Inspection on 27/03/07 for The Chimes

This inspection was carried out on 27th 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

The Chimes 14/08/09

The Chimes 20/12/07

The Chimes 31/10/05

The Chimes 06/06/05

The Chimes 23/09/04

The Chimes 10/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE The Chimes 83 Park Road St Annes Lancashire FY8 1PW Lead Inspector Phil McConnell Unannounced Inspection 27 March 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 The Chimes DS0000009855.V329019.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. The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Chimes Address 83 Park Road St Annes Lancashire FY8 1PW 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) 01253 725146 01253 725146 thechimes@btconnect.com Mrs Margaret Elaine Brady vacant post Care Home 21 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (19), Physical disability (1) The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 21 users to include: Up to 19 service users in the category of old age not within any other category (OP) One named service user in the category of Physical Disability (PD) and One named service user in the category of Mental Disorder (MD). 31st October 2005 Date of last inspection Brief Description of the Service: The Chimes Care home provides residential care for up to 21 older people. It is situated close to the centre of St Annes. Leisure amenities are close by as well as local shops and public transport system. The home is on three floors and a passenger lift is in place. There are a number of aids and adaptations in place throughout the care home suitable for the age range and needs of residents living there. There are fifteen single rooms and three double rooms and at present ten bedrooms have en-suite facilities. The present rate of charging is between £340-£555.00 The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Various information was gathered in order to assess the key standards that are identified in the National Minimum Standards for care homes for older people, including: the pre inspection questionnaire, (completed by the registered manager / owner) an unannounced inspection visit to the service on the 23rd March 2007, which lasted only a short time and a second visit on the 27th March, which lasted approximately 8hrs. 3 service users’ questionnaires, 2 relatives questionnaires and 2 GP’s questionnaires were returned to the Commission for Social Care Inspection (CSCI). During the visit to the home 4 service users’ files were examined, including the most recent person to go and live at The Chimes and discussions took place with some of the service users throughout the day. There was the opportunity to have a brief discussion with a couple of visitors to the home. There was the opportunity to observe the care provided to the service users and the interaction between them and the staff. Four staff files were also examined, including the last person to be employed at The Chimes. (See staffing section). The Registered manager/owner was available for both of the visits to the home. Throughout the visits there was the opportunity to have conversations with other staff members. The homes policies, procedures and all other documentation including health and safety files and certificates were examined. (See management section). A full tour of the home was also carried out. (See Environment section). What the service does well: The homes assessment process is thorough, helping to ensure that sufficient information is provided to enable staff to provide individual needs. Care plans are reviewed regularly to guarantee that peoples changing needs are identified and addressed. There is a consistent reliable staff team, who are committed to providing a good level of care. The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 6 The manager is dedicated and devoted to ensuring that the level of care is regularly monitored and reviewed, in order to improve people’s health and wellbeing. What has improved since the last inspection? What they could do better: Documentation and record keeping in general could be improved, in order to provide better organisation. The initial assessment documents could be renamed, for example ‘Care needs assessment’, rather than the presently named ‘Risk assessment’. This will help avoid any confusion. Care plans need to be more detailed containing more individualised and personalised information. The kitchen is in need of a complete upgrade, in order to improve it to an acceptable standard. The laundry needs to have a general tidy up; this will help with Health and Safety. The rear yard is in need of being tidied up, in order to create a more pleasant atmosphere and improve health and safety. Some areas of the home are looking tired and would benefit from redecoration, especially some of the passageways. Formal supervisions need to be introduced to ensure that staff performance is monitored and any areas for development and training are highlighted. The Chimes DS0000009855.V329019.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. The Chimes DS0000009855.V329019.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 The Chimes DS0000009855.V329019.