Inspection on 20/09/06 for The Chestnuts

This inspection was carried out on 20th September 2006.

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

The Chestnuts 23/08/07

The Chestnuts 14/01/06

The Chestnuts 23/09/05

The Chestnuts 10/08/04

The Chestnuts 18/05/04

The Chestnuts 06/01/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Chestnuts 9 Lodge Road Yate South Glos BS37 7LE Lead Inspector Melanie Edwards Key Unannounced Inspection 20th September 2006 09:30 The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 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 The Chestnuts DS0000003402.V312373.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 Adults 18-65. 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. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Chestnuts Address 9 Lodge Road Yate South Glos BS37 7LE 01454 227252 0117 9709301 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) admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Miss Michaela Jane Spray Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8) of places The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th January 2006 Brief Description of the Service: The Chestnuts is registered to accommodate up to eight residents with learning disabilities. The Home is run by Aspects and Milestones Trust and is divided into two segregated units called ‘Woodland’ and ‘Meadow View’, which are managed as one. The Home is situated in a quiet lane with few other residential buildings nearby. The centre of Yate is about a mile away. The Trust is in the process of building bed-sit accommodation on a plot next door. The property consists of a large, extended Victorian house set in its own grounds with a garden and patio area. The Home has two cars for the use of service users and public transport can also be accessed a short distance from the Home. Parking is available at the front of the premises. The fees charged for staying at the Home are £1375 a week. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Please note due to their range of needs the majority of the residents are unable to express their views verbally about the Home. A senior support worker, and five care assistants were consulted about their roles and responsibilities, their training needs, and how they assist and support residents. Staff were also observed assisting residents with their needs. The environment was viewed throughout. A range of records relating to the day-to-day running and management of the Home were inspected. A selection of resident’s care records and care plans were also inspected. What the service does well: 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 Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 Overall quality in this outcome area is good. Residents’ needs are assessed and are met by the Home. These judgments have been made using available evidence including a visit to the service. EVIDENCE: To find out how effectively the Home is meeting residents’ needs two care plans were reviewed (see also standard 6). There was detailed information written for each resident clearly stating how to assist individuals with their needs. Each resident has a detailed health care needs assessment in place, as well as a social care needs assessment. Both resident’s assessments records were up to date and had been reviewed regularly, which helps to demonstrate residents assessed needs are being monitored by the Home. All of the staff consulted conveyed in discussion and through observations that they had a good understanding of the needs of the residents. Staff also demonstrated that they had a good awareness of how to respond when residents exhibit behaviour that may be challenging. All of the staff conveyed that they aimed to treat residents as individuals, and to respond calmly, when residents exhibit challenging behaviour. Staff were talking to residents in a warm manner. This helps to demonstrate that residents are well supported. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Overall quality in this outcome area is good. Residents’ needs are assessed and their care plans reflect how needs are met. Residents are supported to make decisions and to take risks in their daily lives. These judgments have been made using available evidence including a visit to the service. EVIDENCE: To find out how well residents are being supported to meet their needs two care plans were inspected. The care plans were very informative and contained and had been written from a resident centred perspective, and included relevant plans of care to support residents to meet their healthcare needs and their social care needs. The care plans included information showing how to support, and communicate with the residents and how to assist them with their care needs. The care plans inspected had been evaluated and up dated on a regular basis, which helps to demonstrate residents changing needs are being monitored. Residents’ records also contained relevant letters and assessments from a psychiatrist who will see a resident when required at the Home. There was a physical health care needs record in each resident’s records. This recorded when the resident had last had routine optician, chiropody and dental appointments. The staff also keep daily records, which they write to The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 9 demonstrate they are monitoring residents well being. The records that were seen were kept up to date, and show that staff monitor residents overall well being on a daily basis. There were informative risk assessments in place for each resident. The risk assessments detailed how best to support the resident in a range of activities both in and out of the Home. Residents were observed being supported by staff to attend a range of community based social and therapeutic activities during the inspection. There was also information written in the two residents’ records that showed staff were aiming to support the residents to maintain their independence in various daily living activities both in and out of the Home. This helps to demonstrate how residents are supported to make decisions and maintain their own independence in their daily lives. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,13,14,17 Overall quality in this outcome area is good. Residents are well supported to make decisions and to take risks in their daily lives. They are further supported to be a part of the local community, and take part in a range of leisure activities. Residents are also provided with a varied and well balanced diet. These judgments have been made using available evidence including a visit to the service. EVIDENCE: The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 11 Residents are encouraged and supported by staff to go on regular trips out of the Home, and residents clearly gain satisfaction and enjoyment from these opportunities. One resident went out with staff for a trip to Yate shopping centre for coffee and they clearly enjoyed this activity. There was information recorded in the two residents records seen that confirmed residents regularly attended local activities and residents are also provided with day care support. Three residents had left the Home to attend a range of community social and therapeutic day care activities. An aromatherapist came to the Home to carry out relaxation treatment with residents. The therapist explained that