Inspection on 15/08/06 for Orchardown Rest Home

This inspection was carried out on 15th August 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Orchardown Rest Home 09/10/07

Orchardown Rest Home 11/11/05

Orchardown Rest Home 01/04/05

Orchardown Rest Home 04/11/04

Orchardown Rest Home 29/05/04

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 Orchardown 4-6 Old Orchard Road Eastbourne East Sussex BN21 1DB Lead Inspector Gwyneth Bryant Unannounced Inspection 15th August 2006 08:00 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 Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchardown Address 4-6 Old Orchard Road Eastbourne East Sussex BN21 1DB 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) 01323 726829 Mrs Visnja Mazzoli Mrs Linda Clarke Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is seventeen (17) Service users accommodated must be older people aged sixty-five (65) years or over on admission. 11th November 2005 Date of last inspection Brief Description of the Service: Orchardown is registered to provide care and accommodation for up to nineteen older people who must be aged 65 years or over on admission. Both long term and respite care is provided. Nursing care is not provided. The home is situated close to Eastbourne town centre and railway station. The town shops, library, GP and dentist surgeries are within easy walking distance. The home is a large detached Edwardian house on three floors, with the upper floors accessible via a passenger lift. The home provides two lounges, one dining room and a conservatory looking out to the large rear garden that is well maintained and easily accessible to service users. Grab rails and toilet riser seats are provided throughout the home. Thirteen of the bedrooms have full en-suite facilities, however, en-suite baths are not used as risk assessments undertaken by the Manager found that their use is unsafe for staff. There remain sufficient bathing facilities to meet service users needs, including one assisted bath and a walk in shower. The service provides prospective service users with a copy of the homes brochure with a covering letter offering a visit. The service users guide, the statement of purpose and contract is provided as part of the pre-admission process. Copies of inspection reports and are made available if requested. The range of fees charged as from 1 April 2006 is from £336.96 to £460, which includes toiletries and in-house activities. Additional charges are made for hairdressing, chiropody, newspapers and dry cleaning. Intermediate care is not provided Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over seven hours. The purpose of the inspection was to check compliance with the requirements made at the last inspection and inspect additional standards. There were seventeen people in residence on the day of which six were spoken with. A carer, the manager, the registered provider, one relative and a visiting GP were spoken with. In addition three relatives were contacted via telephone following the inspection. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. Nine surveys were returned and all comments were positive about the standard of care given and this was confirmed by all those spoken with on the day. The only areas where comments were less positive were in respect of activities and this was discussed with the manager and the registered provider. Information was gathered from the pre-inspection information provided by the manager and from previous inspection reports. Comments in surveys included: ‘I was attracted by the homely atmosphere’. ‘it’s a very friendly atmosphere’. ‘very happy to be living here and feel all residents are well looked after’. ‘they (staff) are always happy to help’. ‘this is a lovely place to live in with lovely, kind, friendly and helpful staff’. Where shortfalls were identified or negative comments received, they were discussed with the manager and registered provider who both agreed to explore strategies for addressing them. The GP spoken with on the day was complimentary about the home and said ‘I think Orchardown is one of the best homes and I would be happy to place my mother here’. What the service does well: The atmosphere of the home was comfortable, open and relaxed and residents are encouraged to remain independent and to exercise choice over their daily lives. Satisfactory systems are in place to inform prospective residents of the services provided in the home. Care planning documents were accurate, up-todate and are regularly reviewed. Residents spoken with were happy and spoke positively about all aspects of the care given and all mentioned the quality of meals and the kindness shown by staff. The procedures for the ordering, administration and recording of medication are well managed. The Manager and the registered provider encourage both staff and residents to raise any concerns and action is taken as soon as possible. Staff supervision ensures the Manager is able to monitor good practice by staff and identify training needs. Of the twelve care staff, five have achieved National Vocational Qualification Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 6 (NVQ) in care at level 2 and four are in the process of gaining this qualification. There are satisfactory systems in place for dealing with complaints ensuring residents and visitors feel listened to. There are planned activities each Thursday and themed days are also arranged. The décor and furnishings within the home, including residents’ bedrooms are good. The gardens are attractive, well maintained and accessible to residents. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 7 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 Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 8 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 and 4. Standard 6 is not applicable Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory pre-admission assessments are carried out prior to residents moving into the home which ensure that their needs can be met and they are provided with detailed information on services provided by the home. EVIDENCE: The Statement of Purpose and Service Users Guide are regularly updated and contain all the information required so prospective residents are able to make an informed choice about where to live. Surveys returned confirmed that residents or their representatives received information on the services offered prior to admission. The one relative spoken to on the day also confirmed that the manager provided this information and that a pre-admission assessment took place at the same time. Pre-admission documentation was viewed for recent admissions and it is evident that these documents are used effectively to ensure the home is able to meet the needs of prospective residents. At the time of admission Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 9 information is sought from social and healthcare professionals to ensure all needs are clearly identified and planned for. Intermediate care is not provided and emergency admissions are avoided. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 10 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, and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning systems provide staff with clear direction as to how to meet all aspects of residents’ personal and health care needs and residents are protected by satisfactory systems for the recording, handling and storing of medication. EVIDENCE: Five care plans were viewed and it was evident that pre-admission assessments are used to inform the care planning process. Care planning documents included information on meeting residents’ healthcare needs such as dental, hearing and eyesight checks and also provided clear direction to staff as to how residents daily care needs are to be met. Throughout the inspection staff were seen to treat residents with care and respect. The one carer spoken with demonstrated that she is skilled in enabling residents to maintain personal standards. It was evident that this carer develops effective working relationships with residents that are based on mutual trust and respect. This carer was also knowledgeable about residents’ care needs and personal preferences which ensures their needs are identified and met in full. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 11 Surveys returned included comments such as: ‘Very caring staff’. ‘all the staff are very caring’. ‘I am well cared for and happy’. ‘We are very lucky to have such caring staff’. ‘we (mother & daughter) are very happy with level of care in Orchardown’. ‘…Nothing is too much trouble – I would not wish to be anywhere else’. ‘the staff are all very kind to me – put things back in their place so I can find them’. All relatives spoken with said that they felt the care was good and one said that staff make it seem that they give care as ‘friendship rather than a duty’. Satisfactory risk assessments have been carried out to ensure residents have the opportunity to make choices about their lives and remain as independent as possible. The GP spoken with confirmed that the home ensures prescriptions are renewed appropriately. He added that staff made good judgements in respect of when to access advice or a visit from GP’s and other healthcare professionals. Medication records and storage arrangements were viewed and systems remain effective. Medication administration charts were up to date, accurate and clear. Only staff who have been trained administer medication and staff were observed to be following good practice in respect of medication administration. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 12 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, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place for residents to experience a lifestyle that matches their expectations; choice and preferences in respect of both leisure and meals, but it would be of benefit to residents if activities were provided on a daily basis. EVIDENCE: The home provides in-house activities on Thursdays in addition to outings to local attractions, shopping, tearooms and to the theatre. The home also organises regular theme based events and residents are encouraged to invite family and friends to these events. Residents and relatives all said how much they enjoyed the theme based events as it gave them the opportunity to meet as a community. Comments in surveys included: ‘I would like more activities in the afternoon in Orchardown’. In addition a number stated that they would like activities each day and this was confirmed by those residents spoken with on the day. This was discussed with the manager, the registered provider and senior carer who agreed to use the next residents meeting to find out what activities they would like to be provided. This would be in addition to having casual activities such as the provision variety of board games being made available and allowing residents to chose any or all of them during the afternoons. Two relatives spoken with Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 13 said that more activities would be appreciated as there is a lack of daily stimulation and one said her relative would like the home to arrange for dogs to visit such as the ‘Pets as Therapy’ dogs as the residents enjoyed it when the manager brought in one of her own dogs. Another relative said more opportunity for a gentle walk or exercise would be appreciated. Relatives said they really enjoyed the theme based events as it allowed them to meet other relatives and feel more like a family. Care plans included residents personal preferences and there was evidence to show they are encouraged to exercise choice over all aspects of their daily lives. Those residents spoken with confirmed that they are encouraged and enabled to access the wider community within a risk assessed framework. Comments in surveys included: ‘the staff are always very welcoming to my visitors and the members of my large family’. ‘visitors are made to feel welcome’. Relatives spoken with confirmed that they are made welcome and always offered a cup of tea on arrival. One resident spoken with said they ‘felt like a prisoner’ as they could not go out. This was discussed with the manager and registered provider who explained that the person is newly admitted. They said that this person has particular healthcare needs and it will be necessary to seek further information from this persons’ consultant before the resident could go out unaccompanied. Residents are encouraged to eat in the communal dining room but may eat in their rooms if they wish. Menus were viewed and found to be varied and balanced. A choice of lunchtime meal is routinely offered and salads are also available every day. Supper menus are planned but residents’ may have many different choices based on their preferences. The home maintains a record of residents’ meals to ensure nutritional intake is monitored. Comments in surveys were variable and included: ‘Food has improved’. ‘meat is always too tough – more variety/fresh veg’. ‘food often overcooked’. ‘the staff go to great trouble preparing the meals for me – cutting up the meat and explaining the menu’. Relatives spoken with said that the food was good and enjoyable and residents spoken with confirmed that the food is always good and on the day one resident arranged for the chef to prepare her a packed lunch and to reserve a hot meal for her as she intended to be out for the day. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 14 The home subscribes to an organisation that provides a range of information and support to ensure residents’ autonomy is protected and enhanced. This includes information on advocacy to ensure they have to opportunity to have their views listened to. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 15 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that residents feel that their views are listened to and acted upon and residents are further protected by satisfactory adult protection systems. EVIDENCE: The home has detailed policies and procedures on complaints and the homes complaint book showed that the last complaint was in 2004. All surveys returned stated that the writer knew whom to speak if they had any concerns and that they knew how to make a complaint. Those people spoken with on the day all agreed that generally, they had no reason to complain. Relatives spoken with all agreed that they knew whom to contact if they needed to complain but so far they ‘had nothing to complain about’. The home has detailed policies and procedures on adult protection and all staff have been trained in adult protection procedures. The manager has responded appropriately to an adult protection issue that was identified in the home and has taken the necessary action to protect residents and the issue is being addressed under adult protection procedures. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of decor within the home is good, and all areas are homely, safe and comfortable for residents. EVIDENCE: A tour of the premises was carried out and all parts of the home are well maintained and décor is good. Residents’ rooms were attractively decorated and it was evident that many had taken the opportunity to personalise their rooms with pictures and ornaments. There is an on-going maintenance programme to ensure the home remains in good repair so ensure it remains an attractive and comfortable place for residents. One relative said that they were impressed as the home replaces furniture and beds to ensure the home always looks good. The gardens are attractive and well maintained and all residents spoken with said how much they enjoyed taking walks in the garden or just sitting in the sun. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 17 Laundry facilities are clean and hygienic. Systems are in place for the control of infection and all staff have been trained in this area and were observed to be working in ways that minimised the risk of infection, by wearing gloves and aprons when required. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 18 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, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of staff and the skill mix is such that residents’ needs are met and consistent care is provided. The recruitment practice is robust and provides sufficient safeguards for the protection of residents. EVIDENCE: There is one senior carer and two other carers on duty each morning and two for the afternoon and evening shifts and one night waking staff. In addition cooks, domestics, laundry staff and gardeners are employed. The manager and the registered provider share the ‘on call’ duties. Surveys returned stated that there always seemed to be sufficient staff on duty and only one included the comment: ‘occasionally I have to wait for a member of staff to be available and have time for me’. Relatives spoken with all said they felt there were enough staff and that they had no problems finding staff if they needed to speak to them. Pre-inspection information from the manager indicates that staffing ratios are sufficient to meet residents assessed needs and this information also confirmed that five staff have achieved National Vocational Qualification level 2 or above, in care, and the home is on target to ensure 50 of staff achieve this qualification by 2007 as four other carers are in the process of gaining NVQ 2. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 19 Evidence was available to demonstrate staff also received additional training in infection control, manual handling, emergency first aid, health and safety and the safe handling of medication to ensure they are sufficiently skilled to meet residents’ needs. Recruitment records were viewed and it was found that all staff had provided the required two written references, satisfactory identification and all other documents as required. Protection of Vulnerable Adult first checks are carried out for all new staff and they do no work unsupervised until a satisfactory Criminal Records Bureau check is received. Satisfactory induction and foundation training programmes are in place and implemented for all new staff. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 20 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, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and residents benefit from clear leadership and direction and all aspects of residents’ health, safety and welfare are protected and promoted. The introduction of formal quality assurance and quality monitoring systems would enable to provider to objectively evaluate the service. EVIDENCE: The Manager has been managing the home for a number of years and has satisfactory care related qualifications in management. She has now enrolled on an NVQ Level 4 course in care to ensure she fully meets the regulations. In the interim she has undertaken a wide range of courses including managing complaints, conflict management, supervision and appraisal, health and safety, developing care plans, employment practice, improving financial performance Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 21 and presenting your business each of which enables her to improve on all areas related to managing the home. Residents’ meetings are carried out regularly to enable them to be consulted, as are staff via staff meetings. In addition to regular staff meetings a ‘hand over’ is carried out at the end of each shift. It was clear that these sessions are used as an effective means of verbally communicating residents daily care needs and that staff were familiar with the needs of each resident. Residents are responsible for their own finances if appropriate; relatives and solicitors support others, while the home does not handle the financial affairs of residents. When items are purchased on behalf of residents, receipts are obtained and satisfactory records maintained. Staff supervision records were viewed and it is evident that these sessions are used effectively to identify training needs and ensure good care practice is maintained. Pre-inspection documentation provided by the manager showed that all health and safety checks are carried out regularly including fire drills and servicing of gas and electrical appliances. All staff have been trained in fire safety and manual handling to ensure both residents and staff are protected. Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 X 3 3 X N/A 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 X 3 3 X 3 Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 23 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 OP12 Regulation 16 (2) (mn) 24(1ab) (2)(3) Requirement That a daily programme of activities based on service users preferences be devised and implemented. That formal quality monitoring and quality assurance systems be created and implemented. (timescale of 11/02/06 not met). Timescale for action 15/09/06 2 OP33 15/09/06 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 Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Orchardown DS0000021181.V296190.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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