Inspection on 04/12/06 for The Sycamores

This inspection was carried out on 4th December 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 Sycamores 20/02/06

The Sycamores 05/10/05

The Sycamores 15/03/05

The Sycamores 14/10/04

The Sycamores 27/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Sycamores Victoria Street Newton Hyde Tameside SK14 4DH Lead Inspector Janet Ranson Unannounced Inspection 4th December 2006 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 Sycamores DS0000005584.V320996.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 Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Sycamores Address Victoria Street Newton Hyde Tameside SK14 4DH 0161 368 4297 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) Tameside Care Limited Lynn Mary Davidson Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60), of places Physical disability over 65 years of age (45) The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 60 service users to include: *up to 60 service users in the category of OP (Old age not falling within any other category); *up to 60 service users in the category of DE(E) (Dementia over 65 years of age); *up to 45 service users in the category of PD(E) (Physical disability over 65 years of age). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 20th February 2006 2. Date of last inspection Brief Description of the Service: The Sycamores is a large, two storey, purpose built home registered to provide care for 60 older people, some of whom may have dementia or a physical disability. Accommodation is provided on each of the two floors. Originally commissioned by the local authority, the home is now managed by Tameside Care Limited. There are 60 single rooms, 14 of which have en-suite facilities. The home is divided into self-contained units, each one having its own small kitchen and laundry. There are aids and adaptations to meet the assessed needs of the service users. Paved sitting areas have been created to the front of the home and also to the rear, the latter being secured by fencing. The grounds are fully accessible to the service users, with garden furniture to be used in the better weather. The home is located in a residential area of Newton with associated community resources and transport links to Ashton and Hyde. Fees for accommodation and care at the home are £356.66. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. There is also a voluntary weekly charge for social activities. The statement of purpose and service users guide is available in the main hallway. The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the key inspection, which included an unannounced site visit by one inspector and an ‘expert by experience’. The site visit took place on 5th December 2006 and covered a period of eight hours, from 9:30am until 5:30pm. The Commission for Social Care Inspection are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for older people. During the inspection time was spent talking to residents, relatives and staff and observing the home’s routine and staff interaction with residents. The expert by experience also had lunch with the residents. A total of six residents’ identified needs were looked at in detail. Individual details of their experiences and care were examined from the point of admission to their current care. The inspector looked around the building and a selection of staff and residents’ records was examined, including records of care, medication records, employment and training records. The inspector checked what the Commission had asked the home to do at the last inspection (October 2005) had been done. Questionnaires were left at the home for use by residents, their relatives and the staff to comment on the service. Some of the responses have been incorporated in this report. Two relatives wrote: “I am quite happy with the care … is getting, and if … is happy that makes me happy.” “My friend is very happy.” The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: A resident wrote, “The meals could be a lot better more choice and better served. Could do with fresh fruit.” A carer noted in a comment card that areas of communication and staff interaction could be improved to provide a better service to the residents. The manager is recommended to look into these comments. The Sycamores DS0000005584.V320996.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 Sycamores DS0000005584.V320996.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 Sycamores DS0000005584.V320996.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): 1, 2 & 3 (standard 6 intermediate care is not provided at The Sycamores) Quality in this outcome area is good. The home’s system of assessment reflected individual preferences and social requirements. This meant that the home could be certain they could meet the prospective resident’s diverse needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care needs assessments were contained within the six care files examined as part of the inspection. The home also has a process of assessing potential resident’s needs carried out by a senior member of staff. Prospective residents and their relatives are also invited to visit the home so that they can meet other people and see the accommodation for themselves. By completing such an assessment the home can be sure that individual needs can be met. Two residents said they remembered people talking with them before they visited the home to see for them selves. One person thought this was either their doctor or “someone from social services.” Other residents stated that a The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 10 close member of the family had looked around the home on their behalf and they had then visited and stayed for a meal. One resident was able to locate her copy of the service users guide, however this was not always the case with the other residents who spoke with the expert by experience and the inspector. The statement of purpose was available in the main hallway along with other documents appertaining to the organisation. The expert by experience and the inspector asked a selection of residents if they had signed a contract with the organisation and if they knew how much they were paying to live at The Sycamores. One person did know how much she was paying but along with the other residents was unaware of any contract or terms and conditions with the home. This could be because relatives have taken on this role and the residents actually thought this was the case. A resident wrote, “…was in hospital, sister came and looked around, showed me the brochure.” Another resident wrote, “Just received the booklet on the home. Did not realise that there was not many people in here that you can talk with.” A further resident commented, “(I) didn’t have any prior information, due to being in hospital. Came for lunch one afternoon before moving in.” The inspector spoke with three relatives, two of whom were also unaware of a contract with the home and were not able to say how much their relative was paying to live at the home. The third relative confirmed she had signed a contract and was aware of the cost and was satisfied that the organisation informed her in good time of any increase in the fees. During the inspection the manager was overheard speaking to a telephone enquirer. The manager clearly described the financial process that would be carried out to assess the prospective residents