they visit the Home about twice a week for one to one sessions with most residents. Residents also attend hydrotherapy sessions on a regular basis, and two residents went out for a session during the inspection. A number of residents also attend regular college classes at South Bristol College, during the week. This evidence demonstrates how residents are being well supported to take part in a range of community-based activities. In discussion with staff it was evident that one of the aims of the Home was to support residents to be able to access community facilities as independently as possible. Staff said they often accompanied residents to the local pub and to a nearby coffee shop or to the shops. This helps ensure residents are able to be a part of the community and lead a fulfilling life away from the Home. The menu record was inspected to see if residents are provided with a varied and well balanced diet. There were choices of dishes recorded for each meal which were nutritionally well balanced, and varied. The Home has also recently introduced the use of pictures of different foods to assist residents who have communication difficulties in making a choice of meals, when menus are planned. Residents were offered a choice of cheese-toasted sandwiches or bacon sandwiches for lunch. Residents looked as if they were enjoying their meals. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Overall quality in this outcome area is good. Residents are supported to meet their needs in the way preferred by them. The systems in place for the handling, administration, storage and disposal of residents’ medication are safe. These judgments have been made using available evidence including a visit to the service. EVIDENCE: The procedures and systems in place for administration, storage and disposal of medication were checked to monitor if there are safe systems in place. The medication administration charts of three residents were inspected. There was a photograph of the resident maintained with each record. This should ensure medication is administered correctly to the resident named on the chart. The administration charts were up to date, legible and in good order. The staff had signed for medication administrated, or recorded the reasons for any omissions. All senior staff administering medication attend regular training to enable them to do this safely. There are also written guidelines in place to advise staff of residents preferred way that they take their medication. This will guide staff and ensure medication is administered in the way residents prefer. The stock of medication held in the Home was satisfactorily organised. Medication that was no longer required was being returned to the pharmacist. This helps ensure residents’ medication supplies are kept in good order and can be easily monitored. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 13 The medication administration charts were legible, up to date, and contained the signature of the dispensing member of staff; demonstrating residents’ medication is administered safely. The reasons for any omissions had also been written on the charts. It is evident that the Home has a well-run system for the storage, administration and disposal of residents’ medication. There was information recorded in two residents care records, which confirmed that residents attended regular appointments at the dentist. There was correspondence from the dietician, and a speech therapist who has given advice and support to residents with their particular needs. There was information in the daily records that staff were monitoring and observing the health of residents and call the doctor, if they were concerned about the resident. There was information that showed that residents receive support and treatment as required from the specialist Psychiatrist. This helps to demonstrate that residents’ health care needs are being met. Staff conveyed in discussion that they aimed to monitor residents’ physical health as well as to provide emotional support. As has been written in standard 6 of the report, there was detailed evidence in the care records that showed that the preferred day-to-day routine of the residents and particular likes and dislikes were recorded. This helps ensure residents’ needs are met in the way that is preferred by them. Staff who were consulted were familiar with the information in residents care plans, and how best to support them with their care needs. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Overall quality in this outcome area is good. Residents are supported to make complaints about the service. Also the systems in place to protect residents from abuse are effective in helping to protect residents. These judgments have been made using available evidence including a visit to the service. EVIDENCE: The staff on duty could not locate the complaints procedure or the complaints record book. These will be reviewed at the next inspection of the Home. However all of the staff consulted were able to demonstrate how to support residents if they judged that the resident concerned wanted to make a complaint. Staff conveyed that they would ‘advocate’ for residents and ensure their views were made known to the manager of the Home. Also several staff recently attended a study day on better understanding the principle of advocacy, and how to support residents. This should help ensure residents’ complaints are acted upon by the Home. There are procedures and guidance information on the topic of ‘ the protection of vulnerable adults from abuse’. This helps to protect vulnerable adults who live at the Home, if staff can access the necessary information to ensure their protection. The majority of the staff have attended recent training to help them better understand issues around the protection of vulnerable adults from abuse. Two of the care assistants on duty were asked what actions they would take if they were made aware of an allegation of abuse of a resident. The care assistants were able to explain the procedure they would follow, and that they would report without delay all such allegations to the appropriate senior member of staff. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 Overall quality in this outcome area is good. Residents’ live in a Home that is domestic in style and provides a comfortable environment that is suitable for them and meets their needs. These judgments have been made using available evidence including a visit to the service. EVIDENCE: The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 16 The Home is an older building set in a quiet residential area near to the town of Yate. It is close to local shops and the residents’ access local amenities. The Home has been extended, and divided into two separate areas. Residents are cared for on both sides of the Home, so that residents are cared for in smaller groups, and more personal care can be provided. The environment was clean, tidy and satisfactorily maintained in communal areas and bedrooms were satisfactorily clean. The standard of the decoration and the quality of fixtures and fittings was also satisfactory. There were two housekeepers on duty who were cleaning the Home during the inspection. There are two lounges, and two dining rooms for residents to use, which is beneficial as this helps ensure residents can maintain their privacy and `personal space’ if they so wish. The residents looked