Inspection on 14/04/05 for Mill House

This inspection was carried out on 14th April 2005.

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 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

Mill House 14/11/08

Mill House 16/11/06

Mill House 27/09/05

Mill House 29/09/04

Mill House 09/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Mill House Salters Lane Faversham Kent ME13 8ND Lead Inspector Graham Cummings Unannounced Inspection 14th April 2005 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 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 and 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. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Mill House Address Salters Lane, Faversham, Kent. ME13 8ND Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01795 533276 Mrs Renuha Francis Mrs Heather Karslake CRH 24 Category(ies) of OP 23, DE(E) 1 registration, with number of places Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered to support one Service user with Dementia. Date of last inspection Announced on 29/9/04 Brief Description of the Service: Mill House is a large detached property, which is a listed building situated a few minutes from Faversham town centre. Faversham is a town steeped in history with a railway service to most parts of Kent. The M2 motorway is nearby and there is a shop within walking distance of the Home. The Home is registered to provide personal care and support to 24 Service users who are over the age of 65 years. The property has been adapted for its present use and the Provider has now completed an extension and alterations to provide further en suite bedrooms. Most of the accommodation is provided in single rooms, however there are three rooms for shared occupancy. All bedrooms have a call bell system, telephone point and television point. The Home has a large rear garden with an ornamental fishpond, bird aviary and seating for Service users, this is presently being redesigned following the completion of the building works. There is off road parking for several cars. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and carried out by Graham Cummings Lead Inspector for Mill House and Kim Rogers previous Lead Inspector for the home. The Inspectors arrived at 10:25am and left at 16:15. The Registered Manager Heather Karslake was not available and the Senior on duty Lyndsey Ramsden made the Inspectors welcome. The evidence for this report was gathered through discussion with Staff, Service Users and one family member who was visiting. The Inspectors also looked at available records and toured the home on both levels. The atmosphere was relaxed, pleasant and welcoming. Work has almost been completed on a two-storey extension to the back of the property. The extension will provide four new en suite bedrooms and increase the size of four existing bedrooms and provide these four rooms with en suite facilities. The Home was generally clean and orderly on the day of the inspection, although it did become extremely busy around 14:30 when a review took place and the fire alarms and emergency lighting was being serviced and tested. The Service Users were accepting of all the added activities including having Inspectors on site. Positive comments about living at Mill House were made by several Service Users, one Service User told the Inspector that they ‘had good food, good company and couldn’t ask for anything else’. Several Service Users told the Inspector that the staff are kind and caring. One relative said that the ’Manager was excellent as was the food and staff’, also ‘Mr Francis was very helpful’. An immediate requirement was made at the end of the visit regarding a loose edging strip on the main staircase as it caused a trip hazard to the Service Users. It was not possible to assess whether all of the Requirements from the previous inspection on the 29/9/04 had been implemented as the Manager was not on site, of the four 4(four) Requirements made only one could be confirmed as being completed. None of the 4 (four) Recommendations could be evidenced although one staff member did comment that they had completed NVQ Level 2, this would indicate that some progress is being made towards meeting the staff training requirement. What the service does well: The home is very welcoming and friendly, the Service Users spoken to were positive about the food, care, staff and Manager, one resident said that he ‘ wouldn’t change anything’ and ‘I love it here’. The visiting family member spoken to informed the Inspector that they had been invited to visit the home prior to the placement being agreed and that they had been involved in the formulation of the Care Plan Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 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. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. 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. Prospective service users have an opportunity to “test drive” the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4,6. People who use this service receive clear information to enable them to make a choice about whether or not they wish to live in the home. Statement of terms and conditions could not be found on the Service Users files. (The Manager was not available and may have them filed separately in a locked cabinet). The care needs of a Service User on intermediate placement were being met. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 9 EVIDENCE: Four Service User plans were seen and none included the Statement of Terms of placement, however these may be placed in a separate file that the Manager has in a locked filing cabinet. Care Managers assessments were on file along with the homes pre placement assessment on one Service user that included the preferred form of address, d.o.b, care manager, Next of Kin, personal care requirements, mobility, social diet, oral hygiene, allergies, vision, speech, mental health and continence. There was a homes risk assessment on walking and fire. However there was limited background and social history information on file and Inspectors felt this could be helpful to staff. The Service User concerned was able to discuss past employment and family history with the Inspector. The Service User on Intermediate placement had a hospital and home assessment on file. Inspectors found that there were some differences in outcomes of these assessments i.e. the hospital stated 2 staff to transfer and thickening fluids were required as they had difficulty in swallowing, the home stated 1 staff was needed to transfer and no mention of thickening fluids. The Service user was Diabetic and staff were required to take 2 blood profiles a week, there was no record of this occurring and no procedure or protocol of what to do if the results were outside of the set limits. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. 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. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Not all Service Users had comprehensive Service User Plans and some were lacking in detail this could mean that Service User needs may not be met. Service Users were treated with Respect and their privacy was upheld. Medication was not fully inspected but a requirement is made regarding storage. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 11 EVIDENCE: Inspectors were told by Service Users that they felt they were treated with respect and their privacy was upheld, there were locks fitted on all bedroom doors that could be overridden from the outside, also locks were observed on bathroom and W.C’s. Inspectors observed staff knocking on Service User doors and waiting for a response before entering. Lockable wall cabinets were in all Service Users bedrooms. Out of the four Service User files inspected all had assessments that had been carried out by the home prior to admission three had Service User plans and one had not been formulated although there was an updated assessment completed after the first week of placement. Of the Service User plans inspected only one had a detailed Risk Assessments with Service User needs recorded and actions by staff to meet the Service Users needs. One Service user was a diagnosed Diabetic and the GP details were recorded with a telephone number along with advice from district nurses. Inspectors were informed by staff that they should take a sample of blood by pricking the finger, there was no record of whether this was being done, there was no individual protocol or procedure for staff to follow to carry out this procedure and what to do if the results were outside of the agreed limits, when asked staff said they ‘would not know what to do and he had been stable since moving in’ another member said that ‘ I picked it up as I went along’. Medication storage and administration was not fully inspected, however a large amount of eye drops were stored in a food fridge in unlocked containers, a Requirement was made to purchase a drug fridge. Inspectors noted positive interaction between Service Users and staff during their visit and were of the opinion that the recording of care offered did not support some of the good practices taking place, entries for the previous day for one Service User was - morning shift ‘…seems fine, eaten well’ evening shift – ‘ … very cheerful, walking v. well ‘ night shift – ‘ all ok’ there was no detail of what care, support or choices that had been given to the Service User throughout the day. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 17 (Adults 18-65) are: 12. 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The meals in the home are good, offering both choice and variety and catering for special dietary needs. Staff spoken too had a good understanding of the Service Users support needs this was evident from the relationships that have been formed between staff and Service Users. EVIDENCE: Service Users when spoken with were positive in their comments regarding the home, one Service User stated he ‘would change nothing’; he could ‘go out when he wants as long as he lets staff know he is going out’. He also stated ‘staff treat you right’. During the Inspection a Service users brother called in with some newspapers for him, something he does daily, also the daughter of a Service User was visiting who said that the Provider, Manager and Staff were all very helpful and she ‘knew her mother was in could hands and always kept informed’. A husband of one of the Service Users visited in the afternoon. In the morning staff played music and Service Users were encouraged to participate in a music and movement session and moving arms and legs a staff member did go round the room assisting Service Users if they requested help. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 13 In the afternoon a staff member ran a general Knowledge quiz that was open to anybody that was in the lounge. The menu for the day was on display and the dining area was with placemats, condiments and flowers and cold drinks. The food provided was in ample proportion consisting of fresh vegetables, chicken and potatoes followed by Cheesecake and cup of tea, one Service User was offered a piece of fruit when he said he did not like Cheesecake. Inspectors spoke to the Cook who said that she spoke to new Service Users when they arrived to try and find out likes and dislikes and was able to provide specific diets if required. On inspecting the kitchen Inspectors felt that it was in need of some modernisation, the cooker is a normal family domestic one and it must be difficult to supply a main meal for 19 Service Users plus staff, also it may be beneficial and cost effective to purchase a dishwasher to assist in meeting the Health and Safety standards in cross infection. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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. Including neglect and selfharm. The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Inspectors evidenced that Service Users and family views are listened to and acted upon. EVIDENCE: The daughter of one of the Service Users was spoken to and they felt that they were listened to and any requests had been met by the home, she also said that she had access to the Provider, one Service User also said that they ‘had no complaints’. The home has a complaints procedure,which is displayed at the home and included in the Service User Guide. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) 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. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 Recent investment in the home has significantly improved the appearance of this home creating a comfortable and safe environment for those living there and visiting. EVIDENCE: The home was clean and the tidy and in good décor, although there was a low odour in two bedrooms. The extension has now been completed and this has allowed for an extra lounge area to be available to the Service Users. All new bedrooms have en suite facilities and include television and telephone points and call alarm. Specialist equipment is available to meet the needs of the Service Users. The bedrooms are now all for single occupancy and are furnished with Service Users own belongings where possible. Work is now being completed to the garden that has increased the size of the patio area to Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 16 allow a larger number of Service Users the opportunity to sit outside in the warmer weather. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. 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 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28, Staffing levels are currently insufficient to meet the needs of Service Users. It was felt that staff were trying hard to meet Service User needs but due to some of the individuals needs for two staff to assist in mobility some Service Users were not attended to immediately. EVIDENCE: Staff informed inspectors that there were four Service Users with High level needs, seven with Medium level needs and eight with Low-level needs. This meant there were periods of time throughout the day and night when only two staff were on duty that Staff could not respond quickly to the needs of Service users. Staff told inspectors that it was difficult to respond to some of the Service User needs promptly. Service users stated that ‘they needed one more staff on at night as it’s busy the call bells are going off all night’. One staff member was busy and spoke sharply to one Service user saying ‘ok …..I’m busy’. Staff were discussing the rota during changeover of shift and were not happy with the rota for the following week and working extra duties. Service Users were very complimentary about the staff saying ‘staff are very nice’ and Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 18 another said ‘staff are very patient’. Inspectors using the calculation of care hours found that the estimated hours required to staff the home was approximately 150 hours less than that being supplied by the home at present. Just two staff on duty is not sufficient when some Service Users needs the support of two staff. The Registered Provider and Manager are required to review staffing levels to ensure that staffing is sufficient to meet Service Users needs. Although no training records were inspected staff informed inspectors that a training session on Stages of Dementia had been held and that four staff were completing their NVQ 2’s. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 37 – 43 (Adults 18-65) are: 31. 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 a well run home and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,38 Service Users live in a well run home. The home is run in the best interests of Service Users. Health and Safety issues must be addressed to protect the health and well being of Service Users. EVIDENCE: Service Users and some relatives told the inspectors that the home is run in the best interests of the Service Users. Family members and Staff were generally complimentary about the running of the home these included a Family member saying ‘the manager is excellent’ and ‘care is excellent’ a Staff member saying ‘Heather is a good manager’. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 20 On touring the home it was found that the fifth step on the main staircase the white edging strip was loose and presented as a trip hazard to anyone using the stairs, this needed to be repaired as soon as possible and an immediate requirement was made. It was also noted that there was four wheelchairs and a frame stored outside of the lift and by the fire exit. Foot operated bins and liquid soap needs to be available in all communal bathrooms and toilets. Fire doors need to be checked to ensure they all close correctly, the fire door in the kitchen was quite loose and rattled. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 2 3 3 4 3 5 x 6 3 HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 2 3 3 3 3 3 3 3 Score Standard No 7 8 9 10 11 Score 3 3 2 3 x Standard No 27 28 29 30 2 3 x x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 3 x x MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 3 34 x 35 x 36 x 37 x 38 2 Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 22 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 OP 7 Regulation 15(1) Requirement Service User plans must include a detailed Care Plan with Risk assessments and daily reports by staff should show the care given and reflect the Care Plan The Registered person must promote and make proper provision for the Health and Welfare of Service Users. Any Diabetic must have an individual protocol. The Registered person must ensure that all medication is stored appropriately. A drugs fridge must be provided. The Registered person must promote and make proper provision for the Health and Welfare of Service Users. The kitchen must be updated to include an hygienic method of washing and drying crockery and more suitable cooking facilities. The Registered Person must make sure that the home is free of offensive odours The Registered Person must ensure that at all times suitably qualified, competent and experienced persons are at the Timescale for action 31st May 2005 2. OP 9 12(1) 31st May 2005 3. OP 9 13(2) 1st July 2005 1st July 2005 4. OP 15 12(1) 5. 6. OP 26 OP 27 16(2)(k) 18(1)(a) 1st July 2005 31st May 2005 Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 23 7. OP 38 13(4)(a) 8. OP38 12 care home in such numbers as are appropriate for the Health and Welfare of Service users The Registered Person shall Immediate ensure that all parts of the home to which Service Users have access are so far as reasonably practicle free from hazards to their safety. The fifth stair on the main staircase needs to be repaired or replaced The registered person must 1st May ensure that all fire doors are 2005 working properly. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP 38 (2) Good Practice Recommendations The Registered Person ensures that they have an understanding and practice of measures to prevent the spread of infection and communicable diseases by placing pedal bins and liquid soap in all communial bathrooms and toilets. Regulation 13 (3) 2. Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection 33 Greycoat Street London SW1P 2QF 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 Mill House H56-H05 S23494 Mill House V221372 140405 Stage 4.doc Version 1.20 Page 25 - 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!