Care Home: 18 Harrow Street

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What the care home does well People live in comfortable accommodation. Each person is encouraged and supported to be independent and take part in meaningful activities. They are also were offered choices about what they wish to do and to make decisions about how they spend their lives. They are encouraged and supported to have control over their lives. Parents and the people like the way the home is run, and enjoy staying at the home for short breaks. Parents are also reassured that their relatives are receiving good care and support, and are safe during their stays. There are plenty of activities for the people to enjoy. Staff communicate well with them, and respect their choices and decisions. People living in the home are cared for and supported by a caring, educated and committed team of staff. The staff have worked together for a long time, and know the people well. They are in turn lead by an experienced management team who have extensive knowledge about the needs of people with a learning disability. There is a comprehensive programme of education and training provided for staff, which ensures that staff know how to care and support the people who live at the home. The staff feel valued by the management and feel part of a team to improve, help and support the people living in the home. What has improved since the last inspection? They have provided 3 special high/low beds to make caring for the people easier and safer. In addition, bedrooms have been redecorated and new carpets purchased and a new flat screen TV provided for room 6. As a result of the last inspection by South Kesteven District Council on the 9/3/2008 they were awarded 4 stars "very good" in recognition of the catering standards. CARE HOME ADULTS 18-65 18 Harrow Street 18 Harrow Street Grantham Lincolnshire NG31 6HF Lead Inspector Tobias Payne Unannounced Inspection 9th September 2008 11:00 18 Harrow Street DS0000034259.V370848.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 18 Harrow Street DS0000034259.V370848.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. 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 18 Harrow Street Address 18 Harrow Street Grantham Lincolnshire NG31 6HF 01476 574429 F/P 01476 574429 Janet.Chadwick@HERITAGECARE.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) Heritage Care Ltd Mrs Janet Chadwick Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration. Service Users must only be admitted on the basis that the placing Social Worker has agreed that the room size is adequate to meet the individual’s assessed needs. Condition of Registration. The home may provide short-term respite care to service users for periods not exceeding eight weeks in length. 28th July 2006 2. Date of last inspection Brief Description of the Service: 18 Harrow Street is a bungalow situated at the end of a cul-de-sac in Grantham. It is within half a mile of the town centre, and its amenities. The home is of single storey construction, and is accessible to wheelchair users. There are lawned gardens to one side, and a patio area to the other. The home is part of the Heritage Care organisation, which also provides support to people living in three neighbouring bungalows. The home provides respite personal care and short breaks for up to 5 people over the age of 18, living primarily in the Grantham and Sleaford areas. Approximately 40 people use the facility, and all referrals for the service are through Lincolnshire County Council’s Social Services Dept. People from Grantham continue to attend their usual day service, but those from out of area have in-house activities planned. The fees at the inspection visit on the 9/9/2008 included a) Private funding: from £10 for tea visit (3.30 pm to 7.30 pm) b) Overnight stay 4pm to 10 pm - £50 c) 24 hour overnight stay - £90 d) 7 night stay - £460 each week e) Lincolnshire County Council funding £320 a night All information about the home including the statement of purpose, service user’s guide and copy of the last inspection report can be obtained from the manager of the home. 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes This key inspection was unannounced and started at 11 am. It was undertaken using a review of all the information available to the commission about 18 Harrow Street. It took place over 4½ hours. We spoke with 4 people living in the home who told us they liked living there. We spoke with 3 members of staff plus the deputy and acting manager. The main method was called “case tracking”. This involved selecting one person and tracking the care they received through the checking of records, discussions with them, the care staff and observation of how staff responded to their needs and that of the other people living in the home. We also examined the annual quality assurance assessment (AQAA) that was sent to us by the manager before this key inspection. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the home. It was very clear and detailed. Before making our visit we asked the people who live there to send us comments about the support they receive. We received comment cards from 3 of the people living in the home, 8 relatives and 5 staff. All comments were very positive. What the service does well: People live in comfortable accommodation. Each person is encouraged and supported to be independent and take part in meaningful activities. They are also were offered choices about what they wish to do and to make decisions about how they spend their lives. They are encouraged and supported to have control over their lives. Parents and the people like the way the home is run, and enjoy staying at the home for short breaks. Parents are also reassured that their relatives are receiving good care and support, and are safe during their stays. There are plenty of activities for the people to enjoy. Staff communicate well with them, and respect their choices and decisions. People living in the home are cared for and supported by a caring, educated and committed team of staff. The staff have worked together for a long time, and know the people well. They are in turn lead by an experienced management team who have extensive knowledge about the needs of people with a learning disability. There is a comprehensive programme of education and training provided for 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 6 staff, which ensures that staff know how to care and support the people who live at the home. The staff feel valued by the management and feel part of a team to improve, help and support the people living in the home. 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. 18 Harrow Street DS0000034259.V370848.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 18 Harrow Street DS0000034259.V370848.