Inspection on 01/06/06 for Trembaths

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 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

Trembaths 16/07/07

Trembaths 22/02/06

Trembaths 11/11/04

Trembaths 11/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Trembaths Talbot Way Letchworth Hertfordshire SG6 1UA Lead Inspector Louise Bushell Key Unannounced Inspection 10:00 1st June 2006 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 Trembaths DS0000019596.V297595.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. Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Trembaths Address Talbot Way Letchworth Hertfordshire SG6 1UA 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) 01462 481 694 01462 485 606 home.let@mha.org.uk home.fxg@mha.org.uk Methodist Homes for the Aged Mr Alan Dickinson Care Home 41 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (15), Old age, not falling within any other of places category (41) Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. This home may accommodate 15 older people who require personal care. This home may accommodate 15 older people with dementia who require personal care. This home may accommodate 31 older people who require nursing care. 22nd February 2006 Date of last inspection Brief Description of the Service: Trembaths is a two-storey, purpose-built care home providing nursing, personal care and accommodation for 40 persons over 65 yrs of age. It is owned by Methodist Homes and is situated in a quiet residential area of Letchworth within easy reach of the town and shopping facilities. All bedrooms are single with en suite wash hand basin and toilet. The ground floor comprises a self-contained unit for 15 persons with dementia. The ground floor has its own lounge, dining room, kitchenette, 4 assisted bathrooms and three separate assisted toilets. Also on the ground floor are a main lounge, a hairdressing salon, an administration office, a smaller office, the main kitchen, the laundry room and a staff dining and changing room. The second floor is divided into 2 units for a total of 25 persons requiring nursing care. Each unit has its own lounge, dining room and kitchenette and shares 5 assisted bathrooms and 4 assisted toilets. The managers office is located on the first floor. To the front, the home affords ample parking spaces. It has a very pleasant rear garden, which is securely enclosed, with a patio, a circular concrete path, a summerhouse and a gazebo. Weekly charges range from £566 - £708, dependant on needs. Additional charges are made for newspapers, toiletries, chiropody and hairdressing. Trembaths DS0000019596.V297595.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 key inspection of the year and focused on all of the key standards as defined in the National Minimum Standards. This was an extremely positive inspection, reflecting the positive comments made by both service users and staff. Where information has remained the same from the last report this has been carried forward to this report. What the service does well: The environment continues to be maintained to a high standard with both internal and external decoration being well maintained and presenting a homely feel. All service users rooms are decorated to personal taste and all are encouraged to personalise their rooms. During the inspection the views of many service users were sought, many positive comments were made in respect of the home. A group of service users were playing a quiz, a service user stated that “ the staff are caring and the home is always clean and tidy, it is very well managed”. Another service users stated that they “enjoy the food and the activities are fun”. The home provides a wide range of activities and employs a specific activity coordinator to work with service users who have dementia. Feedback from service users confirmed the range of activities available and comments were received stating, “we like the quizzes and games.” The home has an extremely detailed and effective quality assurance system in place, actively seeking the views of the service users, relatives and other visiting professionals. The internal audits occur every 6 months with specific auditors in the home covering a range of measurable indicators. A new quality team is now employed for the company and further developments have been made to the quality assurance system, making it more detailed. Supervision and appraisals are continued to be offered and feedback from staff spoken to confirm that the process was effective and a useful tool. Records were well maintained for all staff. The home offers a comprehensive and extremely well structured induction programme for all new employees this ensures that core skills and a value base practices are established prior to working with the service users. NVQ participation in home continues to be excellent, with almost all of the team having completed at least NVQ level II. This is a commendable level, ensuring that all care staff have had this available and have been supported in the process of completion. A recent accredited Dementia training course has Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 6 been attended by staff to further expand their specialist knowledge and support them in providing care to the service users. 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. Trembaths DS0000019596.V297595.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 Trembaths DS0000019596.V297595.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): 3 All service users are provided with accurate and adequate information, visits and discussions prior to admission to the home, ensuring that they are empowered and encouraged to make informed choices about where to live. Full assessments are carried out so all service users, relatives, friends etc can be assured that the home is able to meet the needs of the service user. EVIDENCE: Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Care records of service users were inspected and there was evidence of pre admission assessment of needs being carried out in each case. The home receives a copy of the pre admission assessment of needs of prospective service users for those who are funded by the Social Services and discharge letters from hospital, where applicable. The manager or a senior member of staff would carry out the home’s own pre admission assessment of needs of Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 9 any referred service user. For prospective service users outside of Hertfordshire, a senior member of staff of the local MHA home would carry out the initial pre admission assessment. The home has a comprehensive and holistic pre admission assessment of needs for people with dementia and for people needing general nursing care. This information is used to formulate an initial care plan on admission. The home provides nursing and personal care for older people, some of whom may have associated physical disabilities/illnesses and dementia. Trembaths DS0000019596.V297595.