Inspection on 27/05/05 for Rutland Gardens 79

This inspection was carried out on 27th May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rutland Gardens 79 26/10/05

Rutland Gardens 79 02/11/04

Rutland Gardens 79 25/05/04

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

CARE HOME ADULTS 18-65 79 RUTLAND GARDENS Haringey London N4 1JW Lead Inspector Peter Illes Announced 27th May 2005 @ 10:15 am 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 79 RUTLAND GARDENS Version 1.10 Page 3 SERVICE INFORMATION Name of service 79 Rutland Gardens Address 79 Rutland Gardens, London, N4 1JW 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) 020 8800 0429 020 8800 0429 Mr Phivos Joannides Mr Phivos Joannides PC Care Home 3 Category(ies) of LD, LD(E) registration, with number of places 79 RUTLAND GARDENS Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 3 people of either gender who have a learning disability (LD) 2. And who may also fall into the category of old age (LD E) Date of last inspection 2/11/04 Brief Description of the Service: 79 Rutland Gardens is a care home registered to provide personal care for three adults with learning disabilities who may also be over the age of 65 years. The home is run by St Raphael’s Integrity Care Homes, a family owned and managed private company that operate a number of care homes for people with a learning disability in Haringey. The registered manager is also the registered provider. The home consists of a converted two storey terrace house with three single bedrooms. On the ground floor, there is a kitchen, dining room / lounge, a single bedroom with adjoining en-suite facilities and the homes laundry facilities. On the first floor, there are two other single bedrooms, a toilet, a bathroom/ toilet, and the manager’s office/sleeping in room. There is a pleasant paved area at the front of the building. The back garden is partly paved and accessible to service users. It contains a variety of fruit trees. The stated aims of the home include: to provide a high quality of care within a comfortable and homely environment; to enable service users to lead as independent a life as possible and to assist service users achieve their full potential. The home is situated in a residential area of Haringey and close to a large selection of multi cultural restaurants, shops and community facilities located along the busy Green Lanes. Wood Green Shopping Centre and Manor House are within walking distance. 79 RUTLAND GARDENS Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took approximately four and a half hours with the registered manager and the provider company’s service manager, who is a relative of the registered manager, being present or available throughout. There were three service users accommodated at the home at the time of the inspection and no vacancies. The inspection included: discussion with the three service users, one of them of them independently and with staff assisting with discussion with the two service user’s whose first language is Greek; independent discussion with one care staff; discussion with a registered manager of a nearby provider company’s home who visited during the inspection and also with a service user who also visited separately from a nearby care home. The inspector also spoke independently by telephone to a relative who is an advocate for two of the service users. Further information was obtained from a tour of the premises, the pre-inspection questionnaire and a range of documentation kept at the home. What the service does well: Service users and their relatives like the the home. Two of the service user’s first person and a number of staff also speak the service offered at the home to these small scale family type atmosphere at language is Greek and the registered fluent Greek, which greatly enhances service users. The home involves service users as much as possible in deciding how the service to them is offered and has developed a range of ways of talking to them, their relatives and others that have contact with the home. As a result of this service users receive a level of care, including personal care, which suits them as individuals. 79 RUTLAND GARDENS Version 1.10 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 79 RUTLAND GARDENS Version 1.10 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 Standards Statutory Requirements Identified During the Inspection 79 RUTLAND GARDENS Version 1.10 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 standard(s) 2 & 3 Prospective service users can be confident that their aspirations and needs will be assessed to ensure that these can be met should they move into the home. They can also be confident generally that these will continue to be regularly assessed to allow their changing needs to continue to be met. The home currently needs to ensure that further specialist assessments for two service users are undertaken to ensure that their changing needs can continue to be fully met in the future. EVIDENCE: No new service users have been admitted to the home for a number of years. There was satisfactory historical assessment information on the three service user files that was seen to have been updated through regular reviews and that recorded their changing needs. Two of the three service users living at the home are eighty five years and eighty seven years of age respectively. These two service users speak Greek as their first language and their assessed needs related as much to their age as to their disability. Both the registered manager and a number of staff at the home speak Greek including the member of care staff who was on duty at the time of this inspection. This linguistic ability of staff clearly benefited the two service users to receive sensitive care that meets their needs. There was evidence that these two service users needs were being appropriately 79 RUTLAND GARDENS Version 1.10 Page 9 addressed at the time of the inspection. They are both reasonably mobile although, in the inspector’s opinion, they remain increasingly vulnerable regarding their physical functioning because of their age and the physical layout of the home. The registered manager stated that they had both been on a waiting list for an occupational therapy assessment. The purpose of this