Inspection on 04/07/06 for The Willows Care Centre

This inspection was carried out on 4th July 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 Willows Care Centre 16/01/08

The Willows Care Centre 12/01/06

The Willows Care Centre 17/11/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Willows Care Centre Heathercroft Great Linford Milton Keynes Buckinghamshire MK14 5EG Lead Inspector Mrs Caroline Roberts Unannounced Inspection 10:00 4 & 5th July 2006 th 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 Willows Care Centre DS0000065320.V295456.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 Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Willows Care Centre Address Heathercroft Great Linford Milton Keynes Buckinghamshire MK14 5EG 01908 679505 01908 395232 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) Willows Care Centre Ltd Ms Jacqueline Ann Blease Tracy Margaret Davis Care Home 116 Category(ies) of Dementia - over 65 years of age (43), Old age, registration, with number not falling within any other category (43) of places The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4 (four) Step-down beds on the nursing unit That the home is registered to provide Nursing Care for 30 (thirty) service users. That the Registered Care Manager must commence the Registered Managers Award within 4 (four) months of registration. 12th January 2006 Date of last inspection Brief Description of the Service: The Willows care home is a residential home with nursing that is registered to accommodate 116 residents over the age of 65 years. Categories of registration include: Dementia care 43 Frail elderly 43 Nursing 30 The home is situated in the Great Linford area of Milton Keynes close to shops and transport links to the city centre. The building is set over three floors and has three shaft lifts to enable resident’s access to upper floors. All rooms are single with ensuite facilities; the home has ample communal space. CCTV is provided in the entrance area. Ample car parking facilities are available. Excelcare runs the home and the responsible individual is Mrs Kay Shepherd. The home has two managers Ms Jackie Blease registered general manager, and Mrs Tracey Davies care manager. The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the un-announced inspection carried out at The Willows on the 4th and 5th of July 2006. The majority of all inspections conducted by The Commission for Social Care Inspection will be unannounced. The lead inspector was Mrs Caroline Roberts The inspection consisted of meeting with residents, staff and visitors, viewing records and documents pertaining to the provision of care and the running of the home. Evidence gained from this has formed the judgements for this report. The inspector toured the building, gaining permission from a number of residents to enter their bedrooms and viewing a further number from the doorway. The inspector met and discussed the inspection findings with the manager’s and regional manager before leaving. The inspector found staff polite, helpful and welcoming, and would like to thank them for their co-operation and assistance throughout the course of the inspection. The inspector would especially like to thank the residents for their time and for allowing the inspector into their home. What the service does well: Residents said they were happy with the level of care that staff give, with their rooms and the food. “The girls are lovely and kind”” and “cant fault the food” were some expressions about the home from residents. Residents said that staff treat them with dignity and their visitors are always made to feel welcome. All rooms are pleasantly decorated are furnished to a high standard; resident’s personal items give the rooms a homely feeling. The home provides a varied activities programme. The manager acts promptly and fairly to deal with accusations of poor staff conduct in order to safeguard residents welfare. The manager encourages comments from residents, their relatives and visitors and staff aimed at improving the service. The home is managed in an open and transparent manner promoting the involvement of residents, relatives, visitors and staff. The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 6 Staff receive training suited to their role and in order to improve their skills and knowledge 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 Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All of the assessments evidenced were completed fully and clearly demonstrated that the home was able to meet the identified needs of the individual prior to admission to the home. Intermediate care is not provided at this service. EVIDENCE: The inspector viewed both the statement of purpose and the service user guide. Residents spoken with during the inspection said they were not aware of these documents, but the inspector noted both documents were available in the entrance hall of the home. Both documents give residents and their representatives a clear picture of what the home offers. Evidence from the case tracking exercise indicated that potential residents are visited prior to admission to the home and a pre-assessment undertaken to establish if the home can meet their needs. Once admitted to the home for a The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 9 trial period a fuller assessment is undertaken and any risk assessments this then forms part of the plan of care. Intermediate care is not provided in this home. The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. There are care plans in place for each resident, which cover a broad range of health and care needs. Residents are registered with a GP and have access to health and specialist services in accordance with assessed needs. Medication in the home is stored appropriately with no excess stock. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Care records seen showed that each resident had a plan of care drawn up using information from the pre-admission assessments. The plans of care were detailed and well written documents, providing clear guidance for staff as to how individual needs in relation to personal and health care needs were to be met and therefore promoted the welfare of those living at the home. The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 11 One plan of care did not give adequate detail of a residents specific health need (Diabetes) although evidence of regular blood sugar monitoring was available The plans of care had been drawn up with the involvement of the resident or their representative and had been reviewed each month and any changes in the condition or care of residents had been appropriately reflected. Residents at risk of developing pressure ulcers are identified and provided with appropriate equipment in order to avoid deterioration of their skin integrity. Risk assessments had been conducted