Inspection on 15/11/06 for Shaftesbury Court Residential Home

This inspection was carried out on 15th November 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Shaftesbury Court Residential... 01/10/08

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

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

CARE HOME ADULTS 18-65 Shaftesbury Court Residential Home Rectory Road Lowestoft Suffolk NR33 0DQ Lead Inspector John Goodship Key Unannounced Inspection 15th November 2006 10:00 DS0000067476.V320808.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 DS0000067476.V320808.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. DS0000067476.V320808.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shaftesbury Court Residential Home Address Rectory Road Lowestoft Suffolk NR33 0DQ 01502 511168 01502 587702 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) Sanctuary Care Limited Mr Alan Smith Care Home 15 Category(ies) of Physical disability (15) registration, with number of places DS0000067476.V320808.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26 October 2005 Brief Description of the Service: Shaftesbury Court is owned by Sanctuary Care, who took it over in April 2006 from Ashley Homes. Shaftesbury Court was first registered in 1989, to provide residential care for fifteen people with physical disabilities. The home is situated on the sea front, in South Lowestoft, and reasonably close to the town centre. Service users living at the home have access to the sea front and local facilities, which include theatre, pubs, cafes, cinema, sports centre, shops, ten pin bowling, and snooker / pool. The accommodation for service users is located entirely on the ground floor. There are fifteen single bedrooms all with en-suite facilities. There are two dining rooms, one large central communal lounge, a kitchen, and laundry. In addition to the en-suite facilities in bedrooms, there are communal bathroom, shower, and toilet facilities which are adapted to meet the needs of people with physical disabilities. Upstairs, there is a small suite of accommodation, used as two staff offices, and a w.c. for staff use. Access to the first floor is by staircase only, and therefore service users do not go into these areas. Located on the same site (but not part of the residential care home) are four independent flats, in respect of which the Registered Manager of Shaftesbury Court provides oversight and support to the occupants. The range of the fees at the time of this inspection was £625 to £750 per week. DS0000067476.V320808.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and covered the key standards which are listed under each section overleaf. This report includes evidence gathered during the visit together with information already held by the Commission. The inspection took place on a weekday and lasted five and a half hours. The manager was present throughout, together with staff on the morning shift and, later, those on the late shift. The inspector toured the home, and spoke to some of the residents, and the staff, both individually and in a group. The inspector also examined care plans, staff records, maintenance records and training records. A questionnaire survey was sent out by the Commission to residents and to relatives. Eight residents responded and one relative. Their answers to the questions and any additional comments have been included in the appropriate sections of this report. What the service does well: What has improved since the last inspection? The new provider, Sanctuary Care, took over from Ashley Homes in April 2006 and a new Certificate of Registration was issued on 6 April 2006. Although this process took longer than had been originally notified to the residents, they had been kept informed of progress. DS0000067476.V320808.R01.S.doc Version 5.2 Page 6 Some draught proofing had been done to one of the coldest bedrooms. The home as a whole seemed warm, with no residents except one fearing the colder weather. 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. The summary of this inspection report can be made available in other formats on request. DS0000067476.V320808.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 DS0000067476.V320808.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be certain that they will have every opportunity to make sure the home will meet their needs. EVIDENCE: The Statement of Purpose and Service Users Guide were complete but the name of the Commission needed to be updated in the complaints procedure. Prospective service users were invited to the home, to meet the service users and staff, and look around. There was a multi-agency assessment process, before any decisions were made about whether or not the home could provide suitable care. The pre-admission assessment form for the latest admission showed that they had been visited at home prior to admission. This was confirmed by the resident. There was also evidence that the Service Users Guide had been given to their social worker to give to them. The resident confirmed that they had visited the home and seen their room before they moved in. DS0000067476.V320808.R01.S.doc Version 5.2 Page 9 The home was designed to provide care to people with physical disabilities and had the necessary space and facilities to support the needs of the residents. DS0000067476.V320808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that their needs