Inspection on 19/10/05 for Oakhurst Grange

This inspection was carried out on 19th October 2005.

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

The inspector 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

Oakhurst Grange 27/03/08

Oakhurst Grange 14/06/06

Oakhurst Grange 27/05/05

Oakhurst Grange 07/10/04

Oakhurst Grange 26/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Oakhurst Grange Goffs Park Road Crawley West Sussex RH11 8AY Lead Inspector Mrs L O`Donnell Unannounced Inspection 19th October 2005 09.00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oakhurst Grange Address Goffs Park Road Crawley West Sussex RH11 8AY 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) 01293 536481 01293 612452 BUPA Care Homes (CRHCare) Limited No. 2741070 Post Vacant Care Home 120 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30), of places Physical disability (30), Physical disability over 65 years of age (30) Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons accommodated in any of the categories should not exceed 30. 27th May 2005 Date of last inspection Brief Description of the Service: Oakhurst Grange is a care home registered to provide nursing care for up to 120 Service Users aged 65 years and over, 30 of whom may have dementia. The home was purpose built and consists of four separate 30-bedded houses, Copthorne, Charlwood, Balcombe and Rusper. Each house is single storey and each has its own garden area. Copthorne, Charlwood and Balcombe provide general nursing care and Rusper house provides nursing care for people with dementia. There is a further building which houses the reception area, administration offices, laundry and kitchen facilities. Each of the homes has a senior team leader. The post of Registered Manager is currently vacant, however the Commission is currently processing an application for a newly appointed manager to the home. The home is situated within a residential area, close to the town centre of Crawley. The Registered Provider of the home is BUPA. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Inspection involving three inspectors and a pharmacy inspector. This was the same team of inspectors who had undertaken the last inspection in May 2005. The focus of this inspection was again on the health and personal care needs of the residents and how these are met as this was an area of serious concern at the last inspection. At the time of the last inspection the home was failing to meet the majority of national minimum standards relating to health and personal care, and the findings of a long and detailed adult protection investigation had also demonstrated poor working practices. The Registered Providers were served with three enforcement notices and a condition was imposed on the registration of the home preventing further admissions until all of the concerns had been addressed and rectified. In order to monitor compliance with the enforcement notices and imposed condition three additional visits have been made to the home on 17 June 2005, 15 July 2005 and 8 September 2005. Two meetings have also been held with the Registered Providers. In addition both West Sussex Social and Caring Services and Crawley PCT have undertaken full reviews of the residents at the home. During the first two additional visits it was noted that progress was being made towards meeting the requirements of the enforcement notices. By the third additional visit in September considerable progress had been made and it was considered that all of the requirements had been met. Over the past six months the Registered Providers have put considerable resources into improving the standards of care at the home. At this inspection all standards relating to all aspects of residents care were assessed as being met. During this inspection the Inspectors spoke with residents, visitors and staff and reviewed a variety of records. All residents spoken with were generally happy with their care. The majority of visitors were happy with the standards of care provided by the staff team. Residents were observed to be relaxed with the staff. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 6 What the service does well: What has improved since the last inspection? Appropriate procedures are now in place to ensure that pre admission assessments are carried out appropriately and effectively. The Registered Providers demonstrated throughout the inspection that they are able to meet the assessed needs of the residents. The care planning process has been fully reviewed and individual care plans are in place for all identified needs. The health care needs of residents are monitored and met. Residents consider that the staff treat them respectfully and that their privacy is upheld. Activity provision has increased with a variety of recreational activities available within each of the houses. A varied diet is provided and the nutritional needs of residents are closely monitored. A range of new equipment has been provided throughout the home. Competency assessments of all nursing and senior staff have been undertaken and training and supervision provided if identified as necessary. All staff now receive formal supervision. A staff training and development programme has been established. An experienced manager has been appointed and her application to register as manager of the home with the Commission is currently being processed. A thorough audit and monitoring system is now in place. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 7 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. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 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 the following standard(s): 1, 3, 4 Adequate information about the home and services offered is available to prospective residents. Suitable policies and procedures are in place to assess the needs of prospective residents. The needs of current residents are being met within the home. EVIDENCE: Information about the home is currently contained within a brochure which is available to any prospective residents and/or their representatives. This contains adequate information about the home. Due to all of the recent changes and improvements at the home a revised Statement of Purpose and Service User Guide are in the process of being produced and formalised. It is anticipated that these documents will be Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 10 available shortly and the Registered Providers have agreed to forward copies to the Commission as soon as they are completed. No new residents have been admitted to the home over the last six months and therefore this standard could not be fully assessed. However during the last additional visit to the home on 8 September 2005 the policy, procedure and forms to be used for pre admission assessments were seen and discussed with the Registered Providers and the Inspector was satisfied that this process, if followed, would provide full details of the personal, health and social care needs of any prospective resident. Through discussions with residents, relatives and staff and through records seen the Inspectors were satisfied that the current assessed needs of residents were being met. