Inspection on 30/08/06 for Milbury 3 Barn Rise

This inspection was carried out on 30th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milbury 3 Barn Rise 11/01/08

Milbury 3 Barn Rise 03/01/06

Milbury 3 Barn Rise 25/07/05

Milbury 3 Barn Rise 10/02/05

Milbury 3 Barn Rise 16/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Milbury 3 Barn Rise Milbury Care Services Limited 3 Barn Rise Wembley Middlesex HA9 9NA Lead Inspector Dia Balraj Key Unannounced Inspection 30th August 2006 09:00 Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milbury 3 Barn Rise Address Milbury Care Services Limited 3 Barn Rise Wembley Middlesex HA9 9NA 020 8904 4596 020 8904 4596 info.ms@milburycare.com 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) Milbury Community Services Mr Carl Eastman Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3 January 2006 Brief Description of the Service: 3 Barn Rise is a residential home providing personal care and accommodation for 6 men with profound learning disabilities and challenging behaviours. The provider is Milbury Care Services, a nationwide organisation. The home aims to provide a normative life for the service users and enable them to enjoy all the facilities and amenities available within the community. The home is situated in a quiet residential area of Wembley and is close to public transport and shops. The ground floor accommodation consists of a lounge, dining room, kitchen, utility room, one bedroom with en suite and two toilets. The dining room has a patio, which opens on to a large enclosed garden. The first floor accommodation consists of 5 single bedrooms, one of which is en suite, bathrooms and toilets. Some of the residents are supported to attend local day services and the home also provides day care in house. The home has its own transport that enables the residents to access the wider community. The weekly fees vary from £1,305 to £1,386 per week. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on Wednesday the 30th August 2006 in the morning and lasted 7 hours. The inspector spent the morning and whole afternoon at the home. Time was spent observing the interaction between staff and service users and observing the serving of lunch. The inspector interviewed 5 staff members, the manager and the community nurse, who was attending to a service user during this visit. The inspector toured the premises. There were 3 service users at the home when the inspector arrived and two staff on duty excluding the care manager. The inspector was able to meet the remaining 3 service users on their return from the day centre. The inspector noted that all service users are able to express themselves using sign language and staff are able to interpret their needs. Two of the residents have some degree of verbal communication and greeted the inspector. They appeared very relaxed in their environment. One resident has limited speech and can make his needs known. Staff were observed to have a good knowledge of service users’ needs. The inspector would like to thank the manager and staff for facilitating the inspection process. What the service does well: What has improved since the last inspection? What they could do better: Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 6 The premises and furniture are often damaged by service users’ display of challenging behaviour. There were a number of repairs identified in the physical environment, which require attention as follows: • Resident’s bedroom on first floor.The hole in wall by the window requires repair. • 3 wardrobes require lock replacement • The window in utility room cannot be closed • The walls on the staircase, lounge and dining areas require redecoration • The electric fan in small toilet to be secured to wall • The floor coverings in bathroom and toilet need replacement • The radiator cover and top of kitchen door require painting The registered person must undertake a review of the care hours, taking into account peak times and other factors likely to influence staffing levels to ensure that service users’ needs are met at all times. 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. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. A thorough assessment of prospective residents’ needs is carried out to determine whether their needs can be met. EVIDENCE: The inspector obtained evidence from documentation, from observation and from discussion with the manager. There has been no new admission to the home for 8 years. The documentation of the last admission was examined and included a Care Management assessment plan. There was also evidence of care assessments by the Manager. The manager stated that the resident concerned had undertaken visits to the home. The resident was introduced to other residents and had meals at the home to gauge how well he fitted in with the group. Further visits were arranged as a means of gradually integrating the resident. The family was also invited to the home during this period. The care plans examined identified residents’ needs and the action to be taken by staff to achieve objectives. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 9 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, 7,9 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. Service users’ needs are identified and they are enabled to make choices. They are encouraged to develop independence. EVIDENCE: The individual care plans based on every day living skills assessment were well-organised and contained information in relation to care needs, individual lifestyle, history, interests, preferences, goals and assessment of risk. There were examples of where the service had been adapted to meet the changing needs of service users. Staff endeavour to assist service users to make choices. The inspector noted that service users were asked about their preferences in terms of menus and activities by using a combination of sign language and pictorial representation. Service users were observed to be relaxed and free to roam about the house Care plans were up to date with monthly summaries viewed. Any changes in needs would be documented in the care plans. Daily records viewed detailed the care provided and any relevant information was documented to inform other members of staff. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 10 Restrictions on choice have been imposed to ensure the health and safety of service users in view of their profound learning disabilities and challenging behaviour. There were examples of restrictions on choice, which were documented. These included entering the kitchen unaccompanied, taps being turned off in bedrooms. The individual plans are completed at the commencement of the placement and reviewed six monthly. The individual Personal Plans reviews are carried out yearly. Care Managers, advocates, relatives and the staff from the day centre and any other agency who may be involved with the resident all contribute towards the service users’ annual review. This assists in the process of ensuring that a holistic view is taken to encompass as far as possible, the wishes and feelings of the resident. The sample of risk assessments viewed confirmed that they had been reviewed recently. They covered a variety of potential risks to service users in engaging in activities such as: eating and drinking, bathing or taking a shower, pushing whilst using stairs. The risk assessments ensured that adequate precautions are taken to minimise risks to service users. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 11 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): 12, 13, 15, 16,17 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. Service users are enabled to undertake activities in the home and in the local community. Their rights are respected and they are offered a healthy diet. EVIDENCE: The inspector spent the whole day at the home and had the opportunity to observe the interaction between staff and service users. It was difficult for the inspector to consult with the service users about their activities and interests. The inspector gained information by observation, by interviewing staff and from documentation. During the inspection staff were observed interacting with service users in a respectful and positive manner. Service users are not able to seek employment but take part in activities in the local community. They go for a drive, bus ride, walks, park, shopping or for a meal. Service users attend day centres as was observed on the day of inspection. Documentation confirmed that service users attended parties in other homes. Service users went on holiday to Blackpool in June 2006. Staff’s interviews and records confirmed that each service user had an individual programme of activities to suit his preferences. Staff were fully aware of the individual needs of the service users and responded to sounds or Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 12 gestures the service users made, for example, if they were unhappy or wanted something. A staff member was observed interpreting a gesture by serving a drink to a service user Meals are offered three times daily and drinks as and when required. Staff were observed doing puzzles and taking out play equipment to stimulate the service users. There was evidence that family contacts were encouraged and that the family was invited to Individual Personal Plan reviews. Staff have also accompanied a service user to visit his family. Most of the service users have good family contacts and one service user has an advocate. The inspector observed the serving of lunch. The setting was congenial and service users appeared relaxed. Menus were viewed and reflected a varied and nutritious diet. Staff stated that as far as possible, service users are consulted about the meals and preferences are incorporated into meals to ensure service users enjoy mealtimes. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 13 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): 18, 19, 20 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. Service users receive appropriate personal support. The health care needs of service users are met. Service users are protected by the home’s medication policy. EVIDENCE: The evidence was obtained from observation, interviewing staff and documentation. The Health Action plan outlines the personal support required by each service user. On the day of inspection it was observed that sensitive care was provided, for example, help with shaving. Observations made of one service user receiving personal care support showed that the service user was accorded privacy and dignity. The team is multicultural and staff interviews confirmed that they have a good understanding of service users’ cultural backgrounds. The manager stated that although service users could not verbalise their choice of key worker they were matched in terms of being best able to meet the service users’ needs. The inspector observed a good rapport between staff and service users. Service users are registered with the local GP and can make appointments as and when required. They are also enabled to access health care facilities such Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 14 as Psychiatrist, epilepsy nurses, chiropodist, optician, dentist. The community nurse was attending to a service user during this inspection. Documentation suggested that regular reviews were being carried out. The home has a medication procedure. None of the service users self medicate. The MAR sheets of two residents chosen at random confirmed that the administration of medication was in order. All medication had dates of review. All permanent members of staff had followed medication training. The home ensures that only trained staff have responsibility for the administration of medication Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 15 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, 23 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. The complaints’ procedure ensures that concerns/complaints from service users and interested parties are acted upon. The POVA policy contributes to service users being protected from abuse. EVIDENCE: The home has a complaints policy in place. The complaints procedure was displayed on the notice board and in the reception area. CSCI was informed of concerns raised about the home in August 2006. The information has been forwarded to the registered person to investigate in accordance with their complaints procedure. The outcome of the investigation was not available on this inspection. The home has a POVA policy and the staff interviewed had knowledge of the policy including the Public Disclosure Act 1998. Staff had followed POVA training and had knowledge of the policy for dealing with Aggressive behaviour and of crisis intervention strategies. The home had a copy of the London Borough of Brent POVA policy to ensure that appropriate procedures are followed if required. The home had carried out risk assessments to cover activities of daily living of all service users. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 16 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, 30 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. Service users live in a homely environment. The home is clean and hygienic. EVIDENCE: The inspector toured the building. The home was observed to be clean and tidy. A number of requirements of the last inspection pertaining to the physical environment had been met. The manager had forwarded a memo on the 17th August 2006 outlining the outstanding maintenance to be carried out. A number of these have been carried out. The following were outstanding on the date of this inspection: Resident’s bedroom on first floor---The hole in wall by the window requires repair. 