are fully assessed. Their needs are monitored regularly to ensure that changes are made to the support they need. They are consulted on all aspects of life in the home. EVIDENCE: A resident had been moved into another room earlier in the year in order to accommodate the equipment they needed for moving and handling. However, a review of their needs had resulted in confirmation that they required nursing care. They had now moved to a local nursing home. Two care plans were examined. These were for residents with high care needs. They were laid out in the style introduced by the new provider. They were easy to read through and find relevant topics. The plans recorded that regular six monthly reviews were undertaken. A schedule for these reviews was seen in DS0000067476.V320808.R01.S.doc Version 5.2 Page 11 the office. Care plans showed that the home was able to continue to support residents to cater for their changing needs as they grew older. Staff described how some residents were requiring more support with personal care. This was noted in some of the care plan reviews examined. One resident was being PEG fed under the direction of the dietitian. This resident said how supportive the staff were. There had been meetings with the funder earlier in the year to investigate how a resident could have extra trips out. Their requirement for staff support on these occasions could not be funded from the home’s existing fees. The funder was unable to offer more funding for this need. There was a wide range of physical disabilities amongst the service users living at Shaftesbury Court, for example some were able to go out and about, unaided, using electric wheelchairs, whilst others were more confined to the home, and required staff support for the majority of aspects of their care. One resident was being visited by a technician from the NHS Wheelchair Service during the inspection. He was fitting a new belt to the resident’s electric wheelchair, to assist in keeping them upright. The resident was being shown how to adjust and release the belt. The latest resident said that they were due for their assessment for an electric wheelchair shortly. The pre-assessment for a recent admission was followed up on the file, and it became the basis for the initial care plan. This person had not yet been in the home long enough for the three monthly review. All the current residents handled their own financial affairs. Residents meetings were held every 3 months, with a member of staff present only to take the minutes. Other staff could be invited to attend for particular topics. DS0000067476.V320808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can take part in a variety of educational and leisure activities. An individual’s choice of activity may be limited sometimes by the availability of a member of staff for support. EVIDENCE: On the morning of the inspection, five residents were going out, three to Norwich to play football in a gym at the University, one to go shopping with a support worker, and one was going out with a friend. One resident had joined a martial arts course and was training to qualify for their belts, with the help of their key worker. Two residents attend the local college for adult literacy education. DS0000067476.V320808.R01.S.doc Version 5.2 Page 13 The manager stated that the Friends of Shaftesbury Court continued to organise monthly trips for residents, using their minibus. The venues for these trips were decided at the residents’ meetings. This was confirmed by a resident. Another resident wished there were more trips. The file of one resident contained the record of a meeting with the funding authority to discuss the provision of more staffing hours to allow for more trips out to be supported. However to date, no further funding had been agreed. This issue had been under discussion for eighteen months. It is the responsibility of the home to ensure that sufficient staff were available to meet the needs of residents. A requirement is made that the home review the planning of staff rotas and budgets to provide the support to this and other residents whose activities are currently restricted. Two residents confirmed that they were able to choose what they did each day and how they were able to organise their daily routine. Residents’ mail is sorted into pigeonholes in the main lounge for them to collect. Staff were seen to be talking to residents, and discussing future activities such as shopping, or what was for lunch. There was a whiteboard in the corridor near the kitchen listing that day’s menu. There were spaces for each resident to indicate whether they wanted the main dish or an alternative. Food was served to residents already plated. The manager stated that the provision of a silver service was being considered which would enable residents, who were able, to serve themselves vegetables. One resident commented that they had two very good cooks and their experience really showed. DS0000067476.V320808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal needs and healthcare are monitored and action taken as necessary. Records, systems and controls protect residents from harm. EVIDENCE: Staff on duty explained the different ways they supported residents. These were confirmed by residents who appreciated the staff’s support. Care plans included a section for healthcare needs, and there were also medical record sheets detailing interventions from health professionals. Residents’ weight and nutrition was monitored where necessary. The home had one hoist with a built in weighing facility. None of the residents was able or wished to administer their own medication. DS0000067476.V320808.R01.S.doc Version 5.2 Page 15 The Medication Administration Record sheets were audited weekly by a senior support worker to ensure proper completion. A sample was examined and all were completed fully and accurately. All staff who administered medication had received training by the pharmacy supplier. This was confirmed by a member of staff. The latest training had been organised in two sessions in September and October 2006 so that all staff could attend. Records of these sessions were seen. DS0000067476.V320808.