Inspection on 13/03/07 for Tenterden House

This inspection was carried out on 13th March 2007.

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

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

Other inspections for this house

Tenterden House 19/01/09

Tenterden House 17/01/06

Tenterden House 08/09/05

Tenterden House 25/02/05

Tenterden House 07/09/04

Tenterden House 24/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Tenterden House Lye Lane Bricket Wood St Albans Hertfordshire AL2 3TN Lead Inspector Julia Bradshaw Unannounced Inspection 13th March 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 Tenterden House DS0000019563.V333162.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. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tenterden House Address Lye Lane Bricket Wood St Albans Hertfordshire AL2 3TN 01923 679989 01923 680 517 strandee@bupa.com www.bupa.com BUPA Care Homes (BNH) Limited 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) Heather Dawn Constance Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability (13), Terminally ill over of places 65 years of age (3) Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate 5 people (aged 50 years or more) who require convalescent nursing care. 17th January 2006 Date of last inspection Brief Description of the Service: Tenterden House is a period country house that has been extended and modernised whilst retaining the features and atmosphere of the original building. Service users are accommodated in single bedrooms, although one is designated as a double room. Thirteen bedrooms have en-suite facilities. Assisted bathing and assisted toilets are also provided. Communal space includes two lounges, a dining room and an activities room that is used for most of the activities events in the home. Well maintained level gardens surround the building, with lawns, flowerbeds, a patio area, a pergola and views over mature parkland. Interior decor is consistent with the country house style of the building, with pictures, ornaments and fresh flower arrangements contributing to the attractive environment. Adequate car parking is available. The home is located on the outskirts of Bricket Wood in a rural setting between St Albans and Watford. There is convenient access to both the M1 and M25 motorways. The information relating to the service is available in the Service User Guide and Statement of Purpose. The range of fees for Tenterden are between £980.00 and £1200.00. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday and was carried out by one inspector. Discussions were held with service users, visiting relatives, members of care staff, and the deputy manager who was in charge of the home whilst the registered manager was on annual leave. Staff were observed going about their duties and interacting with service users. All observations made indicated that staff were kind, caring and knowledgeable. Documentation examined included a sample of service users’ care plans. A tour was made of the building. All areas inspected were found to be satisfactory. There were 37 residents in the home on the day of the inspection. Staff levels were considered adequate to meet the needs of the service users. The inspection indicated that the home continues to run smoothly, with contented service users and a well-motivated and trained staff team. Only three requirements were made, these were in relation to the call bell system, service user care plans and staff supervisions What the service does well: The home provides a homely and comfortable environment in which service users feel secure and relaxed. Service users spoken with all said that staff were friendly and caring and expressed confidence in their skills and knowledge. The inspector had the opportunity to speak to a visiting relative who was very positive about the care that his wife was receiving. Observations of staff at work dealing with service users indicated that staff treated service users with respect and courtesy. Service users were very complimentary regarding the standard of the meals provided. The inspector also took the opportunity of joining a group of service users for lunch and this meal proved to be both nutritious and flavoursome. Service users were well presented physically and appeared well cared for, with smart hair and fingernails. A hairdresser visits weekly. Cold drinks as well as tea and coffee from a machine in the lobby of the home, were available and being offered. The home should be congratulated on its commitment to providing meaningful activities and offering this service seven days a week. The inspector was able to observe several activities being offered on the day of the inspection, including a bingo session, music and a music and movement session. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Tenterden House DS0000019563.V333162.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 Tenterden House DS0000019563.V333162.