Inspection on 25/10/07 for Walmer Lodge

This inspection was carried out on 25th October 2007.

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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Walmer Lodge 20/03/07

Walmer Lodge 20/09/06

Walmer Lodge 08/12/05

Walmer Lodge 05/05/05

Walmer Lodge 26/11/04

Walmer Lodge 09/06/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood Hall

Muston Road (70)

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

CARE HOME ADULTS 18-65 Walmer Lodge 6 Walmer Villas Manningham Bradford West Yorkshire BD8 7ET Lead Inspector Karen Westhead Key Unannounced Inspection 25th October 2007 09:10 Walmer Lodge DS0000001222.V353840.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 Walmer Lodge DS0000001222.V353840.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. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Walmer Lodge Address 6 Walmer Villas Manningham Bradford West Yorkshire BD8 7ET 01274 499338 01274 499338 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) Mr Suleman Ahmed Chunara Mr Sikander Khan Vacant Care Home 12 Category(ies) of Learning disability (12), Mental disorder, registration, with number excluding learning disability or dementia (12) of places Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th March 2007 Brief Description of the Service: Walmer Lodge is privately owned. It is in the Manningham area of Bradford, approximately one mile from the city centre. The home can be reached by public transport. The home is registered to care for twelve residents who may have a learning difficulty and/or a mental illness. All bedrooms are single. Portable metal ramps are available so that people using wheelchairs can gain access to the building. However there is no passenger lift, to the bedrooms on the upper floors, therefore the home would not be suitable for residents who cannot manage stairs. There is a small garden to the front of the property, which allows parking for two cars. There is further car parking behind the home but this is not used, as the access through is narrow. The fee is £339.92 per week. This fee includes all toiletries, hairdressing, newspapers supplied by the home and chiropody treatment. The manager provided this information on 24th October 2007. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was done by one inspector and had not been prearranged with the Manager. The inspector arrived at 9.10am and left at 2.20pm. At the end of the visit, the manager was told how well the home was being run and what needed to be done to make sure the home meets the required minimum standards. The reason for the visit was to make sure the home was being run for the benefit and well being of the residents and in line with requirements. Before the inspection information received about the home was reviewed. This included the number of reported incidents and accidents, the action plan provided following the previous inspection and reports from other agencies such as the fire safety officer’s report. The manager was also asked to complete an Annual Quality Assurance Assessment (AQAA) prior to the visit being made. This form is used by the manager to carry out a self-assessment of the service being provided and to give factual information about things such as staffing levels, policies and procedures and details of residents living in the home. The manager did not provide this information until the day after the inspection. During the visit the inspector observed staff and resident relationships, spoke to four residents, four staff and the registered manager. Resident plans, risk assessments, healthcare records, meeting minutes, and staff recruitment records were looked at. Surveys were sent to the home to be given to residents, staff and relatives. Pre paid envelopes were also provided so that those filling in the surveys could return them directly to the Commission for Social Care Inspection (CSCI) office. At the time of writing this report none had been returned. What the service does well: Walmer Lodge provides good care. The new manager is making positive changes and is managing the home effectively. The staff group work well together. Residents said they were happy living at the home and think the staff and management are good. The home is clean and tidy and residents are comfortable in their surroundings. Walmer Lodge DS0000001222.V353840.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. Walmer Lodge DS0000001222.V353840.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 Walmer Lodge DS0000001222.V353840.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): 1, 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough admission process is carried out before residents could move into Walmer Lodge. EVIDENCE: The statement of purpose and service user guide provide a lot of relevant information about the home and gives any potential resident an idea about what they can expect if they come to live at Walmer Lodge. A decision had been made to make the home a ‘smoke free’ environment, prior to the recent changes in the law. However, this had not been changed in the statement of purpose. The manager said this would be added. None of the residents object to smoking outside and there had been little disruption in the home as residents had been consulted about this decision. Each resident has a contract setting out the terms and conditions and information about how much they are charged for their stay at the home. This information is held on individual files. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 9 Prior to moving in each resident is assessed; to make sure the home is a suitable place for their needs to be met. The admissions process allows for prospective residents to visit, stay for trial periods, including overnight stays and spend time talking to other residents and staff. This gives them the opportunity to ask questions and get an idea about what it is like living at the home. Staff can also gain some insight about the prospective residents care needs and preferences. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 10 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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are happy living at Walmer Lodge. Their social and care needs are being met and they are consulted about matters, which may affect their futures. EVIDENCE: Part of the visit was spent talking to residents and staff. All of the residents who spoke to the inspector said they were happy living at Walmer Lodge. Staff said they thought the home provided good care. Staff talked about the way each resident was treated as an individual, giving examples of their preferences and how these were managed within the home. All the staff have a good working knowledge of residents’ needs and were able to talk about how they met them and involved the resident in decision-making. Care records for five residents were looked at. All plans and assessments were in the same format. The manager has introduced a new way of reviewing care Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 11 plans. This is to make sure the most up to date information is included and that residents are central to the decision-making around the way care was being given and what they required from staff. All records are being dated and signed. Risk assessments are completed for each resident. These are basic, but when read alongside the plans of care, provide sufficient details for staff to be aware of how situations should be dealt with and how to minimise risks. Staff take a common sense approach to this and do not put undue restrictions on residents in the safeguards put in place. Any new risks identified are discussed as a staff team and if appropriate the resident is included in the discussions with future planning. Any limitations are agreed with the resident and then clearly documented in the care plan. This makes sure residents’ rights are properly safeguarded. The inspector gained the view from what was said and from the records being kept that the care plans are resident focussed, are written for each individual and are used as a guide and working tool by staff. Walmer Lodge DS0000001222.V353840.