, the acting manager said that she had shown the staff how to complete paperwork but there were still some errors. The support staff stated that due to staff vacancies they are having to rely on a lot of agency staff. They also commented that they would like the acting manager to work some care shifts rather than being in the office all of the time. The support staff felt that Caretech managers who do not work at Lindisfarne sometimes come in and set goals for the residents that are not realistic or achievable. It was not possible to look at the staff files to check recruitment, training or supervision as the acting manager was interviewing for new staff when we needed to see the records and no one else had access to the files. They will be looked at as part of the next inspection. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 People who use this service experience poor quality outcomes in this area. Management of this home is not good enough to ensure the residents have a good quality of life. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There is no registered manager at the home at present. As stated in the staffing section of the report the staff spoken to would like to work alongside the acting manager more rather than her being based in the office for the majority of her time. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 23 Following our inspection on 17/12/07 we wrote “Overall we were disappointed that there has been little obvious improvement in the outcomes for the people who live at the home. We accept that the manager is new in post, however we understand that senior managers from Caretech have been heavily involved in supporting the home since our last visit on 25th October 2007, so we are dismayed that so little seems to have changed.” At the time of this inspection the acting manager was still reasonably new, having started work at Lindisfarne at the beginning of December 2007. We made seven requirements in December 2007 (five of which were not met from the previous inspection). At this inspection in January 2008, two of those requirements had been met and five had been partly met, so overall we feel the acting manager has had some impact on the service being delivered. However, the improvements are minimal, and the evidence in this report shows that there is a long way to go in improving the outcomes for the people who live at the home. We checked the fire records and noted that the fire risk assessment for the home was dated 25th July 2006 and stated that it was due to be reassessed on the 29th January 2007 but there was no evidence that this had been done. Records showed that the fire alarms and emergency lighting were being tested on a weekly basis. Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 2 X 1 X LIFESTYLES Standard No Score 11 2 12 2 13 2 14 2 15 2 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 X 2 X 2 X X 2 X Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 25 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 YA6 Regulation 15 Requirement Care plans for each of the residents must give clear guidance to staff on the way in which each person’s individual needs are to be met. Goals must be included, and broken down into measurable tasks with specific timescales. This requirement has been partly met: the timescale has been extended again. Risk assessments must be completed for all risks involving residents, so that risks are minimised. People who live at the home must be given opportunities for personal development. This requirement was not met on 25/10/07, or 17/12/07, and has now only been partly met: the timescale has been extended again. Opportunities for residents to DS0000057383.V359900.R01.S.doc Timescale for action 31/03/08 2. YA9 13(4)(c) 31/03/08 3. YA11 12(1)(b) 31/03/08 4. YA12 16(2)(n) 31/03/08 Page 26 Lindisfarne Version 5.2 take part in meaningful daytime activities, in and out of the home, must improve, so that residents lead full and active lives. This requirement was not met on 25/10/07, or 17/12/07 and has now only been partly met: the timescale has been extended again. 5. YA14 16(2)(m) Residents must have opportunities to take part in appropriate leisure activities so that they can have full social lives. This requirement was not met on 25/10/07, or 17/12/07 and has now only been partly met: the timescale has been extended again. Residents must be supported with personal and healthcare in the way they prefer, and which meets their needs. Medication must be given in accordance with the prescriber’s wishes and instructions. Creams and ointments must be given as prescribed so that the residents receive the treatment as intended. The home must be comfortable, homely and well-maintained. The home must be kept clean There must be an up to date fire risk assessment to prevent residents being put at risk. 31/03/08 6. YA18 12(2) 31/03/08 7. YA20 13(2) 30/01/08 8. 9. 10. YA24 YA30 YA42 23(2)(b) 23(d) 23(4)(a) 30/04/08 31/03/08 31/03/08 Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 27 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 Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lindisfarne DS0000057383.V359900.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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