fees, should they choose to live at The Sycamores. The enquirer was also invited along with the prospective resident, to visit the home to see what was on offer. The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9,10 & 11 Quality in this outcome area is good. The care planning process clearly identifies the residents’ individual health and social requirements. They provide the carers with action to be taken to provide appropriate care on a day-to-day basis enabling the residents to benefit from the individual care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six care plans were examined as part of the inspection process. They clearly set out the residents’ individual personal care needs. The care plans document the action to be taken by the carers to ensure all aspects of health, personal and social care are met and reviewed. Where identified, the resident’s health is monitored and addressed by the appropriate health care professionals. The district nurses are involved on a regular basis as are the chiropodist, audiologist and dietician. The district nurse was visited the home during the inspection. She confirmed to the inspector that she was the “named nurse” for the home. It was The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 12 apparent that she had a good working relationship with the carers. She said the carers worked well together and had a clear understanding of each other’s roles and responsibilities. The home operates a “care pathway” system for those residents who have been assessed by a consultant as being in their final stages of life. This involves other healthcare professionals in addition to the homes care staff and enables the resident to remain in their own room whilst receiving specialist care. A memorial service was held for a recently deceased resident during the afternoon of the inspection. It was attended by residents and staff and was clearly a moving experience. It also offered the residents the opportunity to remember the resident with support from the staff. The senior staff are responsible for the administration of medication. There was evidence to show they had received training to correctly administer medications. Records are retained to show changes to medications and medical interventions. There is a policy and procedure in place to ensure all medications are administered in the correct manner. The medication storage was satisfactory. Requirements about medication made at the previous inspection had been fully met. One person continues to manage their own medications. The associated risk had been documented as required. Based on observation, it was apparent that the staff respected the residents’ privacy by knocking and waiting before entering rooms. The residents and their visitors could be seen through out the home during the inspection. The Sycamores DS0000005584.V320996.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 & 15 Quality in this outcome area is good. The choices offered to the residents meet with their requirements and needs and enable them to exercise elements of control over their lives. The programme of activities provided suits the resident’s requirements for stimulation. Visitors are made to feel welcome and remain in contact with their relatives’ care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a planned programme of activities. During the inspection a small group of residents were enjoying a reminiscence session with a carer. Music was played and the residents were encouraged to remember who was singing and what show the music had come from. This was all very relaxed and unhurried. Several ladies had had their hair done during the morning. Entertainers also visit the home on a regular basis and there is a social evening each Saturday. One resident told the expert by experience she was looking forward to the planned trip to the local theatre. A further resident wrote that there were sometimes activities arranged by the home that he could take part in but, The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 14 “(I) don’t like bingo, aerobics or socials. More interested in trips out. forward to going out on my scooter when the weather is better.” Religious services are held regularly at the home. identify those residents who wish to attend. Look Individual care plans Based on direct observation, the residents benefit from relaxed informal contact with the staff. A regular visitor said the home was very good at making visitors feel welcome and involved. This person particularly liked the “informal atmosphere” stating nothing is too much trouble (for the staff.) The main meal of the day at The Sycamores is served at midday; breakfast is flexible, as and when the residents get up. A lighter tea is available later in the day and supper prior to going to bed. The expert by experience took her lunch with the residents in one of the dining areas. She noted that several residents told her “the food is very good.” The expert by experience also noted that “ relatives can have a meal at the home if they wish, later I spoke with a relative who said “I’m coming to the home on Christmas day for my lunch.” A visitor said to the inspector that she thought the food usually looked good however her relative often commented, “the cooking of the food is not quite as at should be. Food is spoiled and the variety is not very good.” A resident said to the inspector they always enjoyed the meals at the home and there were “good portions.” Another resident said, “the portions can be too large sometimes and I don’t feel like I should leave any.” The expert by experience noted; “The Sycamores is at present undergoing a much needed refurbishment and this is being done with as little disruption to the residents as possible. Regular residents meetings have taken place to discuss progress and most residents felt they had been consulted regarding the décor and furnishings, relatives were also invited to attend the meetings.” The Sycamores DS0000005584.V320996.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 & 18 Quality in this outcome area is good. The home has an accessible complaints system with evidence that residents feel that their views are listened to and acted upon. Staff knowledge and understanding of adult protection issues provides a safe environment to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a policy and procedure concerning reporting and investigation of complaints. This is available to the residents in the service users guide and also displayed in each bedroom. Two residents who spoke with the expert by experience pointed out a copy of the procedure in their bedrooms, one of these residents said they would “tell the manager” if he had any complaints. Those residents who spoke with the inspector were not aware of the process but did say they would either tell their relative of any concerns or speak with a member of staff. They said their expectations would be that the concern would be looked into and made better for them. One resident wrote “Staff are always available to talk to (in response to the question Do you know who to speak to if you are not happy?) The home has a policy and procedure to respond to allegations of abuse. The senior carers have received formal training in the Protection of Vulnerable The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 16 Adults (POVA) as required. The carers who spoke with the inspector confirmed they had also received the POVA training and demonstrated their understanding of their responsibilities. Responses contained in the care workers surveys also confirmed they had received this form of training. The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. Improvements to the home will provide the residents and their visitors with a pleasant warm and welcoming environment, on completion. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each unit and communal areas in the home is undergoing a major refurbishment. This will greatly improve the environment for the residents. There is a display in the main hallway with the intended colours and textures for the redecoration and soft furnishings on each unit. The manager has arranged meetings so that the residents can be kept informed on the progress of improvements the building. Where the improvements had been carried out it was apparent the standard was high, providing the residents and their visitors with an attractive clean environment. It is anticipated the works will be completed by March 2007. The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 18 Those residents who spoke with the inspector and the expert by experience confirmed they were happy with their rooms and the accommodation in general. Those residents who completed a comment card noted that the home is usually fresh and clean although one person wrote, (the home was not clean and fresh) “at the moment due to all the work being done.” Another resident wrote, “the home is usually fresh and clean. The cleaners on this unit are very very good and cheerful.” It was evident that those resident’s who are independently mobile were able to move around all areas of the home at will. Although at times during the inspection some areas of the home were made inaccessible to the residents and their visitors to lessen the risk of accident. The manager is making daily risk assessments because of the recognised risk to health and safety by the presence of builders and associated equipment within the home. There is a room specially equipped for hairdressing that has been redecorated in keeping with the entire refurbishment. The Sycamores DS0000005584.V320996.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 & 30 Quality in this outcome area is good. The residents receive care from welltrained staff that responds to the residents and visitors in a respectful manner. The homes recruitment policy and procedure provides protection to the residents from potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager reported there were no staff vacancies. From observation during the inspection the numbers of staff on duty met with the resident’s assessed needs. The majority of comments from the residents and their visitors confirmed this to be the case. A relative said, “Although my relative is happy at The Sycamores she feels there is not enough staff on her floor.” A resident told the inspector “when I need carers I just ring my hand buzzer.” Another person said, “they would do a lot better if they listened to me” (but was not prepared to explain this comment.) The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 20 A carer who responded “no” to the question “Do you feel you have enough support from the home to do your job well?” giving the reasons as “a lack of communication between officers and staff, and also a lack of time.” This person went on to list the things to change in order that the home worked better as, • • • • • More communication between staff and managers Better staff Better communication between days and nights Time to talk to clients instead of rushing around cleaning More available staff in a morning. The carers who spoke with the inspector and the expert by experience confirmed they had attended an induction programme and had completed all the health and safety (mandatory) training. They said they felt well supported in their role and enjoyed working at the home. Team meetings are arranged at regular intervals. The organisation continues to be a committed to the National Vocational Qualification training scheme with a total 74 of carers achieving level two in care practices. A small number of staff files were examined. They contained the required documentation and there was evidence of references including satisfactory checks with the Criminal Record Bureau. The requirements made at the last inspection concerning the recruitment processes had been fully met. The Sycamores DS0000005584.V320996.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 & 38 Quality in this outcome area is good. The manager of the home has the skills, experience and qualifications to run the establishment. The resident’s financial interests are safeguarded. Systems are in place to protect the residents, their visitors and the staffs’ health and safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is supported through the organisation by the operations director and in the home by senior carers. She has the skills, experience and qualifications to manage the home. Reports of regulation 26 visits made to the home by the registered provider or their representative are supplied to the Commission for Social Care Inspection as required. The operations manager undertakes the visits and the manager The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 22 stated that all visits were unannounced. Other unannounced visits were carried out to check on the health and safety aspects in the home. A system of annual satisfaction questionnaires is being used by the organisation to enable the residents and their relatives to improve or comment on their care. The results are made public and recommendations acted upon. One resident continues to manage their own finances. For those residents who are no longer able to deal with their money the home has a system to protect their financial interests. Small amounts of personal allowances are retained for safekeeping. Satisfactory records with receipts covering all expenses are retained for auditing and inspection purposes. The home has a system of residents meetings that enable the residents to have their say about how the home is organised. No hazards to health were noted during the inspection however on leaving the building it was noted by both the expert by experience and the inspector the pathway to the front and the car park to the side of the building was very badly lit. There is security lighting located part way down the pathway. This is activated by movement but this was not enough to provide safety to the whole of the pathways. The health, safety and welfare is further ensured by the systems in place to report accident and incidents The Sycamores DS0000005584.V320996.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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Sycamores DS0000005584.V320996.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. 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 OP27 OP38 Good Practice Recommendations The registered person should address the comments made by a carer regarding lack of communication and support. The registered person should ensure the safety of the residents, staff and visitors to the home by providing adequate lighting to the pathways at the front of the building. The Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Sycamores DS0000005584.V320996.R01.S.doc Version 5.2 Page 26 - 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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