to be comfortable in their surroundings. The bedrooms were personalised with residents’ personal possessions. There are furniture and fittings provided, including a wardrobe a comfortable chair a bedside cabinet and a chest of drawers in each room. There were also photographs, and pictures displayed in rooms that helped to create a more ‘personal’ feel to the rooms. The standard of the decoration and the quality of the fixtures and fittings was satisfactory. Bedrooms do not have en-suite facilities. There are toilets, and a shower or bathroom facilities located within close proximity of the bedrooms on each floor, which is convenient for occupants use. However there is a small hole in the linoleum on the floor of the first floor bathroom. This should be repaired so that the floor is safe for residents use. There are two kitchens located on the ground floor, leading onto the dining room. The kitchens were of a domestic style and were clean and tidy. However there is a work surface in the small kitchen that should be repaired as there is a small hole in one concern of it, and this could be a potential health and safety risk. There is a laundry room on the ground floor. It contains a washing machine with a sluicing programme, and one tumble dryer, for washing and drying residents’ clothes hygienically. The Home was clean tidy and well maintained in all areas that were viewed. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,34,35,36 Overall quality in this outcome area is good. Residents are supported by a sufficient number of competent, qualified staff who are supported and supervised in their work. These judgments have been made using available evidence including a visit to the service. EVIDENCE: The recruitment procedures were not checked on this inspection. Aspects and Milestones Trust are in the process of moving all staff recruitment records back into the care Homes, however this has not yet taken place for staff at the Chestnuts Care Home. These records may be requested at the next inspection The staff on duty discussed recent training that they had attended. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 18 Staff have attended a range of training in courses relevant to the needs of residents. There was information seen in the staff training records that also demonstrated staff had attended a variety of training courses. Staff are also booked to attend forthcoming training in food hygiene, first aid and fire safety. The staff duty record for September 2006 was reviewed to find out how many staff are on duty on a daily basis to support residents with their needs. There had been a small amount of sickness recorded and ‘bank’ staff and agency staff had covered the shortfall in staff. The Home tries to cover shifts with staff that residents know which helps ensure they are given continuity of care. There are five staff on duty for an ‘early’ shift, and four staff on duty for a ‘late’ shift, to provide residents with support during the day. There are two staff on duty at night. There is also an on call support system to support staff and occupants out of hours and at weekends. Based on the evidence seen during the inspection, the number of staff on duty is sufficient to meet residents needs. The manager, deputy manager and allocated senior care workers undertake the supervision of staff in the Home. The supervision records of staff were not looked at on this occasion .These records may be requested in advance at the next key inspection by the Commission for Social Care Inspection . However based on the discussions with the staff on duty it was evident that the staff feel supported. This clearly benefits residents if staff feel well supported to be able to provide the support, care, and understanding of the residents and their needs. The staff meetings minutes record was looked at. These showed that staff meetings were recorded as having taken place on a regular basis and staff were consulted about a range of relevant matters related to the day-to-day running of the Home. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Overall quality in this outcome area is good. Residents’ benefit from a well run Home and their views will be listened to and represented. The residents’ and staff health and safety is being protected. These judgments have been made using available evidence including a visit to the service. EVIDENCE: Miss Spray is a qualified learning disabilities nurse. Her career record showed that she has a number of years of experience working with residents who have very complex mental health disorders. She is registered with the Commission for Social Care Inspection as the manager of the Home. This demonstrates Miss Spray is considered suitable and qualified to fulfil the role of registered manager. Two staff on duty said that Miss Spray was supportive. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 20 The Home ensures the residents’ records are kept in a locked metal cabinet in the office. The residents care records, and the records that were seen relating to the running of the Home were satisfactorily written, legible, up to date, and well maintained. This helps to demonstrate residents confidentiality is being protected, and also that Ms Spray ensures that legal records required for the effective running of the Home are being kept in order. The monthly monitoring visits of the Home that must be carried out by a representative of Aspects and Milestones Trust are being undertaken as required by law. There are records of these visits being sent to the Commission for Social Care Inspection. The records that have been seen, demonstrate that the designated individual responsible for the visits spends time consulting with occupants and their representatives and observing staff. The Trust is also in the process of carrying out detailed quality audits of its Care Homes. A copy of the audit ‘tool’ that is used was seen during the inspection. This demonstrated that the overall quality of the Home is being monitored on a regular basis. The environment looked safe and satisfactorily maintained in all areas viewed. Staff are provided with regular training in health and safety matters including first aid, and moving and handling practices. This should help protect residents’ health and safety if staff are knowledgeable and well trained in health and safety principles and practices. All staff, as well as occupants are also in the process of completing food hygiene training. The fire logbook record was checked and showed the required weekly and monthly tests of the fire alarms and the fire fighting equipment were being carried out and were up to date. There is a record of the monthly checks of the environment. These checks were up to date and showed that a member of staff audited the health and safety of the Home environment on a regular basis. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 N/A 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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. 2 Refer to Standard YA24 YA24 Good Practice Recommendations The hole in linoleum on the floor of the bathroom should be repaired. The work surface in the small kitchen should be repaired. The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 The Chestnuts DS0000003402.V312373.R01.S.doc Version 5.2 Page 24 - 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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