Inspection on 01/06/06 for Tiltwood

This inspection was carried out on 1st June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tiltwood 19/12/08

Tiltwood 19/12/07

Tiltwood 27/11/06

Tiltwood 08/12/05

Tiltwood 27/06/05

Tiltwood 14/12/04

Tiltwood 24/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Tiltwood Hogshill Lane Cobham Surrey KT11 2AQ Lead Inspector Cathy Clarke Unannounced Inspection 1st June 2006 10:00 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 Tiltwood DS0000029255.V300366.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. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tiltwood Address Hogshill Lane Cobham Surrey KT11 2AQ 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) 01932 866498 01932 867205 manager.burroughs@careuk.com Care UK Community Partnerships Limited Ms Jeni Helen Beck Care Home 50 Category(ies) of Dementia - over 65 years of age (50), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (50), Old age, not falling within any other category (50) Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th December 2005 Brief Description of the Service: Tiltwood is a care home providing personal care to older people located in a residential area of Cobham, Surrey. The home is close to local shops and public amenities and can accommodate up to fifty people. The property has private parking to the front of the building and garden areas outside each of the residential units. The accommodation provided is on ground level with single bedrooms. The home has five self-contained units each with a dining area, lounge and a kitchenette. The home has a main kitchen, bathing and washing facilities and laundry. There are small communal areas throughout the home where relatives, visitors and service users can sit and relax. The current scale of charges is between £680 and £700 per week. Service users are responsible for additional charges for personal items such as toiletries, chiropody and hairdressing. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the Commission for Social Care Inspection (CSCI) year April 2006 to 2007 using the new ‘Inspecting for Better Lives’ (IBL) process. Lead Regulation Inspector Cathy Clarke was assisted throughout the inspection by Jeni Beck proposed registered manager representing the establishment. The IBL process involves a pre-inspection assessment of service information from a variety of sources initially helping to prioritise the order of inspections and identify areas that require more attention during the inspection process. A new Inspection record is compiled from details received from a preinspection questionnaire from the home and notifications of significant events known as regulation 37. Comments and complaints received and previous inspection reports are all considered for inclusion prior to the inspection visit. For more details of ‘IBL’ please visit the Commission for Social Care Website details can be found on the last page this Inspection report. The inspector was with staff and residents at Tiltwood for a period of 6 hrs. This time was spent sampling resident’s care need assessments, care plans, medication processes, contracts and talking to residents, staff and relatives. Staff files were inspected for evidence of good practice in the following areas: recruitment, allocation of staff skills, daily rotas and training. The inspector would like to thank the manager and staff of Tiltwood for the hospitality shown during the inspection. What the service does well: What has improved since the last inspection? Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 6 Staff have received copies of the policy and procedures for administering medication and for medication changeover. Gap monitoring of medication administration records at the end of each shift has been implemented since the last inspection. A weekly count of all non-blister packed medication has commenced. Staff have been made aware that non-compliance with medication policies and procedures will result in disciplinary action being taken. The number of unwitnessed falls in the home has reduced by 50 in the month of May. The carpets and flooring in rooms 3, 9 and 10 have been cleaned. The cushion for armchair in Chestnut unit has been replaced. The laundry bag in the bathroom has been affixed to the frame. The leak under the sink in the kitchen has been repaired and the kitchen floor has been cleaned. Sponge mix and dried foodstuffs are stored in sealed containers. Kitchen overalls and hats have been replaced. Recruitment practices have been improved. What they could do better: The service user guide must be reviewed and updated and the reference to a named nurse be removed from the document. Contracts must be issued to all service users. When receiving new service users to the home whether for assessment or permanent admission staff must ensure that they explain the assessment process clearly and give reassurance to the person who is being admitted and their family. Put systems in place to ensure that the number of service user falls within the home is at a minimum. Medication administration records must have the correct indicator inserted when medication has been refused and destroyed. The service must seek professional advice regarding the eradication of mal odour in Pines Unit and take action accordingly. Systems to control the spread of infection must be put into place. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 7 The kitchen floor area recently maintained must be checked to ensure that the problem has been eradicated. A staffing review must be conducted to ensure the safety and welfare of service users within the home, especially at night. Staff must be working on each unit of the home at all times to ensure the safety and welfare of service users. The minimum ratio of staff trained to NVQ Level 2 or equivalent must be achieved. Staff must ensure that they use the correct manual handling techniques when assisting service users. 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. Tiltwood DS0000029255.V300366.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 Tiltwood DS0000029255.V300366.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are documents in place giving prospective and existing service users useful information regarding the home however the service user guide requires updating. Residents new to the home had received an assessment of their care needs. EVIDENCE: There is a statement of purpose in place and service user guide for prospective service users. The service user guide must be reviewed and updated to remove the reference to a named nurse for service users, as this is not available within this home. Contracts were not on file for two of the four service user files sampled and must be issued to all service users within the home. Intermediate care is not provided by this service. Please see requirements section of this report. Tiltwood DS0000029255.V300366.