referral is to further assist the home meet the service user’s current age related needs and to also to assist plan for any possible future changes in their mobility or other areas of functioning in their daily lives. As this referral has not been responded to for over one year a requirement is made that the home writes formally to the occupational therapy services to ask for this referral to now be considered a matter of priority. The third service user is a younger adult whose first language is English. His assessed needs were seen to be appropriately addressed and he told the inspector that he was very happy at the home and that he also enjoyed attending his day service five days a week. 79 RUTLAND GARDENS Version 1.10 Page 10 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 standard(s) 6, 7 & 9 Service users assessed and changing needs are well documented in their care plans to assist the home and relevant others meet these needs. They are supported to make informed decisions about their daily lives with any restrictions being agreed with them and recorded. Service users are also supported to take appropriate risks in their lives to assist them to safely achieve their aspirations. EVIDENCE: The three service user files contained clear and specific care plans that were based on up to date assessment information and risk assessments. A requirement is made in the Choice of Home section of this report for a further specialist assessment for two of the service users to help plan for their future care. The service users had signed their plans with one having a note that the service user had also had her plan further explained to her in Greek, her first language. There was evidence from discussion with one service user and from documentation at the home that service users rights were only limited after consultation and appropriate risk assessments. An example of this was that 79 RUTLAND GARDENS Version 1.10 Page 11 one service user had restrictions imposed regarding his smoking and this was clearly recorded on his care plan. The registered manager stated that the a relative of one of the service user’s acted as advocate for their relative and one other service user at the home. The husband of this relative was spoken to by telephone who confirmed that he and his wife attended the home on a regular basis including identified reviews and other relevant meetings. The relative stated “that their (service user’s) care at the home is excellent, they are not treated as numbers but as part of the family”. The home has a service user charter that is appropriate and displayed in the kitchen of the home. It lists twenty things that a service user can expect from the home including the recognition of the service user’s cultural identity. Satisfactory individual and general risk assessments were seen during the inspection. There were general health and safety risk assessments including fire and COSHH. Individual risk assessments seen included those that related to identified risks such as smoking, handling food, kitchen equipment, unintentionally being locked in bathrooms and toilets and absconding/ going missing. Individual risk assessments contained evidence that service users had been involved in the process and had signed the individual assessments. 79 RUTLAND GARDENS Version 1.10 Page 12 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 standard(s) 12, 13, 15, 16 & 17 Service users enjoy a range of appropriate activities including within the local community that contribute to enriching their social lives. Contact with relatives and friends is maintained and encouraged in accordance with the service users wishes. Service users rights are responsibilities are respected with any limitations agreed with them. They also enjoy balanced and varied meals of their choice that also meet their cultural preferences. EVIDENCE: One service user attends an external day service five days a week. This service user told the inspector that he enjoyed the day service, especially Fridays as he and some friends played snooker. This was at a public snooker hall and was arranged through the day service. He also stated that he enjoyed Friday as he had fish and chips for lunch. Another service user attends a day service two days a week and staff stated that he also enjoyed attending. One service user is able to access the local community independently and the other two with staff support. Service users files indicate that they access 79 RUTLAND GARDENS Version 1.10 Page 13 community resources such as the pub, church and shops as well as the local day service. Evidence was seen in the records of service user meetings that they are encouraged to suggest any activities they would like to take part in. All three service users had recently enjoyed a day trip to Southend in the provider company’s mini-bus as a result of a suggestion made by one service user at a meeting. The inspector was shown some photographs of service users and staff enjoying themselves on the trip and was told that it had been a successful day. One service user has relatives who visit the home on a regular two weekly basis and one of these relatives also acts as an advocate for their service user and to a second service user in the home. The husband of this advocate was spoken to by telephone and stated that he and his wife were always made welcome at the home. The registered manager confirmed that the same service user also has another relative who comes to visit three or four times a year. A second service user has a relative in Greece who keeps in touch by telephone and the third service user has no relatives. During the inspection a service user from another of the provider’s registered homes situated nearby visited this home independently to chat with service users and staff. He was pleased to speak to the inspector and stated that he often came round for “a chat”. The homes service user charter and policies inspected all promote a philosophy of choice and independence for service users. The home continues to make efforts to involve and engage service users in decisions made at the home including by encouraging them to sign documents or records of meetings where their preferences had been discussed. The menu was seen to be satisfactory including appropriate options for