Inspection on 19/01/07 for Twynhams

This inspection was carried out on 19th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Twynhams 21/05/08

Twynhams 16/05/07

Twynhams 08/12/05

Twynhams 04/07/05

Twynhams 12/01/05

Twynhams 06/07/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Twynhams Old Christchurch Road New Milton Hampshire BH25 6QB Lead Inspector John Vaughan Unannounced Inspection 19th January 2007 09:30 Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Twynhams Address Old Christchurch Road New Milton Hampshire BH25 6QB 01425 618950 01425 618950 twynham@truecare.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Truecare Group Limited ** Post Vacant *** Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category of LD must be at least 18 years of age. Date of last inspection 8th December 2005 Brief Description of the Service: Twynhams is owned and managed by Truecare centrally managed by Truecare Group, which includes C.H.O. I.C.E. LTD and Truecare. The home provides personal care and accommodation for up to 7 male residents who have a learning disability. The home is located close to local amenities in the New Forest town of New Milton that are accessed by service users regularly. The house is a two storey detached property with car parking for several vehicles and a garden to the rear. Residents are provided with single bedroom accommodation with five rooms having en-suite facilities. The weekly fees for living at Twynhams range from £1461.53 to £1919.68. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector met with service users, staff members and the manager during the visit to the home, which took place over one day. During the visit the inspector spoke to service users about their experiences of the home, observed service users and staff, sampled records, had a group meeting and individual meetings with staff and toured the home assisted by the manager, staff and service users. In preparation for this visit the inspector also examined information obtained about the service including incident reports, regulation 26 reports and the most recent inspection reports on the home. Since the visit to the service the commission has been informed that the manager is no longer at the service. What the service does well: Service users benefit from a well developed and varied activity programme that has been put together based on their individual needs and interests. Service users told the inspector about activities they enjoyed which included horse-riding, shopping, going to college and work experience groups. Care plans support the service users with their assessed needs and these are reviewed with the individual on a monthly basis. The home has a very comfortable and relaxed atmosphere and service users and staff talked openly together. The inspector saw positive contact between the staff and service users. A varied an appealing menu is offered to service users reflecting their need and choices and in some cases service users are fully independent in choosing, purchasing and preparing their own meals. The home is clean and tidy and free from any unpleasant smells. Rooms are light and bright and have been decorated to a good standard. Service users told the inspector that they felt very happy with their private rooms which remain private at all times. The home provides a good staff level to meet the needs of service users and these staff are supported to develop their skills through a good training and development programme. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practice of the service ensures that service users have a full assessment before moving into the home to document and respond to their needs. EVIDENCE: The inspector examined a sample of three service users records during his visit to the home. There have been no new admissions to the home since the last inspection of the service. An assessment of need was in place for all individuals and copies of care manager’s assessments were also seen on record. The plans generated from these are assessments are kept under regular review to monitor and respond to changing needs. Service users confirmed that they are fully involved in the assessment process when they cane express their views, needs and wishes for the future. The practice of the home is to complete an assessment of the individual before offering a place in the home. Service users and their representatives are supported to visit the home before choosing to live in the service to tour the home and meet other service users and the staff that will support them. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users assessed needs are documented and responded to within a regularly reviewed care planning system which fully involves the service user and their representatives however work is needed to ensure the guidelines in place to support service users with behaviour that challenges the service meet service user’s needs. EVIDENCE: The inspector looked at the records and files for three service users and talked to individual people about their involvement in planning their support. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 10 Plans all contained information on how to support service users with their assessed needs, including: Physical health, social education, employment, community Access, finance and budgeting and developing self help skills. A monthly review takes place with the service user, their key worker and the manager. A record of the review is maintained and could be seen on the service users files. The people involved in the review signed this record. One service user told the inspector how they had developed their social and independence skills through the support of the staff team and other significant people including their community nurse and care manager. A daily record is kept for each service user and one service user said that staff members sit down with them and agreed what needs to be recorded for that day. The inspector was told that further work is to be undertaken to fully document strategies in a person centred plan and the manager said that they had been on joint training with the Hampshire person centred planning implementation team. One of the plans contained information related to an incident of physical restraint that took place and this had been reported to the commission under regulation 37. The manager said that they were waiting for a response to a referral they made to the organisation’s specialist staff to assess and develop guidelines for future incidents and the use of restraint had not been planned for this individual. The service user’s current risk assessment guidelines for managing behaviour that challenges specifically state that physical intervention techniques are not used. The manager feels that there is however potential for incidents of a similar nature to occur again and they stated that the referral was made for support at the time of the incident. Nearly six months have now passed since this incident and the guidelines have not been updated. The inspector did see guidelines, functional analysis and risk assessments in place for other service users requiring support to manage their anxiety and behaviour. The inspector noted that the use of distraction and redirection is promoted and the manager said physical intervention is used as a last resort. The manager stated that staff attend a four day training course which equips them with knowledge and practical application of these interventions to de- Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 11 escalate incidents however the guidelines do not document the specific redirecting /distraction techniques that work for the individual. Risk assessment strategies were also seen on file linked to service users activities inside and outside of the home. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a service that provides a wide range of activities based on their assessed needs, interests and hobbies together with a balanced and varied menu offering choices and healthy options. EVIDENCE: Each service user has an activity plan and the inspector discussed these with the individual people. Service users were very positive about the activities they take part in and how they are supported to experience new activities and opportunities for employment. One service user explained how their experiences have expanded since living in the home. They have been supported to change activities that they no longer wish to take part in and to make new contacts to prepare for Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 13 employment opportunities. The inspector was told by service users that they are encouraged to be part of the community and a service user talked through their usual routines which included planning for meals, going to the local town to purchase their groceries and preparing and cooking their own meals. On the day of the visit a service user went off into the town to buy some new clothes independently and they said that living in the home has giving them support to make choices about what they want to do. Information seen by the inspector confirmed regular activity for service users which included going to day services, shopping, college-developing reading and maths skills, trips to the pub, horse-riding and going to the library. A service user was preparing for a weekend stay with his parents and he told the inspector that the staff support and encourage him to maintain this contact. Service users also have their own mobile phones to keep in touch with family and friends. Important relationships and contact details are recorded within the service user’s plan. The inspector asked service users about the meals they have in the home and he received positive comments about what is provided. Service users said that they make choices about what they want to eat and staff know what they like and dislike. One service use is vegetarian and they said that they are always offered meals that meet their dietary needs. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical and emotional needs of service users are well met and the medication administration practices within the home keep people safe. EVIDENCE: The inspector saw evidence of contact with General Practitioners, dentists and specialist consultants and a record is maintained of contact with health professionals. Details of health and emotional support needs are included within service user’s care plans. One service user told the inspector about their support network to help them to understand their behaviour and make positive steps to improve their lifestyle. Service users also said that they are supported in a way that they have agreed with the staff team. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 15 None of the service user’s currently self administer medication. A monitored dosage system is being used and medication is stored in a secure cabinet. Medication records were accurate and up to date. Staff members complete medication training before they can administer medication. Some items used as homely remedies are in use in the home however none of these are documented within a homely remedy agreement. The manager was advised to obtain a copy of the Royal Pharmaceutical Society’s guidance on medication administration and the inspector directed him to the appropriate section on this subject. The manager agreed to follow this up with the service user’s GP and the pharmacy. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home has systems in place to record and respond to the concerns of service users and their representatives however despite retraining of staff in adult protection procedures the service has failed to report an allegation and further work is required to demonstrate that these systems are effective in keeping service users safe. EVIDENCE: The home has an established complaints procedure which is available to service users and visitors to the home. The manager provided a complaints file and stated that no complaints have been received since the last inspection. Previous inspections have confirmed that the organisation and home have procedures in place to identify and respond to concerns and allegations of abuse. The last inspection highlighted that staff required updates in adult protection training to protect service users from abuse following a failure to report an allegation of abuse. The inspector met with the staff team who confirmed that they had training on this subject on two occasions since the last visit to the home. The manager also confirmed that two sessions had taken place and another manager who had received training to train other staff on this subject delivered this training. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 17 During the visit the inspector was given information by a staff member that raised concerns about the conduct of a colleague. This information was discussed with the manager who stated that they were unaware of this allegation however the manager then outlined an incident that they felt was related to the concerns raised by the member of staff. The manager described an allegation made by another member of staff that was of serious concern and when asked what action they took the manager stated that the person retracted this allegation and no further action was taken. The inspector asked to see the record of this incident and the manger was unable to provide this, as they had not made any written record of the event. The manager was asked to contact adult services and report both incidents to the care manager or duty manager under adult protection procedures to establish what next steps should be taken to protect service users and investigate the allegations that have been made. Service users are supported to take control of the own monies and undertake the day-to-day transactions themselves. Money held in the home is in separate containers and a record of transaction is maintained for each person. The inspector saw care planning guidelines to support service users to manager their own finances and tow service users told the inspector that they have no difficulty in obtaining their money and feel supported by the staff team in this area. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable, clean and relaxed home that generally meets most of their needs however work is needed to demonstrate that the communal bathing facilities meet service users physical and safety needs. EVIDENCE: The inspector toured the home supported at first by the manager and then by service users who agreed to show the inspector their private rooms. The home is in a generally good state of repair however one service user has contributed significantly to this by undertaking a lot of redecoration themselves. A new conservatory has been constructed and service users are very positive about this new space but feel disappointed that no furniture has been received so they can use it properly. The inspector did note that the group of people living in the home have chosen what furniture will fill this area. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 19 Service users made a positive choice not to smoke in the home and a large shed is designated as the “smoking room”, this area is also earmarked for improvement and service users have plans for decorating and refurbishing the building. The inspector saw a number of service user’s rooms and these all differed in layout and décor based on the individuals needs and wishes. Each person confirmed that they had a key to there room and their privacy is respected one service user has a doorbell and notice on his door to ensure this happens. A regulation 26 report received by the commission stated that a communal shower facility was not safe or suitable for service users needs. The inspector looked at this shower and discussed the concerns with the manager and staff. Staff said that they were at risk of injuring their back or being assaulted by the individual due to the difficult access to the shower. The manager also expressed concerns about the risk of the service user falling when trying to step into the shower. The risks to service user and staff supporting the individual were evident and the manager was required to take steps to provide a more suitable shower facility for this person. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Well-trained and supervised staff members support service users together with recruitment practices that demonstrate a thorough recruitment procedure is followed in the home. EVIDENCE: The inspector examined the staff recruitment and training records. The inspector also looked at the day-to-day staffing in the home and the supervision and support staff members receive to carry out their roles. The organisation has agreed with the commission to hold its staff records centrally and each person has a form held within the home that details all of the checks that have been completed. The inspector examined four of these forms for staff who have started since the last inspection. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 21 Forms were completed fully with details of the individuals Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks , written references, application forms and proof of identity. The manager confirmed that these had been completed with human resources department. Staff training records were examined this provided evidence to confirm that staff are undertaking training and development relevant to their work. Staff undertake an induction and foundation course in line with the Learning Disability Awards Framework (LDAF). Information provided by the manager indicated that thirteen staff have obtained a National Vocational Award (NVQ) at level 2 or above. Discussions with staff and examining training records confirmed that staff undertake training in moving and handling, fire safety, food hygiene, health and safety, management of violence and a first aid course. The inspector spoke to the staff team who stated that they feel well supported by their colleagues and the manager. Staff confirmed that they have formal supervision and two staff members of said that they are waiting for certificates after they completed their LDAF induction and foundation course. Staff said that they have attended training is subjects such as safe medication handling that they have not been required to use at present and some subjects they would like to go one have not been offered as yet. The manager responded by saying that these particular training courses are not relevant to the needs of the service users or the service and are not given a priority. The staff rota was examined and on the day of the visit the inspector noted high levels of staffing available to support service users with their planned activity inside and outside of the home. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users are supported by a service, which is managed in a generally effective manner however some areas of serious concern need to be addressed to fully demonstrate the effectiveness of this management as service users have potentially been placed at risk. A system is in place to obtain the views from service users and their families however this needs to be re-established to demonstrate that it is effective in using these views in developing the service. The home’s heating and hot water systems and fire fighting equipment is maintained and serviced to keep people safe however action to improve the shower room will be required to fully demonstrate that service users are safe. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 23 EVIDENCE: Some areas have been identified within this report including the reporting of allegations that is directly related to the management of this service and will need to be addressed to demonstrate that the home is well managed. The commission has been informed that the manager in post during the visit to the service is no longer working in the home. The manager has not undertaken a review of the service yet. The manager discussed previous audits when questionnaires were sent out to service users, families, staff members and care managers. The manager said that they are looking to set up this consultation process again to obtain service users views. The inspector received feedback from service users to confirm that they are consulted about the everyday events in the home, they attend staff meetings and actively make choices about activities, the décor of the home and any new events that are planned for the service. Regulation 26 visits are completed each month and a report is held in the home and sent to the commission. The inspector confirmed by examining the homes servicing records that the alarm system has been serviced regularly. Weekly alarms tests are completed, a fire drill was carried out in May 2006 and staff training in fire safety took place in March and September of this year. Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 1 X Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 13 Requirement Timescale for action 13/04/07 2 YA23 13 3 YA27 23 The registered person must ensure that the service users current behavioural management plan is reviewed and a clear restrictive intervention strategy is put in place. The registered person must 16/03/07 ensure that the current adult protection practices in the home are reviewed and the manager and staff are retrained to understand their responsibility in reporting allegations to adult services. The registered person must 16/04/07 ensure that the shower facility downstairs is replaced with a facility that meets the service user’s assessed needs. 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 Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 26 Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Twynhams DS0000055837.V329510.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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