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 adequate. This judgement has been made using available evidence including a visit to this service. Each service user has an individual care plan outlining their needs. The home is working with external professionals to improve the health and welfare of service users. Service users spoken to stated that their care is provided with respect and privacy is afforded to them. The significant number of falls within the home is of concern. Medication policies and procedures have been improved since the last inspection and practices are audited on a regular basis. EVIDENCE: A computerised system is in use for planning the care of service users. Care plans sampled were clear and the health care needs of service users had been assessed. The home works closely with the local GP and health care professionals. All service users have regular dentist, optician and chiropody check ups. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 11 Each service user has a set of daily progress notes in place. A multidisciplinary review meeting is held with regard to the care of each individual service user and clear notes are entered onto the computerised system. A falls prevention programme has been put into place at the request of CSCI in response to the high number of regulation 37 notices received involving service user falls. The service is working with an external health care professional to review the reasons behind these falls. The number of falls within the home has reduced by 50 in May. The service must ensure the safety and welfare of service users and continue with the falls prevention programme, putting into action any recommendations made by health care professionals. The Commission for Social Care Inspection has received a falls analysis and risk assessment from the service and is working with the provider to monitor their progress. Medication practices have improved since the last inspection. Each service user has a photo on file. Staff have received copies of the policy and procedures for administering medication and for medication changeover. Gap monitoring of medication administration records at the end of each shift has been implemented since the last inspection however one of the records sampled had the incorrect indicator inserted when medication had been refused and destroyed. The controlled drugs register was viewed during the inspection and found to be accurate. A weekly count of all non-blister packed medication has commenced. A local pharmacy checks medications on a quarterly basis. There is a protocol in place for handwritten medication administration records. There is a medication profile for each service user signed by the GP. Staff have been made aware that non-compliance with medication policies and procedures will result in disciplinary action being taken. During the inspection the inspector observed that personal care tasks were undertaken in private and the dignity of service users was preserved. One service users daughter who was visiting stated that her mother was well looked after. See requirements section of this report. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 12 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 using available evidence including a visit to this service. Service users are encouraged to take an active part in activities and these are individually matched to their preferences. Family and friends are welcome at the home. Service users are assisted to exercise choice and control over their lives within the parameters of their individual risk assessments. A range of choices is available on the menu. EVIDENCE: There are lots of activities available to service users within the home including arts and crafts, ball games, knitting, a day care service which service users can attend. The service offers day care facilities to older people in the local community however the number of people attending is low. Each individual service user has a programme of activities linked to their particular choices and abilities recorded on their plan of care. One of the service users is picked up on Sunday’s to take her to the church of her faith. The service has invited the Church of England to visit service users in the home. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 13 Two service users were being visited by their family and relatives informed the inspector that they were happy with the home and that they can visit whenever they wish. Service users spoken to during the inspection informed the inspector that they enjoyed their meals and there are a variety of choices on offer. There are two meal options available and cooked breakfast can be ordered before 9am by request. Sponge mix and dried foodstuffs are now stored in sealed containers. Records of the meals eaten by service users for each unit of the home were sampled. A discussion was held with the manager regarding one service user who according to the records had refused both options on the menu. The manager stated that the service user would have chosen an alternative meal. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 14 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 adequate. This judgement has been made using available evidence including a visit to this service. There is a complaint and vulnerable adults policy and procedure in place and the staff have received training and development in these areas. EVIDENCE: There have been three “Safeguarding Adults” investigations made since the last inspection. Details of which are confidential. The manager and staff have worked with the local authority to resolve these issues and the policies and procedures of the home relating to vulnerable adults have been followed. There has been one complaint made by a relative of a proposed resident and this has been responded to within the correct timescales. The home has learnt from this experience and further training is to be offered to staff in order to ensure that the issue does not reoccur. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The environment and layout of the home does present problems when ensuring the safety and welfare of service users. The home has a homely feel and is decorated with service users choice in mind. One area within the home had a strong smell of mal odour, which staff have tried to eradicate. EVIDENCE: A full tour of the premises took place and the homes redecoration programme has been completed since the last inspection. Colours in the lounges and furnishings were chosen with service users. The corridors and most of the units were clean and had a homely feel about them. One of the service users spoken to stated that she liked the colour in the unit that she was staying in for respite. There is a strong mal odorous smell in Pines unit and although the service has tried methods of reducing the odour this has not eradicated the problem. The Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 16 service must therefore seek professional advice and take action to eradicate the problem. One of the service users was being assisted by two members of staff on one of the units with personal care. It was recognised that the priority for attention was the service user however the staff should have sought assistance to clean the floor and thus control the risk of infection to others. The leak under the sink in the kitchen has been repaired and the floor maintained. The kitchen floor surface was sticky and where the floor had been repaired the flooring was starting to rise on the left hand side. Sponge mix and dried foodstuffs are stored in sealed containers. Kitchen overalls and hats have been replaced. During the inspection the jelly that was stored in the fridge was left uncovered. Fridge and freezer temperatures were within the required limits. Please see requirements section of this report. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Recruitment practices have improved. The deployment of staff may be insufficient to ensure the safety of residents. EVIDENCE: Discussion was held with the manager regarding the number of staff employed to work on each unit. During the day there are nine care staff and two team leaders to cover the five units excluding the manager, administrator and maintenance person. There is concern that during the night there is one member of staff employed on each unit. Should an incident occur and two staff are required to assist this would leave other units without any staff. A staffing review must be conducted to ensure the safety and welfare of service users within the home, especially at night. During the tour of the home the inspector noted that one of the units was without any staff during the handover period, service users were without assistance during this period. A new induction workbook has been developed and is linked to the National Vocational Qualifications for Care. Staff spoken to during the inspection who work in the kitchen hold the basic food hygiene certificate. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 18 Recruitment practices within the home have improved since the last inspection. Four staff files were randomly sampled and these contained a copy of application forms, interview record and checklist, three written references, identification, Criminal Record Bureau Checks, medical questionnaire and contracts were in place for all staff. New employees undertake a four-day training programme. There is an annual training plan which identifies attendance at either NVQ, corporate Care UK training, mandatory care courses or specific training linked to the needs of staff within the home to meet the complex needs of residents with Dementia. Nine staff hold a valid first aid certificate and twelve staff are trained to administer medication. Discussion was held with the team leader on duty who has worked at the home for fifteen years, she has undertaken specific Dementia training and has completed level 3 NVQ in Care. At the present time 29 of staff hold a relevant NVQ at Level 2 or above. The home must ensure that the target of 50 of staff to be trained to this level is achieved. Seven team leaders hold NVQ Level 3 and one is working towards completion. Verification of six care awards at NVQ Level 2 is taking place and ten care staff are registered and undertaking the award. Two staff hold NVQ 2 in Care. One member of the day care staff was observed by the inspector assisting a service user up out of a chair using an unsafe method of manual handling. Discussion was held with the manager and further training has been sought for this member of staff. Please see requirements section of this report. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. The homes manager is in the process of registering with CSCI. The home is run in the best interests of service users and the home has the required policies and procedures in place. The manager has worked with external health care professionals and The Commission for Social Care Inspection to promote and protect the welfare of service users. EVIDENCE: The manager holds NVQ Level 4 Registered Managers Award and has gained experience in the field of care over many years. A rotating team of Senior Managers within Care UK on a monthly basis carries out service specific quality monitoring visits. Customer satisfaction and Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 20 catering surveys are carried out annually. A named person within the organisation is responsible for the quality assurance internal audit. There are twenty service users who are subject to Power of Attorney and one subject to Guardianship. A record of all personal allowances is kept. No savings accounts are kept at the home. Individual bank accounts are set up if finances need to be managed. Service users pay for their day-to-day expenditures such as toiletries, hairdressing, chiropody and external activities. The service pays any transport costs when taking service users out on visits and the service users usually pay for lunch. The head office of Care UK deals with charges and invoicing for the service. The manager has worked with external health care professionals and The Commission for Social Care Inspection (CSCI) to promote and protect the welfare of service users. This work is ongoing and the manager is monitoring progress and keeping CSCI informed. Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 2 2 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 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 1 STAFFING Standard No Score 27 1 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 6 (a) (b) Requirement The service user guide must be reviewed and updated and the reference to a named nurse be removed from the document. Contracts must be issued to all service users. When receiving new service users to the home whether for assessment or permanent admission staff must ensure that they explain the assessment process clearly and give reassurance to the person who is being assessed and their family. Timescale for action 31/08/06 2. 3. OP2 OP3 5 (1) (c) 12 (3) 12 (5) (b) 14 (1) (c) 31/08/06 31/08/06 4. OP8 12 (1) (a) 5. OP9 13(2) The service must ensure the 31/08/06 safety and welfare of service users and continue with the falls prevention programme, putting into action any recommendations made by health care professionals. t Complete and accurate records 31/07/06 must be kept of all medication administered, or not, to service users. This requirement has been partially met from the DS0000029255.V300366.R01.S.doc Version 5.2 Page 23 Tiltwood 6. OP26 16 (2) (k) previous inspection and a revised timescale has been given. The service must now seek professional advice to eradicate the mal odour on Pines Unit. Systems to control the spread of infection must be put into place. The kitchen floor area recently maintained must be checked to ensure that the problem has been eradicated. Foodstuff must be covered and stored appropriately to reduce the risk of cross contamination. A staffing review must be conducted to ensure the safety and welfare of service users within the home, especially at night. Staff must be working on each unit of the home at all times to ensure the safety and welfare of service users. The minimum ratio of staff trained to NVQ Level 2 or equivalent must be achieved. Staff must ensure that they use the correct manual handling techniques when assisting service users. 31/08/06 7. 8. OP26 OP26 16 (2) (k) 23 (2) (b) 31/08/06 31/08/06 9. 10. OP26 16 (2) (g) 12 (1) (b) 31/08/06 31/08/06 OP27 11. OP27 12 (1) (b) 31/08/06 12 13 OP28 18 (1) (a) 18 (1) (a) 30/06/07 31/08/06 OP30 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 Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Tiltwood DS0000029255.V300366.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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