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10 All residents have a detailed plan of care in place which sets out their health, personal and social care needs. Health care needs of residents are monitored, met and maintained. Residents are protected by the policies and procedures in place for the administration of medication Residents advised that they felt that their privacy and dignity was respected. EVIDENCE: It has been evident throughout each of the additional visits made to the home that progress has been made within the care planning process. During the last additional visit in September a sample of care plans were seen and these provided detailed information on the assessed needs of the residents. Whilst it was noted that all residents do have a care plan in place, during this inspection the care plans of three residents were reviewed in each of the houses. All of the care plans seen provided detailed information as to the Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 12 assessed needs of the residents and covered health, personal and social care needs. Risk assessments were included within the care plans. It was demonstrated that relatives are invited to be involved in the reviewing of care plans. Although it was not always clear as to how residents were supported to be a part of this process. The care plans seen were generally well documented with new or revised care plans initiated when individual needs changed. However some inconsistencies were noted and these were discussed with the Registered Providers during the return visit to the home. Personal care needs are recorded within the care plans however the Inspectors considered that these would benefit from further information being recorded to ensure care is given in the way individual residents prefer with clear guidelines as to the support and assistance required by staff. However it was demonstrated during the additional visit in September that care planning, risk assessment and recording of information form part of the competency assessment of staff, and ongoing staff supervision and the Inspector is confident therefore that these issues will be addressed. There are individual plans of care in place for assessed health care needs. It was evident that care staff monitor the health of individual residents, with any changes being reported to the nursing staff who in turn liaise with doctors or other health care professionals as necessary. Any visits by other health care professionals are recorded along with the outcome of these. The Inspectors considered that further information should be included in some care plans to assist all staff in monitoring certain health care needs i.e. information relating to catheter care, details of symptoms of urinary tract infections. Records are kept of the incidence and treatment of pressure sores. Consent to photograph any wounds is obtained to assist in the monitoring of the treatment. This information is currently kept within the care plan and this was discussed with the Registered Providers and it was agreed that this would be reviewed and improved to ensure the privacy and dignity of residents was upheld. Equipment identified as necessary for the promotion of tissue viability is obtained. This should be kept under review to ensure that appropriate equipment is in place i.e. it was noted that some divan beds are being used with pressure relieving mattresses. Nutritional screening and monitoring has greatly improved with care plans in place supported by monitoring forms being used to record food and fluid intake, where necessary. Consistency in the forms used was noted as having Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 13 been an issue, however the Registered Providers were aware of this and the correct current forms to be used are now in each house. Procedures for pain management are in place and it was noted that forms are being used to provide appropriate information for staff. However it was noted that different formats were being used throughout the individual houses and this was discussed with the Registered Providers who are to review and ensure consistency. The pharmacy Inspector reviewed the administration of medication in each of the houses and it was noted that the home demonstrated good working practices. A risk assessment had been completed for a resident who self-administered some of her medicines. Records of receipt and administration were recorded on printed charts supplied by the pharmacy. Times of administration of when required medicines were recorded. However staff were unaware of current guidance for disposal of medicines. A staff member advised that it sometimes took up to an hour and a half to complete a medicine administration round. An oral syringe designed for one medicine was being used for another. The Registered Provider should ensure that each of these issues is addressed. Residents when asked considered that their privacy and dignity was respected by staff. Staff were very clear about their responsibilities and how they ensured that the privacy and dignity of residents was maintained. Observations made on the day supported this. However there was one incident in which the Inspectors considered that the privacy and dignity of one resident was compromised and this was raised with the Registered Provider. The majority of residents and relatives spoken with were happy with the care provided. Where any issues or concerns had been raised changes and improvements had been recognised and it was hoped would continue. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Opportunities for social and recreational activities within the home have improved. Further development should be undertaken to ensure that the social care needs of all residents are recorded and met. Residents are able to have visitors at any reasonable times. A varied diet is provided and the nutritional needs of residents are monitored and met. EVIDENCE: At the time of the additional visit in September a third activities co-ordinator had been employed at the home and a weekly programme of activities for each of the houses had been produced. At this inspection it was confirmed that as one of the houses will shortly close for the foreseeable future, one activities co-ordinator has been allocated to each of the other three houses. This has resulted in greater activities input into each of the houses. The range of activities has increased, demonstrated through the weekly programme and through discussions with residents and staff. Group activities Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 15 include ball games, music and singalongs, reminiscence, church services, board games and bingo. In addition time is allocated for one-to-ones. During the inspection care staff were also observed to participate in activities. Within the care plans seen it was noted that that individual social care needs and personal preferences have been recorded. Through these it was evident that further development of activities is necessary to ensure that all assessed needs are provided for within the activities programme. Both residents and relatives confirmed that visitors to the home are welcomed at any reasonable times. It was observed during the inspection that residents are able to see their visitors in private. Menus seen during the inspection showed that a variety of meals were served and that residents had a choice of meals. All residents spoken with confirmed that the food served was generally good. Where nutrition is identified as a care need there are monitoring charts in place and residents weight is monitored. Since the last inspection nutrition training has been introduced for all staff. A second chef has been appointed and the kitchen hours have been extended. In addition a separate snacks menu is available for residents to choose from between 7pm and 7am. The meals for each day are displayed within the dining areas of each house and mealtimes were observed to be relaxed with staff available to provide appropriate assistance as required. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 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 the following standard(s): 16, 18 There is a complaints procedure in place and records show that complaints have been dealt with satisfactorily. Residents are protected from abuse. EVIDENCE: Each house maintains a record of any complaints received which are collated by the Registered Provider. Of the complaints seen all had been resolved satisfactorily. The majority of relatives spoken with did not have any issues or concerns but advised that they would be happy to raise any issues with the staff team if necessary. Any ongoing issues are monitored by the Registered Provider who has established regular meetings with a relative to aid communication. Training in adult protection and abuse awareness has been provided by West Sussex Social and Caring Services. All staff spoken with were aware of their responsibilities under the adult protection procedures. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 17 The findings and concerns raised by the adult protection investigation and included within the last inspection report have been addressed by the Registered Providers. This is supported and demonstrated by the improvements and changes made within the home as observed during this inspection. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 26. The location and layout of the home is suitable for its stated purpose. Residents are able to access both internal and external communal facilities. Specialist equipment is obtained for residents when a need is identified. The home is clean and hygienic and systems are in place to control the spread of infection. EVIDENCE: Since the last inspection large parts of the home have been redecorated. In particular there have been a number of environmental improvements made within the house providing dementia care. There are accessible garden areas for each of the houses. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 19 Each of the houses has a lounge, sun lounge and dining area with suitable furnishings. A full audit of equipment within the home has been undertaken and since the last inspection a range of new equipment has been provided where a need has been identified. Where specific equipment is used this is risk assessed and this information is kept within the care plan. Where necessary consent has been sought from the residents representatives. It was noted that in some cases pressure relieving mattresses are placed on divan beds and this should be kept under review to ensure that this is appropriate and meets the needs of both residents and staff by enabling safe working practices. A variety of hoists are available in each of the houses however some staff did advise that on occasions they have had to wait for a particular hoist if it was already being used. This reflects the importance of keeping the audit of equipment under review. At the time of the inspection the home was found to be clean and tidy and there are procedures in place in respect of infection control. Staff were aware of their responsibilities in infection control and were observed to use protective clothing as necessary. Some staff advised that they had identified a need for additional protection clothing but had not yet received this. This was raised with the Registered Providers who are to address this issue. A new type of lock has been fitted to the bedroom doors within the dementia care house. However staff and a relative raised concerns with the new system. This was discussed with the Registered Providers who are to review and risk assess on an individual basis. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 30 The needs of the current residents are being met by the current staffing levels. However this should be kept under review particularly as the number of residents increases. A staff training and development programme is now in place and a range of training has been undertaken. EVIDENCE: At the time of inspection the staffing levels within each of the houses was six staff (including two trained nurses) from 8am – 2pm, five staff (including two trained nurses) from 2pm – 8pm and then three staff (including one trained nurse) for the night shift. The dependency levels of all residents are kept and reviewed regularly. A high percentage of the staff on duty were spoken with during the inspection. Staff generally felt that staffing levels were not appropriate and that staffing levels could be improved, particularly care staff levels at busy times of the day. It was also noted that although the dependency levels within the houses differed the staffing levels within the houses were the same. This should be reviewed and addressed by the Registered Providers. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 21 During the additional visit in December it was clear through records seen that a detailed competency assessment had been carried out with all senior and nursing staff within the home. This was seen to cover all aspects of their role and responsibilities, including care planning, meeting health care needs and staff supervision, with objectives set and monitored. Ongoing supervision has assessed the percentage achievement against each objective set with additional training as identified. In addition formal supervision is now in place for all staff and it was clear that the training programme being developed for staff linked directly with the training needs identified through the supervision process. A new assistant manager has also been appointed to the staff team and he has had the responsibility of setting up the staff training and development programme. An overview of all staff training has been produced and this shows that a programme of training including moving and handling, fire safety, first aid, food hygiene and infection control has been implemented. Records showed that the training planned for the next two months included further courses in the above training areas and in addition to these, pressure care, wound management and management and prevention of strokes. Through records seen and discussions with staff a need for training in specific conditions i.e. diabetes, MS and other conditions specific to the care of the elderly was identified. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 36 The Commission is currently processing an application for the post of Registered Manager. Staff are now receiving regular formal supervision. EVIDENCE: At the time of inspection the post of Registered Manager was vacant. However the person in charge at the time of inspection has submitted an application for registration to the Commission which is currently being processed. She is already registered with the Commission as the Registered Manager for another home and has a number of years experience. She has been present at the home during the last few months and has been involved in the changes and improvements made. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 23 All staff now receive regular formal supervision which is recorded. Mention has already been made of the competency assessments carried out with senior and nursing staff and this is ongoing. Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X X Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Oakhurst Grange DS0000024184.V258929.R01.S.doc Version 5.0 Page 27 - 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!