3 wardrobes require lock replacement The window in utility room cannot be closed The walls on the staircase, lounge and dining areas require redecoration. The electric fan in small toilet to be secured to wall The floor coverings in bathroom and toilet need replacement The radiator cover and top of kitchen door require painting Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 17 Due to the challenging behaviour of service users the home is frequently required to repair/ replace fixtures and fittings. Service users bedrooms viewed were spacious and individualised. Personal items were stored in their bedrooms and reflected their personal and cultural needs. Equipment was provided to maximise their independence. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 18 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, 33, 34,35 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. Service users are supported by competent and qualified staff. EVIDENCE: The home has a recruitment policy, which is based on equal opportunities and checks ensure the protection of service users. The home’s recruitment policy states that applicants must pass a CRB and POVA and POCA checks before being employed. They must also have 2 satisfactory current references and show that they are eligible to work in the UK. Staff files inspected were of an appropriate standard. On the day of inspection there were 4 members of staff on duty when all service users were present. This staffing ratio was judged adequate to meet the needs of all 6 service users when all are present at the home. The roster was examined and in a number of cases there were three members of staff on shifts during peak hours. Staff undertake duties such as cleaning, cooking, driving in addition to caring duties. Discussion with staff confirmed that the number of care staff on duty on Fridays, Saturdays and Sundays when all service users are present must be reviewed. Staff are required to accompany service users for outdoor activities and to undertake indoor activities in the home. The management is required to review the number of care hours paying particular attention to peak times to ensure that the service meets the needs of service users at all times. The ratios of care staff to service users Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 19 must be determined according to the assessed needs of service users and taking into account risk assessments. The home must also ensure that it complies with the staffing ratio agreed with the placement authority. The manager stated that Milbury Services would be advertising to recruit to the vacant posts. 5 staff members were interviewed. 5 staff hold the NVQ level 2 and have followed training including: Makaton, Food Handling, Medication, epilepsy, Fire safety, Moving and Handling, first aid, POVA and non violent crisis intervention. Two sample files confirmed that supervision is carried out 6 times a year with the manager or the deputy manager. All staff interviewed stated that they had received a copy of the GSCC code of conduct. The yearly appraisal identifies areas for development for example training in challenging behaviour as identified in appraisal. Staff have undertaken training in equal opportunities including learning disability training. . Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 20 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): 37,39,42 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. Service users benefit from a well run home. Service users are confident their views underpin all self-monitoring, review and development by the home. The health, safety and welfare of service users are promoted and protected. EVIDENCE: The home is well managed by a Manager who is enthusiastic in caring for the service users in a supportive way. The manager possesses the RMNH and RMN and is completing the registered manager’s award. The registered manager has undertaken periodic training in a number of areas including interviewing techniques, management and supervision. The home is unable to hold meetings with the service users due to their challenging and difficult behaviours and limited verbal communication skills. The annual development plan for the home was done on the 14th September 2005. The care managers, the relatives were invited to comment on the quality of provision of care. The suggestions implemented included the Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 21 replacement of patio doors and the new flooring in the lounge and dining room. A planned annual review is scheduled for the 28.9.06. The Employers Public Liability Certificate was displayed on the notice board and expires 1/04/07. The home’s annual health and safety check of electrical appliances was carried out on the 2.12.05, fire alarms on 14.3.06 and fire extinguisher on 2.12.05. The manager carries out weekly fire alarm checks and the records seen indicated this. These checks are audited by the home’s Operations Manager, who visits monthly either announced or unannounced to carry out Regulation 26 visits. Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 23 no Are there any outstanding requirements from the last inspection? 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 YA24 Regulation 23(2)(b) Requirement The registered person must ensure that the following works are carried out: Resident’s bedroom on first floor---The hole in wall by the window to be repaired. 3 wardrobes require lock replacement The window in utility room cannot be closed The walls on the staircase, lounge and dining areas require redecoration. The electric fan in small toilet to be secured to wall The floor coverings in bathroom and toilet need replacement The radiator cover and top of kitchen door require painting The registered person is required to review the number of care hours taking into account risk assessments to ensure that the service meets the needs of service users at all times. The registered person must ensure that the vacant posts of support workers are filled. DS0000017428.V308187.R01.S.doc Timescale for action 20/10/06 2. YA33 18(1)a 16/10/06 3 YA33 18(1)a 30/10/06 Milbury 3 Barn Rise Version 5.2 Page 24 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 Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Milbury 3 Barn Rise DS0000017428.V308187.R01.S.doc Version 5.2 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!