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 Standard 6 N/A Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good pre – admission assessment in place, which helps to ensure that sufficient information, is gathered, in order to establish if peoples’ needs can be provided by the home. EVIDENCE: The admission policy and procedure was examined and it was found that the policy had been reviewed in January 2007. Four of the service users’ files were examined including the last person to be admitted to The Chimes and their files contained relevant assessment documentation including: admission assessments, care plans, social services assessments and up to date daily record sheets. The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 10 It was suggested the homes own assessment document would benefit from being renamed to ‘care needs assessment’ or similar, other than the present title of ‘Risk assessment’. It was explained to the manager that the present title creates some confusion. Although there was adequate information within the files, they are generally disorganised. It was recommended to the manager that ring binder files would enable better management of the filing system. This would help ensure that all loose pages within the files are made secure and if possible include a photograph of each person. This will avoid any confusion with loose pages being put into the wrong file and the photograph will assist with easier identification. Documentation was observed showing that a prospective service user had visited the home before going to live there on a permanent basis. One person said, “I used to come here on respite and eventually came to live here” and one person wrote, “I received information from friends who stayed here and I used to visit them here”. This helped individuals to be a little more familiar with the home and the staff and also enabled people to be more at ease and relaxed when they went to live at The Chimes. The Chimes DS0000009855.V329019.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good care plans and risk assessments are in place, helping to ensure that individual’s care and health needs are being appropriately met. EVIDENCE: Four service users’ care plans were examined and they were found to be up to date with evidence that they are regularly reviewed and containing relevant information with guidance on how to provide individuals care needs. It was evident that care plans were developed from the initial assessment and there were individual risk assessments in place. However, the care plans would benefit from having more detail, in order to make them individualised and personal to the specific service user. The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 12 The manager was informed of this during the inspection visit. Individual information was available with regard to service users’ specific health needs and there was evidence that, hospital appointments, GP’s appointments and other treatments and consultations with other health professionals had been carried out. This demonstrated that people’s health needs are monitored and treated correctly when necessary. The questionnaires returned to the Commission were all positive with regards to the medical support that people receive. Some of the comments from service users were, “I’ve always had a very good response to all my medical needs” “I only have to say if I need to see a doctor and it happens” and the survey forms returned from GP’s were also positive, with one GP saying “the home has a good grasp of individual needs”. There is a policy in place for staff to adhere to regarding the procedures for the receipt, recording, storage, handling, administration and disposal of medicines. Records were examined to ensure that all medicines received and administered were maintained. Medicines were kept in a locked cupboard and any controlled drugs were kept in a separate locked secure cabinet that met the Misuse of Drugs (safe custody) Regulations 1973. Trained members of staff administered controlled drugs, with the register being signed and countersigned by a second carer. The controlled drugs register was up to date with accurate recording in place. The medicine administration records were also observed to be accurate with medication being correctly administered. Members of the staff team were observed demonstrating a caring, sensitive, dignified and respectful approach, with service users responding positively and it was evident that good relationships existed between service users and the care staff. Some of the comments from service users were, “the staff are very helpful” and “the staff are always very caring and attentive”. The Chimes DS0000009855.V329019.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 adequate. This judgement has been made using available evidence including a visit to this service. The activities and leisure pursuits available are limited in variety and consistency. There is a need to increase the frequency and choice of interests, in order to further stimulate and motivate people. EVIDENCE: There was a programme of activities available for inspection, which listed various events taking place in the home, including: bingo, dominoes, chairexercises, weekly quiz, and monthly entertainer (sing-a-long). Throughout the summer monthly outings for larger groups are arranged. The manager commented, “People tend to like 1 to 1 outings and this happens on a daily basis”. There are regular visits from different faith/religious representatives, including: Church of England, Roman Catholic and Jehovah Witness. The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 14 Comments received from service users regarding the availability of activities, varied from “activities are available if I feel like doing them” “there is bingo and dominoes, but the quiz has stopped” and “there is very little going on, everyone just sits around” One staff member said, “everyone is treated exactly the