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Inspection on 13/02/07 for Springfield Care Home

Also see our care home review for Springfield Care Home for more information

This inspection was carried out on 13th February 2007.

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

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

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

What the care home does well

The home provides a friendly environment, which was in reasonable environmental condition on the day of the inspection. The manager and staff seem committed to providing good standards of care for the residents. Residents say they feel respected and are helped to socialise in a manner that is comfortable for them.

What has improved since the last inspection?

The requirements from the previous inspection have been addressed or are in the process of being addressed. The recruitment procedure and the maintenance of staff records has improved and contributes to the efficient recruitment of staff and the protection of residents. There is more comprehensive evidence of staff training, which will help ensure the quality of care for resident`s continues to improve. The proprietor has redecorated and re-carpeted parts of the communal areas in the home.

What the care home could do better:

Risk assessments or the review care plans are not conducted for residents appropriately. This puts residents at risk physically and psychologically. Staffing levels are not always sufficient to ensure the appropriate supervision or stimulation for residents, particularly those with Dementia. The complaints process does not ensure that individual`s care, or the homes care practices, are reviewed following complaints. The homes dining area needs to be made more appealing for residents to sit and enjoy their meals.

CARE HOMES FOR OLDER PEOPLE Springfield Care Home Lawton Drive Bulwell Nottingham NG6 8BL Lead Inspector Andrew Sales Key Unannounced Inspection 13th February 2007 10:00 X10015.doc Version 1.40 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 Springfield Care Home DS0000002305.V329254.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Care Home Address Lawton Drive Bulwell Nottingham NG6 8BL 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) 0115 927 9111 0115 979 4759 ckpatel1@tiscali.co.uk Annesley (Oldercare) Limited Mrs Eileen Hester Care Home 40 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (40) of places Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To accommodate one named out of category service user for respite care To include up to 7 elderly service users with Dementia. The registration reverts to 40 places for Older People when the placement of the one named individual ceases. 26th April 2006 Date of last inspection Brief Description of the Service: Springfield is a care home providing personal care and accommodation for 40 older people. The home has seven registered places for people with a diagnosis of dementia. The home is owned by Annesley (Oldercare) Limited. The home is located on the outskirts of Bulwell town centre which is approximately 7 miles to the north of Nottingham city centre. The home was purpose built and was opened in November 1989. It consists of a three-storey building with the lower ground floor being used to accommodate the dining room and conservatory, kitchen and laundry. All but four of the homes bedrooms are single. All bedrooms have en-suite facilities that consist of a toilet and wash hand basin. There is a passenger lift. The gardens are mainly laid to one side and the rear. They are easily accessible from the conservatory and consist of lawned areas. There is a car park to the front of the building. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted by A. Sales and M. Williams on 13 February 2007. The report has been written by A. Sales The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting six residents and tracking the care they receive through review of their records and either discussion with them, their relatives, the care staff and observation of care practices. The inspector also spent time talking to other residents in the home, relatives and three members of staff. Overall the feedback was good. Residents were happy to express their views about the home, they were positive in terms of the skills and attitude of the staff and of the overall standards of care, food provision and their environment. What the service does well: What has improved since the last inspection? The requirements from the previous inspection have been addressed or are in the process of being addressed. The recruitment procedure and the maintenance of staff records has improved and contributes to the efficient recruitment of staff and the protection of residents. There is more comprehensive evidence of staff training, which will help ensure the quality of care for resident’s continues to improve. The proprietor has redecorated and re-carpeted parts of the communal areas in the home. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are assessed prior to entering the home. The home is not fully capable of meeting all of the needs of residents it admits. Intermediate care is not provided. EVIDENCE: The records of six resident’s were checked as part of this inspection. The files contained assessments conducted by the manager and/or senior care staff and where appropriate local authority extended social care assessments. All of the assessments contained relevant information, though some concerns as to the detail and content of the assessments are raised in National Minimum Standards (NMS) 7. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 9 Residents and relatives spoken with said they felt staff were competent and polite and were aware of their needs. They also felt that staff understood the importance of residents undertaking tasks at their own pace. The home has a significant proportion of residents who have Dementia, approximately ninety percent, whilst only being registered for seven. Evidence throughout this report indicates that the general personal care needs of residents are met and many individuals are satisfied with their overall care. However significant areas of improvement have been identified to ensure people with Dementia are appropriately supervised and have their individual needs assessed, with suitable staff resources to deliver this. The home does not provide intermediate care. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Progress has been made on improving arrangements to ensure that the health care needs of residents are identified and met. Significant improvements to the assessment of resident’s individual needs is still required. This places residents at risk. EVIDENCE: All of the six residents whose records were checked as part of this inspection had care assessment plans in place. It is acknowledged that the manager has continued to develop these care plans but there are significant gaps in the assessment process that are placing individuals at risk. For example, some plans identify that a person has problems with mobility or continence, but there is limited information to show staff how that person needs to be helped. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 11 The records show that the care plans are being reviewed at least once each month. This process is recorded as diary entries with ‘no change’ written and signed by staff. This does not evidence that a meaningful review has been conducted in consultation with residents or advocates. It is particularly important given that most residents cannot communicate effectively, that they or their representatives, are being involved in the review process and advocacy services are made available. The care plans that were inspected, also did not contain risk assessments. These need to be completed to ensure the safety of residents and staff. Resident’s care plans contain details of each resident’s individual health care needs, which may include, continence, dietary intake and weight monitoring. However a number of residents assessed as incontinent or of poor mobility did not have a tissue viability, continence or mobility assessment. Relatives and visiting professionals felt that the staff did their best but often some very confused residents could be left unsupervised and be put at risk. The accident book showed 32 incidences of falls since December 2006. Those residents who had falls did not have their care plans reviewed. This should be done as a matter of course to highlight any changes in health, any additional support measures needed and to identify any professional help that could benefit the resident. The inspector discussed issues relating to the management of falls, which were raised at previous inspections. The manager showed the inspector new instructions for staff, that have been introduced to reduce the incidence of falls and to deal with emergencies more effectively. There is evidence that people have been appropriately referred to health care professionals. Care plans viewed, contained records of visits by district nurses, General Practitioners and other professionals. The inspectors spoke with one of the district nurse team who described the level of input in the home and commented that standards of care and attention to pressure care had improved a good deal since some serious incidents were investigated in 2006. The inspectors observed detailed District Nurse records. Staff were observed during the visit interacting professionally when assisting residents. All of the residents and relatives who spoke with the Inspectors, commented positively on the conduct and attitude of the staff. They reported that the staff provide a good standard of care and areas of concern would be discussed with the registered manager. Staff training records evidenced that medication training was provided for staff responsible for the administration of medication. The homes medication administration systems have been well maintained. There is a policy and Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 12 procedures for receiving, recording, storing, handling, administering and disposal of medicines. The home is registered with the local pharmacist and support and advice be obtained as and when needed. The pharmacist visits twice a year and conducts and audit of the homes medicines. The deputy manager showed the inspector the storage and records for medicines, which is a well managed process. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a reasonably flexible daily routine, but the home does not presently have the resources or skills to fully meet the recreational and social needs of the residents. EVIDENCE: Some of the residents spoken with stated they were happy with the level of activities within the home. Other residents said they could not get out when they wanted to, as they had no relatives and staff did not have the time to assist them. The manager described that some entertainment was brought into the home. However, residents were observed spending long periods of time sitting in the lounge. Whilst some social preferences are recorded on care plans there is no structure to assess residents wishes and allocate resources to meet these needs. Considering the number of people at Springfield who now have Dementia, there is no ‘person centred’ planning evident in care plans. Evidence from relatives, residents and staff suggest that the current staff ratio of about one Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 14 to six is considered insufficient to meet the whole needs residents with dementia. Staff were observed throughout the day making every effort to engage residents when they had time away from essential duties, but overall there is no structure to deliver person centred care for people with conditions such as Dementia. There was a large number of relatives visiting on the day of the inspection and we were able to speak with five of them. Residents and relatives spoken with, commented that were made welcome at any time when visiting the home. The accommodation allows for relatives to visit in private rooms where required or there is a quiet lounge if desired. They all stated that they were pleased with the care their relative received and that they were always well presented and appeared well cared for. The dining area appeared uninviting, it was dark and tables were not well presented. There were plain table cloths on the tables with no table decorations. The residents, when asked, said this was normal but they commented that they did not expect anything more. Residents were observed briefly, eating lunch during the visit. The food appeared well presented. Resident’s spoken with commented positively on the standards and quality of food. Staff spoken with, were well aware of resident’s individual preferences. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has complaints and Adult Protection procedures in place to promote the safety of residents, but the high level of complaints and Adult Protection referrals questions their effectiveness. EVIDENCE: The home has a complaints procedure but the complaint record, individual residents’ records, and anecdotal evidence indicated that this is not always followed up appropriately. We have received five complaints over the past year, alleging poor care practice. These were referred to the provider to investigate. Also two incidents have been investigated under the Nottinghamshire County Councils policy on the Protection Of Vulnerable Adults. (P.O.V.A) procedure. Staff told the inspectors that they had not been made aware of this or that there had been an investigation, nor given any feedback. The home has policies on the Protection Of Vulnerable Adults. Staff spoken with had a good understanding of Protection Of Vulnerable Adults procedures and said they had attended training. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,23,25,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some improvements to the décor of the building have been made which have helped provide safer and more comfortable surroundings in which to live. EVIDENCE: Generally the home is kept fairly clean and reasonably well maintained. Residents said they felt it was homely and they felt comfortable with the surroundings. Resident’s rooms are personalised and kept clean. Residents spoken with said they were comfortable in their private accommodation. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 17 The hallways on both floors have recently been re-decorated and carpeted. Other parts of the home’s décor and furniture would benefit from replacement. The homes proprietor said he plans to do this in stages. The inspectors observed some bathrooms and toilets with rubbish bins without lids or bags for waste. This is unhygienic. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment of staff are satisfactory and offer protection to people living in the home. The deployment and number of staff available is not sufficient to meet the needs of the residents. EVIDENCE: Three staff files were seen. They contained all relevant recruitment documents and are now well maintained. Interviews which take place are recorded and kept on file. All of the personnel files that were examined revealed that thorough preemployment checks were carried out. The staff spoken with confirmed all the recruitment procedures had taken place. Staff demonstrated a clear understanding of their roles and responsibilities. The inspector observed training certificates on staff files. These covered mandatory training subjects and other training subjects relating to the different support needs of older people. Staff spoken with, commented that training and support were available at the home. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 19 Some residents said they could not get out when they wanted to, as they had no relatives and staff did not have the time to assist them. Many residents were observed spending long periods of time sitting in the lounge. Relatives and visiting professionals felt that the staff did their best but often some very confused residents could be left unsupervised and be put at risk. The inspectors observed staff supporting residents with patience and sensitivity. When possible they took every opportunity to engage them with conversation. But residents and staff said there was little time for staff to do anything meaningful or stimulating with residents due to the time they had and the dependencies of the people living there. Since the inspection we have received a further complaint, about staff shortages at night time. We have asked the provider to investigate this and address in the overall review of staffing levels. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Some aspects of the home are being managed more effectively, though the interests of the residents are not always given priority. This results in some practices that do not promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: Residents, staff and visiting professionals who spoke with the inspector, said they felt some issues in the home had improved and the manager and staff Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 21 were committed to making things better. This relates in particular to attention to pressure care and working alongside the District Health staff. Some residents and staff said the management team were on hand for support and advice. Some staff and relatives said they were not always convinced that the manager would act on their concerns. Some residents stated that they felt they were sometimes consulted about day to day issues. Residents meetings are held and the registered owner attends these to listen to residents concerns or ideas. Some of the staff spoken with, said they felt supported by the manager and that they are approachable to discuss any issues. Other members of staff felt they went largely un-noticed by senior staff. The staff confirmed they receive some supervision and attend team meetings. Evidence was observed on files of staff support and disciplinary issues being discussed and recorded. The three staff files observed, evidenced that staff have now undertaken training in most mandatory health and safety subjects. This is an improvement since the last inspection. Staff spoken with, were generally aware of health and safety procedures and commented that training was being provided. The inspector observed a satisfactory policy with regards to the safe keeping of resident’s personal allowances. The resident’s accounts were observed, cash balances were not checked on this occasion. Records for Health and Safety monitoring and the servicing of systems and appliances were inspected on this occasion and were found to be up to date. The main areas of concern for the safety of residents have been identified earlier in National Minimum Standards (NMS) 7,8 and 27. These areas relate to the management of risk for residents, the review of care plans following accidents and the ability of the home to meet the needs of residents with Dementia. Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 2 X x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 X X X 3 X 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x 3 X 3 X X 2 Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 OP4 Regulation 12 Timescale for action The registered person must 30/04/07 make proper provision for the health and welfare, of residents and ensure the home is able to meet the needs of residents admitted to the home. The registered person must 30/03/07 ensure that all residents care plans have suitable risk assessments in relation to their health and daily activities. The registered person must 30/03/07 ensure that all residents care plans are reviewed at the required frequency and after incidents or accidents. The registered person must 30/03/07 ensure that residents and relatives are consulted over assessments and reviews and that this is documented in the care plan. The registered person must 30/03/07 ensure that sufficient resources and systems are in place to minimise the risk of falls. The registered person must 30/04/07 ensure that residents psychological health is monitored DS0000002305.V329254.R01.S.doc Version 5.2 Page 24 Requirement 2. OP7 OP38 14 and 15 3. OP7 OP38 14 and 15 4. OP7 14 and 15 5. OP8 OP38 13.(4,b-c) 13.(5) 13(1,b) 6. OP8 Springfield Care Home 7. OP12 12(1,2,3) 8. OP15 23(2) 9. OP16 OP38 13 (4,c) 10. OP26 OP38 13. 11. OP27 OP38 18(1,a) regularly and preventative and restorative care provided The registered person must ensure that residents are given opportunities for stimulation through leisure and recreational activities in and outside the home which suit their needs, preferences and capacities, particular consideration is given to people with dementia and other cognitive impairments. The registered person must ensure that improvements to the dining area are made, to ensure it is made a more appealing place to eat. The registered person must ensure that a review of practices and procedures is conducted following complaints or allegations. The registered person must ensure that all private and communal areas have bins provided with lids and waste bags. The registered person must ensure that the staffing levels are reviewed to reflect the needs of the residents. 30/05/07 30/05/07 30/03/07 30/03/07 30/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. Extracts may not be used or reproduced without the express permission of CSCI Springfield Care Home DS0000002305.V329254.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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