Inspection on 03/07/08 for Melrose Care Home

This inspection was carried out on 3rd July 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Melrose Care Home 18/07/06

Melrose Care Home 13/09/05

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Melrose Care Home 9./11 Wykeham Road Worthing West Sussex BN11 4JG Lead Inspector Beth Tye Unannounced Inspection 3rd July 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Melrose Care Home DS0000063715.V367566.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. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Melrose Care Home Address 9./11 Wykeham Road Worthing West Sussex BN11 4JG 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) 01903 230406 01903 216258 melrose.care@tiscali.co.uk Melrose Care Limited Mrs. Elizabeth Anne Seymour Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2006 Brief Description of the Service: Melrose is registered to provide personal and nursing care for up to twenty residents aged 65 years and over. The home was registered with a new owner in June 2005. Melrose is situated on a main road in a residential area of the town of Worthing. A park is opposite the home. Public transport links are within walking distance. The building is a large detached house, which has been converted. Accommodation is provided on two floors with a passenger lift providing access to the first floor. Bedrooms are mix of double and single. There is one lounge and a dining room providing communal facilities. A garden with seating area is accessible to residents, at the rear of the building. A driveway with parking is at the front. Melrose Care Home DS0000063715.V367566.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 3 star. This means the people who use this service experience excellent quality outcomes. The unannounced inspection visit was carried out by Ms Beth Tye and was arranged to assist the Commission in assessing the home’s compliance with the key standards of the national minimum standards for care homes for older people. Planning for the visit took into account information received on the service since it opened. The Annual Quality Assurance Assessment was returned to The Commission for Social Care Inspection (CSCI) and informed us areas of improvement, which have been carried out and also identified areas for further improvement. Survey forms received from people living in the home, relatives and members of staff also contributed to our planning. On the day of the visit the inspector spoke at length with the manager and the owner, who was also at the home on the day. Residents living at the home, staff working at the home and visitors were spoken with to gain their views of the service, all comments were positive and all residents spoken to said they enjoyed living at the home. Two sets of admission assessments and the individual plans of care for people living in the home were looked at. A case tracking exercise for these residents was undertaken to examine how their assessed needs were being met. Other records sampled included recruitment and training records for four members of staff, the supervision plan, the record of complaints, quality assurance records and records relating to health and safety issues in the home. The premises were viewed including communal areas, kitchens, bathrooms and bedrooms. A number of interactions between people living in the home and staff, arrangements for lunch and medication dispensing were observed. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The manager intends to audit the staffing records to ensure information is more ordered. The home intends to continue to recruit volunteers to assist in one to one activities with residents. Residents life stories and diversity needs are to be incorporated in the care files to ensure information is in one place and easily accessible to staff. There were no recommendations or requirements made at this inspection. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 7 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. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good Residents were not accommodated in the home without an assessment of their needs being carried out. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Melrose provides prospective residents with detailed information regarding the home prior to admission. This enables people to make an informed choice about moving into the home. Information is provided in a comprehensive Service User Guide and a Statement of Purpose. The manager stated in the AQAA (Annual Quality assurance Assessment), that both documents are updated regularly. Residents spoken with said they had made a choice to live at Melrose and had received information regarding the facilities and services available Two pre-admission assessments were looked at during the visit. They were clear, very detailed and were specific to the individuals. The assessments seen Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 10 focus on the outcomes for individuals in health, personal care, social interests and diversity. An emphasis is made on individual choice, with details such as preferred bed times and times of meals. It was noted from the care plans seen during the visit that prospective residents are given the opportunity to visit the home prior to admission if they chose to. Families and residents are encouraged to visit the home ‘on spec’ so that their first impression is ‘genuine’. The home has a website which offers links to CSCI reports and independent advice on choosing a suitable care home. All information about the service is available in bold print. Melrose offers respite care but not intermediate care. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good Staff have appropriate training and information to ensure they are able to meet residents’ health needs. Medication is dispensed in line with the homes policies and procedures. Current care practices ensure residents feel they are treated with respect and their right to privacy has been upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care plans were examined as part of the case tracking process. Each care plan contains relevant details relating to the residents health needs and social well-being. Since the last inspection the manager has improved on existing care plans to ensure information is comprehensive and more ‘person centred’. The care plans seen detailed all aspects of health, personal and social care and the actions staff needed to take to meet these needs. In line with the manager’s current training, the existing care plans will be reviewed and updated again to include advanced care planning for the Gold Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 12 Standards ‘end of life’ framework. This will provide staff with the opportunity for reflective practice and extensive reviews around end of life care. Information seen on care files was up to date and easily accessible. There was evidence to demonstrate that staff undertake regular care reviews and up dates the care plans as changes occur. All aspects of care planning are agreed prior to admission and again during regular reviews, where appropriate signatures are obtained for changes, demonstrating that residents and their families are encouraged to participate in decision making. Individual risk assessments