same. There’s just one thing, I would like to see more activities, people just sit around doing nothing”. Generally the feedback from different sources demonstrated that there is a need for a more varied and consistent approach to providing stimulating, motivating and interesting activities in practice. It is important that people are encouraged and motivated to maintain interests and be involved in appropriate and relevant activities, in order to provide stimulation and promote well-being. This was discussed with the manager following the inspection visit. There is an open house policy at the home and in discussion with some visitors, they were able to confirm that they can visit whenever they wish and they are able to see their relative in the privacy of their own room. It was observed during a tour of the premises that people had brought into the home their own personal belongings. This helped to demonstrate people’s own choices and individuality. There was a choice of menus available, which were seen to be nutritious, varied and appetising. All of the comments regarding the meals were positive, including: “very good home cooking and a good choice” “we get plenty to eat and I usually have to leave some” and “I usually like the meals and I don’t have a big appetite and I am a fussy eater”. The Chimes DS0000009855.V329019.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. There are good policies in place, which help inform the staff of the importance of protection matters. The protection of service users would be enhanced by staff receiving ‘Safeguarding Adults’ training. EVIDENCE: The home had a comprehensive complaints policy and procedure in place, regarding the safeguarding and protection of vulnerable adults. This policy was updated in January 2007. There had been one complaint received by the commission for social care inspection (CSCI) since the last inspection and this had been adequately dealt with. In speaking to some of the service users and family members there was a general awareness of who to speak to if they had a concern or a complaint and they were also aware that the inspector for CSCI could be contacted if they chose to do so. Some of the comments were, “I have no complaints, I wouldn’t hesitate to complain if I thought anything was wrong” “I would complain to my daughter, The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 16 but I have little to complain about” and one relative wrote, “I have never had any reason to be concerned”. There was a thorough policy in place to deal with a suspicion or allegation of abuse. The government’s guidance on the protection of vulnerable adults, entitled ‘No Secrets’ is mentioned in the homes procedures. However, the staff members who were spoken to were not familiar with the ‘No Secrets’ document and unsure of the correct procedures to follow, in the event of an alleged or suspected abuse situation. It was recommended to the manager that the ‘Protection of vulnerable adults’ training should be more of a priority, than it is at the present time. This will help ensure that vulnerable people are supported and cared for by adequately trained staff. The Chimes DS0000009855.V329019.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 and 26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although the majority of the home is clean, safe and hygienic, the kitchen is in need of being refurbished and upgraded, in order to help promote a healthier and safer environment for food protection for service users. EVIDENCE: A full tour of the home was completed and some renovations have taken place since the last inspection visit, including: all of the bedrooms have been redecorated, toilets and bathrooms have either been refurbished or are in the process of being done and the bathroom on the ground floor is being changed into a ‘wet room’ (a walk in shower) which will be suitable for wheelchair users. The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 18 Some areas of the home (passageways) are looking quite tired and are in need of being redecorated. The laundry is well equipped and situated in a separate building at the rear of the main building, whilst this is satisfactory the laundry is in need of having a good tidy up, it looks disorganised and unkempt. The kitchen is in quite a poor state, with unhygienic badly damaged worktops, unit doors and the walls and ceiling are in desperate need of being refurbished. The kitchen is in need of a complete overall. An inspection carried out by the Environmental Health Department have given the organisation a six week timescale to complete the work, in order to bring the kitchen up to an acceptable standard. The front and side gardens are well maintained, however the rear of the premises is looking very untidy and there is a potential risk of this causing some health and safety issue. The manager was informed of these concerns at the inspection visit and an assurance was given that they will all be addressed. The service users’ bedrooms demonstrated their own personality, containing individual’s own personal possessions, including photographs, ornaments and items of furniture, helping to demonstrate that people are encouraged to bring their own belongings into the home, helping to maintain familiarity and identity. There was appropriate specialist equipment observed around the home, such as lifting hoists, passenger lift (being serviced during the inspection) and walking frames, thereby helping to ensure that individual needs are catered for, whilst independence is promoted. The Chimes DS0000009855.V329019.