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): Standards 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home receive clear and detailed information to suit their needs to enable them or their relatives/advocates to make an informed choice as to whether or not they wish to live in this home. Where a person is referred to the home they receive a comprehensive assessment to ensure that their needs can be met. EVIDENCE: There was clear and detailed information about the home in the form of a statement of purpose and service user’s guide both of which were in picture form to aid understanding. We noticed that our address and phone number referred to our old Lincoln address. We asked that all information now referred to our Cambridge Regional office. The manager agreed to act on this as soon as possible. She also told us she wanted to improve the information by providing it in a DVD. Most of the referrals for short breaks are made through Lincolnshire County Council’s Social Services. The home uses a detailed pre-admission booklet, which they complete with each person and their carers. This gives information about their likes; dislikes, preferred routines and support needs, and forms the basis of the care plan. A plan for introduction to the home is discussed with the each person and their carers, and will usually involve a few visits prior to 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 9 an overnight stay. Each person or their carers received a service user’s guide, a detailed contract for occupancy and comments, suggestions and concerns. All information was again clear and detailed. Staff had the skills to be flexible in the way they worked taking into account the varying and complex needs of the people coming into the home at times at short notice, as a result of a crisis affecting their carers. Others came in regularly for short-term care and were known to the staff. 18 Harrow Street DS0000034259.V370848.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): Standards 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. There is detailed care planning, which includes risk assessments. People enjoy choices about what activities they want to get involved and have a varied social programme. People are encouraged to make decisions for themselves and be independent with the support and guidance of staff. EVIDENCE: Each person had a detailed care plan outlining his or her care and support. This had been produced wherever possible with the involvement of the person, their family/advocate and other relevant people. Care plans were very detailed and included personal information, care plan with separate sections about mobility, sleep, eating and drinking, communication, medication, personal hygiene, leisure and a daily record. Information was very detailed and very specific for each person’s needs. This information enabled staff to understand and support each person. 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 11 There were also very detailed risk assessments covering transport, moving and handling and where required cooking or working in the kitchen. All entries were dated with signatures from staff. Choice and decision making was clearly shown in the care plans. The people were given choice concerning their interests, activities and lifestyle. Staff received training to assist and support them. The care records were very detailed, person focussed and reviewed regularly. Reviews took place every 6 months. These included wherever possible the person and their family/advocate, representatives. Staff had very good communication skills and spoke to the people in a calm, friendly and relaxed manner. We looked at the financial records for the people living in the home. They were well maintained with receipts and signatures. Records were kept securely. 18 Harrow Street DS0000034259.V370848.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): Standards 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People continue to be involved in meaningful and appropriate activities, which include educational and recreational activities. They enjoy varied and nutritious meals. EVIDENCE: The manager showed how the care team works to ensure that when a person comes to the home they continue to go to their usual day services and colleges. Transport is not provided for those who go to Sleaford day services, and they would be expected to pay for a taxi. The home is close to the town centre, and they have a mini-bus for outings, which can take people who use wheelchairs. On the day of our visit 4 people were going out into Grantham for the morning with a member of staff and late returned having been to a local pub. Before they went we spoke to 4 people who were positive about the home. They told us “there are lots of things to do”, “I like going out” and “I went to a nature 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 13 park which I liked”. There is no activity timetable, but ideas are discussed with them each day, depending on the interests of the people staying at the time. As a result of identifying people’s needs the manager had extended the range of activities by individual memberships to local health club for swimming and gym use, as well as being a member of a local snooker club. They told us that the staff respected their privacy, and always knocked on their bedroom doors before going in. They told us they enjoyed their food and could ask for the food they would like to be on the menu. There was list in the kitchen, which showed each person’s likes and dislikes, and any special dietary requirements. Staff had been trained to help people who had particular dietary needs. As a result of the last inspection by South Kesteven District Council on the 9/3/2008 they were awarded 4 stars “very good” in recognition of the catering standards. The people within their risk assessments were supported/guided in cooking or preparing food or helping in the kitchen. All staff were required to prepare meals and all had food hygiene training provided. 18 Harrow Street DS0000034259.V370848.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): Standards 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. People benefit from being fully involved in identifying their own needs and choices. Clear care plans, created from assessments of need help to ensure that people’s health and welfare needs are fully met. Medication is safely given by staff who know what they are doing. EVIDENCE: People from Grantham see their doctors during their stays, but those not from Grantham are registered with local doctors as visitors, to ensure that their health needs are met. There was a close working relationships with local doctors, community nurses, occupational and physiotherapists as well as where required dietetic advice. Where needed, staff accompanied the people to these services. The home is equipped to care for people with mobility difficulties, with hoists, high-low bath, high-low beds and grab rails. People also brought with them any special equipment they needed during their stay. The people told us that the routines in the home were flexible, and they had choice over how they lead their daily lives. The manager had a very detailed and clearly written medication policy. All the staff gave medication. Staff receive in-house medication training, and had to 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 15 complete two written tests, and undertake observed medication rounds before being assessed as competent. There was a photograph of each person and very clear directions about the way each person took their medication. They had checks at each shift of medication in the home. Records were very clear and detailed. 18 Harrow Street DS0000034259.V370848.