the two service users of Greek origin. A request book was seen that was used in addition to the main menu and that included requests for specific Greek dishes. Service users spoken to stated that they enjoyed the food at the home. Food was in date and stored appropriately. Fridge and freezer temperatures were recorded regularly and seen to be satisfactory. The kitchen was clean and tidy. 79 RUTLAND GARDENS Version 1.10 Page 14 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 standard(s) 18, 19 & 20 Service users receive sensitive personal support in accordance with their needs and their individual preferences. Their emotional and physical health needs are promoted and relevant specialist medical treatment is obtained when required. The implementation of the home’s procedure for the safe administration of medication is poor and must be improved to ensure that service users are properly protected in this area. EVIDENCE: The registered manager confirmed that the two older service users continued to need significant personal support with regard to washing, toileting and dressing. The third service user was more independent with his personal care although also needed significant verbal prompts as well as physical assistance with identified tasks such as shaving. Personal care needs were recorded on service users files and the staff member spoken to was able to describe in practical terms how the support needs of service users were met in a way that they felt comfortable with. One service user stated that he was comfortable with the personal care that he received and a relative spoken to was also satisfied with this aspect of care at the home. All three service users are registered with local GP’s and evidence was seen that external specialist health professionals also support them when required. One service user had received planned in-patient treatment at a local hospital 79 RUTLAND GARDENS Version 1.10 Page 15 since the last inspection and her needs following that treatment were satisfactorily recorded. All three service users are mobile to varying degrees and the registered manager stated that none were suffering from pressure ulcers. The home had an appropriate medication policy that had been signed by the registered manager and medication was appropriately stored with satisfactory checks made on the temperature of the medication cupboard. One service user was receiving prescribed medication at the time of this inspection. A requirement was made at the last inspection that all medication administered must be correctly recorded and that had been complied with although there remain issues regarding the safe administration of medication. On inspecting the one service user’s prescribed medication the inspector was particularly concerned that two identified doses of medication that should have been administered earlier that day had not been administered. Other prescribed medication to be administered at the same time was recorded as having been administered and these had apparently been placed in the same section of this service user’s dosset box (container) that is used to store the medication on a weekly basis. There was no record of this omission on the service user’s medication administration record (MAR) chart and none of the staff at the home were aware that it had not been administered or why. Requirements are made regarding the safe administration of medication and that all staff that undertake this task must have received safe administration of medication training from a person competent to do so and that this is regularly updated. 79 RUTLAND GARDENS Version 1.10 Page 16 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 standard(s) 22 & 23 Service users and relatives are able to express their views and concerns and have these appropriately dealt with by the home. Service users are also protected by a satisfactory adult protection policy that staff are aware of. EVIDENCE: The service user and relative spoken to indicated that they knew how to raise concerns if they needed to and stated that they were confident that these would be acted upon. The home had an appropriate complaints policy and procedure that gave details of the Commission and also that any complaints made must be responded to within twenty-eight days. The complaints book was inspected and no complaints had been recorded since the previous inspection. The home had a clear whistle blowing policy and adult protection policy that were both seen. The latter specifically related to the adult protection procedure for the local authority that the home is situated in and included contact details from that procedure. Evidence was seen that the registered manager and one member of care staff had undertaken adult protection refresher training since the last inspection. The staff member spoken to was aware of the practical steps that would need to be taken should an allegation or disclosure regarding adult abuse be made. 79 RUTLAND GARDENS Version 1.10 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 standard(s) 24, 27 & 30 Service users live in a home that is comfortable, well decorated and generally well maintained. Although further attention to promoting the health and safety of service users is needed in identified areas of the premises. Service users benefit from adequate numbers of toilets and bathrooms to meet their needs although some identified maintenance is needed in one bathroom. The home was clean and tidy throughout creating a pleasant environment for both those that live and work at the home as well as for those that visit it. EVIDENCE: The home was clean, comfortable and generally well maintained. The house is a converted domestic terraced property with two service user bedrooms on the first floor and one on the ground floor. Shared spaces that are also on the ground floor comprise: lounge/ dining room, kitchen and separate laundry facilities. There was a carpet protector used in the ground floor hall outside of the entrance to the kitchen and the edges of this had started to curl. There was also a rug in the lounge/ dining room that had a corner starting to curl. Both of these are a potential trip hazard and a requirement is made regarding this. 79 RUTLAND GARDENS Version 1.10 Page 18 The home has adequate bath and toilet facilities