Inspection on 03/03/06 for Mayfield House

This inspection was carried out on 3rd March 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mayfield House 08/11/07

Mayfield House 16/11/05

Mayfield House 02/12/04

Mayfield House 17/05/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood Hall

Muston Road (70)

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

CARE HOME ADULTS 18-65 Mayfield House Woodhouse Lane East Ardsley Wakefield West Yorkshire WF3 2JS Lead Inspector Karen Westhead Unannounced Inspection 3rd March 2006 09:30 Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 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 Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 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. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Mayfield House Address Woodhouse Lane East Ardsley Wakefield West Yorkshire WF3 2JS 01924 828 181 01924 872 623 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) J C Care Ltd Mrs Mary Illingworth Care Home 15 Category(ies) of Learning disability over 65 years of age (15), registration, with number Physical disability over 65 years of age (15) of places Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2005 Brief Description of the Service: Mayfield House is owned by J C Care, which is a subsidiary of Craegmoor Health Care. It is managed by Joy Andrews, who has not yet been through the registration process with the CSCI. Mayfield House is a semi-detached property, which is joined to another care home owned by the same company. The home is situated in its own grounds and ample parking is available. The care home is on Woodhouse Lane, which is within easy walking distance of the main road. The area is well served by public transport. There are a number of local facilities and residents make good use of amenities in the area. The care home is registered to provide accommodation and care services for up to fifteen residents with a learning disability, who may also have a physical disability. Fourteen rooms are used for permanent residents and one room is used for residents who need respite care. The home is spread over two floors. There is no passenger lift, however some ground floor bedrooms are available. The home provides staff over twenty-four hours. There are at least five staff on each shift during the day and evening. A senior member of staff oversees each shift. Two waking staff are in the home during the night. The home employs a handyman and domestic staff. At present there are no catering staff employed, care assistants cook all meals. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection year runs from April to March and within that twelve month period, the Commission for Social Care Inspection (CSCI) is required to undertake a minimum of two inspections of all care homes. This was the second inspection of this home for the 2005/2006 inspection year. One inspector undertook the inspection, which was unannounced. The visit started at 9.30am and finished at 1.30pm. The purpose of the inspection was to ensure the home was operating and being managed for the benefit and well being of the residents and in accordance with requirements. The last inspection of this service was on 16th November 2005. At that time four requirements were highlighted with no recommendations. Two of the four requirements have now been addressed. Work is still required to ensure the care plans are up to date and that appropriate risk assessments are in place. During the course of the visit, the inspector spent a large proportion of time speaking with residents, staff members and the senior on duty. The manager and Deputy were on sickness leave. A number of documents were inspected during the visit; some areas of the home were seen, such as bedrooms and communal areas. All staff on duty were spoken to and observed carrying out their work. Individual and group discussions were held with residents. A number of CSCI comment cards and post-paid envelopes were left, to be distributed to residents and their relatives. One comment card asks questions about the inspection process and the way the inspector carried out her duties. After completion these are returned to the CSCI. Feedback about the findings from the inspection were given to the senior at the end of the visit. What the service does well: Mayfield House continues to provide a good level of physical care for the residents living there. It is a shame this is not reflected in the care records. However, based on outcomes the residents seen on the day of the visit appeared content and comfortable. Staff were observed carrying out their duties in a competent and professional manner. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 8 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 Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Residents, relatives and interested parties are given sufficient information to help them make a choice about the home and whether it will be suitable. Prospective residents are fully assessed before coming to stay. They are given an opportunity to visit Mayfield House prior to them making a decision about moving in. All residents have a contract with the home and know what services are provided. EVIDENCE: Throughout the visit the inspector was talking and interacting with residents. For those able to share their views, their level of satisfaction with the care provided ranged from those who were generally happy but had plans to move on and those who were content at the home and wished to stay for the foreseeable future. No complaints were raised with the inspector. Residents who experience difficulties with communication were seen relaxing around the home. They appeared comfortable and staff were using a wide range of methods to communicate effectively with them. Some of the literature given to residents has been modified using pictures and symbols. This is an example of good practice. The admission procedure for planned admissions is good. The procedure allows for residents and their families, if appropriate, to visit the home as Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 10 many times as needed before a decision is made about the placement. The visits vary in duration and the timescale is determined on an individual basis. However, the usual plan is for residents to share meals and leisure time at the home to familiarise them with the routines and give them the opportunity to meet other residents and staff. The staff see this as a two way process. They take the opportunity to assess the needs of the resident and ensure the home can cater for any specialist requirements as well as the general care needs of the person. The most recent admission had been an emergency. However, the resident had stayed at the home previously, during respite stays and was happy to return for a specified amount of time until her preferred options were possible. Information held on file showed that the needs and preferences of a diverse group of people were being met in relation to their individual ages, gender, cultural, social and religious beliefs. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 and 10 Resident’s personal files and supporting documentation is not being maintained appropriately and does not reflect the care and attention being provided. Information held about residents is kept securely. Information is not routinely shared with others unless the reasons are discussed and agreed with the residents if possible. If this is not possible then decisions are made in the best interests of the resident and this is recorded. Residents with capacity understand that information given in confidence may need to be shared if it is serious. EVIDENCE: The inspector viewed a random selection of care plans. The file relating to the most recently admitted resident was purposefully selected along with others. Those seen contained a contract of terms and conditions, plan of care, evaluation and review. Appropriate progress had been made with the records relating to the new resident. However, all of the other care plans were found to be out of date and not reflecting the care being delivered currently. This was highlighted after the last inspection and little progress has been made. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 12 Records and personal information is kept in the office, which can be locked. During the course of the inspection some residents referred to ‘their file’ and knew a broad outline of what was kept. The policy on confidentiality is referred to in the staff handbook and staff, when signing their contract of employment, sign to acknowledge their compliance. In discussion with staff, they were clear about their roles and responsibilities and that information given to them in confidence may on occasion have to be shared with senior staff and others. It was evident when talking to residents and subsequently to staff, that up to date risk assessments were not in place. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14, 16 and 17 Residents have appropriate support from staff, outside agencies and other professionals in order for them to lead a fulfilling lifestyle inside and outside the care home. Educational, social and recreational activities provide a good balance and allow the opportunity for personal development. Family links are maintained and residents are able to develop intimate and personal relationships with people of their choice where appropriate. Assistance and guidance is provided in these areas if necessary. Residents are offered a healthy diet and some said they enjoyed mealtimes. There is a focus on some residents improving their cooking, meal planning and preparation skills. EVIDENCE: Written evidence on file and in the daily notes showed that residents were maintaining outside links and being given help, reassurance and assistance. However, not all the information was up to date. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 14 Where appropriate, residents have a key to their rooms. The inspector noted that residents respected each other’s belongings. The inspector was given permission to inspect bedrooms by residents who were able to give consent. Some resident accompanied the inspector. Residents, who are able, are involved in household tasks. Residents who are reluctant or less able to engage are given support in accordance with their abilities. Some residents were proud of their achievements and enjoyed showing the inspector around their home and bedroom. Residents are enabled and supported to use community facilities. This includes services locally and out of area. Staff are proactive in their efforts to ensure residents attend leisure activities, educational placements and therapeutic recreation. During the course of the visit residents were seen interacting with staff about their days activities. Appropriate support was being offered and the inspector gained the impression that this practice was the norm. Residents with specific physical and complex needs are provided with specialist support. Residents, who were able to share their experiences, confirmed they were satisfied with the levels of activity provided. Those residents with limited understanding and speech were supported appropriately and systems were in place to monitor their involvement in organised and ad hoc events. Residents were pleased with the delivery of a ‘people carrier’, which is to be used for their benefit. However, the mini bus has been taken to have a tailgate fitted and this has not been returned. This has a direct effect on the residents who use a wheelchair for all transfers. They are not able to use any other form of transport for journeys away from the home. Food provision is organised around the needs of the resident group. A menu is published and rotated weekly. However, the food actually provided was not being recorded so the overall food provision was not assessed. On the day of the visit a variety of dishes were offered to residents. Residents were seen to make an active choice and in a couple of instances changed their minds and this was attended to. One resident is unable to eat the food at a day service. This was quickly picked up by the staff and now a prepared dish is sent with the resident. Drinks and snacks were offered and provided to residents throughout the visit. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 A policy relating to care of the dying is in place. Appropriate agencies and other professionals are brought in to provide specialist support in the delivery of care. Systems are not in place to monitor resident’s weights. EVIDENCE: There is a policy in the home, which relates to care of the dying. Where possible the wishes of residents in this area have been documented. For residents with limited understanding, staff have made enquires with either family members or representatives to make sure records are accurate and reflect any specific wishes. A district nurse and tissue viability nurse were present during the inspection. The inspector took the opportunity to discuss the care being delivered to one resident who had returned from hospital with pressure sores. They confirmed that the staff in the home were working in close partnership with them and improvements were being made. The district nurse had devised a simple programme of care, which the staff in the home could work to. Monitoring forms were being used to ensure repositioning and rehydration was being maintained according to the condition of the resident. Additional equipment Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 16 had been ordered and an interim strategy put in place until the home had taken delivery. The needs of the resident must be continually monitored to ensure the correct care can be provided. Since the last inspection staff authorised to administer medication had been identified and sample signatures provided. The residents are not weighed often enough. It was noted that some residents had not had their weights taken since November 2005. Staff confirmed that they were reliant on a community nurse bringing a pair of sit on scales and this only occurred every three months. This is wholly inadequate given the frailty of some of the residents and the identified difficulties highlighted with dietary intake and condition. One resident returned from a hospital admission during the visit. He was collected by a member of staff who he related well to and given a warm welcome on his return. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has a robust adult protection procedure and all staff have been trained to understand the subtle aspects of abusive behaviour and the action to be taken if suspected abuse is reported to them. EVIDENCE: All staff have been trained in the protection of vulnerable adults. Training varies from base line in house training to a one-day session provided by an external trainer. In the last six months there has been one adult protection issue in the home. This resulted in an investigation being initiated by the registered provider, Craegmoor. The final report is to be forwarded to the CSCI when a decision about the outcome will be made. No complaints had been received since the last inspection. Staff on duty were able to describe the action to be taken in the event of concerns being raised or if they observed bad practice. They were fully aware of the whistle blowing and complaints procedure. It was not possible to ascertain whether residents felt confident about the complaints procedure. An entry in resident’s daily records stated that one resident had received some bruising. This had not been explored or documented as an incident. All unexplained bruising should be recorded in a way, which allows incidences to be monitored and audited. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 29 and 30 The premises are generally well maintained. Attention is given to detail and a homely atmosphere. The home was found to be clean and tidy, apart from one bedroom, which had an unpleasant odour, extractor fans needed cleaning and the laundry room was cluttered. There is a ramped access. A number of residents have specialist aids and adaptations due to their physical disabilities. EVIDENCE: Mayfield House is a no-smoking building. Staff support residents in their efforts to keep the home clean and tidy. The range of tasks undertaken rely on the skills and abilities of the resident. However, staff are aware of their duty of care and make sure thorough cleaning is undertaken where necessary. Appropriate systems are in place to check the fire safety equipment. Issues needing attention included the laundry room, which was found to be cluttered. A cleaning order had been delivered and staff were finding difficulty in storing the goods. One bedroom had had the carpet lifted and the underlay had been left in place. There had clearly been a problem with the Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 19 management of incontinence and the underlay had also been affected. The extractor fan in one bathroom was clogged up with fluff. Residents have access to a communal bathroom and a variety of toilets are situated on each floor. However, due to the complex needs of one resident, the manager had taken the decision to fit external bolts to the toilet and bathroom doors. This prevents access by the more vulnerable residents. Whilst it is acknowledged that this has been done to prevent, what could be a fatal incident. Documentation was not available to show that appropriate risk assessments had been carried out to cover all eventualities. This was highlighted at the last inspection. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Staff have clear roles and responsibilities. The recruitment and selection programme is robust. There are sufficient staff on duty to cater for the needs of the current resident group and appropriate training has been provided. EVIDENCE: The senior member of staff on duty confirmed that the overall staffing levels were good. At the time of the visit there were no staff vacancies, following the recruitment of two additional staff. Staff have attended a number of courses, some routine and others more client focused. However, the induction training for new staff must be continued and completed in a timely manner. Staff were seen carrying out their respective duties. They were found to be knowledgeable, competent and committed to their work. The manager and deputy were on sickness leave at the time of the visit. A senior member of staff assisted with the inspection. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 and 43 There is a defined management structure. The homes policies and procedures are written in a way, which is resident-focused and protects their best interests. EVIDENCE: It is noted that the current manager has not submitted an application to register with the CSCI. The fire records were checked and found to be in order. Risk assessments are not being carried out and do not reflect an accurate picture of the current residents. The organisation has adequate insurance cover in place. Senior managers within the organisation have a business plan and managers in the home are expected to contribute to this. Managers present their budget forecasts and discuss the needs of each home as part of the overall financial plan. During Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 22 the course of the visit no problems with highlighted regarding the financial viability of the home. The home is visited on a monthly basis by an official from the main office. A report about the running of the home is completed and a copy forwarded to the CSCI. Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 23 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 2 28 X 29 3 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 2 14 3 15 X 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X 2 3 X 3 3 X X 3 Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 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. Standard YA6 Regulation 15 Requirement The registered person must make sure the care plans are kept up to date and reflect an accurate picture of current events. This is outstanding from the last inspection on 16th November 2005 2. YA24 13 and 23 The registered person must make sure there are adequate risk assessments in place. This is outstanding from the last inspection on 16th November 2005 3. YA13 16(2)(m) The registered person must make sure appropriate transport arrangements are in place for residents to access community facilities. The registered person must make sure there is a record detailing the food actually provided to each resident. The registered person must make sure residents wellbeing is monitored on a regular basis. DS0000001480.V284547.R01.S.doc Timescale for action 27/04/06 20/04/06 20/04/06 4. YA17 16(2)(i) 20/04/06 5. YA21 12 20/04/06 Mayfield House Version 5.1 Page 25 6. YA23 12 7. YA24 23(4) The registered person must make sure there is a system in place to monitor and audit incidents of unexplained bruising/injury to residents. The registered person must make sure that the extractor fans do not pose a fire risk and are kept clean. Adequate storage facilities must be in place for cleaning materials and toiletries. The registered person must make sure that there are appropriate risk assessments in place to take into account the use of bolts to the doors leading to toilets and bathrooms. The dignity and privacy of residents must not be compromised by this arrangement. The registered person must make sure the home is kept odour free and hygiene levels must be maintained. 20/04/06 20/04/06 8. YA27 13 20/04/06 9. YA30 16(2)(k) 27/04/06 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 Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Mayfield House DS0000001480.V284547.R01.S.doc Version 5.1 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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