Inspection on 27/08/07 for Manorbrooke

This inspection was carried out on 27th August 2007.

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

Manorbrooke 27/08/08

Manorbrooke 05/06/06

Manorbrooke 17/01/06

Manorbrooke 15/08/05

Manorbrooke 15/09/04

Manorbrooke 22/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Manorbrooke Bevis Close Stone Dartford Kent DA2 6HB Lead Inspector Tina Thomas Key Unannounced Inspection 27th August 2007 11:00 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 Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manorbrooke Address Bevis Close Stone Dartford Kent DA2 6HB 01322 223628 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) patricia.isted@kent.gov.uk Kent County Council Mrs Patricia Joanne Isted Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th June 2006 Brief Description of the Service: Manorbrooke is a care home providing personal care for 33 Older People. Kent County Council (KCC) is the registered provider. Manorbrooke was opened in the 1960s as a purpose built local authority home. All bedrooms are for single occupancy, with 19 rooms situated on the ground floor. Nine bedrooms have en-suite facilities. All bedrooms are connected to the call bell system and have a television point. None of the bedrooms have a telephone point. There is a passenger lift to all rooms on the first floor. The home is divided into three units. The first floor unit has a large/dining room. The two units on the ground floor have their own day lounge, but share a large dining room. The home is situated in Stone, off the main road between Dartford and Gravesend. Buses, shops, post office, church and pubs are within easy walking distance for able-bodied residents. Gravesend and Dartford are about 5 and 2 miles away respectively. Darent Park Hospital and the Bluewater Shopping Centre are nearby as is access to the main A2/M25 interjunction. The maximum current fee payable is £351.91, with additional charges for newspapers, toiletries, hairdressing, chiropody, dentists and opticians. The latest Inspection Report is publicly displayed in the main reception. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process took place over a period of time, information was gathered, and it concluded with an unannounced site visit. This means that people at the home including the staff did not know the inspection was going to take place. The inspection looked at key standards. Judgements were made by taking into account evidence from a range of documentation including the homes own Annual Quality Assurance Assessment (AQAA), a tour of the home, views of people living at the home, the staff and the Manager. What the service does well: What has improved since the last inspection? The manager has purchased new beds to replace some of the aged divan type beds. The hallways have been recarpeted and some bedrooms have been redecorated. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 6 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. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Failure to comply with regulations may mean that people do not receive adequate information regarding the home before choosing to live there. Pre-admission assessments are not always conducted for the purpose of admission to the home. EVIDENCE: The manager should produce documentation, which shows what it is like to live on a day-to-day basis at Manorbrooke. The home does have some of the documentation in place, but it does not discuss everything that is required by law. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 9 The manager was told that this needed to be improved at the inspection of December 06. A requirement was made with a timescale of 31/07/07. The provider has failed to meet the timescale. This requirement has been reissued. In the interim people that live are considering living at the home may not have all the information they need to make an informed choice. Two people were spoken with regards their experience of coming to live at the home. One said that her relatives chose the home for her, but she was happy with the choice. The second person said that she had chosen recently to live at Manorbrooke. She felt that she was given adequate information before coming to the home, but also had prior knowledge of the home as a visitor. Every person that chooses to live in the home has an assessment. This is to ensure that the home can meet people’s needs. The pre-admission assessments for Manorbrooke are usually conducted by a KCC Care Manager or sometimes the senior team leaders from Manorbrooke. Two pre admission assessments were viewed. They were holistic in nature and considered peoples health and social care needs. Both assessments showed that the people were judged able to have care packages within their own home. Therefore the assessment does not reflect the suitability of the person to live a Manorbrooke. There was no audit trail to show how the people came to be living at Manorbrooke. The home does not offer recuperative care. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The planning of care does not always give staff suitable information to deliver care safely and with a consistent approach. People’s health care needs are generally well met and the home works well with other health care professionals. Some practices regarding medication need to be improved. Some practices within the home do not ensure that people in the home are always treated with dignity. EVIDENCE: Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 11 Each person has a plan of care. Two care plans were viewed. Whilst the contained some valuable information, they did not fully reflect the needs of the individuals. They did not clearly tell staff how to deliver care in a consistent fashion. The information was not always well reviewed or evaluated. Information in care plans sometimes contradicted the information found in risk assessments. For example one risk assessment said that a person needed to be hoisted at all times, but the care plan said the person could walk with two staff sometimes. This could put people in the home and staff at risk. People’s individual information was not always stored in their care plans. Sometimes it was in books or charts elsewhere. The information was not always transferred to the care plan, and there was no information in the care plan indicating where the information in books or charts might be stored. This means that the care plan does not always show the whole picture regarding a person’s care. Daily records did not cross reference with the care plan and therefore information pertaining to care was not always recorded. Care staff do not have access to care plans when they are writing their daily records. It was discussed with the manager at the inspection of June 06, and a requirement made that care plans must be complete of all current needs and support. The provider has failed to meet this requirement, which has been reissued. Care plans need to be improved so that care staff know how to deliver the care that people need and so that care is delivered with a consistent approach. People that spoke with us felt that their health care needs were being met. Care plans showed that when necessary the home called in specialist help, for example dieticians, psychiatric nurse, district nurse. One GP expressed that she had found that staff always worked in a professional manner and followed her orders promptly. The home had pressure reliving equipment and other aids. All staff that administer medication have had training to do so, with the exception of the administration of oxygen. Staff are administering oxygen without having suitable training and in contradiction to a risk assessment regarding oxygen. This could put people at risk. The manager should ensure that staff have suitable training. Staff competency is regularly reviewed by team leaders and the manager. Some handwritten entries to administration of medication charts had not been properly signed and dated. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 12 People in the home said that they thought that they were treated with privacy and dignity. All the people spoken with said that staff were nice and kind. Observation showed some very good interaction between people living in the home and the staff. However, this was not always consistent. One staff member dealt inappropriately with a person that had cognitive impairment, despite having recently completed dementia training, another expressed inappropriate opinions regarding care. Two toilets were found to be dirty. These are the types of things that can affect people’s dignity. The Provider should ensure that the manager has access to sufficient funds to enable her to meet outstanding requirements within the set timescales. Some outstanding requirements affect the health, safety and well being of people living at the home, the staff and people visiting the home. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is not always conducted so as to maximise service users’ capacity to exercise personal autonomy and choice. EVIDENCE: People living at the home who spoke with us, thought that the routines of daily life were flexible. Care staff also thought that routines were flexible. However, a copy of staff procedures in the procedures manual showed that care routines were regimented. They did not refer at any point to choice for people living in the home. For example : ‘7am Any double handers to assist each other’. This means that people that require two members of care staff to assist them are always first up in the mornings. Staff procedures in the afternoon says ‘A and B(Staff) then to assist allocated clients to bed. A to do night drinks a 7.15.’ The manager discussed following the site visit, that this tool was only meant as an aide –memoir and is not intended to override peoples choices. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 14 It was noted that the home sometimes defers choice to members of the family. This has happened on occasions when there has been no record of any cognitive impairment of the person living at the home. The home has an activities rota and two members of staff are responsible for activities. People living at the home confirmed that activities do occur at the home. On the day of the inspection there were no activities available to people in the home. The TV in one of the lounges was broken and some people were frustrated that it would not turn on. It eventually did turn on after a long period of time. Peoples past social interests are recorded in their care plan, but this information is not used to inform their current activities. No consideration was given to people with dementia regarding their current needs and they were not recorded in the care plan. People at the home said that their relatives were always made welcome. Care plans show that relatives were involved in people’s reviews if they chose them to be. People at the home exercise some autonomy over their lives. They see who they choose, wear what they want, and they personalise their own bedrooms. Sometimes, the routines of the home do not allow for autonomy. For example people only have one bath a week. Staff and people living at the home all agreed that the food at the home was very good. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home know that they are able to complain and believe that their complaints would be taken seriously. Not all staff have training regarding the safeguarding of adults. EVIDENCE: People who spoke with us said that if they had any concerns they would feel happy to approach the manager or one of the team leaders. If people want to complain formally there is a complaints procedure that is on display on the notice board area of the home. There is also a copy of it in each person’s brochure or service user guide. The home keeps records of any complaints and how they have been dealt with. Not all staff have undertaken prevention of abuse training, which covers how to recognise abuse and how to report perceived incidents. The home has suitable policies and procedures in place. This helps to keep people in the home safe. One member of staff was seen to react in an inappropriate manner to a person with dementia. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Failure to meet regulations means that people live in a home that is not well maintained in all areas this could put people at risk. The home is generally clean and free from offensive odours EVIDENCE: Some areas of the home are nicely decorated with good quality furnishings. New carpets have been replaced in corridors. New beds have been purchased in some rooms and there is an ongoing programme to replace old divan type beds in people’s bedrooms. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 17 Some areas of the home are in need of redecoration and this has been recognised during two inspections. Areas in need of redecoration/repair include the corridors, the outside path, which is a trip hazard, and exterior sofits. At the inspection of June 06 the manager said that she had obtained quotes for this work and was awaiting approval of this work by the registered provider. Requirements were made regarding these issues but the timescales have been breached. These requirements have been reissued. In the homes Annual quality assurance assessment (AQAA), the manager says that she has now to obtain new quotes to again submit. The Provider should ensure that this work is completed promptly. The manager says in the AQAA that budget restraints had made it hard to imporve as much as they would like. The registered provider should ensure that sufficient funds are available to enable the home to meet regulations, therefore ensuring the safety of people that live in the home. A kitchenette located within one of the lounges which people had access to, had water that was too hot. This could cause scalds. The team leader said that she would get the maintenance person to address this immediately. Peoples own rooms were comfortable and personalised with their own belongings such as ornaments and photographs. The home is generally clean throughout. There are some isolated areas in the home that smell of urine and some toilets were found to be dirty. The manager has ensured that the laundry facilities have improved and new machines have been purchased. The laundry has new flooring to ensure that it can be easily and properly cleaned, preventing staff and people living in the home from risk of infection. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are generally satisfied with the care they receive. There are still some areas of training, which need attention. The recruitment procedures help to keep people safe. EVIDENCE: People in the home that spoke to us said that all the staff were very nice. Team leaders who were standing in for the manager who was on annual leave, were well trained, had a good knowledge of the general running of the home, the people that lived in the home and their conditions and regulations. Most care workers demonstrated a good knowledge of the likes and dislikes of the people they cared for. They had a good awareness of the strengths and weaknesses of the home. Some however, as discussed in other areas of the report did not demonstrate good practice or work with the limits of the homes own policies for example: dealing with aggression. Staff expressed that sometimes they felt that the home was short of staff, particularly of an evening. Two staff work of an afternoon/evening shift on the Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 19 ground floor. Sometimes they need to bath people at this time. This means that only one member of staff is left to care for the remaining people some of who according to care plans have cognitive impairments, or aggressive behaviour. The manager in response states that additional staff are available on the first floor to help out on the ground floor, as well as the ground floor team leader. The manager should ensure that there are sufficient staff to meet the needs of people living at the home at any given time. 14 out of 24 care staff are trained to NVQ level2 or above. A further 6 staff are currently undertaking this training. This means that staff have a basic understanding of care. This helps to keep people safe. People in the home that spoke to us said that all the staff were very nice. Team leaders who were standing in for the manager who was on annual leave, were well trained, had a good knowledge of the general running of the home, the people that lived in the home and their conditions and regulations. Most care workers demonstrated a good knowledge of the likes and dislikes of the people they cared for. They had a good awareness of the strengths and weaknesses of the home. Some however, as discussed in other areas of the report did not demonstrate good practice or work with the limits of the homes own policies for example: dealing with aggression. Staff expressed that sometimes they felt that the home was short of staff, particularly of an evening. Two staff work of an afternoon/evening shift on the ground floor. Sometimes they need to bath people at this time. This means that only one member of staff is left to care for the remaining people some of who according to care plans have cognitive impairments, or aggressive behaviour. The manager should ensure that there is sufficient staff to meet the needs of people living at the home at any given time. The manager says in the homes AQQA that the home now has a suitable induction, which is linked to Skill for Care. However, there was no evidence of this during the site visit. Administration staff were unaware of the new induction process. The home has suitable procedures in place when recruiting staff. This helps to keep people safe by making sure that staff have appropriate references, and that the have CRB checks in place before they start working in the home. There is a programme of training for staff this includes mandatory and service specific training. The training matrix shows that sometimes some staff do not undertake all the mandatory training, or have sufficient updates. This could leave people living at the home at risk. Observation showed that although people undertake training it does not ensure their competency, for Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 20 example working with people with dementia. The manager should ensure that staff are competent to work with people in the home. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has an improvement plan for the home, which she effectively communicates to residents and staff. However the manager is reliant on the service provider to ensure adequate resources are available to carry this out in greater detail. This puts people at risk, as their health and safety cannot be assured. EVIDENCE: The manager was not present during the inspection as she was on annual leave. The home is well managed on a day-to-day basis and the manager is appropriately trained. Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 22 However, the manager does not have total autonomy regarding budgeting. This was highlighted in the inspection report of June 06 as it affects outcomes of the people that live in the home. Despite this the Provider has not as yet addressed this issue. The provider should ensure that when the manager needs to apply for finance to meet requirements or regulations that this is conducted in a prompt manner. Should the financial position be that there are insufficient funds to allow the manager to meet her statutory duties, the Commission should be notified by the Provider promptly. The home does have a development plan and the AQAA highlights where and how the manager intends to improve the service. People at the home have meetings so that they have input into how the home is conducted. Menus and staff routines have been changed as a direct result of the meetings. The health and safety of people at the home is not always well protected. Examples are to be found in other areas of the report but include unsuitable risk assessments, raised water temperatures, unsafe pathways, and staff not having mandatory training Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 1 x x x x x 1 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x x x x 2 Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 24 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. 2. Standard OP7 OP19 Regulation 15 23(2)(b) Requirement Care plans must be complete of all current needs and support. Timescale of 31/12/06 NOT MET The driveway and remaining paths must be repaired or resurfaced. Timescale 30/06/06 and 31/12/06 NOT MET The home must be kept in a good decorative order both internally and externally. This refers to corridors and roof soffits. Timescale 30/06/06 and 31/12/06 NOT MET The service provider must be make sufficient resources available to ensure the home is kept in a safe and good decorate state both internally and externally. Timescales of the 30/09/06 and 31/12/06 NOT MET The registered person shall produce a written guide to the care home which shall include details of the total fee payable in respect of the services referred to in sub-paragraphs (b) and DS0000037766.V348463.R01.S.doc Timescale for action 19/10/07 19/10/07 3. OP19 23(2)(d) 19/10/07 4. OP34 25 19/10/07 5. OP1 5 19/10/07 Manorbrooke Version 5.2 Page 25 (ba) and the arrangements for the payment of such a fee; a statement of whether any of the matters mentioned in subparagraphs (b) to (bc) would be different in circumstances where a service user’s care was being funded, in whole or in part, by a person other than the service user. Time scale of 31/07/07 NOT MET 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 Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Manorbrooke DS0000037766.V348463.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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