for a home registered prior to April 2002. These comprise; one bath/ shower room with a toilet and a separate toilet on the first floor and a bathroom/ toilet on the ground floor. A ceramic soap dish attached over the bath in the first floor bath/ shower room had broken leaving a sharp edge that was a health and safety hazard, a requirement is made regarding this. The service user spoken to stated that he could have a bath whenever he wanted to. The home was clean and tidy throughout and free from unpleasant odours. The home had satisfactory laundry facilities and a satisfactory infection control policy that was seen. Evidence was seen of continence promotion training on staff files and from discussion with staff there was also evidence to support that the needs of the two service users who are incontinent are appropriately dealt with. In addition to this evidence was seen that the local primary care trust continence advisor had recently attended the home to give advice to staff regarding one of the service users. 79 RUTLAND GARDENS Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 & 35 An effective staff team supports service users meet their current and changing needs and aspirations. Service users are also protected by a robust staff recruitment procedure. A well trained staff team is generally meeting service users needs although a further improvement to this is needed in an identified key area. EVIDENCE: The staff rota inspected showed a minimum of one staff member on duty during the day and one staff member sleeping in at night. The staff member on duty matched the record on the rota. One new staff member had been recruited since the previous inspection. This staff member’s file was inspected and contained evidence of satisfactory enhanced criminal records bureau and protection of vulnerable adults clearances that had been obtained before the person started work. The file also contained copies of two satisfactory references, proof of identity and employment history. This, and further discussion with the registered manager, showed evidence to support that the home operated a robust recruitment procedure. The home has invested in a distance learning training programme for staff that supplements other direct methods of training. Evidence was seen of a 79 RUTLAND GARDENS Version 1.10 Page 20 satisfactory training programme from both staff files inspected and from discussion with the registered manager, service manager and staff at the home. This included adult protection, food hygiene, first aid and induction training. There was also evidence that some staff had undertaken safe administration of medication training but not all and a requirement is made regarding this in the Personal and Healthcare section of this report. 79 RUTLAND GARDENS Version 1.10 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 Service users views are effectively sought to contribute to the overall development of the services provided by the home. Health and safety is a priority for the home although further attention is needed regarding identified hazards on the ground floor. EVIDENCE: The home had undertaken an appropriate service user survey/ questionnaire since the last inspection and copies of these were seen on all three service user files inspected. The home also has a current business plan with aims and objectives for 2005 that were compatible with the service user survey results and that the registered manager felt were achievable. There was also evidence of other less formal service user feedback including records of regular service user meetings as well as one to one discussions with staff and discussions with relatives. The relative spoken to by telephone stated that he and his wife were kept informed of developments being considered at the home. 79 RUTLAND GARDENS Version 1.10 Page 22 A range of satisfactory health and safety documentation was seen including: general risk assessments for the home including fire and water temperature; electrical installation certificate; portable electrical appliances testing; gas safety certificate; appropriate fire documentation including servicing of the fire alarm and fire extinguishers. The home has a direct feed water supply system and there was satisfactory evidence that the home had carried out significant work to update the system since the last inspection and following an unannounced visit by the water authority. A requirement is made in the Environment section of this report regarding dealing with identified trip hazards related to areas of flooring in the home. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 79 RUTLAND GARDENS Score Standard No 24 25 26 27 Version 1.10 Score 2 x x 2 Page 23 6 7 8 9 10 LIFESTYLES 3 3 x 3 x Score 28 29 30 STAFFING x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x 79 RUTLAND GARDENS Version 1.10 Page 24 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 2 Regulation 13(1)(b) Requirement The registered person must ensure that a formal written referral is made for an occupational therapy assessment for two identified service users and that this referral specifies the particular vulnerabilities of these service users. The registered person must ensure that all service users are assisted to take all medication that is prescribed for them and that this is accurately recorded including any reason for non administration. The registered person must ensure that all staff that administer medication receive regular updated training in the safe administration of medication from a person competent to do so. The registered person must ensure that any floor covering in the home does not constitute a health and safety hazard. The registered person must ensure that the broken ceramic soap dish that is fixed to the first floor bathroom wall is removed or replaced to ensure it does not Version 1.10 Timescale for action 30/6/05 2. 20 13(2) 30/6/05 3. 20 13(2) 30/6/05 4. 24 13(4)(a) 30/6/05 5. 27 13(4)(a) 30/6/05 79 RUTLAND GARDENS Page 25 constitute a health and safety hazard. 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 None Good Practice Recommendations 79 RUTLAND GARDENS Version 1.10 Page 26 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 79 RUTLAND GARDENS Version 1.10 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!