Inspection on 17/12/07 for Sycamore Cottage

This inspection was carried out on 17th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Sycamore Cottage 09/12/08

Sycamore Cottage 16/06/08

Sycamore Cottage 05/06/07

Sycamore Cottage 04/10/06

Sycamore Cottage 25/10/05

Sycamore Cottage 05/05/05

Sycamore Cottage 07/10/04

Sycamore Cottage 15/04/04

Sycamore Cottage 30/09/03

Sycamore Cottage 23/01/03

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

CARE HOMES FOR OLDER PEOPLE Sycamore Cottage Skippets Lane West Basingstoke Hampshire RG21 3HP Lead Inspector Tracey Horne 17 th Unannounced Inspection December 2007 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 Sycamore Cottage DS0000011821.V354436.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. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sycamore Cottage Address Skippets Lane West Basingstoke Hampshire RG21 3HP Telephone number Fax number Email address Mr Vanderslott Web address Name of registered Mr Vanderslott(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01256 478952 Mr A Vanderslott Mrs K Vanderslott Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (6) of places Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th June 2007 Brief Description of the Service: Sycamore Cottage is a privately owned and managed care home registered to provide accommodation personal care and support for up to twenty residents over the age of sixty-five years with dementia. The home is situated in a private residential lane close to public transport within easy travelling distance of the main centre of the North Hampshire town of Basingstoke. The current fees charged ranged between £395- £440 per week. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards (NMS) and Regulations. The findings of this report are based on several different sources of evidence. These included: an unannounced visit to the home, which was carried out on the 17th December 2007 between 09.30 and 15.30, by Mrs Tracey Horne, Inspector, speaking to residents and staff in the communal areas and bedrooms, looking at records and observing interaction between people living and working at the home. The registered manager was not available during this inspection, but the responsible person, Mr Vanderslott was. The people living in the home prefer to be referred to as residents, therefore the rest of this report will reflect this. We sent to the providers the Annual Quality Assurance Assessment (AQAA) prior to this visit for completion and return, which provides us with all the information about the home including improvements made and what also needs to be done but it was not returned. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the CSCI. What the service does well: What has improved since the last inspection? Prescribed medication is stored appropriately. A stair lift has been replaced. The windows at the front of the house have been replaced with UPVC and work is underway to replace the remaining windows. A new wide screen television has been bought for the small lounge, and the lounge has been redecorated. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 6 What they could do better: Out of the nine requirements made during this inspection, four have been repeated from previous inspections because improvements have not been made. Residents and /or their representatives need to be consulted during the pre admission assessment and care planning process. Evidence of this needs to be maintained. Care plans must be reviewed regularly and risk assessments must be completed where necessary. Reasons why prescribed medicines have not been administered must be recorded on the Medication Administration Sheets (MARS) There is continued offensive odours in some parts of the home that need to be eliminated. Evidence to show staff have received training to carry out their job must be available within the home and staff must receive regular, formal supervision by an appropriate trained person at least six times a year. Criminal Record Bureau (CRB) checks must be obtained before staff are confirmed in post and a Protection of Vulnerable Adults (POVA) check has been completed. A way of monitoring quality assurance must be devised that includes seeking the views of residents. We will be requiring Mr Vanderslott to submit an action plan detailing how the requirements will be met within the given timescale. Mr Vanderslott acknowledged that the management of filing/records system needs to be improved. Further work has been planned to improve the condition of the home which although is comfortable and nicely decorated in some areas, others are showing signs of wear and tear and need attention. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 7 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. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 8 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 Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 9 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 and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The system for assessing resident’s needs prior to admission ensures residents needs can be met but did not include evidence to confirm residents or their representatives had been consulted during the assessment process. The home does not provide intermediate care. EVIDENCE: The manager undertakes assessments of the residents and Mr Vanderslott reported that these assessments are used as part of the care plan. Staff reported that the residents are offered the opportunity to visit the home prior to admission. However not many residents actually do due to their poor health. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 10 One relative confirmed they visited the home prior to an assessment being carried out, but they were not consulted as part of the assessment as it was completed when their relative was in hospital. We looked at records for two residents who were recently admitted, neither record included confirmation that the prospective resident or their relative had been consulted. This issue was raised at the last inspection and remains an outstanding requirement. Mr Vanderslott confirmed that the service does not provide intermediate care. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 11 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. Further improvement is needed to show that individual’s needs are reflected in their care plan, which has been developed and reviewed with service user’s involvement. Risk assessments regarding activities to safeguard residents and staff were not available. Medication practices in the home need improving to ensure they are managed well. Residents receive health and personal care based on their individual needs and are treated with dignity and respect whilst their privacy is maintained. EVIDENCE: Four care plans were seen and included basic information about each resident. One of which had been reviewed recently as part of a social services review. It was discussed with Mr Vanderslott that monthly reviews should be in place due to the changing needs of the residents. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 12 This issue was raised at the last inspection and remains an outstanding requirement. It was recorded on two residents pre admission assessments that they were prone to falls, although this was included in the care plans, no risk assessments were available to show how the risk may be minimised. Mr Vanderslott said that he recalls completing some but none could be located at the time of the visit. A requirement was made. Records showed that residents accessed appropriate healthcare professionals, such as their doctor, chiropodist and district nurse as required. A sample of the Medication Administration Record (MAR) sheets was seen, some of which were not complete. There were gaps where ‘when required’ medication hadn’t been administered. Staff said that it this was probably due to the resident not needing it. This was discussed with Mr Vanderslott as MAR sheets must be completed to show the reason why prescribed medicines have not been administered. A requirement was made. There was no record of staff signatures to check against the initials made on the MAR sheet, Mr Vanderslott said this would be rectified. Records showed that staff adhered to the procedures for the receiving and disposal of medication. Medication is administered by one member of staff, who said they had completed medication training about two years ago, no records were available to show this, therefore a requirement was made to ensure that staff receive relevant safe administration of medicines training. The inspector observed the staff interacted well with the residents and found them friendly and respectful when providing for their needs. Two relatives said that the staff are very caring and respectful. Sycamore Cottage DS0000011821.V354436.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 and 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The social activities, family contacts and the provision of varied and nutritious meals were well managed and reflected residents’ interests and choices. EVIDENCE: There were some activities available on the day of the visit. One carer was observed playing game with a group of three residents that they seemed to enjoy. Some residents were sat in the main lounge where a radio was playing and two residents were in the small lounge with the television on. Some residents were having their hair styled by the hairdresser who visits the home once a fortnight. Comments from relative were that there were limited activities provided. Carers provided some of the activities as able and this was dependent on time available to them. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 14 Mr Vanderslott confirmed the home do not have any other entertainment other that that provided by staff or the resident’s relatives. Two relatives said it was difficult for staff to motivate the residents as most of the time they prefer sleeping. The home has an open visiting policy and a record of all visitors to the home was maintained that showed that there was no restriction on visiting times. Residents said that they could see their visitors in private or in communal areas as preferred. One relative spoken with said that he visited at various times and there was no restriction on visiting. The home has a planned menu that indicated that there is a choice of meals at lunchtime. Staff reported that the menu was rotated on a four weekly basis. During the last inspection it was discussed with Mr Vanderslott that residents may benefit if the menu was produced with pictures or photographs. Mr Vanderslott said that this has not been done but he would look into improving this. The home does not have a cook and one of the carers cooks the lunchtime meal and the other carers prepared teatime meals and all meals at the weekend. Relatives said that the food always appears appetising and nutritious. Staff were observed to be available at lunchtime to offer support with meals as required. Sycamore Cottage DS0000011821.V354436.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 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home ensures that residents are able to complain but evidence of staff receiving training in the recognition and prevention of abuse would ensure residents are protected. EVIDENCE: Mr Vanderslott said that the home had not received any complaints for a couple of years, the complaints log confirmed this. Staff said they were aware of the home’s procedure for dealing with complaints and relatives said they were confident the staff would take any concerns they may have seriously. Policies and procedures for the protection of vulnerable adults were available and included the Hampshire safeguarding adult procedures. Discussion with staff indicated that they have some knowledge of what constituted abuse. Staff reported that they would approach the manager or Mr Vanderslott if any allegation of abuse were made to them. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 16 Mr Vanderslott said he has provided training surrounding the homes policies and procedures, but there was no evidence available to show who had attended and when. Therefore a requirement was made for all staff to attend abuse awareness training. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 17 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 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements are being made, and are needed to ensure residents are accommodated in a safe and comfortable environment that meets their needs. The majority of the home was clean but offensive odours still persist in some parts of the home. EVIDENCE: A tour of the building was undertaken as part of the visit. A new chair lift has been installed to support residents in maintaining their independence. Most of the bedrooms were personalised and comments from some of the residents were that they liked their rooms. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 18 Two relatives said that residents were encouraged to bring personal items with them when they moved into the home. There are two communal lounges and most furnishing was in a satisfactory condition. The décor within some areas of the home was in need of attention with paint peeling on the banister and landing, tiles broken in one bathroom, commodes had stained bowls and some had peeling paintwork. There continues to be offensive odours lingering in one communal area and three bedrooms. This was an issue of concern at previous inspections. A further requirement was made. One bedroom radiator was not working, a small electric fan heater had been placed in the room. Mr Vanderslott said the problem is intermittent, and has requested a plumber deal with it. Residents’ benefit from well-maintained gardens, one resident said they enjoy sitting on the decking area in warmer weather. The staff clean the home, one member of staff is allocated time each day to complete domestic duties and laundry. Infection control procedures were in place. Staff were observed to follow this guidance, gloves were available and the home have a contract with a clinical waste company to ensure bins are emptied regularly. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 19 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 and 30 Quality outcome in this area is poor. The judgement has been made using available evidence including visits to the service. Residents’ benefit from appropriate staffing levels. All staff have achieved an NVQ level two or above, but not all records were available to show this achievement. The recruitment process needs improving to ensure the welfare of residents is safeguarded. There is a training programme in place, but the lack of records to show staff have received training is detrimental to the welfare of the residents. EVIDENCE: Mr Vanderslott said that there were sufficient staff on duty day and night to provide personal and domestic care. Staff said there are enough staff on duty to meet individual and group needs of residents. Mr Vanderslott said that all staff have achieved an NVQ level 2 or above, although only one certificate was available to confirm this. One member of staff said they might have forgotten to provide a copy for their records. A requirement was made. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 20 The records of the two most recently recruited staff were seen. Most recruitment checks had been completed, but records showed that both staff members commenced work before a POVA and CRB check had been completed. A requirement was made. Records were available to show dates of when staff had received training, and staff said they had received recent training in dementia. But in the majority of cases, no evidence was available to show they had received training in health and safety, manual handling, first aid, fire awareness, infection control, abuse, safe administration of medicines, dementia awareness or new staff induction. A requirement was made. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 21 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, 36 and 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the home. Further work is needed to ensure residents’ benefit from a well organised home, with additional work on risk assessments to ensure the health and safety of residents and staff is improved. The lack of a quality assurance system does not ensure that residents are able to contribute their views for the development of the home. There is a lack of structured supervision for staff and their practices are not monitored as part of their work. There is a programme in place for the servicing of equipment in order to ensure the safety of the residents. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 22 EVIDENCE: The home has a registered manager who for the past two years has only been available to work a maximum of twenty hours a week in the home. Mr Vanderslott said the home employ three senior carers, but the registered manager prefers to be responsible for record keeping and supervision of staff, as stated in this report, all of which have not been satisfactory and must be improved. Mr Vanderslott said that this situation would be reviewed after Christmas. Staff reported that they seek support from Mr Vanderslott as required. Two relatives and the hairdresser said they had never met the registered manager and occasionally see Mr Vanderslott at the home. One relative of a recently admitted resident said this was the first time they had seen Mr Vanderslott at the home and they visit up to three times a week. Residents said they were very happy and the lack of manager didn’t appear to have affected the care and support residents receive. Relatives confirmed this and said the staff are approachable and in their opinion seem to work well despite lack of management guidance. It was apparent that filing of paperwork had not been completed adequately, resulting in some not being found. This is also reflected in other areas of this report. Mr Vanderslott is aware that records management must be improved and records filed appropriately and said that this would be rectified. Mr Vanderslott needs to develop a quality assurance process, which seeks the views of residents, and their relatives to ensure their views are obtained. Mr Vanderslott said that he obtains views by speaking to residents and staff, but this needs to be formalised. Mr Vanderslott confirmed the home is not involved with any residents’ finances, their relatives have the responsibility. An example of which is, the hairdresser provided an invoice for Mr Vanderslott who contacts the resident’s relative to provide payment. A sample of the supervision programme for staff was seen it showed that staff had not received supervision since September 2006. This has been discussed at the last two inspections. This requirement remains unmet. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 23 A sample of the servicing of equipment was seen. Records of staff training showed that no staff had received fire awareness or fire drill training in the last twelve months. Two staff said they had received fire awareness training from a fire fighter in the past six months. A requirement was made. Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 24 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 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 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 3 1 X 2 Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 25 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 provider/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 OP3 Regulation 14(c) Requirement Timescale for action 17/02/08 2 OP7 15(1,2) 13(4.b,c) 3 OP9 13.2. Schedule 3.3(i). 4 OP19 23.2(b,d) There must be evidence available to confirm that residents or their representatives had been consulted during the initial assessment process. This is a repeat of requirements made on 5th June 2007. 17/02/08 A review of all care plans and include risk assessments as appropriate, must be undertaken involving the resident or their representative where possible. Thereafter reviews of plans must be monthly with the involvement of the resident or their representative where possible. This is a repeat of requirements made on 5th June 2007. The registered person must 17/02/08 ensure Medication Administration Record (MAR) sheets show accurate records of why prescribed medication was not administered. The registered person must 17/02/08 ensure that there is a programme of routine DS0000011821.V354436.R01.S.doc Version 5.2 Sycamore Cottage Page 26 5 OP26 6 OP30 7 OP29 8 OP33 9 OP36 maintenance and the home is kept in good state of repair. 16.2(k) The home is to be kept free of unpleasant and adverse odours. This is a repeat of requirements made on 4h October 2005, 25th October 2006 and 5th June 2007. 13(6), The registered person must 17(2) ensure that all staff receive Schedule relevant training in first aid, food 4 (14), hygiene, manual handling, 18.1(a,c,i) abuse, health and safety and fire as well as training specific to the needs of the residents in the home. And evidence of training undertaken is kept in the home. Schedule The registered person must 2. 7 ensure staff are confirmed in post once a POVA check has been cleared. 24 The registered person must ensure there is an effective quality assurance system in the home, to seek the views of residents and their relatives 18(2) All staff must receive supervision at least six times in a calendar year. This is a repeat of requirements made on 4th Oct 2006 and 5th June 2007. 17/02/08 17/02/08 17/02/08 17/02/08 17/02/08 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 Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Sycamore Cottage DS0000011821.V354436.R01.S.doc Version 5.2 Page 28 - 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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