Inspection on 26/01/07 for The Marshes

This inspection was carried out on 26th January 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 Marshes 24/01/06

The Marshes 30/08/05

The Marshes 24/01/05

The Marshes 06/09/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Marshes 3b Nursery Close Hailsham East Sussex BN27 2PX Lead Inspector Lucy Green Key Unannounced Inspection 26th January 2007 11:00 The Marshes DS0000047638.V322314.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 Marshes DS0000047638.V322314.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 Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Marshes Address 3b Nursery Close Hailsham East Sussex BN27 2PX 01323 440843 EX21 01323 449555 nursery@regard.co.uk 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) The Regard Partnership Limited Jonathan Borthwick Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is six (6) Service users must be aged between eighteen (18) and sixty-five (65) years on admission. Service users with a learning disablity only to be accommodated. Date of last inspection 24th January 2006 Brief Description of the Service: The Marshes is a purpose built bungalow, situated in a quiet residential area of Hailsham. The home shares the same site and Registered Manager as Lynfords, another home owned by the same organisation. Resident accommodation provides six single bedrooms, a large communal lounge and a kitchen/diner. The two bathrooms are fitted with the necessary adaptations. The grounds are secure and provide a well-maintained garden and ample parking. The home is registered to accommodate six younger adults with learning disabilities. The Registered Providers of the service are The Regard Partnership. This organisation owns a large number of homes across England and Wales. Information received from the Manager details that the current fees at The Marshes are based on a block contract rate of £1276.56 per week. More detailed information about the services provided at The Marshes can be found in the home’s Statement of Purpose and Service User Guide – copies of these documents are available in the hallway of the home and can be obtained directly from The Regard Partnership. Latest CSCI inspection reports are on available on request from the home. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at The Marshes are referred to as ‘residents’. This report reflects a key inspection based on the collation of information received since the last inspection, feedback from a range of representatives and an unannounced site visit which lasted four hours and twenty minutes on Friday 26 January 2007 between the hours of 11am and 3:20pm. The site visit included discussion with all parties, a tour of the premises and an examination of medication, care and staffing records. There were six residents living at The Marshes at the time of this inspection visit. During the visit, the Inspector met with all of the six residents. Due to the complex needs of the residents at The Marshes, it was not possible to gain much verbal feedback from the residents themselves. The Inspector therefore made judgments about the quality of care based on observation and feedback from other stakeholders. The Inspector spoke individually with the Manager and four staff members, including a Senior Carer, two support workers and a member of relief staff. Comment cards were sent to other stakeholders as part of this inspection, including General Practitioners, relatives and the local Community Learning Disability Nurse. At the time of this report, feedback had been received from a one relative and one Health Care Professional. What the service does well: The Marshes is a relaxed and friendly home where residents are supported to lead healthy and fulfilling lives. The culture of the home respects fundamental values of privacy, dignity and freedom of choice. Residents were observed to have positive relationships with the staff who care for them. The home has a core team of staff who have worked with the residents at The Marshes for a number of years and who know and understand their needs. This coupled with the input and enthusiasm of a new Manager has enabled residents to benefit from a team of people who are committed to putting their interests first. Residents are supported to access a range of activities that reflect their interests and meaningful to them. The standard of planning and provision of holidays at The Marshes is excellent, with five of the six residents going on at least one holiday in the last twelve months. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 6 The quality of care planning is good with sufficient information to enable staff to support residents with their healthcare and personal routines in a sensitive and appropriate way. 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. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 7 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 Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents benefit from an admission process that ensures their individual needs and aspirations are assessed prior to moving into the home. EVIDENCE: There are currently no vacancies and there have been no new admissions to The Marshes since the last inspection. This standard therefore could only be assessed in respect of the admission systems in place. The admission policy details two stages of assessment. The Regard Partnership has a central referrals department who undertake an initial assessment of all prospective residents. The Manager reported that a copy of the prospective resident’s social care assessment would be obtained and then a representative from The Marshes would meet the individual and conduct their own assessment. The second stage of the assessment covers more specific issues such as the home’s Statement of Purpose and compatibility with the other residents living at the home. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from care plans which provide staff with the necessary information and risk management strategies to support them safely and effectively. Residents are offered choice and the opportunity to make their own decisions wherever possible. EVIDENCE: The Inspector viewed the care plans for three residents. It was evident that the newly registered Manager has worked hard to improve the system of care planning and ensure that each resident has a plan of care that provides comprehensive and accessible information to guide staff in the appropriate delivery of care. Care needs for one resident have changed significantly over the last twelve months and the support required was clearly documented in the care plan and was observed to be reflected in staff practices. Discussion with staff highlighted that they were knowledgeable about changing needs. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 10 The Inspector is pleased to report that the new care plans have been developed with a more objective and goal focused approach to care management. The home has also introduced person centred plans with residents and these were found in resident’s bedrooms. The home has also adopted a more comprehensive approach to risk taking and residents are supported to take some risks in order to maximise choice and independence. Each risk assessment is directly linked to a management strategy and a support plan which shows how that risk is controlled. Evidence gathered from documentation, discussion with residents, staff and feedback from other stakeholders highlights that the home provides a service where a considerable effort is made to involve residents as far as possible, in making decisions about their lives. Throughout the inspection it was evident that the residents have a lot of choice about their daily lives. Staff were observed offering choice about drinks and activities. Conversations with staff highlighted that offering choice is something that is instinctive to them. At the time of inspection, all residents were observed spending time doing the things they chose and that they enjoy. The bedrooms viewed were found to be decorated and furnished to reflect individual tastes and interests. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to lead healthy and fulfilling lives. Residents benefit from a range of nutritious and well-balanced meals. EVIDENCE: The weekly activity schedules for the three individuals case tracked provided documentary evidence that residents participate in a range of appropriate activities. For one resident this included attendance at a day service three days each week, a pottery course at a local college on a Friday and a range of other in-house activities including; aromatherapy, music and various trips and outings. Staff informed the Inspector that one resident has a keen interest in woodwork, it was therefore pleasing to see that his weekly schedule included a woodwork course at college. Another resident has been recovering from a hip The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 12 fracture which has had major impacts on his mobility and consequently affected the some of the activities he used to undertake. It was however identified that a weekly swimming session has now been incorporated into his schedule to enable him to not only participate in an activity he enjoys, but also use the exercises recommended by the physiotherapist in a fun way. Residents continue to access a wide range of community based activities, including trips to the cinema, shopping and meals and drinks out. Conversation with the staff on duty revealed that with the exception of one resident who was unable to go on holiday due to health issues, all residents have been on at least one holiday in the last twelve months. Holiday destinations included Spain, Somerset and Yorkshire. One resident’s holiday centred around visiting relatives who live a long distance from the home. The consensus of opinion from staff and the Manager was that all holidays this year had been a huge success. On the day of the inspection, it was observed that the routines of the home were reflective of individual needs. It was evident that residents are enabled to choose where to spend their time and make informed choices about their daily lives. During the course of the inspection two residents attended college courses, three residents went out shopping and for coffee and one resident chose to visit his friends at the adjacent home. The Marshes has a positive approach to enabling residents to maintain contact and relationships with families and friends. There was evidence in the care plans that the home supports residents to meet with and receive visits from their families. Staff spoken with demonstrated a commitment to supporting residents to with family relationships. During the inspection, one resident was collected by relatives and taken out for the afternoon. The Inspector received a letter from one relative who complimented staff on the quality of care at The Marshes and commented; “[resident’s name] is very happy……..staff have been very kind and helpful to him”. Meals are generally prepared according to a six-weekly rotating menu. The menus viewed were found to be varied and well-balanced. Staff reported that menus are drawn up by staff on the basis of their knowledge of residents’ likes and dislikes. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the provision of flexible and respectful personal and healthcare support and are protected by the systems in place to manage medication. EVIDENCE: It was observed during the inspection that personal care is provided with dignity and respect. The three care plans viewed contained detailed support plans to guide staff in the delivery of care. In addition to the main care plans each resident now also has a person centred plan that is kept in their bedroom. Staff support residents to ensure their health needs are met, with care plans containing a record of any visits or contact with professionals external to the home. There was evidence of involvement from General Practitioners, Dentists, Physiotherapists, Chiropodists, Optician and the local Community Learning Disability Team. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 14 Comment cards were sent to the Community learning Disability Team and General Practitioners with whom the residents at The Marshes are registered. At the time of this report, one had been returned containing generally positive feedback that healthcare needs are met by the home. The storage and administration of medication were found to be generally satisfactory. Staff receive appropriate training in the management of medication. Records were found to be accurate and current. It was pleasing to note that as a result of the recommendation made at the recent inspection of the other home on this site, the Manager has begun to implement consent forms in respect of the medication that is held on behalf of residents. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and visitors to the home benefit from and are protected by the open culture at The Marshes and know that their concerns will be listened to and acted on. EVIDENCE: The home has a complaints procedure in place and a pictorial format has been produced for residents. The CSCI has not received any complaints about the services provided at The Marshes since the last inspection. The Manager stated in information submitted both before and during the inspection, that the home has received two complaints about the service in the last twelve months. It should be noted however, that none of these complaints relate to the quality of care and all have been satisfactorily resolved by the Manager. The home seeks to operate an open culture where issues are openly discussed and opinions shared. Positive interaction was observed between residents and staff during the inspection. Various systems are in place to protect residents from abuse. The recruitment file for the only new staff member was inspected and provided evidence that new staff are employed subject to robust checks. In line with a requirement of the last inspection, the adult protection policy and procedure has been reviewed and updated to reflect recent changes in legislation and best practice guidance. The four staff members spoken with confirmed that they had The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 16 attended training in the protection of vulnerable adults and that they were clear of their responsibilities in this area. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a clean, comfortable and well maintained home. The physical adaptations enable residents to move safely and independently around their home. EVIDENCE: The Inspector undertook a partial tour of the home and found that it was clean and tidy throughout. The Marshes is a large purpose built bungalow which is situated in a quiet residential area of Hailsham. The home is generally well maintained and provides residents with sufficient private and communal space to meet their needs. Level access is provided both internally and externally. Resident accommodation is provided in six single bedrooms and it is evident that residents have been encouraged to decorate and furnish their rooms to The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 18 their own personal tastes. Communal space comprises of a large lounge and a kitchen / dining area. The external grounds offer a garden and patio area. The home has two assisted bathroom facilities and a separate toilet. One of the bathrooms has recently been fitted with a new bath which staff reported has been a welcome improvement. Maintenance of the home is under contract with Reside and the home operates a log book for referrals that have been made and when work is carried out. The Manager reported that there are currently no major pieces of maintenance work outstanding for The Marshes, although two staff spoken with did identify that sometimes there is a delay in repairs and refurbishment. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a dedicated and competent team of staff and are protected by the robust recruitment procedures that are in place. Staff have both the skills and support to enable them to perform their roles effectively. EVIDENCE: The Manager reported that staff hours are applied flexibly, but with a minimum of three staff during the waking day. It was reported that there is an additional staff member on a ‘middle’ shift to provide support with day services and activities. The rota was found to be reflective of this. At night, the home is covered by one waking and one sleep-in person. The latter is shared with Lynfords. The atmosphere in the home was observed to be calm and relaxed on the day of the inspection and there were sufficient staff on duty to meet the needs of the residents. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 20 The recruitment files for the one new staff member was viewed and found to contain the required information, thus demonstrating a robust system of recruitment. There was documentary evidence that new members work towards completion of approved induction and foundation programmes. The training audit was viewed and it was evident that there has been a recent increase in the provision of training at The Marshes. The Manager reported that some staff were also undertaking distance learning courses including dementia care, supporting people through bereavement and loss, equality and diversity and safe handling of medication. Discussion with staff confirmed that the frequency and availability of training has improved. Conversation with a member of relief staff identified that they are also included on training updates (where their own availability allows). In information submitted to the Commission as part of the inspection process, the Manager stated that currently nineteen of the thirty staff members (staff work across both The Marshes & Lynfords) have completed National Vocational Qualifications. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a safe and well run home that has effective systems in place to self-audit and improve. EVIDENCE: A new Manager has been appointed to The Marshes since the last inspection. This individual has been in post since February 2006 and has been successfully registered with the Commission for Social Care Inspection. There is documentary evidence that the Manager has brought with him, a wealth of knowledge and experience and has worked hard over the last eleven months to further develop and improve quality of care The Marshes. The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 22 All staff spoken with acknowledged the changes and efforts that have been made by the new Manager and commented that he is both supportive and approachable. The Regard Partnership has implemented robust systems for monitoring quality assurance and there are a number of checks by the organisation to ensure that the home is performing. Monthly monitoring visits are carried out on behalf of the Registered Provider and copies of these reports were viewed during the inspection. In addition to these, The Regard Partnership now undertakes ‘mock CSCI inspections’ which generate a list of improvements for the home to action. The Manager also confirmed that annual questionnaires are sent to relatives to gain formal feedback about the quality of services. The home has a number of systems in place to gain feedback from residents and these were evidenced by way of monthly 1-1 meetings between residents and their key worker. In line with the organisation’s policy, monthly residents’ meetings are also conducted at The Marshes, which the Manager reported is primarily used as a time to be reflective about recent activities and outings. Various systems are in place to ensure the Health and Safety of the home are maintained. The information submitted by the Manager provides evidence that safety audits are being conducted on a regular basis. It was a requirement of the last inspection that the home ensure all staff have the appropriate level of fire training. This was discussed with the Manager at the recent inspection of Lynfords and he has since followed advice from the local fire and rescue service and updated the home’s fire risk assessment with respect to the frequency of training. The Marshes DS0000047638.V322314.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 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 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X 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 X 12 3 13 3 14 4 15 3 16 3 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 Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations The Marshes DS0000047638.V322314.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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