Inspection on 15/06/06 for St Theresa`s Rest Home

This inspection was carried out on 15th June 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Theresa`s Rest Home 15/11/05

St Theresa`s Rest Home 23/08/04

St Theresa`s Rest Home 27/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE St Theresa`s Rest Home 6-8 Queen Anns Garden Enfield Middlesex EN1 2JN Lead Inspector Mr David Hastings KEY Unannounced Inspection 15th June 2006 09:30 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 St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 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. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Theresa`s Rest Home Address 6-8 Queen Anns Garden Enfield Middlesex EN1 2JN 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) 020 8360 6272 020 8360 6272 Mrs Lila Cecilia Paul Mr Jose Roy Paul Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home will not admit service users with a diagnosis of dementia. Three specified service users who have developed dementia may be accommodated in the home. The home must advise the registering authority at such times as any of the specified service users vacates the home. 15th November 2005 Date of last inspection Brief Description of the Service: St Theresas is a privately run home owned by Mr Jose Paul & Mrs Lila Paul and registered to accommodate twenty-three older service users of either sex. The home is a large converted house in a tree-lined road in Enfield. The bedrooms are on three floors and are comprised of thirteen single bedrooms and five double bedrooms. One single room and one double have en-suite facilities. The lounge/dining area is on the ground floor with a conservatory attached. There is a large garden to the rear of the house. The home is well serviced by public transport and there are shops nearby. The stated aim of the home is to foster an atmosphere of care and support which both enables and encourages our residents to live as full, interesting and independent a lifestyle as possible with rules and regulations kept to a minimum. The current scale of charges range from £360 to £415 per week. A copy of this report is available on the CSCI website and / or from the home. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Thursday 15th June 2006 and lasted seven hours. The inspector spoke with ten residents and four staff. The inspector also spoke with a number of visitors to the home. A partial tour of the home took place and seven service user plans were examined along with other documents relating to staffing, medication, health and safety and service user information. The inspector was assisted by the registered provider who was open and helpful throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Two requirements relating to safe water temperatures and the manager recording her whereabouts on the rota have been restated. Unmet requirements impact upon the welfare and safety of residents. Failure to comply by the revised timescales will lead to the Commission for Social Care Inspection considering enforcement action to secure compliance. As a result of this inspection eight new requirements have been issued. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 6 Residents need to be more involved in the review of their care plans. The home must provide clarity around the issue of transport and escort provision for service users attending hospital appointments etc. A photo of each resident must be attached to his or her individual medication chart. Better systems must be found for returning and storing clothes brought back from the laundry. An inventory of clothes and personal items must be completed for all new residents coming into the home. Both the complaints system and the quality assurance system must be formalised in order to provide better information for residents. The electrical installation certificate must be renewed. The inspector is confident that these requirements will be complied with by the registered provider within the timescales given. 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. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 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 St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (6 not applicable). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have their needs professionally assessed before admission so that they know the home can meet all their needs. EVIDENCE: The assessment for the most recent service user to be admitted to the home was examined. This was detailed and appropriate. The assessment indicated that the service user did not have dementia and the manager was clear that no service user would be admitted to the home with such a diagnosis. This is in line with the home’s conditions of registration. The manager informed the inspector that she always assesses any potential service user herself. A number of service users have developed dementia during the time they have lived at the home. The registered provider has applied to the CSCI for a minor variation for these named service users. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All service users have an individual plan of care that staff understand and follow in order to meet the service users’ health, personal and social needs. Staff must remember to record service user’ views about their care. Service users have good access to health care professionals. Service users get the right medication at the right times by appropriately trained staff. Service users are treated with respect. However more attention needs to be paid to the storing of service user’s clothes. EVIDENCE: Seven service user plans were examined. These contained information regarding all aspects of care outlined in Standard 3 and were sufficiently detailed to enable staff to understand the individual needs of service users. Staff interviewed had a good understanding of these plans and were able to give detailed accounts as to how they meet the needs of people living in the home. There was evidence that plans are being reviewed monthly. However it was not always evident that service users had been involved in this monthly review of their care provision. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 10 It is important that service users have a say in how their care is provided by the staff at the home. This is also important, as service users’ views must be incorporated into the home’s quality assurance systems. A requirement has been issued that staff record service users’ views about the care provided to them when care plans are reviewed. Service users that the inspector spoke with were positive about the care and support they received at the home. Care plans contained information about the health needs of service users and evidence that service users have access to heath care professionals including GPs. This was confirmed by service users that the inspector spoke with. Risk assessments were contained in all plans examined and these were varied and detailed. Risks covered manual handling and pressure care. No service users currently have pressure sores and pressure relieving equipment is being used for service users who have been assessed as being at risk. Written information was seen regarding doctors’ visits. This information included the outcome of the doctor’s visits