CARE HOMES FOR OLDER PEOPLE
Oak Lodge Rectory Lodge Oakley Basingstoke Hants RG23 7EL Lead Inspector
Marilyn Lewis Unannounced 30 June 2005 09:30 a.m.
th 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. 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. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Oak Lodge Address Rectory Road Oakley Basingstoke Hampshire RG23 7EL 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) 01256 780222 01962 782377 Forest Care Ltd Mrs Sarah M McColl CRH 41 Category(ies) of OP Old age PD(E) Physical disability - over 65 registration, with number of places Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 18th January 2005 Brief Description of the Service: Oak Lodge is a care home providing nursing care for forty one persons over sixty five years of age and those of that age who have physical disabilities. The home is one of two homes owned and operated by Forest Care Limited. Oak Lodge was opened in 1995 and the establishment forms part of a large Georgian Manor House with conference facilities. It stands in extensive grounds in Oakley, on the outskirts of Basingstoke, Hampshire. Residents are acommodated in thirty five single rooms and three double rooms sited over three floors. Two passenger lifts and stairs allow access to all areas of the home, including a large lounge, small lounge for smokers and a conservatory. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six hours on the 30th June 2005. The inspector toured the home and had the opportunity to speak to seven of the thirty- nine residents, a visiting relative, three care staff, the administrator, temporary cook and the activities co-ordinator. The registered manager assisted the inspector with the inspection process. Care plans were sampled for four residents and personnel records for three staff members. Records were also seen for medicines, accidents, fire and staff training. Service users living at Oak Lodge prefer to be known as residents and this has been respected in this report. The registered manager Mrs McColl is known as the Matron of the home and this is the title given to her in the report. What the service does well:
Residents are only admitted to the home following a full care needs assessment and they and their relatives have the opportunity to visit the home, prior to admission, to ensure the home can meet their needs. Staff follow good procedures for dealing with medicines and residents, where appropriate, are supported to administer their own medication. Residents are treated with respect and their right to privacy is upheld. The home has an interesting and varied activities programme and are supported by an enthusiastic activities co-ordinator. Residents feel able to exercise choice and keep control over their lives. Meals provided offer choice and a well balanced diet, with menus developed following discussion with residents. Residents and their relatives know how to complain and are confident any complaints made will be taken seriously and acted upon. Residents live in a well-maintained, comfortable environment with sufficient bathroom and toilet facilities, homely communal rooms and pleasant, personalised bedrooms.
Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 6 The courtyard and gardens are attractive with many window boxes and containers of summer flowers. All areas of the home are extremely clean and in good order. Strong leadership and trained and supervised staff provide residents with a good staff team that is able to meet their needs. The homes’ robust recruitment procedures protect the health, safety and welfare of the residents. Residents and their relatives benefit from the open ethos and management approach of the home. What has improved since the last inspection? What they could do better:
The service user guide lacks all the information required to allow prospective residents and their relatives to make an informed choice about admission to the home. Individual care plans seen did not reflect the current needs of the residents in all aspects of care. Residents’ safety could be compromised by fire doors being wedged open.
Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 5 No one is admitted to the home without a full care needs assessment and prospective residents and their relatives are able to visit the home prior to admission to ensure the home can meet their needs. However although the home has a clear statement of purpose the lack of relevant information in the service user guide could mislead people as to the services provided. EVIDENCE: The home has a good statement of purpose that provides clear information on the services and facilities provided. However the residents guide states that the home is able to admit people with mental incapacity and this is not reflected in the homes’ registration. The guide also needs to include the size of the bedrooms, the experience of the matron and current qualifications of staff members. Residents are provided with a clear contract outlining the terms and conditions for residency at the home. The contract includes the services covered by the fees and documents services that are provided at an additional cost such as hairdressing, newspapers and dry cleaning.
Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 10 A full needs assessment is undertaken for all residents prior to admission. The assessment is undertaken by the matron or deputy matron and is conducted in the prospective residents’ home or place or residency. The assessment includes all aspects of personal, emotional and social care needs and relevant information from care managers and health professionals is included in the assessment report. The matron said that relatives are encouraged to participate in the assessment process and if unable to be present are updated via telephone conversations and during visits to the home prior to their relatives admission. Residents and their relatives are able to visit the home prior to admission which is for a trial six week period that can be extended if necessary. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 and 10 Residents are treated with respect and their right to privacy is upheld but lack of some relevant information in the individual care plans could put residents’ health and welfare at risk. Staff follow good procedures for dealing with medicines and residents, where appropriate, are supported to administer their own medication. EVIDENCE: Care plans were sampled for four residents. The plans were detailed and included notes of the residents’ preferences for participating in daily living activities such as wishing the curtains left open at night and food likes and dislikes. The care plans contained risk assessments including those for falls, pressure areas and nutritional needs. The plans were in a generic format that required personalising for the individual resident and in some areas this had not been completed for example one plan stated that pressure care was as planned but the plan did not provide the information required to support those needs. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 12 Staff follow good procedures for dealing with medicines. Medication records seen were up to date and had been completed appropriately. Records checked for controlled medicines matched the stock held. Staff received training on the administration of medicines and up to date information on medicines used in the home was readily accessible. Procedures are in place for one resident who has been assessed as able to self administer her own medication and a lockable storage space is provided in her room to store the medicines. On admission residents are given a copy of the charter of rights for residents. The charter is based on the rights for choice, privacy, independence, dignity and fulfilment. It was evident during the inspection that residents were treated with respect and their right to privacy was upheld with staff knocking on doors and waiting before entering rooms. One resident remarked on her pleasure at ‘being able to organise my own life’ Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and15 Residents are able to exercise choice and control over their lives and are able to participate, as they wish, in a good programme of varied and interesting activities. Menus have been developed following consultation with residents who are able to choose from a selection of balanced, well presented meals enjoyed in pleasant surroundings. EVIDENCE: The home employs an enthusiastic activities co-ordinator who has developed a good programme of activities suitable for the residents. During the morning of the inspection some residents were busy making greeting cards and there were paper flowers in the lounge that residents had made recently. The programme includes exercises and games, bingo, sing a long, painting, quizzes and crafts. One resident commented on ‘how very, very good’ the activities co-ordinator was in developing new ideas and projects for them. The activities programme was displayed around the home and care plans seen indicated that staff remind the residents of the activities taking place in the day. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 14 Ministers from local churches visit frequently and a service is held once a month for those wishing to attend. A group of ladies from the Methodist church visit on a regular basis to chat to residents. The matron said that two outings had been arranged for residents to visit coastal resorts. Visits werealso made to the theatre and other places of interest chosen by the residents. On the day of the inspection two residents were going out for lunch at a local restaurant. Residents commented on their enjoyment of the summer fete held at the home in the previous week. The registered manager said that funds raised were going to be used for the arranged outings and other leisure activities. A visiting relative said that she was always made to feel welcome at the home and could visit at any time. It was evident during the inspection that the residents were able to exercise choice and control over their lives. While some residents chose to work on crafts, others spent time quietly reading a daily newspaper, chatting or being attended to by the hairdresser. One resident said that ‘he appreciated being able to spend time alone in his room’ and another said that ‘it was good to be able to spend time quietly in the morning and join the activities during the afternoons’. Residents were able to choose where to take their meals with the majority joining together in the dining room for lunch but some preferring to take their meals in their own rooms. The home employs a cook for Monday to Friday and another for the weekends. During the evenings, light suppers are prepared by kitchen assistants. At the time of the inspection the main cook was on leave and a temporary cook was working at the home for two weeks. He was aware of the residents dietary needs and their preferences for food items. The menus looked varied and balanced with choice available for all meals. Meals for the day of the inspection started with a choice of cereals, porridge, toast, poached/boiled egg and a cooked breakfast. Lunch was Lasagne or sausages, sauted potatoes and fresh coleslaw with fruit sponge and jam sauce for pudding. Bowls of fresh fruit were available in the dining room. The cook said that residents preferred a light supper with lentil soup, mackerel and sandwiches on the menu for the evening followed by strawberry mousse. Choice for supper was available and some residents frequently requested poached egg or cheese on toast. During lunch on the day of the visit many of the residents took their meal in the pleasant dining room. All the residents spoken to said the food provided was good. Meals served were well presented and looked appetising. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 15 However, eight comment cards received by the Commission from residents indicated that they only sometimes enjoyed the meals provided. This was discussed with the matron who said that changes had recently been made to the menus following comments made by residents, with one example being the increase of scampi on the menu as it was a particular favourite of the residents. On the day of the inspection two residents said that the food had improved recently. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 17 Residents’ legal rights are protected and they and their relatives know that complaints will be listened to and acted upon. EVIDENCE: The home has a complaints procedure in place that indicates who will investigate the complaint and timescales for the process. It was evident from the records that all complaints are taken seriously. Two residents spoken to said that they knew how to make a complaint and felt it would be acted upon by the registered manager. A visiting relative was also aware of the procedures but said there had been no reason to complain. The matron said that all the residents were on the electoral roll and many had participated in the general election earlier in the year by using the postal voting system or visiting the local polling station. Advocacy services, when required, are normally accessed through the residents’ care manager or solicitor. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 Oak Lodge provides specialist equipment as required and a clean, well maintained environment that has comfortable communal rooms, personalised bedrooms, sufficient bathroom and toilet facilities and attractive outdoor areas for all those living and visiting the home. EVIDENCE: Oak Lodge provides accommodation for forty- one residents who require nursing care. The home forms part of a large Georgian Manor House standing in extensive grounds. An area of the Manor House is used as a conference centre and connecting doors between both establishments are designed so as not to allow people visiting the conference centre to enter the home other than through the main entrance to the home. The main entrance has a keypad entry system to ensure staff are aware of visitors to the property. All visitors are required to complete the visitor record book on entering and exiting the building.
Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 18 The main entrance to the home is accessed via a courtyard, which at the time of the inspection looked very attractive with many window boxes and containers of summer flowers in place. A variety of seats are available for residents in the courtyard area and on the patio at the rear of the property. The home has a large lounge and conservatory. Since the last inspection an area of the lounge has been separated to provide residents with a smoking room. This has worked well as at the time of the last visit some residents felt uncomfortable with smoking allowed in the conservatory where many of the activities take place. The smoking room would however benefit from a larger extractor fan as the room could get very smoky in poor weather when the windows could not be opened to allow additional fresh air into the room. Small sitting areas are sited on each of the three floors of the home to provide quiet areas for residents and their visitors. Vases of flowers were sited throughout the corridors and hallway of the home making the home look cheerful and homely. The home has sufficient suitable bathroom and toilet facilities and all bedrooms have en-suite hand basin and toilet facilities. Specialist equipment including hoists are provided for residents assessed as requiring them and grab rails and ramps are sited where needed to allow residents to be as independent as possible. Two passenger lifts and stairs allow access between floors. The home has thirty- five single rooms and three shared rooms. Residents in shared rooms are satisfied with their rooms and were aware they would be sharing prior to moving into the home. One shared room is occupied a husband and wife. A resident in one room said that she had been offered the opportunity to move to a larger room when one became available. All residents spoken to said that they liked their rooms. Many of the bedrooms have large windows that provide pleasant views over the homes’ extensive grounds and the surrounding countryside. Residents are able to bring personal belongings into the home and bedrooms seen contained many personal items such as pictures, ornaments and small items of furniture, including televisions and audio equipment. Residents are able to have a private telephone in their rooms if they wish so that they can make calls in privacy. The home is centrally heated with radiators covered for safety. The radiators are thermostatically controlled allowing the resident to control the temperature of their own room. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 19 All areas of the home looked extremely clean and it was evident when the inspector spoke to the two domestic staff that they took great pride in keeping the home so clean and tidy. Staff, including the domestic staff, receive training in infection control and disposable gloves and aprons are readily available throughout the home. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 20 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The homes’ robust recruitment procedures, good staff training programme and flexible approach to the number and skill mix of staff on duty at any one time ensures residents’ health, safety and welfare are protected. EVIDENCE: At the time of the inspection rotas seen indicated that a sufficient number and skill mix of staff were on duty during the day and evening. The matron said that when forty- one residents were in the home or a resident was poorly, a second trained nurse was required for the night duty. This was based on the number of residents, their care needs and the layout of the home. At present there are thirty-nine residents at the home. The home employs separate administration, catering and domestic staff. The home has robust recruitment procedures in place and records seen for contained all the information required including proof of identity and two written references. Checks are made with the Criminal Records Bureau before an employee can commence work at the home. All staff have received training in moving and handling, fire safety and infection control. Sixteen of the thirty- three staff members have attended sessions in wound care and eighteen have attended training for dementia care with three more currently receiving training. Twenty seven staff have completed first aid training and trained staff have also attended sessions for care planning.
Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 21 Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 34, 35, 36 and 38 Strong leadership and regular supervision supports staff to meet the needs of the residents, who benefit from the open ethos approach operated at the home. The homes’ clear financial procedures safeguard residents’ financial interests. Training in safe working practices, secure storage of hazardous substances and recording of all accidents promotes and protects the health, safety and welfare of the residents and staff. However safety in the home could be compromised by the wedging open of fire doors. EVIDENCE: The matron is a trained nurse with many years experience in providing nursing care. She is currently studying for the Registered Managers Award and has recently successfully applied for registration with the Commission.
Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 23 The matron operates an open door policy and staff, residents and a visitor spoken to, all said they felt able to approach her at any time. General meetings for all staff are held three monthly at a time most convenient for staff members. The trained nurses meet frequently. A staff meeting was due to be held later in the day and the matron said she was going to use the meeting as an opportunity to praise the staff for the good work undertaken in the last few months. Meetings for residents are also held three monthly and more often if residents wish to discuss issues arising between the set dates. All meetings are minuted and minutes made available to the interested parties. The homes’ administrator is responsible for the day to day financial accounts of the home and the records are then passed to external accountants. Records are kept of all transactions. A current certificate for employers liability insurance was displayed in the main entrance of the home. The matron said that the residents handled their own financial affairs or were assisted by their relatives. Small amounts of residents’ monies are kept securely on the premises. Monies are held individually and records checked for two residents matched the amount held. The matron, deputy matron and senior trained staff support staff members through regular supervision meetings. The supervision sessions are recorded and are signed by both parties. The matron said that staff are able to choose which staff member they wish to be the supervisor. All accidents in the home are recorded and accident forms seen had been completed appropriately. Records seen indicated that all staff had received fire safety training and had attended fire drills in the last year. Three fire doors were seen wedged open during the inspection visit. The registered manager should seek advice from the Fire Safety Officer with regard to the risk of wedging open fire doors. During the tour of the home it was noted that hazardous substances were stored securely in locked cupboards. The kitchen was clean and in good order with food stored appropriately and the temperatures of fridges and freezers monitored and recorded. There were no requirements made following an inspection of the home by a health and safety officer in February 2005. Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 3 x 3 3 3 x 2 Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 25 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 OP1.2 Regulation 5 (1) Requirement The service user guide must inform prospective residents of the services provided at the home, including the catergory of person to be admitted to the home, the experience of the registered manager, current qualifications of staff and the number and size of rooms in the property. The individual care plans must reflect the current needs of the resident and the support required to meet those needs. The registered person must ensure fire doors are not wedged open. Timescale for action 31/07/05 2. OP7.2 15 31/07/05 3. OP38.2 13(4)( c ) 01/07/05 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 Good Practice Recommendations Oak Lodge H54 S11655 Oak Lodge v228363 300605.doc Version 1.30 Page 26 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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