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Inspection on 10/10/05 for Ramsgate Care Centre

Also see our care home review for Ramsgate Care Centre for more information

This inspection was carried out on 10th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Families and advocates are included in all events that are undertaken and everyone is kept informed and up to date with developments in the home. Regular discussions are undertaken, both formal and informal, with service users to ensure choices are constantly available. Service users were walking around the home chatting and laughing with staff and visitors. Many were in their rooms and stated they choose where and how they spend their days and staff support them if they wish to have meals in their rooms. Meals are a relaxed and unhurried experience, with all breakfasts being served in bed to most service users every day. Those choosing to eat in the dining room are able to do so and food choices have been increased at other meal times. Many service users at this time expressed their pleasure at the food provided and stated their needs and choices are being met.

What has improved since the last inspection?

There is new carpet in the lounge that leads onto the garden area, creating a clean and comfortable atmosphere. Service users stated they enjoy sitting in this area and are happy they have new carpeting that brightens this room. The dining room now has new, non-slip flooring that gives a clean and fresh look to this area. Trolleys are used for to serve lunches and this supports choice and control for service users. Each person can now decide at the mealtime exactly what they want to eat from a choice of hot meals and salads, served each day by the manager who then observes and talks with service users.

What the care home could do better:

Ensure all toilet and bathroom areas have pump soap in place to comply with infection control. While records were, in the main, clearly and accurately recorded, not all incidents/accidents were fully recorded in all appropriate areas, this must be monitored to provide full information and ensure the continuity of care. Care plans were also up to date but are not a good support to staff as much information has to be sifted through before finding the appropriate page of information. Also, this does not support record keeping as finding the relevant page on which to write daily reports is in the centre of the care plan and not readily accessible. There is no allocated maintenance man available to undertake minor jobs in the home. This does not support service users who may need small maintenance jobs undertaken in their rooms and minor work is not being completed around the home. There is a procedure for the administration of medication, but procedures are not in place for all other areas of work in the home, particularly covering abuse. This has been discussed on several occasions and the organisation was to develop these for the group of homes in Kent. While some new policies are in place, procedures are required to support staff, the induction process and to ensure the safety/protection of service users.

