Inspection on 01/02/06 for Noire House

This inspection was carried out on 1st February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Noire House 23/07/07

Noire House 03/08/06

Noire House 04/08/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Noire House 31 Abbotts Road Erdington Birmingham West Midlands B24 8HE Lead Inspector Joe O`Connor Unannounced Inspection 1st February 2006 10:40 Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Noire House Address 31 Abbotts Road Erdington Birmingham West Midlands B24 8HE 0121 382 0217 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) Robinia Care West Midlands Limited Rosemarie Ann Fitzpatrick Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Residents must be aged under 65 The manager must obtain an NVQ Level 4 in Management or equivalent by December 2005. That Mrs Rosie Fitzpatrick is also registered for The White House, 219 Green Lane, Wylde Green, Sutton Coldfield, Birmingham, B73 5LX with the condition that the responsible individual provides additional management support with a suitably qualified and competent deputy manager at both the White House and Noire House working at least 30 hours per week. 4th August 2005 Date of last inspection Brief Description of the Service: Noire House is a modern purpose built home at the end of Abbotts Road in Erdington. It provides accommodation to four people with learning disabilities. The house feels light and airy with a homely atmosphere. To the rear of the property is a large garden, which surrounds both sides of the premises and is laid to lawn. There is some off road parking. The ground floor of the premises consists of a large lounge, with a conservatory that is used as a dining room. There is also a large kitchen, which is occasionally used as a second dining room. A toilet, separate laundry area and office are also located on the ground floor. There are four single bedrooms on the first floor, all of which are a good size and a bathroom with a shower. The service is well situated for local amenities such as Erdington, Star City and The Fort retail park. It is also close to bus routes for Birmingham City Centre. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day. The Inspector spoke to one service user who had limited verbal communication. The other service users were out for the majority of the day. The Inspector also had opportunity to talk to a newly appointed manager. Service users care plans and risk assessments were inspected. Staff training records was also examined and a number of health and safety records were sampled. What the service does well: What has improved since the last inspection? The service has a new manager who has had relevant experience of working with people who have a learning disability and autism. He has developed the statement of purpose and service user guide that uses pictures and symbols making them more accessible for the service users. Each service user has their own copy individually personalised with photographs of their bedroom. Menus have been developed in a picture format allowing service users greater accessibility when choosing their meals. The complaints procedure has been made into a more accessible format that includes symbols and informs the service users they can contact the CSCI at anytime and they will not be victimised for making a complaint. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 6 Service users weight is being recorded every month and the manager is developing individual health action plans for each service user in line with the Department of Health’s Valuing People’s Guidelines. Staff supervision is occurring more frequently since the last inspection. All staff are now registered for training towards the Learning Disability Award Framework. All staff have also registered for medication training provided by Boots Pharmacy. The manager has developed a new format for recording service users meetings that show any requests for future activities are being acted upon by staff. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 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 Noire House DS0000064613.V281616.R01.S.doc Version 5.1 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): 1, 5 Information is available to prospective service users that are in an accessible format enabling them to make an informed choice about where to live. Service users have a statement of terms and conditions that provide a breakdown of fees to be paid. EVIDENCE: The Registered Manager had left her position at the end of October 2005 and a new manager has been appointed. The new manager had developed the statement of purpose and service user guide into a more accessible format that combines the use of symbols and photographs. Each service user has their own service user guide that is individually personalised. Including photographs of their bedroom. Since the last inspection improvements have been made to each of the service users’ statement of terms and conditions that provided more information of the fees to be paid. At the time of the inspection the service users were out participating in daytime activities. One service user returned later and indicated through hand movements that he had going out horse riding. The other service users returned later and were going out to the Star City to watch a film. There have been no new admissions since the last inspection hence Standard 2 was not assessed. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 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, 8, 9 Care plans provide detailed information of service users needs and how they should be met but these have not been reviewed ensuring they reflect individual circumstances. Improvements are being made in ensuring service users meetings provide evidence that service users requests and decisions are acted upon by staff. Service users have risk assessments concerning limitations on their independence and how they should be supported at home and in the community. EVIDENCE: Two service users care plans were sampled during the inspection and it was noticed these had not been reviewed since the last inspection. One care plan sampled did not reflect changes for one service user who was having more problems with his mobility and was becoming more prone to falls. It was disappointing to see that no progress had been made in the development of the This is Me book which provides the service user a more person centred approach to planning their care. Since the last inspection improvements have been made to the means of recording outcomes during the weekly service users’ meetings. The minutes for these had been re-designed to show that the staff was addressing any Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 10 requests made for future activities from previous meetings. Two service users care records sampled included risk assessments guidelines covering how service users should be supported when going out and how many staff were required. One risk assessment guidelines seen referred to the requirement that one service user should not be left alone when being bathed. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 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, 14, 17 Service users do not have enough opportunities for leisure activities and for a holiday. Service users records of food eaten do not provide enough evidence confirming service users are being offered a varied range of nutritious meals. EVIDENCE: During the course of this inspection one of the service users was out on a horse riding activity, which on his return showed how much he had enjoyed this by laughing and jumping up and down. Two service users were out at their day services provided by the Local Authority. An examination of service users daily records indicated that they had been involved in trips to the cinema, pub lunches and shopping. However, it was noted the daily recording of service users did not always state in detail how service users spent neither their leisure time nor how they responded to activities that had been provided. It was noted that when examining one of the service users meetings minutes it had been written that one of the service users had asked had twice requested to go swimming but there was no evidence confirming this had been done. When this was discussed with the manager it was stated the service user had an ongoing problem with a veroucca but would be looking to purchase socks especially made for swimming. At the time of this inspection a service user had Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 12 asked to go out with the others to Star City but was told by a member of staff he was not going out with them because he had already gone out today. This is unacceptable and service users must have the opportunity for leisure activities of their choice whether planned or unplanned. It was also discovered the same service user had not been able to go to church every Sunday because there were not enough staff available to take him. None of the service users had gone on holiday last year and the manager must now ensure service users are able to choose a holiday of their choice for 2006. The manager stated he was talking to a day service manager who works for Robinia who provides activities for another service in the area to discuss the possibility of widening activity choices for the service users at Noire House. Since the last inspection the manager has introduced a picture format for the menus to improve their accessibility for the service users. When examining the records of food eaten during the week it was noted there was some repetition of meals provided for lunch with no evidence confirming service users were making a choice of what they wanted to eat. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 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 Service users moving and handling requirements are identified within a risk assessment framework. Service users healthcare is appropriately arranged by staff promoting and maintaining their good health. Medication management is d to a good standard maintaining service users’ good health. EVIDENCE: Two service users records examined indicated appropriate action was being taken ensuring service users healthcare needs were being met. Records were in place confirming service users had received treatment from a GP, Dentist, Chiropodist and Optician. Reviews had occurred of service users homely remedy protocols that were signed by their GP. A number of service users had undergone reviews of their medication with a Consultant Psychiatrist from the Primary Care Learning Disability Trust. Any concerns regarding service users health were followed up. One example was a service user who had developed problems with their teeth requiring them to have an emergency admission to the dental hospital to remove teeth that had been infected. An examination of the service user’s daily record indicated staff had responded quickly to the service user’s deteriorating health. Since the last inspection improvements had been made in recording service users’ weight and it was noted this was being done on a monthly basis. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 14 During the course of this inspection it was noted manual handling assessments were not in place within the service users care records but at the time of publication this report these had been completed. An examination of the Medicines Administration Records found there were no gaps but it was noted that medication with “as directed by your doctor” did not specify how many tablets were to be administered. Overall the management of medication was to an acceptable standard and all of the staff had signed up to the Safe Handling of Medicines course provided by the Boots Pharmacy. It was noted that since the last inspection that medication audits had occurred to check staff competency. There was a policy and procedure in place for the administration of medication within the service. The manager stated he would be developing individual health action plans in line with the D.O.H. Guidelines on Valuing People. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 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 Service users have a complaints procedure that is available in an accessible format. Improvements must be made in safeguarding the use of service users’ motability vehicles to protect their financial interests. EVIDENCE: Neither the CSCI nor the service have received any complaints since the last inspection. The current manager has developed the complaints procedure that is available in an accessible format and the photograph of the inspector was on display in the hallway. An examination of service users finances indicated two signatures were being maintained on the individual expenditure records, which was a requirement from the previous inspection. The manager had made amendments to the organisation’s procedures regarding adult protection, physical intervention and whistleblowing informing staff about contacting the CSCI. A matter was discussed with the manager regarding the use of a motability vehicle for one of the service users. It had been noted that a member of staff during supervision was warned about the over use of the vehicle. There were no written guidelines in place regarding the arrangements for its use with the service user and their family to state if they were in agreement as to its use. The manager stated the service user’s current agreement with Motability was shortly ending and that the organisation would be providing a vehicle for all of the service users but in the mean time written guidelines must be in place regarding the service user’s vehicle. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 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 The premises are maintained to an acceptable standard providing a clean and safe environment for the service users. EVIDENCE: The building was clean and tidy at the time of this inspection with no offensive odour apparent. The laundry facility was clean and tidy. There are procedures in place for the control of infection. There is a maintenance book and it was noted the roof on the conservatory had been repaired following a leak. There are appropriate facilities in place for the removal of clinical waste. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 17 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, 35, 36 Service users receive care and support with appropriate numbers of qualified staff. The organisation provides training to all staff employed in enhancing their development but some staff have not provided evidence of their qualifications. Staff receives supervision enabling them to undertake their duties effectively. Service users should have adequate numbers of staff on duty to provide more opportunities for activities at the weekends. EVIDENCE: An examination of three staff training records indicated staff had yet to complete updated food hygiene training. At the time of publication of this report the manager provided confirmation that staff would be undertaking updated training during the first week in March 2006. Two members of staff did not have evidence of their qualifications for NVQ Level 2 & 3. The current manager stated one member of staff had been asked on a number of occasions to bring in their NVQ certificate and had so far still not brought it in. Since the last inspection all staff have been registered for training towards LDAF. The majority of care staff working in the service are qualified to NVQ Level 2 and above. The manager stated there had been a change with the training provider for challenging behaviour and physical intervention. The new training provider Team Teach is accredited with the British Institute for Learning Disabilities. There is currently one night waking support staff vacant. An examination of the staff rota indicated that the number of staff varied on some days from three to Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 18 two. As previously stated a member of staff commented that one service users had not been able to go to Church because of “staffing shortages”. The manager must ensure staffing levels are adequate during the weekend for service users to pursue particular interests during the evenings. The manager has introduced a communication board that shows the service users through the use of photographs of who is on duty each day and evening. Since the last inspection the manager has set up a schedule of staff supervisions ensuring these occur every six weeks. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41, 42 Service users live in a home that is run by a manager who is committed to improving practice. Improvements have been made with the organisation visiting the service every month but the reports for these do not provide enough evidence service users views are heard. Records are generally up to date and secure protecting the interests of service users. Service users interests have been safeguarded with reviews undertaken of the organisation’s policies and procedures. Service users health and safety is promoted and maintained but some improvements are required. EVIDENCE: The new manager has been in position since October 2005 and is qualified to NVQ Level 3 and A1 (NVQ Assessor Award) and has commenced training for the Registered Managers Award. He also is qualified in working with service users who have autism and challenging behaviour. An application has been made with the CSCI to be the registered for the service. The manager demonstrated a commitment in improving practice in the service and had addressed the majority of the requirements from the previous inspection. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 20 Since the last inspection improvements had been made in the frequency of the visits made by a representative from the organisation. The visits were occurring every month but there was little in the way of content confirming service users and staff were being consulted about how the service was being managed. Records were generally up to date and held in a secure facility. The manager has re-organised the storage of the staff recruitment records into structured files. Health and safety records were satisfactory and documented evidence was in place confirming the fire alarms were being tested every week and the emergency lighting every month. There was a risk assessment for the prevention of fire. A fire drill and fire training had occurred prior to this inspection. There is a folder in place with product data sheets for the storage and use of materials under COSHH Regulations. These were stored in an appropriate locked facility. There were fire evacuation procedures in place that were in a picture and symbol format. Records were being maintained for the water temperatures of the water outlets used by service users and the hot water tank had been tested for the prevention of Legionella. An examination of the accident book found six accidents had occurred since the last inspection. However, three of these had not been notified to the CSCI under Regulation 37. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 N/A 3 N/A 4 N/A 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 N/A 26 N/A 27 N/A 28 N/A 29 N/A 30 3 STAFFING Standard No Score 31 N/A 32 2 33 2 34 N/A 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 N/A 3 3 N/A LIFESTYLES Standard No Score 11 N/A 12 N/A 13 2 14 2 15 N/A 16 N/A 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 N/A 2 N/A 2 N/A 3 2 N/A Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1)(2) Requirement Timescale for action 01/04/06 2. YA13 3. YA14 The Registered Person must ensure service users care plans are reviewed to ensure any changes in individual circumstances are documented. This is Me person centred plans must be developed providing service users with their own individual plan. 16(2)(m,n) The Registered Person must 01/04/05 ensure service users have wider opportunities for activities during the evenings and weekend. Service users must be able to attend places of worship as part their programme of activities. 16(2)(m,n) The Registered Person must 01/04/06 ensure service users are given the opportunity to choose and arrange a holiday of their choice during 2006. The daily recording of service users must be more detailed in reflecting how service users spend their leisure time. Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 23 4. YA17 16(2)(1) Sch4(13) 5. YA20 13(2) 6. YA23 13(6) 7. YA32 18(2) 8. YA37 9(2)(b)(i) 9. A33 18(1)(a) 10. YA39 26(1) 11. YA42 13(4) 37(1)(f) The Registered Person must ensure the records of food eaten by service users during the week demonstrate service users are being offered a choice of meals. The Registered Person must ensure “as directed” medication prescribed by the GP must have specific instructions on how it should be administered. The Registered Person must ensure a written agreement is in place concerning the use of service users’ Motability Vehicle. This must be done in consultation with the service users, their family and social worker. The Registered Person must ensure staff provides evidence of their NVQ qualifications to go on their individual records. The Registered Person must ensure he provides confirmation that he has completed the Registered Managers Award. The Registered Person must ensure there is adequate staff on duty during the weekend to provide service users with a wider range of leisure opportunities. The Registered Person must ensure that the reports of the visits undertaken by a representative of the organisation provide more detail in comments from service users and staff. Outstanding Requirement. Timescale 4 September 2005 not met. The Registered Person must ensure any accident in the care home is notified to the CSCI without delay. 01/04/06 01/03/06 01/03/06 01/04/06 01/05/06 01/03/06 01/03/06 02/02/06 Noire House DS0000064613.V281616.R01.S.doc Version 5.1 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 Noire House DS0000064613.V281616.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Noire House DS0000064613.V281616.R01.S.doc Version 5.1 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!