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, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good, flexible service is provided and residents have opportunities to do different activities, including using community facilities. Residents are treated as individuals and they receive different levels of support depending on their level of need. EVIDENCE: At the time of the visit there were only a few residents at home. Some residents had gone out independently, including to a relative’s home, to see friends or attend religious services. It was clear that residents were able to make a choice about times for getting up, going to bed and bathing. Some residents said they can ‘do what they want’. On arrival at the home residents were seen getting up leisurely and others were still in their bedrooms or asleep. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 13 Residents talked about doing different things, which included having parties, helping around the home, spending time with staff and time in their rooms. One resident, who relies on staff to support them with activities, was seen engaging in a discussion with staff whilst doing craftwork. Some of the residents attend external day services. One resident has a work placement and others make use of community facilities. Residents said they enjoyed going out during the day. One resident said he had a bus pass, which meant he could travel on the bus regularly. Residents talked about visiting relatives and having visitors to the home. Two visitors arrived during the inspection and it was clear that they were used to using the private visitors room and that they felt comfortable in the home. Residents use a local hairdresser or barbers rather than a mobile hairdresser. An optician and chiropodist visit the home and provide an in-house service. Meals are varied and suit resident’s likes and dislikes. Halal meat is provided for those wishing to eat according to their religious beliefs. A recent residents survey, carried out by the home, showed that residents were satisfied with the food provided. One resident had said they did not like the ‘snacks’ being provided at teatime, so this has been changed to include an alternative the resident likes. Walmer Lodge DS0000001222.V353840.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems in place to make sure residents receive the right support from healthcare professionals. EVIDENCE: Staff said residents use a variety healthcare services, this includes the dentist, chiropodist, community psychiatric nurses, consultants and GP’s. Residents said they tell staff when they are not well. According to the needs of the resident staff will go with them to appointments. A health care summary sheet stated that residents had attended dental, GP, nurse and optician appointments within the last twelve months. Residents’ weights are not being routinely monitored. This was discussed with the manager. If concerns are identified about the increase or loss of weight of a resident, an assessment/care plan should clearly state how often a resident should be weighed and this must be followed. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 15 Medication records were looked at and had been completed correctly. No controlled medication was being held at the home. The home uses a monitored dosage system. Medication was looked at and this corresponded with the medication records. All staff that give out medication have completed training. One resident takes care of his own medication. A week’s supply is given to him at a time and staff check with him that he has taken it and if there are any problems. This works well and the resident values the independence he has and the trust from staff that he will manage his medication. Walmer Lodge DS0000001222.V353840.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory procedures are in place and residents will report their concerns to staff and management. Systems are in place to make sure residents’ finances are safeguarded. EVIDENCE: The manager said the home had not received any complaints within the last twelve months. The home has a complaint’s book to record any complaints. Residents said they would talk to staff and the manager and would tell them if they were unhappy. One resident said she had talked to staff when she had a problem. Staff said the manager was very approachable and they would be comfortable talking to her about any concerns. Staff were clear about reporting any concerns to the manager. The manager was familiar with adult protection procedures and her responsibility to report any concerns. There had been one referral to the Bradford Adult Protection Unit in the last twelve months. This had been carried over from 2006 and had been successfully addressed and the action plan put in place was now being carried through in the home. This included improved communication with the day service the resident attended and an increase in the level of activity the resident took part in when not at day services. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 17 The manager said there had been no occasions when any form of restraint or physical intervention had been used within the last twelve months. Financial records were looked at. All financial transactions were recorded and receipts were obtained for any purchases made. The manager had sought the advice of the local authority and there is now a better way of recording and handling residents finances, which safeguards them against potential abuse. Walmer Lodge DS0000001222.V353840.