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 in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a thorough recruitment process, which gives the confidence that service users are protected and safeguarded as much as possible. EVIDENCE: The staffing levels were examined and found to be adequate and satisfactory. Four staff files were examined, one of which was the most recent employee to join the staff team and they contained most of the necessary information needed to meet the requirements for this staffing section, including: Criminal record bureau checks (CRB), application forms, references, job descriptions and mandatory induction training. However there was no documented evidence that formal staff supervisions are taking place and in discussion with some of the staff, it was apparent that they were unfamiliar with any supervision process. There were copies of relevant policies and risk assessments in staff files, including a risk assessment for the cellar steps and The Chimes fire plan. It was also evident that the completion of the National vocational training (NVQ) for the staff team is well underway. The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 20 As previously mentioned the training with regard to abuse awareness training appears to be limited and it was suggested that it would be a good practice to incorporate some initial training into the induction programme. Some of the training is provided in house and other training is provided by outside trainers. The Chimes DS0000009855.V329019.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 and 38. (Standard 36 re - supervisions. See staffing section). Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is adequately managed, ensuring as much as possible that service users receive a satisfactory service. EVIDENCE: The manager has many years of experience in the care profession and she has been the registered manager and owner of The Chimes for over 16 years. The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 22 The registered manager ensures that there is always a senior member of staff on duty. A previous recommendation was made regarding the service users’ personal finances. The records were examined and they were found to be up to date, well maintained and well organised, with two signatories and receipts being kept, helping to ensure that individuals’ finances are sufficiently safeguarded, thereby protecting vulnerable people. The home’s policies and procedures were examined and found to be up to date and satisfactory, helping to ensure that policies are kept up to date and relevant for the care and protection of vulnerable adults. The home continues to maintain the ‘Investors in people award’, which is an independent quality-monitoring organisation. In discussion with other staff members, there was a general opinion that the management is fair and approachable, some of the comments were, “The management is really good, you can talk to them about anything” and “this is the best place I have ever worked, the manager is really good”. The formal supervision of the staff team does not appear to be happening. (See staffing section). The were a number of health and inspection certificates available for examination, including: Legionella checks, domestic water checks, lift service reports / certificates, bath hoist and lifting hoist checked March 2007, transfer of waste certificate 2006/2007 and documented evidence of Fire drills regularly taking place. Unfortunately the Gas, Electric and Portable Appliance Testing (PAT) inspection certificates were not available for examination during the inspection visit. The manger said that these checks had been completed, but could not find the certificates. The manager was informed that these certificates must be available for inspection, in order to help ensure that health; safety and welfare of service users and staff is promoted and protected. (The certificates have since been forwarded to the Commission) The Environmental Health department have already issued some requirements with regards to the kitchen environment. (See environment section). The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 1 X X X X X X 2 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 The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 24 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 OP12 Regulation 16 (2) (m) (n) Requirement The registered person shall consult service users about their social interests and provide an activities programme to meet their needs. The registered person shall ensure that the kitchen is safe, hygienic and well maintained. The registered person shall ensure that all parts of the home are reasonably decorated (passageways) The rear of the building should be appropriately maintained to a reasonable standard, to ensure safety. The registered person shall ensure that staff are suitably qualified, competent and appropriately trained, especially in the protection of vulnerable adults. The registered person shall ensure that care staff have formal supervisions at least 6 times annually. Timescale for action 30/06/07 2. 3 OP19 OP19 16 (2) (j) 23 (2) (d) 30/06/07 31/07/07 4 OP19 23 (2) (o) 30/06/07 5 OP30 18 (a) (c) (i) 31/07/07 6 OP36 18 (2) 30/06/07 The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 25 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 The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 The Chimes DS0000009855.V329019.R01.S.doc Version 5.2 Page 27 - 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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