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): 1-5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users have a thorough assessment prior to admission to the home. Prospective service users are welcome to visit the home and on admission all have the placement reviewed to ensure that it is suitable. Adequate information is available to prospective service users and their relatives/advisors to enable them to make an informed choice about whether the home is somewhere they would like to live. Contracts are issued to all residents on admission. EVIDENCE: The home has a statement of purpose and service user’s guide that contain the required information and these are available to service users. Contracts of occupancy are held on resident’s personal files. The manager or one of the Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 9 trained nurses assesses the needs of prospective service users prior to admission and the assessment is used to inform the initial care plan. An example of a pre-admission assessment was seen on the personal file of a recently admitted service user. Residents said that visitors were able to visit freely and could be entertained in any of the lounges or the garden. Staff were said to be most friendly and welcoming. The home does not provide intermediary care. Care plans inspected had a thorough assessment to ensure the home could meet the service user’s needs. Prospective service users are welcome to visit the home prior to admission and a review takes place after 6 weeks to ensure the service user’s needs are being met. The inspector randomly selected care plans of three service users. The assessment plans seen contained adequate information in order to develop a plan of care on admission. The care plans incorporated all aspects of care and support required; physical, mental health, (including behaviour management) nutrition, and when necessary dealing with falls, and pressure sores. The inspector listened to a staff member working with a service user providing basic care. The carer was patient and supportive, explaining what they were doing and encouraging the person to be as independent as possible. They appeared to have a good relationship and the carer was aware of the service users specific needs, set out in the care plan. Tenterden House DS0000019563.V333162.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): 7-11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are set out in individual care plans covering medical, health details and personal care needs, with risk assessments in place for nutrition, falls, pressure sores, moving and handling etc. and instructions to staff on how to proceed. Risk assessments were up to date and had been reviewed. The home has sound policies and procedures for the safe management of medication that ensure service users are protected and receive medicines as prescribed by their GPs. The arrangements in the home for health and personal care are such that service users feel they are treated with respect and that staff promote their privacy and dignity. However call bell response times should be improved. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 11 EVIDENCE: The service provision is on two floors. The care plan format is used across the service, and those viewed by the inspector showed that work had been carried out since the previous inspection to improve risk assessments and to ensure these had been updated on a regular basis. The service accommodates service users with varied, complex needs, including people suffering from terminal illness. It is therefore imperative that as part of the admissions process the wishes regarding funeral plans are discussed and reflected in individual care plans. One care plan inspected did not contain this information. BUPA is in the process of introducing a new care planning system into their homes and this will be introduced into Tenterden later on this year. It would be considered good practice to record the night checks of service users with epilepsy, currently these records are not retained. The only concern raised by several service users was in respect of the occasional long waits for attention from staff in response to pressing the nurse call buttons. This issue continues to be a problem and there is a recommendation that this call system be upgraded and improved in order to ensure the health and safety of service users is maintains. The issue is clearly with the inadequate system rather than the response times of the care staff. The home has a comprehensive medication policy and operates sound procedures to ensure that staff handle medication correctly. A full inspection of the medication procedure and policies within the home was carried out and the recording, administration and storage of medication was found to be in excellent order. The home complies with the policy and procedures relating to controlled medication and the home records on the day of the inspection, confirmed that these procedures are being adhered to. The deputy manager confirmed that a GP visits the home every week and that this relationship is very positive. The home has a policy of rotating all RGN’S around each unit every three months, which appears to be working effectively and gives an objective over-view of care throughout the home. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager has a real interest in providing a wide range of different activities within the home. The programme is diverse and extensive. Service users commented on how much they enjoyed the activity programme and there appeared to be great participation. Service users can maintain social and family contacts, and staff are welcoming towards visitors. Service users receive a wholesome and nutritious diet that corresponds to individual assessed and recorded needs, with a reasonable level of choice. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 13 EVIDENCE: Service users were observed participating in the day’s activity, which was a game of bingo. The activity was very much provided to the level and ability of the participates. It was encouraging to watch service users laughing and joking; there was a real ‘group feeling’ in the room. Relatives can visit service users at anytime, and several relatives were seen in the home at the time of inspection. Service users spoken to said that the food provided was good. Some service users chose to eat in their rooms. The chef consults with service users on likes and dislikes, and was eager to change and adapt menus according to feedback received. The inspector joined a group of service users for lunch and all spoke very positively about the range of meals they received and the standard of he meals and choices offered. The inspector found the meal both flavoursome and plentiful and would like to thank the chef for the meal provided. The manager and activity staff should be congratulated on providing a varied and diverse range of activities. The home has 82 hours allocated for activities within the home. The inspector was particularly impressed to discover that this service is offered over a seven-day period. There was an activity programme displayed in the reception of the home. On the day of the inspection service users were enjoying a game of bingo and a music and movement session. Service users spoke very positively about the range of services provided including, Pub style lunch, trivia quiz, Chocoholics day, Easter tea, music and health, cooking and craft, book mornings, and the hairdressers visits once a week . Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 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. 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. Adequate procedures are in place to ensure that complaints are dealt with appropriately. Service users feel that any issues they raise will be listened to, taken seriously by staff and management and acted upon. Policies and procedures in place and staff training is provided to ensure that service users are protected from abuse. However, care must be taken to ensure appropriate referrals are made regarding safeguarding adult issues. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 15 EVIDENCE: Details of the complaint procedure are contained in a BUPA leaflet as well as the statement of purpose and service user’s guide, all of which are available on the premises to residents and relatives. All the service users spoken to said that they knew how to make a complaint should it be necessary and expressed confidence in the likely response from the manager and the organisation. Two complaints have been received since the last inspection took place. During discussions with the deputy manager is became clear that one of these complaints should have been dealt with through Adult Care Services under the Adults safe guarding procedures. However the manager stated that although ACS were initially contacted the home managed this issue as a complaint and not Adult safe guarding. The deputy manager accepted that in hindsight, this particular issue should have been dealt with under the “Safeguarding Adults” procedure. The outcome of the home’s investigation was resolved to the satisfaction of all parties involved. Records confirmed that all staff receives Adult safe guarding training as part of their “rolling” training programme. Tenterden House DS0000019563.V333162.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- 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The building is suitable for the needs of elderly and physically disabled service users, providing a safe, well-maintained and comfortable environment. However the current ‘call’ system is not as effective as it should be to maintain service users dignity or health and safety. The home has numerous fully accessible indoor and outdoor communal facilities. The home is clean, tidy and odour-free. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 17 EVIDENCE: There was no apparent concern with the communal areas inspected. All were seen to be clean, tidy and well maintained. The kitchen equally had good food hygiene practices in place. The toilet and bathing facilities provide a range of equipment to allow individual needs to be met. This can make the facilities appear cluttered. All equipment appeared in good working order and had been tested earlier in the year. A programme of repair and replacement is in operation in the home, and this is incorporated in the maintenance plan. Several areas of the home have been decorated/refurbished since the last inspection took place, including, new carpets in several of the bedrooms, new carpets on the middle stairs, four new vanity units have been fitted, the main hall and activity room have been decorated and new curtains and bedspreads have been purchased. The home has stated that they could benefit from a “wet” room, as there are currently no shower rooms within the home. There were no concerns raised on the day of inspection relating to health and safety. Fire extinguishers had been checked in 4/01/07, the last fire drill was carried out on the 1/9/06.The last fire checks were recorded on the 2/3/07. All fire doors are fitted with automatic door closures. The hot water temperatures are checked and recorded by the maintenance person. All water temperatures were recorded within safe limits. The maintenance of the home is well managed and carried out on a regular basis. There has been an ongoing issue relating to the current “call” system. Although response times have improved since the last inspection was carried out, the system still appears inadequate and requires replacing with a more reliable and effective system in order to protect service users dignity and / or their health and safety. There was a concern regarding some of the bed rails that are currently fitted to the beds. However the maintenance person is in the process of implementing a new “bed-rail” checklist into the home, which includes checking that all bed rails are fitted correctly. The maintenance person checked the bed rails that the inspector noticed were ill fitting, before the inspector left and adjusted them accordingly. Tenterden House DS0000019563.V333162.