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): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person when coming into the home receives a copy of “comments, suggestions and concerns” which was clear and in pictures. No complaints or safe guarding adults’ issues had been received by the commission and the home since the last inspection. We asked that the manager amended the complaints procedure with our Cambridge address. EVIDENCE: Each person when coming into the home received a copy of “comments, suggestions and concerns” which was clear and in pictures. No complaints or safe guarding adults’ issues had been received by the commission and the home since the last inspection. We asked that the manager amended the complaints procedure with our new Cambridge address. The manager told us they had an adult protection policy and all staff as part of their induction received abuse training. The home also had a copy of Lincolnshire County Council’s adult protection procedures. The policy was however not the current one (2005 rather than 2007). The manager agreed to obtain a new copy. We spoke with 2 members of staff who knew about abuse and what they should do if they suspected abuse. There is an established work force and no new member of staff had been recruited since 2003. 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 17 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): Standards 24, 25, 26, 27, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in clean, safe, and comfortable accommodation suited to their needs. EVIDENCE: As the home provided short term care, rooms had been decorated to try to reflect individual male and female tastes and in different colours. Staff confirmed that maintenance issues are attended to promptly, and the home was clean and tidy at the time of the inspection. People we spoke to told us they liked their bedrooms. They provided high/low beds, hoists and bathing equipment. In addition, bedrooms had been redecorated by talking to people about what they wanted, and new carpets purchased and a new flat screen TV provided for one person. There were attractive accessible garden areas. 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 18 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): Standards 31, 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a safely recruited, well-trained, established, supported staff team available who have the skills to meet the varying needs of the people living in the home. EVIDENCE: During our visit we observed that the number of staff available was suitable for the needs of the people living in the home. From 7 am to 9.30 pm there were 2 staff and from 9 pm to 7.15 am there was one member of staff who provided sleep in cover but was available if required. There was a handover period when staff passed information from one shift to the next. Records showed that there continues to be a well established team of staff. There has been no new member of staff since 2003. Training is co-ordinated by a member of staff, and training dates are e-mailed from the training department. Each member of staff had an individual training record. Over the past year training had included, health and safety, record keeping, food hygiene, moving and handling, epilepsy and fire prevention. In addition, all staff had a recognised qualification in care. This included a nursing qualification for the deputy and manager and National Vocational Qualifications for the rest 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 19 of the 7 staff. Of this 3 staff were studying for NVQ level 3. Staff said that training opportunities were good, and Heritage Care has the Investor in People Award. Staff commented, “we work very well as a team”, “it is a very friendly place to work”, “we receive enough information about new people coming to the home” and the manager is very approachable and supportive”. We discussed with the manager the need to ensure that each person had a mental capacity assessment in accordance with the Mental Capacity Act 2005. She had information about this and agreed to ensure this was carried out and staff received training. Staff now received formal supervision. 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 20 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): Standards 37, 38, 39, 40, 41 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People and staff benefit from the positive leadership of the management team. Management record systems show that residents’ health, welfare, safety and choices are promoted. The management team ensures that the people living in the home with the support of the staff, relatives, and staff have the opportunity to voice their views and opinions. EVIDENCE: The manager and deputy manager were both registered nurses with extensive practical and managerial knowledge about caring and supporting people with a learning disability. Staff said that they felt valued and supported, and that communication was good within the home. They said that the home was very well organised and managed, and comments from people we spoke with supported this. Previous inspections had noted that whilst the manager carried out quality assurance reviews there was no information at the time of 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 21 the last inspection visit and again at this visit that these had taken place. The manager told us that the area manager made regular monthly monitoring visits but the only reports of these visits we could find were dated October 2007. We noted that the statement of purpose stated there would be an “annual service quality assurance review including an audit and feedback from service users”. We could not see that this had taken place. We received comments, which included, “Staff do an excellent job”, “Staff are fantastic”, “we are always kept up to date”, “this is a brilliant place” and “a well managed service”. Records throughout our visit were available, up to date and well maintained. Heritage care had comprehensive health and safety policies, which also included detailed and up to date risk assessments. These included risk assessments covering all aspects of daily living activities. A detailed fire risk assessment had also been carried out. There were regular tests of the fire system as well as regular fire drills. 18 Harrow Street DS0000034259.V370848.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 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 3 2 3 3 3 4 3 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 4 25 3 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 3 3 3 3 3 X 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 23 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 YA39 Regulation 24 Requirement Timescale for action 09/11/08 2 YA39 26 The owner must establish and maintain a system for evaluating the quality of the services provided at the care home. This taking into account wherever possible the views of the people and or their representatives about the manner in which the services are provided. This will ensure that a quality-based service is provided which suits the needs and wishes of the people living in the home. The owner must ensure that 09/11/08 where monthly monitoring visits take place by the area manager the reports of these visits are available in the home to be viewed by an inspector during an inspection visit. This will ensure that the organisation is aware of the quality of the service being provided which suits the needs and wishes of the people living in the home. 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 24 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 18 Harrow Street DS0000034259.V370848.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. 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