CARE HOMES FOR OLDER PEOPLE Ramsgate Care Centre 66-68 Boundary Road Ramsgate Kent CT11 7NP Lead Inspector Brenda Pears Announced 10/10/2005 at 09:30hrs The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ramsgate Care Centre Address 66-68 Boundary Road, Ramsgate, Kent. CT11 7NP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01843 585444 Choicecare 2000 Limited Registered Care Home 41 Category(ies) of Older Persons registration, with number of places Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Ramsgate Care Centre is a detached property that is registered for 41 elderly service users. Accommodation is on two floors and all rooms are en suite. There is a shaft lift in use to access all floors. The Home is located in a residential area of the town with easy access to public transport, shops and amenities. A number of parking spaces are available on site and there is on street parking available close by. The Home is spacious and has wide corridors throughout the building, giving easy access for wheelchair users. There are a number of lounge areas sighted around the building. There is an open-air courtyard with seating for service users in the centre of the Home plus a large garden to the rear. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the inspection process consisted of speaking with the registered manager, staff members and service users. The methods of inspecting the home included checking records, tracking service user care plans, examining staff files, observations and a tour of the building. Service users spoke to the inspector in groups and also individually during this inspection. Visitors were also happy to speak to the inspector at this time. The inspection focused on the quality of life experienced by service users and also on the core standards that must be covered in the inspection year. As part of the pre-inspection process, residents and relatives were consulted for their views of the home. The service users returned their comment cards, providing valuable feedback about the home, which helped in the planning of this inspection. Service users were happy to speak about the care that is provided by the home and stated that staff are always available when needed and that they feel well cared for in the home. What the service does well: Families and advocates are included in all events that are undertaken and everyone is kept informed and up to date with developments in the home. Regular discussions are undertaken, both formal and informal, with service users to ensure choices are constantly available. Service users were walking around the home chatting and laughing with staff and visitors. Many were in their rooms and stated they choose where and how they spend their days and staff support them if they wish to have meals in their rooms. Meals are a relaxed and unhurried experience, with all breakfasts being served in bed to most service users every day. Those choosing to eat in the dining room are able to do so and food choices have been increased at other meal times. Many service users at this time expressed their pleasure at the food provided and stated their needs and choices are being met. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Ensure all toilet and bathroom areas have pump soap in place to comply with infection control. While records were, in the main, clearly and accurately recorded, not all incidents/accidents were fully recorded in all appropriate areas, this must be monitored to provide full information and ensure the continuity of care. Care plans were also up to date but are not a good support to staff as much information has to be sifted through before finding the appropriate page of information. Also, this does not support record keeping as finding the relevant page on which to write daily reports is in the centre of the care plan and not readily accessible. There is no allocated maintenance man available to undertake minor jobs in the home. This does not support service users who may need small maintenance jobs undertaken in their rooms and minor work is not being completed around the home. There is a procedure for the administration of medication, but procedures are not in place for all other areas of work in the home, particularly covering abuse. This has been discussed on several occasions and the organisation was to develop these for the group of homes in Kent. While some new policies are in place, procedures are required to support staff, the induction process and to ensure the safety/protection of service users. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4, & 5 All new admissions are undertaken following a pre admission assessment. The Service User Guide and Statement of Purpose need a few additional documents to fully support prospective and permanent service users. Visits are undertaken and encouraged prior to a decision being made about entering the home, providing an opportunity to take time to consider all relevant matters and to experience routines in the home. Service users are given appropriate information to inform choices and to confirm the home can meet individual needs and that appropriate care is provided. EVIDENCE: The Service User Guide and Statement of Purpose have been completed to provide appropriate and current information for any person wishing to move into the home. However, there are a few more documents that are to be added before these are fully completed. A copy of the Service User Guide will Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 10 then be in every room of the home, providing details that will assist and inform the decision making process for all prospective and permanent service users. Service user files have pre admission assessments in place. Full needs are assessed including personal and religious needs. Care Plans are developed by the home and with staff who observe and discuss needs with service users and/or family/advocates as necessary. This assessment enables the home to ensure they are able to meet individual needs and also provides initial contact between service user and staff. Visits to the home are encouraged prior to admission and this was confirmed through discussions undertaken with service users and visitors at this inspection. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 & 10 Care plans are in place and reviewed regularly and while these were organised, the current format makes it difficult to find appropriate information easily or quickly. This does not support staff who need to record or read information that underpins the care provided. Service users are treated with respect and the right to privacy is upheld. Personal and social care needs are set out in care plans and fully supported by the home, providing appropriate service user care and good practice. Medication is dispensed and stored appropriately by the manager and senior staff, ensuring safety and full compliance with requirements. EVIDENCE: Visits by healthcare professionals are recorded on each care plan and contain full information of care given. Specialist organisations are contacted to support service users and appropriate support and aids are obtained. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 12 While information was on care plans and files are set in sections relating to different areas of care, information is not currently easy to find. Papers are tidy but a copy of a complete care plan is difficult to put together. This does not support staff, particularly new staff, who need to get information and details of each service user to appreciate individual personalities, backgrounds and care needs. All information is relevant and should collectively give a clear picture of a person and how they wish to be supported in all areas. Medication is dispensed by the manager and senior staff following appropriate training. Care staff who have been trained do assist but do not dispense medication. The storage area for medication is secured and safeguarded with barred windows. Discussions at this time and questionnaires received prior to this inspection confirm that service users right to privacy and respect is observed at all times. This was also evidenced when a tour of the building was undertaken and those wishing to remain in their rooms were treated and addressed appropriately. Visitors also stated that family and other service users are treated with respect and are supported appropriately. There is a controlled drugs cupboard and training covering the safe handling of medication was undertaken in August 2005. The medication trolley has the service user name clearly presented on each shelf to support safe practice. Medication administration sheets contain clear information, pictures of service users and were up to date at this time and dispensing procedures are also in place. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 & 15 Choice and autonomy are supported and encouraged, with choices being undertaken with support if required, providing a good quality of life. Food has improved in the home and a variety of meals are offered at all times and special choices, individual needs or diets are catered for. Providing nutrition and a sociable, relaxed experience for service users. All aspects of service user needs are met by the home and family, friends or advocates are encouraged to maintain contact. EVIDENCE: Visitors were observed to be welcomed into the home and to also be playing an important part in the routines and discussions with all service users. Creating a relaxed and social atmosphere for their immediate relatives and those who do not have many visitors. A hairdressing room is situated in the home and many service users had their hair styled and then joined some visitors and other service users in the open-air courtyard in the centre of the home. There was much laughter and conversation being enjoyed and all service users were welcomed to participate with visitors and friends. The family members stated they often spend time in this area of the home to enjoy a chat in the sheltered area and some last minute sunshine. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 14 Choice and autonomy is supported and encouraged through regular meetings with service users and also through informal discussions each day. This was confirmed through discussions at this time and in questionnaires received prior to this inspection. The manager is always available and ensures time is taken to speak to service users as part of daily routines. The manager also serves all lunches and this provides an opportunity for discussion and observation to be undertaken. Breakfast is served in bed each day and those wishing to eat in the dining room are able to do so. Lunch is served by the manager and a hot and cold trolley contain choices of foods and these are chosen at the mealtime and not ordered in advance. If a salad is chosen, then this is made up of the individuals preferences and hot /cold potatoes can also be added. Sandwiches are made to each person’s preferences and service users stated they enjoy the meals and the food has greatly improved recently. One person had previously not always had the exact food that was liked or requested, but the inspector was informed that this has now changed and all preferences are met and any requests are always met correctly. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 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 standard(s) 16 & 18 Service users know their complaints will be listened to and acted on and service users are protected from abuse at all times. EVIDENCE: The home’s complaint procedure was seen on display and every service user is to be provided with a copy in their Service User Guide. A record of complaints is maintained and the procedures undertaken support service user privacy. The home has an abuse policy and also a policy for whistle blowing, however, there are no procedures to give direct guidance to staff should any form of abuse be suspected. All complaints or actions that may be seen as abuse are addressed quickly and appropriately. The home has informed the Commission for Social Care Inspection and all appropriate organisations of any protection matters and reported fully on completion of investigations. Further details can be found in this report at standards 31 – 38. The manager is to undertaken an intensive training course on adult protection and on completion, the manager will be trained to assess and give training regarding adult protection matters. This will strengthen knowledge as well as supporting the full protection of service users. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 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 standard(s) 19,23,24 & 26 The standard of the environment within the home has improved through redecoration and refurbishment. Continuing this programme will ensure the home is comfortable and welcoming in all areas. The home was clean and pleasant at the time of the inspection visit and the garden area is well maintained, providing a clean and orderly environment for those living in the home. EVIDENCE: The fabric of the building has been much improved with new carpeting, flooring and decoration in many areas. The continued upgrading of the home will ensure service users are provided with the best possible environment in which to live. Service users stated they are pleased with the current alterations and decoration that has been completed. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 17 Regular maintenance has not been undertaken internally or externally on a regular basis. Currently there is a large maintenance team that prioritise work schedules. Smaller maintenance jobs have to be submitted, authorised and then put on a list for the maintenance team. This is not allowing smaller matters to be dealt with quickly and this is then adding to the overall impression of the home. The home would benefit from an allocated maintenance person to be on site permanently to address all work and support service users to have minor jobs undertaken quickly. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 & 30 The recruitment and induction processes do safeguard service users. Staff demonstrated a clear understanding of their roles and service user needs. There is a training matrix in place to ensure refresher and core training is up to date at all times. Staff are therefore provided with appropriate skills to support service users and meet individual needs. EVIDENCE: Staff files show that the appropriate selection and recruitment processes are in place to ensure the full safety of service users. Discussions with visitors, service users and questionnaires received confirmed that service user needs are met. Staff stated they are supported by the management processes in the home and expressed a clear understanding of service users needs. Training undertaken includes fire safety, food hygiene and healthy eating and health and safety. Training to be undertaken includes first aid and with over 50 of staff having NVQ level2, 5 staff have NVQ level 3 and some staff are currently undertaking NVQ level 4. The manager has almost completed the RMA management award. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 19 Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35,37 & 38 The manager is supported by the senior staff in providing clear leadership throughout the home with staff demonstrating a good awareness of their roles and responsibilities. Service users benefit from a safe and well run home and the systems of consultation are good, with a clearly defined management structure that enables service users to feel supported at all times. The best interests of service users is at the centre of care delivered in the home and all financial interests are safeguarded. Accidents must be fully recorded in all appropriate areas to ensure the full safety of service users through continuity of care and information. EVIDENCE: Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 21 Service users confirmed that consultation is undertaken regularly. The staff group, visitors and service users were observed to be relaxed and confident when dealing with management at this inspection. Staff are supported through an appropriate induction programme with new staff being additional on shift until assessed as being fully competent by the manager. Supervision is undertaken every two months and the manager is supervised regularly through the organisation. Financial matters are monitored and families have been included in all matters that relate to the safe keeping of service user money. A recent incident in the home resulted in the dismissal of a member of staff following some mishandling of monies. The police were immediately informed and families were involved and kept fully up to date with events at all times. While accidents are recoded and monitored, information was not completely recorded in all areas. This does not ensure the full tracking of incidents and does not support the sharing of information to provide full safety and appropriate care at all times. Staff expressed a good awareness and knowledge of service user needs and were seen to be supporting people in a considerate and appropriate manner. Discussions and comments received all confirm that family/visitors/advocates are welcomed and are included in the daily routines of the home. This supports service users to feel the home is their own, to have control over their lives and to feel that their views are heard and regarded as being important. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x 3 3 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 Standard No 16 17 18 Score 3 x 2 x x 3 x 3 x 2 3 Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4&5 Requirement Timescale for action 02/02/06 2. 67 3. 18 4. 18 & 37 5. 37 That the Service User Guide contains full information regarding choices of where complaints can be made and appropriate addresses and telephone numbers to support this 14 Care plans are to be in a format that support staff and ensure the full needs of service users are met. 12, 13, 17 The abuse policy must contain & 20 up to date, clear and full information that supports staff and protects service users. 12 & 17 Local procedures are to be developed to support staff in their duties, to support the induction process and to protect/support service users. 12,13 & All incidents/accidents to be fully 17 recorded in all appropriate areas, to provide full information and ensure the continuity of care. 05/12/06 02/02/06 02/02/06 01/12/05 6. Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent. TN23 1HU 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 Ramsgate Care Centre H56-H05 S23710 Ramsgate Care Centre V244744 270905 stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!