for those at risk of developing pressure sores. The incidence of pressure sores, their treatment and the outcome were recorded within the plan of care. The Tissue viability tool used by the home uses many clinical phrases however, when the care staff were questioned of their knowledge around this tool all were able to refer to the guidance sheet which clearly explains the phrases and terms used within the tool. Evidence was available to demonstrate that a variety of external professionals had been involved in the care of those living at the home to ensure health care needs were being met. The inspector had the opportunity to talk with many of the residents during this inspection, comments received from those living at the home included, “The staff are kind” “The food is out of this world” “I have a lovely room, and can have my visitors whenever I want” One resident showed some dissatisfaction with the service, stating that it can take up to an hour for call bells to be answered, and that some days he is not given a wash, this was immediately fed back to the manager who went to see this person to discuss changes to his care plan to ensure a more structured routine that will suit him. Throughout the 2 days of this inspection it was noted that staff were extremely busy on the nursing unit, out of the 30 residents accommodated on this unit 13 are cared for in bed, 17 need 2 carers for all personal care intervention and a further 9 need a second carer for specific tasks. Meal times are also very busy with 3 peg feeds and 14 residents needing assistance with their meal. It was suggested to the managers that they could train some of the domestics and ask them to assist those residents that only need minimal assistance. Based on the staffing levels on this group of 2 qualified and 5 carers the managers need to ensure that when undertaking assessments for potential new residents they take into consideration the already high dependencies on this group, and ensure that a balance of need is achieved if they are not going to increase the staffing levels. The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 12 Staff were seen to be treating residents with respect and dignity by knocking on doors before entering and by speaking to them respectfully. Induction records showed that staff received instruction about how to make sure that residents’ right to privacy and dignity were upheld. Medications in general were well managed. Policies and procedures were in place, the medication administration records were kept up to date and medications were stored appropriately. Handwritten entries had been signed checked and countersigned to reduce the possibility of incorrect transcribing. A requirement is made that a copy of the hospital discharge sheet or copy prescription is attached to the medication sheet. An error was noted on one medication sheet, a staff member had written medication prescribed on the wrong medication sheet, it appeared that this had also been signed as given then scribbled out, it was clear that the homes own system had not worked here as this handwritten entry was not signed. The manager was made aware of this who immediately commenced an investigation; legal advice was also being sought with regards to disciplinary action on the member of staff for failing to follow the medication policy guidelines. All medications returned to the pharmacy for destruction are recorded in a book. The Willows Care Centre DS0000065320.V295456.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Residents interests and previous lifestyle are taken into consideration when developing care packages and contact with family and friends is encouraged. The food is well presented and appeared appetising and nutritious EVIDENCE: Care records showed that individuals had been asked about their likes and dislikes and the routines they like to keep, which mean staff could support them to continue in their preferred routines, as was their choice. Communication with residents was seen to be upbeat and right to meet individual’s communication skills. Choices were being offered, such as “do you want to go to the lounge, or to your room for a rest? and in offering drinks and snacks. The home has it’s own cinema room, which was decorated with flags to celebrate the world cup this had been a popular area within the home during the football. The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 14 Each floor of the home has activity co-ordinator hours allocated; recruitment for the vacant hours is ongoing. One activity co-ordinator was observed providing a small group activity on the dementia care group, and assisting with the church service. Family and visitors are welcome at any time and during the day were observed in the lounges and resident’s bedrooms at the choice of the resident they were visiting. Details of the next of kin and contact numbers were recorded in the all the files seen. The menu offered a choice at each meal, and staff checked with individuals what they wanted that day. The menu had a good range of meals, including fresh fruit and vegetables and many meals were cooked from fresh produce. Residents were complimentary of the quality of the food. The Willows Care Centre DS0000065320.V295456.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The home operates a transparent approach towards complaint investigations. POVA policies are available in the home and staff are trained in this area. EVIDENCE: The home has a complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence and the service user guide copies of which, are displayed in the entrance area. It was noted that the home has received 10 complaints since the home opened in October 2005, all have been responded to within agreed time frames with full investigation reports available. The training records seen indicated that some staff had received POVA training and further staff are planned to attend in this years training plan, this will be monitored at the next inspection. POVA policies are available for staff. A disclosure was made to the inspector during this inspection, the manager was made immediately aware who talked with the resident and family and contacted Milton Keynes POVA team for a full investigation to commence. The manager promotes a very transparent approach ensuring all parties are kept fully informed. The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 16 The Willows Care Centre DS0000065320.V295456.