and any amendments to the care plans as a result. From discussion with staff, service users and relatives, there appeared to be some confusion regarding the provision of escorts and transport when service users need to attend hospital appointments. The manager informed the inspector that transport is increasingly difficult to obtain from doctors surgeries. It was not always clear who was responsible for paying for transport and/ or escorts for service users to attend appointments etc. A requirement has been issued that clearer information regarding the provision of transport and escorts is given to all service users and their families/representatives. The records in relation to the receipt, administration and disposal of medication were examined. All records were detailed and accurate Records indicated that all staff who administer medication have undertaken the appropriate training. One requirement has been issued that all medication charts have a photograph of the individual service user attached to it. This will further ensure that the medication is given to the right service user. Service users that the inspector spoke with were very positive about the staff team and said that they were treated with respect and dignity. This was further confirmed by observation between staff and service users. Staff were friendly and polite towards service users. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 11 During the inspection the inspector found that, in some shared rooms, service user’s clothes were being mixed up together. This meant that service user’s under garments were not being returned to the individual’s own cupboards. Even though service users may share a room this does not mean that their own clothes should be stored together. The manager informed the inspector that this may be as a result of a small minority of staff not paying enough attention when they return clothes from the laundry. Some comments that the inspector received indicated that clothes sometimes were not returned from the laundry. Better systems for returning clothes from the laundry are needed. It was also found that no inventory of clothes/ belongings are being recorded when service users are admitted to the home. This also makes keeping track of individual’s clothes more difficult. Two requirements relating to these issues have been made in the relevant section of this report. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to choose from a variety of activities provided by the home. Service users are helped to exercise choice and control over their lives and they are encouraged to maintain contact with family and friends. The home offers a good range of well cooked, fresh meals, which the service users enjoy in pleasant surroundings. EVIDENCE: Service users’ recreational interests are recorded in their plan of care. The home has a schedule of activities displayed in the home. Staff were observed sitting and talking with service users. A recommendation was issued at the last inspection that the schedule of activities should be reviewed to include a more “person centred” approach. The manager was able to describe how a number of service users are kept occupied at the home by helping out laying tables and watering plants. A new activities book has been purchased and two staff have attended a course on chair based exercises for older people. Service users said they were satisfied with activities available in the home. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 13 The visitors’ book indicated that service users could have visitors at any reasonable time and the inspector saw a number of visitors during the inspection. Friends and family of service users said they were always made welcome by staff when they visited. There was evidence from care plans that service users can choose when to get up and go to bed and what menus they would prefer. No service users currently manage their own finances as this is either dealt with by their family or by the local authority. There was evidence that service users are encouraged to bring in their own personal possessions and furniture. Service users that the inspector spoke with confirmed that they were able to exercise choice and control over what they did at the home. Service users that the inspector spoke with were positive about the food at the home and confirmed they had a choice of menu. The cook was aware of the different dietary needs of service users and the kitchen was clean and well stocked with food. Lunch was relaxed and unhurried and staff were observed providing discreet assistance were needed. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and the manager of the home acts upon any concerns quickly. Service users are protected from abuse by clear procedures and a well trained staff team. EVIDENCE: Service users that the inspector met said they had no concerns or complains about the home but they knew who to speak to if they did. Two complaints have been received since the last inspection. These were verbal complaints and the manager had not recorded them. It was clear from discussion with the manager that the complaints had been dealt with promptly and effectively. A requirement has been issued in the relevant section of this report that the complaints system must be formalised and any complaint made to the home must be recorded and responded to. This will enable service users and their representatives to have better clarity about how the manager is dealing with their complaint. Staff interviewed had a good understanding about the issue of protecting service users from abuse. Records also indicated that staff have undertaken Adult Protection training. The manager was able to describe how the home’s procedure worked in conjunction with the local authorities’ Adult Protection procedure. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate judgement has been made using available evidence including a visit to this service. The owners are working hard to improve the general condition of the premises and the home is clean, comfortable and has a homely atmosphere. The issue of safe water temperatures must be addressed as this could impact on the safety of service users. EVIDENCE: The home is an older property and until the new providers took over has suffered from under investment. The inspector was pleased to see a rolling programme of maintenance and refurbishment by the provider. This includes work on the outside of the building as well as regular room decoration. A requirement was issued at the last inspection that the home be maintained at a comfortable temperature. At the last inspection a number of service users said the home felt cold. On the day on this inspection all parts of the home were being maintained at a comfortable temperature. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 16 Another requirement was issued that water temperatures in wash hand basins must be maintained close to 43 degrees. Although water temperatures tested on the day were satisfactory, the CSCI has not received written confirmation from a qualified plumber that the water temperatures of wash hand basins are satisfactory and do not effect the water temperatures of the kitchen or the laundry. This issue impacts on service users safety. The requirement has been restated. Staff at the home have undertaken infection control training and certificates were seen on files examined. The laundry area was clean and the washing machine has a sluice cycle for heavily soiled laundry. On the day of the inspection all parts of the home were clean and free from offensive odours throughout. Service users informed the inspector that the home was always clean. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a committed and caring staff team who have a good understanding of service users’ individual needs. Staff receive the training they need to carry out their duties and responsibilities effectively. Service users are protected by the home’s thorough recruitment procedures EVIDENCE: Service users that the inspector spoke with were very positive about the staff at the home. One service user commented that, “The staff here are very good”. There appeared to be sufficient staff on duty to meet the needs of the service users on the day of the inspection. Staff interviewed had an excellent understanding of the needs of the service users and interactions observed between staff and service users were supportive, friendly and caring. Staff rotas were available for inspection and found to be satisfactory except that the manager was still not recording when she was due to be in the home on the duty rota. This was a requirement from the last inspection and is restated. This is an important issue, as all staff need to know when the manager is due in the home and fosters a more professional management approach. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 18 Of the thirteen care staff five have completed their NVQ level 2 or equivalent. This does not yet meet the requirements of the National Minimum Standards. However records indicated that the manager is working hard to meet the standard through the home’s workforce development plan. This plan was detailed and outlined the training needs for all staff at the home. It was clear from discussion with staff and from the staff training record that the manager is very proactive with regard to staff training. Staff spoken to said there were good training opportunities at the home. Four staff files were examined. All these files contained the information required by this standard including CRB disclosures, proof of identity and two references. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager carries out her duties and responsibilities in a caring and professional manner. Quality assurance systems need to be formalised so that service users can judge how well the home is doing in meeting its objectives. Service users’ financial interests are safeguarded by clear accounting procedures. Overall there are good policies and procedures in place to monitor heath and safety compliance in the home. EVIDENCE: The manager is currently undertaking the Registered Manager’s training and is due to complete this in November 2006. Service users that the inspector spoke with were very positive about the manager and one service user told the inspector that the manager always says to her, “Don’t forget, this is your St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 20 home”. The service user clearly appreciated the manager’s attitude towards her care. Service users and visitors were generally positive about the home and the inspector saw a number of glowing testimonials from friends and relatives about the home. The manager informed the inspector that she carries out regular questionnaires for service users and their representatives. However these are not collated or made available to service users. A requirement has been made that the quality assurance system is reviewed and formalised. This must include the collation of any questionnaires and making this information available to all interested parties, including current and prospective service users. This will give information to service users and their representatives about how well the home is doing in meeting their objectives of care. As stated previously in this report, no service users currently manage their own financial affairs. The home does hold small amounts of money on behalf of service users. This money is used to purchase small items and to pay for hairdressing. A random selection of this money was inspected and found to be accurate with clear audit trails including individual receipts. Two requirements were issued at the last inspection relating to fire safety. All the names of staff who attend fire drills are now being recorded and the fire emergency plan has been reviewed and sent to the local fire officer. Both these requirements have now been complied with. Satisfactory certificates were seen in connection with gas safety, portable appliances and Legionella checks. The electrical installation certificate has expired and a requirement has been issued that this is renewed. St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 21 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP19 Regulation 13(4) c Requirement The registered provider must ensure that written confirmation is sent to the CSCI from a qualified plumber that wash hand basin temperatures can be safely maintained at 43 degrees whilst not affecting the hot water storage and supply to the kitchen and laundry. (Timescale of 01/01/06 not met) This requirement is restated. 2. OP27 18(1) a The registered provider must ensure that the manager’s hours of working are clearly recorded on the weekly duty rota. (Timescale of 01/12/05 not met) This requirement is restated. 3. OP7 15(2) The registered provider must ensure that service users’ comments and views regarding their care are sort and recorded every time the care plan is reviewed. 01/09/06 01/08/06 Timescale for action 01/08/06 St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 23 4. OP8 1291) b 5. OP9 13(2) 6. OP10 12(5) 7. OP10 16(2) f 8. OP16 22(1) 9. OP33 24(1) 10. OP38 23(2) b The registered provider must ensure that a clear policy is developed regarding the provision of transport and escorts to doctor/hospital appointments. A copy of this policy must be sent to the CSCI and made available to all service users and their representatives. The registered provider must ensure that a photograph of the service user is attached to their individual MAR chart. The registered provider must ensure that all service user’s personal items and possessions are recorded in an inventory when they are admitted to the home. The registered provider must ensure that the systems for returning clothes from the laundry are reviewed so that service user’s clothes are not mixed up together and are stored in their own cupboards. The registered provider must ensure that the complaints system is revised and formalised so that all complaints are properly recorded and responded to. The registered provider must ensure that the quality assurance system for the home is revised and formalised so that it meets the requirements of Standard 33 of the National Minimum Standards for Older People. The registered provider must ensure that the electrical installation certificate is updated. 01/09/06 01/09/06 01/09/06 01/09/06 01/09/06 01/10/06 01/09/06 St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Theresa`s Rest Home DS0000045869.V289920.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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