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 Service users have full assessments on their individual files, ensuring that an individual plan of care can be set out meeting individual needs. The home has a comprehensive medication policy and procedure guidelines, which supports in the safe administration of medicines. Care plans are in need of completing to ensure a consistent level and approach of care is offered to individuals. Regular reviewing must occur of all are plans and risk assessments. Records relating to the service user must be fully completed. EVIDENCE: Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. All service users care plans were generated from the pre admission assessment and provides the basis of care to be offered to the individual. All care plans detail specific actions to be taken by the staff to ensure all aspects of the service users health, personal and social care needs are met. All care plans are currently being implemented within the home. All care plans are reviewed once a month to ensure monitoring and changing needs can be addressed. Through thorough inspection it was noted that a Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 11 number of care plans, risk assessments and other personal documents pertaining to individual service users were not fully completed. All documents must be audited and regularly checked through line management to ensure accurate and fully completed details are maintained at all times. The plan is drawn up with the involvement of the service user as much as possible, some care plans had been signed by the service user and or representative. All service users spoken with appeared well cared for. Self-care is promoted within the home where ever possible. Appropriate risk assessments and monitoring charts are in place to ensure an appropriate level of support is offered. The ethos of good practice within the home ensures that preventive and restorative care is provided. Specialist medical support and advice is offered within the home to any service users who may require it. All necessary equipment is provided within the home to meet service users needs. Following discussions with service users is was confirmed that the staff are very caring and supportive, encouraging them to make decisions about their lives with appropriate assistance provided. Service users commented that they felt respected at all times. Privacy and dignity was observed being upheld within the home. Medication systems and procedures were observed within the home and appeared to be extremely well managed, effective safe and organised. Records were well maintained. Advice is sought from the pharmacist regarding polices and best practice within the home. The home has a sound relationship with the local pharmacy that they use. Pharmacist reports were available for inspection and were recorded to determine effective management and systems are in place. Trembaths DS0000019596.V297595.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. The home supports all service users to maintain family, representative and community links as they wish, thus empowering and encouraging service users to maintain, respect, dignity and personal autonomy over choices in their lives. Wholesome, adequate, varied meals are provided within the home presenting a well-balanced nutritious diet for all service users supporting them to maintain a healthy life. EVIDENCE: Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to the service. Daily activities are offered and one part time activity coordinator works in the home. Feedback from service users was positive regarding the activities available. Outsider entertainers are also brought in, providing a range of activities such as singing and dancing and massage. The home provides a coffee morning at the weekends and encourages visitors and volunteers to the home. A calendar of events was displayed and each month all service users receive a copy. Involvement in other local community events is encouraged; emphasis is given to autonomy and choice for the service users. Residents and family meetings take place in the home and minutes are typed and are placed on notice boards throughout the home. Service users views and opinions are expressed freely and efforts are clearly made to ensure that service users Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 13 maintain vital links, personal autonomy and choices. If further support and or advice is required in order to ensure freedom of choice for the service users, the home is able to link with specialist advocacy services in the best interest of the service user. Residents commented that they are able to enjoy a full and stimulated life style with a variety of options available to them. The home has sought the views of residents and considered their varied interests and abilities when planning the routines for daily living and arranging activities. Routines are flexible and service users can make choices in major areas of their lives. Routines and activities are service user focused, regularly reviewed and can be adjusted as required. Wholesome meals are provided within the home. Feedback provided by many service users was extremely positive regarding the choice and availability of foods. A four-week rolling menu is in place, which is seasonal. All service users can make and are empowered and encouraged to make choices over the meals and the foods they eat. Hot and cold drinks are available throughout the home. Lunch was observed within the home and appeared to be unhurried and a calm atmosphere. The kitchen was extremely well organised with excellent recording systems in place. The entire kitchen was clean and well presented. Foods were appropriately labelled and placed with the fried and freezers. Stock rotation occurs in the dry food store, which is regularly cleaned. Residents are actively encouraged to keep in contact with friends and family and supports is provided as required. Policies and procedures promote service user involvement at all levels. Trembaths DS0000019596.V297595.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 The home has a comprehensive complaints procedure in place, which ensures that the rights of all service users are maintained. Robust polices, procedures and training for staff is in place regarding abuse, to ensure all service users are protected. EVIDENCE: Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home holds a comprehensive complaints procedure, which is on display throughout the home. The ethos of good practice ensures that all complaints are taken seriously and acted upon. The open management encourages and empowers staff and service users to make complaints with effective resolution. The procedure includes clear time scales and is accessible to all. A record of all complaints is maintained within the home. Service users and visitors spoken with stated that they were aware of the complaints procedure and would not hesitate in making their complaints known to the management. They stated that they felt confident that their complaint would be dealt with effectively. The home has received two complaints since the last inspection, both of which have been dealt with effectively and resolved. Policies and procedures regarding the protection of service users are of a high quality and regularly reviewed and updated. Staff are clear when an incident requires external input and who to refer the incident to. Staff have received suitable adult protection training. Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 15 Residents and others associated with the service are happy with the service provision. Feedback received was very positive commenting on the kindness of the staff and the approachable nature of the manager. Other positive comments received were with regards to food, activities and the general environment. Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 16 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): 21, 22, 23, 24, 25 & 26 The home is extremely well maintained, equipped and furnished. All areas are safe, comfortable and homely. This ensures that service users are able to maximise their independence and live in a warm, suitable, caring environment. EVIDENCE: Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to the service. The home is well maintained, clean and tidy. Two maintenance persons are employed to work in the home, providing a total of 70 hours a week. This has ensured that the home has remained in good order throughout. There is a renewal and redecoration plan in place, with all emergency and minor works being completed promptly. The home is very bright and airy, promoting an accessible safe space for all service users. Service users spoken to confirmed that they like the decoration of the home and feel that it is a homely calm environment to be in. Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 17 Indoor and outdoor communal space is well decorated in crisp bright colours, the outdoors has a large seating area and well maintained grassed and path areas. Work is currently being undertaken on the completion of a sensory garden in a small self-contained area. This area will be a safe and secure environment for service users to sit or walk, promoting independence and exercise where appropriate. Communal indoor space provides lighting of a domestic style and a friendly homely atmosphere suitable for the needs of the service users. Bathrooms and toilet facilities are in abundance throughout the home, ensuring that they all suitably located for all service use, staff and visitors. Service users spoken to stated that there are ample toilet facilities available at all times. Specialist equipment is also provided in abundance throughout the home, ensuring all identified needs can be met. Suitable grab rails and other aids are available throughout. A call point system is available throughout the home and call bells are suitably located for all service users. The system allows there to be a call record maintained to ensure a reasonable response time is provided to all service users. Service users confirmed that a reasonable waiting time occurs if they require assistants. There is a passenger lift to enable service users to have access to the first floor or ground floor. All rooms are single and provide adequate and suitable ensuite facilities. Rooms are personalised and well decorated. All service users are encouraged to personalise their rooms to individual tastes. Laundry facilities are sited so that soiled articles are not carried through where food is prepared. Hand washing facilities are provided throughout the building and staff are actively encouraged to maintain good hygiene practices. Policies and procedures are in place for the control of infection through out the home. Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 18 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 The home is suitably staffed to ensure that individual service users needs are met at all times. Staff are adequately trained ensuring service users are in safe hands at al times. Recruitment and selection polices and procedures are robust ensuring service users are protected. EVIDENCE: Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Staff were observed to be working in such numbers within the home to meet all service users needs. Staffing rota’s reflected that adequately trained staff are working at ant time within the building. Service users confirmed that they feel their individual needs are met with staff that are adequately trained. Ancillary staff are employed in such numbers ensuring that the building remains well maintained and functions as a clean environment. The home currently has a total of 32 individuals that have competed their NVQ level 2. This is a commendable level, ensuring that all care staff have had this available and have been supported in the process of completion. The home has sound recruitment and selection procedures in place, ensuring suitable checks have occurred on all staff for the safety and protection of the service users. The home has a detailed induction process of all staff that it staggered for the staff member ensuring that key task and training can occur at key stages throughout the process. The training and induction programme is Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 19 in line with the National Training Organisation’s guidelines and ensures that staff are meeting the aims of the home and meets the changing needs of the service users. Recent training has included dementia care and Alzheimer’s Awareness. One of the senior nurses in the home is a trainer for managing violence and aggression within the home. Both managers have recently completed the training, which will enable them to cascade information and training to all staff regarding dementia and Alzheimer’s disease. All training needs are identified in supervision and appraisals. The home has an annual training schedule in place of which all staff are empowered and encouraged to apply. Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 20 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 The manager’s qualifications and style of operation of the home ensures that it is run in the best interests of the service user. Health and safety issues within the home are well maintained and managed ensuring that the welfare of service users and staff are protected. EVIDENCE: Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The manager has the required qualifications and experience and is competent to run the home. He works continuously to improve services and provide increased quality of life for the service users. There is a strong ethos of being open and transparent in all areas of running the home. The manager and staff are service user focused and leads and supports throughout the home. The managers are aware of current developments nationally and across the CSCI. Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 21 Suitable systems are in place for the management of financial issues and thus ensuring that service users rights and welfare is safeguarded. Secure facilities are provided for the safekeeping of money and valuables on behalf of the service user. Records and receipts are kept of possessions handed over for safekeeping. The registered manager may be appointed as an agent for a service user only where no other individual is available. In this case, the manager ensures that, the registration authority is notified on inspection and records are kept of all incoming and outgoing payments. The manager has the skills and the ability to deliver good business planning; effective financial controls and provides a quality assurance and monitoring process. The home has access to professional business and financial advice and has all the necessary insurances in place to enable it to fulfil any lose or legal liabilities. Where the money of individual service users is handled, the manager ensures that the personal allowances of these service users are not pooled and appropriate records and receipts are kept. Written records of all transactions are maintained. The registered manager ensures that service users control their own money except when they state that they do not wish to or they lack capacity and that safeguards are in place to protect the interests of the service user. Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X X 3 3 3 3 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 Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (2) Requirement All care plans, risk assessments and other documents regarding the service user must be reviewed and fully completed. Timescale for action 30/09/06 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 Trembaths DS0000019596.V297595.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Trembaths DS0000019596.V297595.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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