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, 26, 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is pleasant, generally well maintained and residents are comfortable in their surroundings. EVIDENCE: The inspector carried out a tour of the building. All communal areas and bathrooms and the majority of bedrooms were seen. The home was clean and tidy and there were no odours. Decoration, furniture and furnishings are of a satisfactory standard. There is a small garden at the front of the home, which residents freely access. The large concreted area at the back of the home is not used. Consideration should be given to utilising this area; this might give residents more space and privacy. A shelter could also be provided for those residents and visitors who wish to smoke. Residents were very clear that their bedroom was their personal space. Bedrooms were personalised and each room had a lot of items that reflected Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 19 individual tastes. This is good practice and demonstrates that everyone is encouraged to make their rooms homely. There are two main communal areas, a commercial kitchen and quiet room. The residents were using all the communal rooms and were seen to walk freely around the home. There were photographs, pictures and ornaments in communal areas, which helped to create a homely atmosphere. The manager said that all residents could easily access the home. A portable metal ramp is available to make it easier for visitors with a wheelchair/pushchair to get up the front steps. However, all residents have to be fully mobile to live at the home, as there is no passenger lift. The washer and dryer are in a cupboard. The condensing dryer has no outside vent and therefore the door of the cupboard must be left open in order for the machine to operate correctly. There is no risk assessment in place to account for this. At the time of the visit the door was wedged open. Paintwork in the home, including doors and skirting boards have been repainted and some carpets have been replaced. This refurbishment needs to continue as other areas of the home show signs of wear and tear. Walmer Lodge DS0000001222.V353840.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): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team work well together and everyone works hard to provide good individual care. But recruitment practices do not safeguard residents. Staff are well supported and systems are in place to make sure they receive training and supervision. EVIDENCE: Some staff have worked at the home for a number of years. Staff at the home have a good working knowledge of the residents and were able to provide information about individual likes and dislikes. Staff said ‘the staff team get along, the new manager has made changes but these have worked out, it’s a nice atmosphere to work in’. Residents talked very positively about staff and they obviously enjoy spending time with them. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 21 Four weeks of daily records were looked at for five residents. These showed that residents were engaged in a variety of activities and were receiving the level of care they needed. Three weeks of staff rotas were looked at. There are three staff to cover the morning shifts, this included the manager, and two in the evening. There are two staff working during the night from 8pm until 8am. This includes one waking and one sleeping in member of staff, who was available in the case of an emergency. If any of the residents are unwell or require additional input from staff the rota is flexible enough to allow additional waking staff to work during the night. The manager said that for planned hospital appointments or instances when an escort is needed, additional staff are brought in so that the home is not left with insufficient cover. One staff member had been recruited in the last twelve months. The recruitment records were looked at. However, the application form was out of date. The member of staff had worked at the home previously and his current employment had been based on an application form he had completed in March 2003. This is not acceptable as the information was out of date and will have changed. Some of the staff team are bi-lingual and can talk to residents in their preferred language. The AQAA and training record stated that staff had completed all mandatory training within the last twelve months. Some of the staff are qualified to NVQ level 2 or 3. Some are working towards level 4 and other staff have either a nursing qualification or equivalent. Walmer Lodge DS0000001222.V353840.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, 38, 39, 41 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall management of the home is good. The manager promotes resident choice and creates a homely and relaxed atmosphere. Recording systems must improve to make sure the welfare of residents can be monitored. EVIDENCE: The manager has worked at the home as a senior member of staff and recently took over as the manager. Residents and staff were very positive about the manager and everyone said she was making a positive impact on the home. Residents meeting minutes confirmed that residents had opportunities to put forward suggestions. They had talked about what they enjoyed and what they wanted to do. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 23 Once a month the provider visits the home and looks at the general conduct. The manager confirmed the visits were completed regularly. Copies of reports from these visits are sent to the CSCI. The inspection identified some problems with the monitoring of residents weights and the recruiting of staff. There was evidence that when incidents take place, incident forms are being completed. The pre inspection questionnaire stated that policies and procedures were available and regular maintenance and health and safety checks by external agencies were completed at the home. Walmer Lodge DS0000001222.V353840.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 2 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X 3 2 X Walmer Lodge DS0000001222.V353840.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 YA1 Regulation 4 & 17(2) Schedule 4.1 12 Requirement The registered provider must make sure the statement of purpose includes correct information and is not misleading. The registered provider must make sure that the weights of residents are monitored. The information recorded must be kept up to date. The registered provider must make sure a risk assessment is in place when there is a potential risk of fire associated with the use of equipment. The registered provider must make sure the correct pre employment checks are made before employing staff. Out of date application forms must not be used. The registered provider must make sure the home is managed in a way which safeguards residents and that a robust recruitment procedure is followed at all times. Timescale for action 28/11/07 2. YA19 12/11/07 3. YA24 23(4) 12/11/07 4. YA34 19 & Schedule 2.6 12/11/07 5. YA42 12 & 19 12/11/07 Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA24 Good Practice Recommendations Consideration should be given to making use of the area at the back of the home. This should include the provision of a shelter for those who wish to smoke and to provide a more private area for residents to use. Walmer Lodge DS0000001222.V353840.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Walmer Lodge DS0000001222.V353840.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. 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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