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): 27-30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users living in the home have a range of complex needs, the work is therefore challenging and demanding. The skill mix is effective and balanced. The procedures for the recruitment of staff are robust and offer protection to people who live in the home. Supervisions need to be more regular, in line with the NMS standards and regulations EVIDENCE: As part of the inspection process staff rotas were examined, and found to be adequate. The level of staffing is a minimum of 2 registered nurses and 10 carers on each shift during the day Service users interviewed generally stated positive things about the staff ”even when there busy they always offer to help”. All the members of staff spoken to during the inspection were enthusiastic about their work and were observed to be working with service users in a caring and professional manner. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 19 The home provides an extensive training programme and recent training includes, fire training, dementia, food hygiene/nutrition, bed rails training, epilepsy training, challenging behaviour training and moving and handling. The manager has almost completed her RMA. Although there is staff supervision programme in place, the current regularity of supervisions does not meet the required standard of providing a minimum of six supervisions per year (see requirements). Staff meetings are held in varying frequency and with various groups of staff. These include, carers meetings, RGN/senior carers meetings, activities meetings and head of department meetings. The home has thorough procedures for the recruitment, induction and training of staff members. The recruitment files for three employees were viewed. These contained all the information and documents required by regulation including photographs, Criminal Records Bureau disclosures and references Tenterden House DS0000019563.V333162.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 good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of the service users. Good record keeping was found. The health and safety of the service users was protected The manager is qualified and experienced provides strong leadership to staff to promote the caring ethos and achieve the aims of the home. Staff feel well supported are supervised and communications systems in the home are effective. However the frequency of formal individual supervision should be increased for all care staff. Records are properly maintained and kept up to date. Policies and procedures are in place to ensure safe working practices are followed to protect and promote the health, safety and welfare of service users and staff. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has been in post since late September 2005. She is a registered nurse and has commenced the NVQ4 course in management. Although not previously experienced in residential care management she has an excellent grasp of relevant management techniques and staff spoken with rated her communications skills as excellent. She is maintaining the home’s caring ethos and has already introduced some initiatives designed to improve practice in the home, such as more frequent team meetings and successful recruitment of new staff. BUPA has an effective quality monitoring system that includes canvassing the views of residents and other interested parties. The Operations Manager also makes a significant contribution to the process by virtue of his regular monthly visits and constructive reports on the conduct of the home. The manager said she felt well supported by senior colleagues and other staff echoed this. However, although individual staff supervision takes place the frequency needs to be increased to meet the standard of six sessions per year. The maintenance man conducts regular fire drills, with staff present recorded. The fire log showed that fire drills are taking place (last carried out on the 1/9/06). All records seen were maintained satisfactorily. Aside from the ‘call’ system no health and safety problems were noted on touring the premises. The ill fitting bed rails were adjusted before the inspection ended. Completed risk assessments were on service users’ files. Footplates were fitted to all wheelchairs in use. The home has suitable insurance cover in place and a valid certificate was on the entrance hall wall. (Valid until June 2007). Tenterden House DS0000019563.V333162.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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Tenterden House DS0000019563.V333162.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 OP10 Regulation 13.(4) (c) Requirement The current emergency call system is inadequate and ineffective and therefore must be upgraded, in order to maintain the dignity, and health and safety of service users. The frequency of one to one supervision sessions for care staff must be increased. The National minimum Standard requires six times per year Either the service user or their representative must sign all service user plans. Timescale for action 31/07/07 2. OP38 18.(2) 30/04/07 3. OP7 15.(2) (c) 31/03/07 Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 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. 1. Refer to Standard OP37 Good Practice Recommendations The manager should consider implementing a system of recording waking night care checks for the people who have epilepsy. Tenterden House DS0000019563.V333162.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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