Inspection on 08/10/08 for Shardeloes

This inspection was carried out on 8th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Shardeloes 19/12/06

Shardeloes 15/11/05

Shardeloes 06/06/05

Shardeloes 02/11/04

Shardeloes 04/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

Dovedale Court

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Shardeloes Shardeloes Ashtead Woods Road Ashtead Surrey KT21 2EQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kenneth Dunn     Date: 0 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Shardeloes Ashtead Woods Road Shardeloes Ashtead Surrey KT21 2EQ 01372273228 01372270711 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Care Management Group Ltd (trading as CMG Homes Ltd) The registered provider is responsible for running the service Name of registered manager (if applicable) Rosaleen Leen Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Mental Disorder, excluding learning disability or dementia - MD Date of last inspection 8 8 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home Shardeloes is a care home for 8 adults with learning disabilities. The home is registered to admit both male and female residents, of whom a maximum of three may also have a mental disorder. Shardeloes is situated in a residential area of Ashtead. The building is a large detached house with an adjacent self-contained flat affording opportunity for semi-independent living for one resident. Accommodation is situated over 2 floors and each resident has a single room. There is a large communal lounge, separate dining room and a well-equipped kitchen on the ground floor. There are also separate utility facilities. The home has off-road parking and a large garden at the front of the premises. There is also a spacious secluded garden to the rear. Weekly charges range from #1,078- #1,350. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. The inspection of this Care Home for Younger Adults was an unannounced Key Inspection. The inspector looked at how well the service is doing in respect to the National Minimum Standards for Care Home for Younger Adults. The site visit took into account detailed information provided by the registered provider and the manager, and any information that Commission for Social Care Inspection has received about the service since the last inspection. The inspector looked at how well the service was meeting the standards set by the Care Homes for Adults (18-65 years) Page 6 of 30 government and has in this report made judgements about the standard of the service. Documents sampled during the inspection included the care plans, daily records and risk assessments, medication procedures. The service has submitted the Annual Quality Assurance Assessment prior to the inspection, some details of which have been added to the report. One complainant has contacted the Commission for Social Care Inspection with information concerning a complaint made to the service since the last inspection. From the evidence seen by the inspector and comments received, the inspector considers that the service would be able to provide a service to meet the requirements of individuals who have diverse religious, racial or cultural needs. The inspector would like to thank the people who use the service and the staff for their time, assistance and hospitality during this inspection. The quality rating for this service is 2 star. This means the people who use this service experience an good quality outcome. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The statement of purpose should be reviewed to ensure that Prospective residents have sufficient information about the service and the services offered by Shardeloes. Individual aspirations and needs are assessed prior to people being offered a place at the service. Evidence: The deputy manager stated that a review of the statement of purpose and service users guide has been undertaken by the service. It was stated that the updated statement of purpose now demonstrates a range of a information, which will enable the people who use the service or their representatives to make an informed decision on whether the service is able to meet their specific needs. The inspector was not not able to sample the reviewed document at the time of the site visit therefore a requirement was made. There has been no new service users since the last inspection visit (19/12/2007). A random sample of the individual files of the people who use the service was conducted, Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: and in all cases there had been detailed needs assessment completed for the individuals concerned. The assessments were detailed and contained relevant information to enable the service to design a care plan for each individual. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service should be confident that their assessed and changing needs are reflected in their individual plans. Individuals living at Shardeloes are supported to make decisions about their lives, to enable them to take risks as part of an independent lifestyle. The people who use this service participate in all aspects of life in the home. Evidence: Three care plans were sampled as part of this site visit. They contained a detailed record of abilities, health needs, personal care needs and family and social relationships. A life picture and pen portrait was completed and a where am I going section. Clear support plans were in place for routines and strengths and need lists clearly defining individual preferences for example favourite community and leisure activities, meals and tasks. It was evident that plans were regularly reviewed with annual, six monthly and monthly reviews recorded. The care plans showed evidence that the reviews process sought the views of the resident and their families. There is a Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: key worker system in place and members of staff spoken to were aware of the care plans and their involvement in the review processes. Residents spoken to had been given many opportunities to make decisions and take risks in their day to day lives. The residents have the freedom to make decisions and take risks. In order to ensure the continuing safety of the residents a wide range of comprehensive risk assessments have been completed including personal care such a bathing, health, self help skills including the use of the kitchen. Some individuals have emotional difficulties, which could lead to possible aggression to other with clear plans and management guidelines in place. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service have opportunities for personal development and are supported to take part in appropriate activities. Individuals living at the service are fully integrated into the wider local community. The staff support and encourage individuals to engage in appropriate leisure activities and in personal and family relationships. Meals are designed to healthy and flexible. Evidence: The home has its own transport to enable the people who use the service to access community facilities shops, pubs, cinema and other places of interest. Staff stated that individuals living at the home are actively encourage and supported to be as independent as they can. There is good documentary evidence that the people who use the service are supported by their key workers to make their own choices and to Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: live their lives as they wish and as far as they are able. The service has designed a series of risk assessments to ensure that the individuals living at the home are safeguarded whilst in the community. During the random sample of the risk assessments it was evident that there was areas where further work must be carried out to ensure that known risks are fully documented and relevant risk assessments are completed to safeguard the individual or individuals concerned. This was discussed during the site visit with the staff on duty and a representative from the registered providers. Please review the requirement section of this report. A member of staff stated that household routines are kept to a minimum and are only in place to enable the people who use the service to share their homes facilities and to work together as a team. A random review of care plans of the individuals living at Shardeloes demonstrated that the service and in particular the key workers maintain good records of the support being offered to enable the residents to maintain family links and friendships outside of the home. Observations made during this site visit confirmed individuals living at the service had unrestricted access within the home. Care Homes for Adults (18-65 years) Page 15 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for personal support are good ensuring that the people who use the service are supported in the way they prefer. The arrangements in place for meeting the health care needs of individuals living at the home are appropriate. The procedures for the management of medication should safeguard the people who use the service. Evidence: The people who use the service are supported by the staff in a way that promotes their privacy and dignity. It was noted that care staff knock on doors before entering bedrooms. The service has developed an arrangement between two individuals allowing one to use his toilet, which is the closest to the dining and sitting rooms. This was discussed during the site visit and it was agreed that this arrangement must be formalised and fully documented in both individuals care plans and fully risk assessed. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: A random review of care plans demonstrated that the preferences of the people who use the service are recorded, developed and discussed during reviews. Observations throughout the site visit confirmed staff supported individuals to maintain their independence in daily living. The home operates a health action planning and the people who use the service have access to a GP, dentist, optician and chiropodist to maintain good health. The service has a robust policy on safe storage and handling of medications. The medication recording sheets were sampled they had been dated and signed by staff. Medications are stored in a locked metal cabinet secured to the wall in the staff office. However during the medication audit a large quantity of Diazepam, Colobazm and Rectal Diazepam was found with no records on the active medication recording sheets. This was discussed with the deputy manager who explained that the medication is rarely administered. The medication was recorded when it first came into the service but they had not transferred the running total from the relevant medication recording sheets and therefore it would be difficult to ascertain the actual quantity on site without a full audit of the relevant medication recording sheets. The medication was however securely stored and the people who use the service were safeguarded by the safe storage. Therefore the registered provider is required to ensure that all medication stored on site must have a total recorded on the medication recording sheets. Care Homes for Adults (18-65 years) Page 17 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All required policies, procedures and practises are in place to ensure that the people who use the service are safeguarded, as far as reasonably possible, from harm or abuse. Evidence: The home has a robust complaints policy, which fully complies with the National Minimum Standards. The inspector was informed on the day of the site visit that there has been no complaints made since the last inspection. The Annual Quality Assurance Assessment stated that no complaints or safeguarding incidents have been recorded by the service in the last twelve months. The Commission however was notified by Surrey Social Service of a safeguarding incident involving one of the people using the service. This was discussed during the site visit and it was stated that there had been a clerical error in completing the Annual Quality Assurance Assessment and there has indeed been a safeguarding meeting that is awaiting a closure. A requirement has been made in respect to the error in the Annual Quality Assurance Assessment please refer to the requirement section of outcome area 8 of this report. The home has a policy on abuse and a whistle blowing policy. It was stated in the Annual Quality Assurance Assessment that the staff have had relevant training in protection of vulnerable adults. A member of care staff stated that any allegations of abuse would be taken seriously recorded and be handled by the manager. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: The home has a copy of the local authority (Surrey County Council) procedure on safeguarding vulnerable adults. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service live in a homely and comfortable environment. The home is clean and hygienic throughout. Evidence: The premises are safe, bright, cheerful, and airy with sufficient light, heat and ventilation. On the day of the inspection the home was clean, well presented and relatively free from mal odour. A full tour of the service was undertaken as part of this site visit the standard of decor was generally good throughout the home. The furnishings and decoration are domestic in character. It was disappointing that the leather couches in the sitting room had paint splashes all over them. It is therefore recommended that the paint splashes on both of the couches in the sitting room be removed. Bedrooms were nicely decorated, well presented and personalised. The majority of the people who use the service were pleased to allow the inspector to review their bedrooms, one in particular was very proud of the new floor and decoration of his room. The service has small single purpose sensory room that is designed to offer a quite and calm area for the residents. The room however had a strong mal odour and had the appearance of a general store room. In addition the ceiling lights had no bulbs or Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: shades and it was not clear if they were live and could therefore be considered a health and safety hazard. Please refer to the requirements section in outcome are 8 of this report. Care Homes for Adults (18-65 years) Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service are supported by competent and qualified staff team. Staffing numbers need to be reviewed to ensure that individuals are supported by an effective team. Recruitment policies and procedures are well established but require to be closely adhered to. Evidence: The staffing numbers on the day of the site visit were observed to be limited and were only just meeting the needs of the people living in the home. Initially only two members of staff were on site with six residents, the deputy manager was off site on an errand for the home. It was stated by a member of staff that the required staffing figures for the home should be three care support workers, manager and one deputy. It was stated that the service has had several vacancies for full time care support staff for some time. The inspector was informed that the service is continuing the process of recruitment in an effort to have all vacant post filled. It is stated in the Annual Quality Assurance Assessment that one area of planned improvement in the next 12 months is to recruit our full complement of staff so that we will work well together and maintain the continuity within the home. Three staff files were sampled as part of this site visited and demonstrated that all Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: staff have a criminal record bureau (CRB) and POVA checks completed by the service and are reviewed regularly. However, more work needs to be done to ensure information set down in Regulation 19 and Schedule 2 of the Care Homes Regulations 2001 (as amended) is sought for all staff. In particular a full employment history should have been taken and any unexplained gaps can be followed up. The Annual Quality Assurance Assessment states that all staff have a comprehensive induction training this includes all mandatory training. This was supported by the deputy manager during the site visit. However a review of the staff training matrix did not support this and gaps within the staff teams mandatory training was evidenced. Care Homes for Adults (18-65 years) Page 23 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service benefit from a well run home. The service actively seeks feed back a have a robust quality assurance processes in place. The health, safety and welfare of residents are promoted and protected. Evidence: The home holds regular staff meetings which was confirmed by staff spoken to and from records sampled Service user Quality assurance questionnaires have been updated which were available for viewing. The company has also updated feedback questionnaires to include relatives and other stakeholders. The Responsible Individual carries out monthly regulation 26 monitoring visits and were reviewed as part of this site visit. The home holds regular meetings with the people who use the service being supported to engage and be pro active in the meeting. The CSCI received pre- inspection in the form of a Annual Quality Assurance Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Assessment information, which indicates that the company provides a range of policies, and procedures, which have been updated with the manger bringing this information to staff attention during staff meetings. Substances hazardous to health (COSHH) were stored securely and appropriately. Health and safety checks are completed and recorded regularly which were sampled including fire prevention records, fridge and water temperatures. The manager provided information to indicate that records and certificates and identified systems are in place for routine service and maintenance arrangements for the environment. However as was previously stated in this report issues were raised over the ceiling lights in the sensory room. A requirement has been made to this effect. Care Homes for Adults (18-65 years) Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 The registered provider must ensure that the statement of Purpose is reviewed and a copy submitted to the CSCI. The people who may use this service have sufficient information about the service and the services provided. 10/11/2008 2 18 12 The registered provider must developed guidance,procedures and risk assessments allowing one individual to use anothers en suite toilet. The use of private areas must be minimise to ensure privacy and maintain dignity. 13/11/2008 3 20 13 The registered provider must ensure that a running total of all medication kept on site is maintained. 13/11/2008 Care Homes for Adults (18-65 years) Page 27 of 30 The people using the service are safeguarded by the home safe storage policies. 4 24 23 The registered provider must ensure that the sensory room is fit for purpose and offers a safe environment for the people who use the service. To ensure that the service is a safe environment. 5 33 18 The registered provider must ensure that the home is effectively staffed at all times. The needs of the people who use the service must be met by a full complement of staff. 6 34 19 The registered provider 14/11/2008 must ensure that the staff files contain information set down in Regulation 19 and Schedule 2 of the Care Homes Regulations 2001 (as amended) is sought for all staff. In particular a full employment history should have been taken and any unexplained gaps can be followed up. 14/11/2008 14/11/2008 In order to protect the people who use the service. 7 35 18 The registerd provider must ensure that all manadatory training is undertaken by staff. 14/11/2008 Care Homes for Adults (18-65 years) Page 28 of 30 To ensure that needs can be effectively met. 8 42 13 The registered provider 14/11/2008 must ensure that the health and safety of the people who use the service are protected and regulation 26 visits are fully undertaken. The people who use the service are protected by the service health and safety procedures. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 24 The paint splashes on both of the couches in the sitting room be removed. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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!