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Qulaity in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Residents live in a safe and very well maintained environment EVIDENCE: The home is situated in a suitably quiet area, and as a purpose built unit, has been designed to meet the needs of older people. The home has two large passenger lifts for easy access to all floors, and corridors are wide, and easy for people in wheelchairs to use. All of the bedrooms are for single use, and have en-suite facilities. Each bedroom has a locked drawer for any personal items, and doors can be locked if requested. Each group has a bathroom, which is fitted with disabled bathing facilities and grab rails. The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 18 All six groups have a lounge/diner, and these had comfortable armchairs, and tables and chairs for mealtimes. They were laid out in a style, which looked, informal, and allowed for different grouping of residents. The tiled floors in the lounge areas take away from the homely feeling the home promotes; one resident stated that she felt they made the lounge feel cold and unwelcoming. There is a large conservatory on the ground floor and the cinema room. The home has a large laundry room on the ground floor; dirty clothing is put into linen sacks and sent to the laundry, Soiled items are put in red alginate bags, and these are washed on sluice programmes before normal washes on the machines. A laundry person is employed each day, and the laundry was very tidy and organised. The home was generally clean, which is a credit to the housekeeping staff. The Willows Care Centre DS0000065320.V295456.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Qulaity in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service Staffing arrangements provide for a suitable mixture of qualified nurses, care staff, administrative staff, domestic, catering, activities and maintenance staff. There is a good rapport between staff, with most respecting and recognising each other’s roles and responsibilities. Residents are protected by the homes recruitment policies and procedures Staff are provided with a training programme in order that they can meet residents needs. EVIDENCE: There is a recorded staff rota displaying which staff are on duty throughout the day and night. There is always a senior on each group and a nurse on the nursing unit. Staffing levels are currently: Four staff throughout the waking day on each of the dementia care groups Three staff throughout the waking day, on each of the frail elderly groups plus a float. The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 20 Two qualified nurses and five carers in the morning and two qualified and four carers in the afternoon on the nursing group. Staff are paid enhancements for weekends and bank holidays, and staff with NVQ qualifications are paid a higher hourly rate. The above information was ascertained from the duty rotas and discussions with care staff. Three files were viewed during the inspection and included the documentation required to ensure that the homes recruitment procedures are sufficient to protect residents. They also contained evidence of induction training and certificates of training courses attended. The manager has a training matrix in place to ensure that all mandatory training is undertaken by staff with regular updates. This had recently been updated and during this exercise the manager had noted that some staff (mainly night staff) had not maintained all of their training as required, a letter has been sent to each of these staff with required attendance dates for planned training. Training that has taken place since April of this year includes: Food Hygiene 10.5.06 /13.4.06 /9.6.06 Health and safety 11/4/06 /11.5.06/ 13.6.06 POVA 24.4.06, 9.6.06 Care [planning 25.4.06 M&H 27.4.06/3.5.06 /27.5.06 /5.6.06/ 27.6.06 Dementia training 18.5.06 First aid 20.6.06 Fire training 5.7.06 The Willows Care Centre DS0000065320.V295456.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Both of the Manager’s have the necessary skills and training for the roles, to ensure practice in the Home is in the best interest of Service Users. Quality assurance systems are in place at the home The home does not hold any residents finances. There are satisfactory procedures in place to ensure the Health and Safety of residents and staff. EVIDENCE: The Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 22 This home has two managers both of whom are registered with the Commission for Social Care Inspection. Both of the managers are available to staff and residents alike on a daily basis. They are committed to improving care, this is the third inspection of the home since the opening in October 2005 and the inspector was able to see all of the hard work the managers have put into ensuring that this home is a success. The home does not manage any of the resident’s finances. The general manager readily produced all records and policies requested for inspection. Staff files were kept locked up but policies and procedures were available for staff to access. The Organisation has a quality assurance audit of which the records following the audit undertaken by the facilities manager on the 7.3.06 were viewed. The paperwork available did not clearly demonstrate what had been viewed to ascertain the outcome. The regional team including managers from other homes in the area also conduct weekend and night audits with documentation of the outcome of these visits maintained. The regional manger undertakes regulation 26 visits. On two separate occasions staff were observed to be transporting residents in wheelchairs without the use of footplates, this practice is to cease as puts residents at risk. The manager spoke with the staff to address this issue immediately. There are detailed Health and Safety policies in the home. These serve as a training manual and reference document for staff to use. These cover policy areas such as fire prevention and care of substances Hazardous to Health (COSHH). These policies ensure that the health and safety of the residents and staff are maintained at all times. Records made available for inspection purposes evidenced that regular service agreements are in place to further ensure safety The Willows Care Centre DS0000065320.V295456.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 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 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 N/a X X 3 The Willows Care Centre DS0000065320.V295456.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 2 Standard OP38 OP9 Regulation 13(4)&(5) 13(2) Requirement Timescale for action 08/07/06 The practice of transporting residents in wheelchairs without the use of footplates is to cease. Where staff enter hand written 08/07/06 instructions as to the administration of medicines in a MAR sheet, a copy of the original prescription must be held with the MAR sheet as evidence of the transcribed instructions. 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 Willows Care Centre DS0000065320.V295456.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Willows Care Centre DS0000065320.V295456.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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