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to raise concerns, and if necessary complaints, which are dealt with properly. EVIDENCE: No complaints had been made to the Commission since the last inspection. The complaints log showed that two complaints had been made by residents in September 2006. The record noted the process for dealing with them, talking to the residents about their complaints, and what action had been taken by the manager to resolve the issues. All residents who responded to the survey said that they knew who to speak to if they were not happy, and that they knew how to make a complaint. Staff received training in the protection of vulnerable adults; the training schedule showed the dates when this had taken place. Staff were asked for their understanding of the action they must take if they witnessed abuse or it was reported to them. All were able to describe the correct action. DS0000067476.V320808.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,28,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst individual rooms are suited to residents’ needs, residents cannot yet expect that their rooms will be warm enough at all times for their comfort. The storing and re-charging of electric wheelchairs continues to intrude on residents’ communal areas. EVIDENCE: One resident who was in one of the corner rooms stated that they still needed to keep their radiator on full for twenty-four hours to maintain a reasonable temperature in the room. They were angry that promises to improve the insulation and replace the windows and doors had been broken. “I have lived here for ten years, and each winter is unbearable.” They acknowledged that their external door had recently been improved by additional draught proofing. DS0000067476.V320808.R01.S.doc Version 5.2 Page 18 Action to replace doors and windows as appropriate had been on the capital projects list of the home for over a year. The Commission had made it a requirement that action should be taken to agree a funded programme by July 2005. The manager believed that the work had been programmed with funding before the change of owner. This funding had not been transferred at the change. The new provider’s estates manager had inspected the windows and doors. He had actioned some immediate remedial work. It was not expected by the manager that there would be wholesale replacement of windows and doors, but instead improved draught exclusion and some repainting. The radiators in each room did not have thermostatic controls. However they did have lever action controls which could be set at any position. Wheelchairs were still being re-charged in one of the dining rooms, taking up significant space. A requirement was made last year to provide a better facility but this had not happened. The hot water in the shower room of one wing was measured at 43°C and was within the parameter of the standard. The carpeted areas in the corridor behind the kitchen were worn and torn. All the resident’s rooms that were visited were personalised to a greater or lesser extent, with TVs, computers, books, and personal items. Several doors to the rooms had been personalised with pictures, signs and notices. A replacement call system was being installed during the inspection, and was due to be handed over that day. The old system had first been reported faulty in August 2006, and its installation had been delayed because of the need to await parts from abroad. One resident commented that while it was broken, the standard of care was reduced as it took staff more time to attend to their care needs. The staff were looking forward to the facilities on the new system. During the day, some residents were instructed in the new system by the installers. The shift handover listed which residents these were, and who would need reassurance about the way it worked. The residents’ confirmed that the home was always clean and fresh. DS0000067476.V320808.