Inspection on 24/01/07 for Pepenbury

This inspection was carried out on 24th January 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pepenbury 16/07/09

Pepenbury 17/07/07

Pepenbury 21/02/06

Pepenbury 05/10/05

Pepenbury 27/01/05

Pepenbury 29/06/04

Pepenbury 19/06/03

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Pepenbury Cornford Lane Pembury Tunbridge Wells Kent TN2 4QU Lead Inspector Ruth Burnham Key Unannounced Inspection 24th January 2007 09:30 Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 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 Pepenbury DS0000023975.V303332.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pepenbury Address Cornford Lane Pembury Tunbridge Wells Kent TN2 4QU 01892 822168 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) www.pepenbury.info Larkfield Hall Limited Mr Steven John McDermott Care Home 70 Category(ies) of Learning disability (70) registration, with number of places Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21/2/06 Brief Description of the Service: Pepenbury stands in extensive grounds on the outskirts of Tunbridge Wells, the site includes the main administrative premises, eleven detached houses providing service user accommodation, day activities facilities, a swimming pool and a woodland area. The centre of Tunbridge Wells is approximately two miles away and local facilities are available in the village of Pembury. Items produced by service users who live on the site and who attend for day care are on sale to the public. Two of the houses provide semi-independent living accommodation and two others are dedicated to providing a service to people with behavioural difficulties. Staffing levels vary across the houses depending upon the level of need of the residents. Fees range from £504.00 to £1220.00 per week. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over seven hours and was undertaken by Regulatory Inspectors Ruth Burnham (lead), Lynnette Gajjar & Justine Williams. The inspection focussed on four of the eleven houses on the site, two of which were the more challenging behaviour units. Time was spent speaking with service users, house managers, senior support staff and support staff and with the Executive Director and senior management team. A brief tour of all the houses was also made, care plans and other documentation were read. Throughout the day staff and residents were helpful in supplying information, staff spoken with demonstrated commitment to providing a professional service and there was good interaction between staff and service users. Information was also gained from the pre inspection questionnaire completed by the service; comment cards returned from service users and a small number of relatives and health and social care professionals and telephone conversations took place with relatives and social care professionals. The majority of comments made were positive. Some concerns were raised about adult protection issues, moving residents within the home and taking care of resident’s clothing. What the service does well: What has improved since the last inspection? People who live in the home are better protected through improvements in the handling of medication. The privacy of residents is safeguarded through the insistence of the home that visiting professional provide services in private. Damaged furniture has been replaced in Swallows. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 6 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. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who are thinking about moving into the home have good information and opportunity to try out the service. Staff providing care have access to all the information which will help them to meet the needs of people who are admitted to the home. EVIDENCE: People who are considering moving into the home are provided with information about what life will be like there. They are able to visit the home and spend time with staff and residents. The service user’s guide and statement of purpose is made available on disc and in a pictorial format. Care plans contain a copy of the guide, statement of purpose, and a signed individual statement of terms of conditions. There are admission procedures to ensure that the needs of people who are considering living in the home can be met. There was some concern about one admission which was case tracked during the inspection. Information was out of date. The manager said that the full documentation relating to the admission was not seen during the inspection, it was not with the service user plan. The manager has produced an action plan in which he states that current admission procedures will be reviewed. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 - 10 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Independence is promoted and confidentiality is respected. The variable quality of care plans may mean that individual needs are not met. EVIDENCE: People who live in the home have individual care and support plans for staff to follow, the quality of those seen varied from unit to unit. The management confirmed that they are reviewing all care records. This will improve the guidance for staff to promote a consistently high standard of care for residents. Some care plans inspected did not contain the most up to date information, provide evidence of recent reviews or reflect changes in needs. Recording was not consistent. People who live in the home are encouraged to participate in the running of their houses. They are supported to make individual choices and decisions and are encouraged to achieve as much independence as possible. Houses hold weekly service users’ meetings. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 10 People are protected from harm in their daily living activities through risk assessment, such as accessing the community, using public transport, personal care and also in relation to particular individual activities or behaviours. The management of personal finances was not inspected during this visit. It was noted at the last inspection that residents are encouraged to participate in managing their own personal finances and transactions made with and on behalf of residents are recorded on financial record sheets. The confidentiality of residents’ personal information is maintained through the secure storage of records. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 - 17 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who live in the home, benefit from opportunities to take part in a wide range of activities. They are supported to maintain contact with family and friends. EVIDENCE: People who live in the home enjoy a range of daily and weekly activities, agreed with them and appropriate to their interests and abilities. These include day activities on site such as woodwork, gardening and swimming. Residents are also supported to become involved in activities in the local community and more able residents can become involved in voluntary work. They are also supported to attend clubs and groups and take part in social outings. House notice boards contain information about community activities such as the cinema or theatre. Residents are able to access very local facilities such as the bank or shops independently or with support Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 12 People who live in the home are able to personalise their bedrooms, those seen reflected personal interests and hobbies ranging from a collection of toy cars, football and music. Links with families and other contacts are supported, there were family photographs and greetings cards displayed in bedrooms. People who live in the home are involved in meal planning and choice of menu. Their health is promoted through the provision of sufficient and nutritious food. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 - 21 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The personal and healthcare care needs of the majority of service users are met. Where areas of concern were noted immediate action was taken to increase support. EVIDENCE: Residents’ personal support needs and preferences are recorded in care plans. Due to the wide range of needs accommodated at Pepenbury the level of support required can vary considerably. The majority of service users are well supported with their personal care needs. It was disappointing to find that one service user was not receiving adequate support. The dirty bathroom and poor state of cleanliness and order in the bedroom reflected this. The resident was also being placed at risk from the clutter and obstacles in the path of their zimmer frame. When these shortfalls were drawn to the attention of the manager immediate action was taken to put adequate support in place. People who live in the home have access to specialist support from a variety of health and other professionals who reassess as needs change and provide staff with guidelines to manage health or behaviours. Service user files contained Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 14 evidence of assessment and in some cases ongoing involvement from such agencies as occupational therapists, community learning disability team nurses and district nurses. Residents are provided with support to access optical and dental appointments. Health is monitored through weight charts. They are protected through clear policies and procedures for the safe handling of medication. Medication is administered by staff who have been trained to do so safely. There was some concern about managing medication, which is only given when required. The manager has produced an improvement plan stating that guidelines will be in place by the end of February 2007. Specific information about these medications will be made available to the duty and on call manager. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgment has been made using available evidence including a visit to this service. People who live in the home are protected from harm through sound recruitment procedures. However they are not adequately protected from being harmed by other residents. EVIDENCE: Pepenbury has a complaints procedure that is available to service users in written and pictorial format. Information given on the pre inspection questionnaire regarding complaints stated that seven had been received in the last twelve months, four had been substantiated or partially substantiated and all were responded to within the given timescale. People who live in the home are protected through sound recruitment procedures. All staff are checked through the Criminal Records Bureau before working at the home and they all receive adult protection training. Guidelines are put into place and training is given to staff working with service users who exhibit challenging or self-harming behaviours, to minimise risk to themselves and others. There have been a high number of incidents reported to the Commission where there has been some form of assault by one resident on another. This raises serious concern that people who live in the home are not adequately protected from abuse. It is recognised that caring for people who exhibit challenging behaviours, which can include violent outbursts, is difficult to manage. The management are to be congratulated on their diligence and honesty in reporting incidents to the Commission as required by regulation. The management explained that behaviours are constantly changing. Individual examples were given where requests have been made to the Local Authority for additional funding to support higher staffing levels where risk increases but these have been refused. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 16 Further discussion took place about using Local Authority Adult Protection Procedures to increase the protection of service users. The manager said that incidents are reported to the local Authority but not specifically to the individual care managers of victims of assault. It was agreed that this would be done in future. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 - 30 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The majority of service users live in a comfortable, clean, safe and wellmaintained environment. Action has been taken by the manager to improve the safety and quality of life of service users following the inspection. EVIDENCE: People who live in the home are accommodated in a variety of houses or bungalows. The majority of the living units were clean and reasonably decorated providing a homely environment. Action that was required following the last inspection had not been carried in that windows and uncovered radiators had not been risk assessed to maintain the safety and security of residents. A number of radiators were very hot to the touch and had not been covered to protect residents. The registered manager informed the inspector following the inspection that risk assessments have now been carried out. People who live in each house have access to their own small garden and patio. Residents have personalised their bedrooms to differing degrees to reflect their individual interests. Each house has sufficient bathrooms and toilets for the number of residents and rooms in Linnets have en suite facilities. The majority of houses were Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 18 beautifully clean so it was disappointing to find that the quality of life for people who live in two of the houses seen was being adversely affected by the failure to maintain a clean and safe environment. One house, Hawthorn, was very dirty. In the other house, The Pines, the bedroom of one service user was unfit for use due to the overpowering smell and extreme untidiness, the manager informed the inspector that the carpet in this room has been replaced since the inspection. People who have physical disabilities benefit from the adaptations and specialist equipment provided. Unfortunately the health and safety of one resident, who relies on a walking frame or wheelchair, was compromised by a number of obstacles in the hallway leading to her bedroom. The operations manager who saw this during the inspection asked staff to remove them and make the hallway safe. The registered manager contacted the inspector following the site visit to confirm that a new manager has been recruited for Hawthorns and the adjoining house. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 - 36 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. People who live in the home benefit from the support of a committed, well trained and enthusiastic staff team. Residents are at risk of harm where staffing levels do not ensure that resident’s are adequately supervised. EVIDENCE: People who live in the home benefit from the support of a staff team who are enthusiastic and committed to promoting their welfare. The staffing structure within the houses varies depending upon the needs of the service users. Residents are protected through rigorous recruitment procedures. Records examined during the inspection showed that at least two written references are taken up and previous employment history is explored. A small number of agency staff are employed for one to one work, the same agency staff are used to provide consistency. Staff are clear about their roles and those spoken with showed a high level of commitment to service users and understanding of their needs. Staff and residents interacted well. There was some concern that a number of residents are not receiving adequate supervision. Examples of this were seen in that waking night staff from one unit were leaving residents in that unit, to make half hourly checks on a resident in another unit who has dementia. The manager has informed Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 20 the inspector since the visit that this service user has now been moved into a house with waking night staff. Where it had been identified that residents with challenging behaviours needed additional supervision and support, this had not been provided. The responsible individual said that additional staff had not been provided as the placing authority had refused requests for additional funding. People who live in the home benefit from the support of a well-trained staff group. The recruitment and training manager is responsible for co-ordinating induction and all other training; house managers provide information on training needs identified during supervision and appraisal meetings. Monthly development days were introduced in 2005 focussing of different topics. Supervision is given six weekly with six monthly appraisals, documentation is in place to record full supervision sessions and briefer meetings. A comprehensive training programme is on offer and Pepenbury continues to promote NVQ training. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 - 43 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. People who live in the home benefit from the support of a strong management team. Areas of concern identified during the inspection and failure to meet previous requirements indicate that internal quality assurance systems are inadequate. EVIDENCE: People who live in the home benefit from the combined knowledge and experience of a well qualified management team. Responsibility for the day to day running of Pepenbury is shared between the registered manager and senior management team, overseen by the Executive Director. The views of service users are taken into account and they are consulted about the running of the home. The atmosphere throughout the home was open and friendly. Staff and management at all levels demonstrated a commitment to act in the best interests of residents. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 22 It was of concern that issues identified during the inspection where people who live in the home are at risk of harm are not being picked up by the home’s own quality assurance system. For example there were two requirements from the previous inspection that had not been addressed. Also the home’s own monitoring systems were failing to identify serious issues such as those noted in two of the houses. The manager was reminded about the requirement to produce a quality assurance report at regular intervals; this has not been done. Safe working practices were in evidence, additional vigilance regarding environmental checks is needed to prevent potential health and safety hazards such as there are a number of very hot radiators that have not been covered. Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 2 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 1 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 2 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 3 3 3 1 3 3 2 3 Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 24 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 YA6 Regulation 15(2)(b)(c) Requirement The registered person shall keep the service user’s plan under review and after consultation with the service user revise the plan In that care plan documents in use on service user and induction files must reflect current needs and be a record of the most recent review held. The previous timescale for action was by 30/4/06, some work has been done towards meeting the requirement. 2 YA18 12(1) The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users; to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. In that all service users must be provided with adequate support with DS0000023975.V303332.R01.S.doc Timescale for action 30/03/07 30/03/07 Pepenbury Version 5.2 Page 25 their personal hygiene and care needs. 3 YA23 12(1) The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users; to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. In that all service users must be adequately supervised to ensure that they do not harm or are not harmed by other service users. The registered person shall ensure the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally; all parts of the care home are kept clean and reasonably decorated. Specifically Hawthorns, Cornford and Pines The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. Specifically there must be sufficient staff to prevent service users from harming each other and to provide adequate supervision at night The registered person shall establish and maintain a system for evaluating the quality of the services DS0000023975.V303332.R01.S.doc 28/02/07 4 YA24 23(2)(b)&(d) 30/03/07 5 YA32 18(1)(a) 30/03/07 6 YA39 24 30/03/07 Pepenbury Version 5.2 Page 26 provided at the care home. 3. YA42 13(4) (c) The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated In that radiators must be guarded or have low temperature surfaces and environmental risk assessments be further broadened. The previous timescale for action was by 30/4/06, The manager has produced an action plan following this inspection which states that this requirement has now been met. 30/03/07 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 Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Pepenbury DS0000023975.V303332.R01.S.doc Version 5.2 Page 28 - 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!