are in place, for example: risk of falls, pressure area damage and nutrition and action taken is recorded. This gives staff a better understanding of need and responses in addition to supporting residents to maintain independence safely where possible. Records showed that residents have access to other community based health professionals as required. These include a private physiotherapist, dentist, optician, a CPN, chiropodist and community matron. The manager has established links with GP groups and St Barnabus hospice in respect of end of life care. Outcomes and action required by staff is recorded on individual care plans. This provides staff with up to date knowledge about appropriate care practice. Staff complete a full induction and mandatory training programme. Training is also provided in respect of specialist health needs such as dementia, mental capacity act, nutrition and continence training. Any training the manager completes is cascaded down to the nurses on the team. This training provides staff with the skills and knowledge base to respond appropriately to resident’s specialist health care needs. Case tracking, feedback and discussion with the residents and their relatives confirmed good practice is maintained in the home and residents are treated with dignity and respect. The medication administration procedures were discussed and policies and procedures are in place to ensure safe medication administration. A random selection of medication was checked and found to be in order. Medication administration charts are completed correctly, which indicated that residents are receiving their medication as prescribed. Photographs of residents are displayed in the home as an extra safeguard towards safe administration. Records seen were in good order and up to date, demonstrating staff follow appropriate procedures. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 13 Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is excellent Residents find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social and recreational interests and needs. Residents maintain contact with family and friends Residents receive a wholesome appealing balanced diet in pleasing surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An on-going programme of activities are organised at the home on a daily basis, offering stimulation to those residents who are less able to explore interests outside the home. Residents meet regularly to discuss and review the activities offered. Activities include group outings, art and crafts, florist groups, bowls, exercise, music, quizzes, and entertainment. Two of the residents who enjoy exercise but not group activities have been provided with personal training sessions. Community groups such as Help the aged and the Blind society contribute to the activities programme to ensure residents specialist needs are meet. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 15 Volunteers are recruited to the home to ensure individual activities of choice are undertaken on a regular basis. This promotes ‘a sense of self worth’, individual choice and preferences in the home. Religious and cultural needs are identified as part of the care planning process. The home holds monthly communion and staff escort individuals to religious services in the community as requested. One resident from a different culture was provided with books, films, music and food, which related to his ethnic origin. He also has a GP who speaks his language. Another resident specifically requested a preference for a particular wine with her meals. The home ensured this was provided. A resident who is partially sighted has been supported to establish links with the local Blind society and provided with specialist equipment such as a press button clock and radio for her room. Residents confirmed that they can choose what they want to do as far as social events, routines and also what times they go to bed and get up in the morning. Flexibility enables individuals to have choice and express a preference in their daily routines. Staff escort residents to community events and appointments as required. Residents and relatives confirmed that the visiting arrangements for the home are open and visitors can come and go as they please and are made welcome by the staff. Resident’s and relatives meetings are held on a regular basis. These meetings give the residents and their families the opportunity to comment on how they view the home and contribute to decision-making. The menu offered at Melrose offers a wide range of balanced, home cooked food. The cook is experienced and qualified to fulfil her role. The menu offered takes in to account the preferences of residents and specialist dietary needs. This promotes choice for the residents and provides an opportunity for them to eat what they prefer. An alternative meal is on offer at lunchtime and teatimes. Residents spoken with said they ‘really enjoyed the food’ and there was ‘plenty to eat’. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good Residents and their relatives know that their complaints will be listened to, taken seriously and acted upon. The registered provider has ensured that residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaint procedure, which is outlined in the statement of purpose and displayed throughout the home. Complaints are recorded and investigated with feedback to complainant within 28 days with the actions taken in line with the homes policy and procedure. All residents and visitors spoken to said they knew who to complain to and that they would not hesitate to do so if they thought it appropriate. Complaints are a standing item on the homes resident meeting agenda to enable residents to feedback their opinions. Staff induction and training records indicated that all staff have received training in safeguarding vulnerable adults. All training is up dated on an annual basis in line with best practice and legislation. Records relating to the homes recruitment procedure were examined. These demonstrated that all staff under-go appropriate checks prior to employment and the recruitment procedures for the home are robust. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 17 Links with an advocacy service are available through the carers liaison at the local branch of Help the Aged. Residents are encouraged to remain politically active if they wish to and many exercise their right to vote. They are assisted to fill in forms and use the postal voting system as required. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good The home was clean, tidy, well maintained and free from offensive odours. The bathing facilities are able to meet the needs of all residents. Equipment and safety checks necessary to ensure the welfare of the residents are in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the visit the home was found to be clean, tidy and free from offensive odours. The premises is a converted large house, which gives a homely, domestic feel. The décor and furnishings are comfortable and well maintained. Since the last inspection a large conservatory has been built at the back of the house, which provides residents with a light comfortable, additional seating area. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 19 The garden is attractive with suitable seating, tables and shade for the residents, who wish to sit outside during the summer months. The layout of the building means some communal areas, bedrooms and bathrooms have restricted space. The manager considers this when any prospective new resident wished to move into the home, particularly if they have high dependency needs and a necessity for specialist equipment. Regular health and safety checks are undertaken, including risk assessments for the environment. A full time maintenance man is employed at the home to ensure the premises is well maintained and safe. A new wet room has been built on the ground floor and has proved popular with residents. Various moving and handling equipment is available in the home. Staff had received training in the safe use of this equipment. All beds could be adjusted in height. Hand-rails, raised toilet seats and frames are available through out the home. Staff had received training in the control of infection. They were observed complying with correct hygiene procedures and wear protective clothing. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is excellent The staff numbers and skill mix are appropriate to meet the needs of the resident’s accommodated. Staff receive mandatory and specialist training and a high proportion of them had completed NVQ training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rotas reflected that there are enough skilled staff on duty at all times in the home. There are three care staff and one qualified nurse from 8am to 8pm. Both staff and residents fed back how this had helped to allow more time for activities and one to one care, particularly in the afternoons. In addition, the home has dedicated catering and house keeping staff which enables care staff to focus on their roles and responsibilities providing care for residents. The home has recruited volunteers to assist residents with activities and escort them to appointments in the community. Comments made about the staff by the residents included ‘they are kind and patient’, ‘compassionate’, ‘my dignity and privacy is very much respected,’ and ‘all the staff are very helpful’ Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 21 Training records and four staff files were looked at during the visit. They showed that staff have received induction training which includes all aspects of care in the home, health and safety and best practice guidance. The staff induction pack includes appropriate policies and procedures and the GSCC code of conduct handbook. The mandatory training for staff covers fire safety, manual handling, health and safety, adult protection, and infection control. Additional training beyond the basic requirements include, the mental capacity act, bladder, bowel and nutrition, dementia and challenging behaviour. The manager is currently training for the Gold Standards Framework for End of life care. This knowledge will be cascaded down to the staff team in the coming months. Records show that the home has reached the target of standard 28.2 by ensuring more than 50 of staff are trained to National Vocational Training level 2 or above. Recruitment procedures were found to be robust and in line with the homes recruitment policies. All staff files seen were found to contain the necessary documentation required by Schedule 2 of the Care Regulations. In the interests of the residents the home has a provider agreement with one care agency to ensure that in the event an agency worker is used they are known to the home and have received an induction. Two members of staff were spoken with during the visit. They confirmed that they have undertaken relevant training and attend regular supervision and staff meetings. All staff received an annual appraisal in June 2008. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is excellent Residents and staff benefit from the home being run by an experienced and qualified manager. Various quality audits and action plans are carried out in the home throughout the year. The home has good systems in place to protect the health and safety of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager of the home is experienced and qualified to undertake her role. The manager attends regular training in line with legislation and best practice to ensure the home provides high quality care to its residents. She keeps herself updated with clinical nursing issues and works most of her shifts as the nurse in charge. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 23 The manager has one day per week supernumerary to complete her managerial duties, although more is provided if required. The owner and registered individual for the home is very involved in service delivery and is responsible for completion of administration at the home. She has membership to West Sussex Forum, RNHA and CTC to keep abreast of new care related developments. Staff spoke very highly of the manager, they confirmed they are trained and feel ‘very supported’. Staff informed the inspector that handovers occur following each shift, supervision and staff meetings are held regularly. Records and meeting minutes confirmed this. Feedback from staff demonstrated a commitment to meeting resident’s individual needs and preferences on a daily basis. Quality assurance at Melrose is undertaken in various ways. The home sends out annual questionnaires to involved parties, the results of which are published and an action plan is drawn up from the findings. In addition the home holds regular quality assurance meetings for residents, to input about how the home can be improved upon and to involve them in decision-making processes relating to changes. The manager carries out several audits through the year and implements change were necessary to improve services. The manager and owner also talk, informally to residents and visitors, gaining their views on the facilities and services at the home. The inspector found there is a strong emphasis on residents’ choice and preference at Melrose and the systems in place support this process. The home has clear policies and procedures in respect of residents’ finances. All monies are handled by the residents or their relatives. Power of Attorney forms are agreed and signed where appropriate. The AQAA completed by the owner and manager prior to the visit contained comprehensive information that we were able to evidence during the visit. Clear details were given regarding how the home had improved since the last inspection, areas that it needs to improve, and the ways in which they are planning to do this. The health and safety aspects of the premises have been improved since the last inspection. Risk assessments are completed and reviewed. All relevant health and safety checks and audits are undertaken on a regular basis to ensure the safety and welfare of residents and staff is maintained. Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 24 Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 X X X 3 3 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 3 3 4 Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone 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 Melrose Care Home DS0000063715.V367566.R01.S.doc Version 5.2 Page 28 - 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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