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by trained and competent staff. Residents are protected by the home’s recruitment procedures. EVIDENCE: There were seven staff on duty during the day and one senior, and two waking night staff. The provider was still discussing with the funder about paying for staff cover for trips outside the home. Several residents commented that they would like more. The training schedule was examined. It listed staff who had attended or were attending moving and handling, fire, POVA, First Aid, Food Hygiene, COSSH and equal opportunities courses. Twelve staff were qualified at NVQ Level 2, one was studying for it, and three were due to start in December 2006. DS0000067476.V320808.R01.S.doc Version 5.2 Page 20 The file for the two newest members of care staff were examined. Both the POVA response and the CRB certificate had been received prior to the start dates. There were two references, a full employment record and all identification documents in each file. The CRB certificate numbers for all staff appointed since the last inspection were recorded by the inspector. The schedule for staff supervision sessions was posted in the manager’s office with the dates when sessions took place. The manager had been trying to reduce the numbers of shifts which could only be covered by agency staff. The recent appointment of two staff had halved the number of agency hours used. Two further posts were being advertised and it was expected that when filled the agency hours would reduce further. The residents’ survey questionnaire showed that staff listened and acted on what was said. One resident said that staff “can be a bit distracted when they are busy and forget about me, but this is not intentional.” One resident wrote that “if agency staff don’t understand what I am saying, they find it easier not to listen to me.” However all other replies to the survey said that staff were kind and helpful. “One thing you can rely on is the staff.” “The staff are very friendly and they give me all the support I need.” DS0000067476.V320808.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,40,42,43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are consulted individually and collectively about the running of the home. They are protected by a good quality assurance system, and appropriate policies and records. EVIDENCE: The home was displaying the new Certificate of Registration showing the name of the new Provider. The Home’s Insurance certificate was displayed and was valid until 31 March 2007. DS0000067476.V320808.R01.S.doc Version 5.2 Page 22 The manager stated that the change of ownership to Sanctuary Care had gone smoothly. There had been some changes to care plan layouts, and to staff files. The manager reported to the same area manager. However the process of changing provider had led to delay in actioning some of the statutory requirements from the last inspection. Residents’ meetings were held every 3 months, with a member of staff present only to take the minutes. Other staff might be invited to attend for particular topics. The minutes of the last meeting on 19 September 2006 showed that topics raised included matters of décor, food waste and the menu board. The last staff meeting had been held on 26 October 2006. Topics included, improving care plans, budgets, capital and replacement programme, and the wearing of badges by staff to ensure that visitors knew who they were speaking to, as a protection for confidential information. A Fire Officer from the local fire station had visited the home in September 2006. His report found all systems were working and fire protection was up to the standard required. The report made some recommendations about the contents of the Fire Risk Assessment, otherwise this document met the legal requirement. The fire log recorded the weekly testing of the fire alarms and the emergency lighting. The accident log showed nine reports since February 2006, to different residents. Quality assurance was maintained by, amongst other means, audited care plans, visits by the providers’ QA officer, monthly visits by the regional manager, and regular meetings of the residents. The financial viability of the home was dependent on the fees paid by Suffolk Social Care Services (SCS). The SP Block Gross Subsidy had been withdrawn in June 2005. Ashley Homes and now Sanctuary Care had been seeking since then to agree new fee levels with SCS to maintain viability and proper staffing levels. No agreement had yet been reached and the home was operating on a deficit budget until this shortfall had been solved. Residents received all their benefits into their own bank accounts, with direct debit payments to Sanctuary care for their fees. Residents kept cash in their own rooms in locked drawers. DS0000067476.V320808.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 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 3 X 3 2 DS0000067476.V320808.R01.S.doc Version 5.2 Page 24 YES 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 YA14 Regulation 16(2)(n) Requirement Timescale for action 31/12/06 2. YA28 23(2) 3. YA24 23(2)(b) 4. YA43 25(1) The registered person must undertake a review of the staffing rotas and budgets to determine how those residents, whose outings are currently restricted, can be supported. The registered person must 31/12/06 provide suitable storage and charging facilities for electric wheelchairs that does not intrude into the communal areas. (This is a repeat requirement for action originally required by 31/12/06.) A funded and timed programme 31/12/06 for the improvement of the home’s insulation and draughtproofing must be sent to the Commission. The manager must send a 31/12/06 written assurance to the Commission that the home will remain financially viable. This assurance must include a financial and business plan for the current year with a projection for the next planning year. DS0000067476.V320808.R01.S.doc Version 5.2 Page 25 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 DS0000067476.V320808.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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