Care Home: Ashford Lodge

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What the care home does well Relatives of people living in Ashford House made the following comments in the surveys they completed - They take his considerations/thoughts into account; they arrange a variety of trips to prevent ... getting bored; ... is very contented and happy; we have been very impressed with the total staff team and the enthusiasm they bring to their work at the home; we are not aware of any significant improvements that could be made to what we believe is an excellent service; the staff have been very proactive in obtaining the right skills needed to cope with ... changing needs. These were some of the comments made by staff through completing surveys or during the inspection visit - residents are learning more and becoming more independent with daily living skills; the service supports the clients and staff very well; they provide training the staff need; good communication; they adhere to policies and procedures at all times; promoting independence to service users. The company strives to maintain a high standard of care and support. We saw this in the way people were consulted about their life in the home. Clear and detailed person centred assessments take place before a person moves in. Existing residents have a chance to have a say about new residents and what sort of person they would like to live with. Staff support people to live their lives fully and be actively involved in running the home. There is a strong `ordinary life` ethos in the home. All care and support is planned with resident`s full input. Staff are supported to develop through a process of having their competency in important areas checked. This keeps residents safe as well as demonstrating good quality assurance practice. What has improved since the last inspection? There were no requirements from the previous inspection. The provider changed in February 2008. There have already been changes and improvements made and this includes a lot of refurbishment and redecoration to the building. One member of staff commented on how much the residents had enjoyed this as they were involved in making choices and decisions. The new manager has brought in lots of new ways of enabling residents to make choices and for staff to record outcomes. She has also set up an information board in the entrance hall, so residents, visitors and families can be updated with how the service is progressing with Regulation 26 & CSCI reports on display for all to read. She has also made some of these available in an `easy read` format. What the care home could do better: The manager and team have already identified a range of things that they could improve on, such as improving and personalising residents health plans. Because there is a commitment to reviewing and evaluating the service provided to residents, improvements take place quickly and smoothly. The manager must start the process of registration with CSCI. This is so that all persons involved with the home are clear that the person in charge has had undertaken the regulatory interview process. CARE HOME ADULTS 18-65 Ashford Lodge Ashford Road Bagham Cross Kent CT4 8DU Lead Inspector Christine Lawrence Unannounced Inspection 30 July 2008 10:00 Ashford Lodge DS0000067170.V367324.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 Ashford Lodge DS0000067170.V367324.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. Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashford Lodge Address Ashford Road Bagham Cross Kent CT4 8DU 01227 731 437 01227 731 466 rmuller@precisioncare.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) ACH of London LLP Manager in post, not yet registered Care Home 9 Category(ies) of Learning disability (0) registration, with number of places Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 9 . Date of last inspection 27 February 2007 Brief Description of the Service: Ashford Lodge is a residential home providing care and support for up to nine people with learning disabilities. The home is situated just outside the village of Chilham where there are a few local amenities. Colleges, shops, and other amenities are a short drive or train ride away in the nearby towns of Ashford and Canterbury. Ashford Lodge has eight single bedrooms in the main house. All the bedrooms have en suite baths and/or showers. One of the bedrooms is situated on the ground floor. Outside, within the grounds, there is an annexe. This provides a bedroom, bathroom and kitchenette/dining room. It is suitable for more independent living. There is car parking within the grounds of the home. The weekly core fee for this home is £1,285:00 but the final fee will vary depending on the assessed support needs of the individual. Ashford Lodge DS0000067170.V367324.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 3 star. This means the people who use this service experience excellent quality outcomes. The inspection visit was carried out with a few days notice. We, that is the commission for social care inspection (CSCI) looked at various records in the home and had discussions with the manager. We also used information from the annual quality assurance assessment completed by the manager and information from the annual service review carried out by the commission in March. Surveys completed by staff and people who use the service also provided information for this report. We spoke to staff and residents and made observations of residents and staff interacting. What the service does well: Relatives of people living in Ashford House made the following comments in the surveys they completed - They take his considerations/thoughts into account; they arrange a variety of trips to prevent … getting bored; … is very contented and happy; we have been very impressed with the total staff team and the enthusiasm they bring to their work at the home; we are not aware of any significant improvements that could be made to what we believe is an excellent service; the staff have been very proactive in obtaining the right skills needed to cope with … changing needs. These were some of the comments made by staff through completing surveys or during the inspection visit - residents are learning more and becoming more independent with daily living skills; the service supports the clients and staff very well; they provide training the staff need; good communication; they adhere to policies and procedures at all times; promoting independence to service users. The company strives to maintain a high standard of care and support. We saw this in the way people were consulted about their life in the home. Clear and detailed person centred assessments take place before a person moves in. Existing residents have a chance to have a say about new residents and what sort of person they would like to live with. Staff support people to live their lives fully and be actively involved in running the home. There is a strong ordinary life ethos in the home. All care and support is planned with residents full input. Staff are supported to develop through a process of having their competency in important areas checked. This keeps residents safe as well as demonstrating good quality assurance practice. Ashford Lodge DS0000067170.V367324.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. Ashford Lodge DS0000067170.V367324.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 Ashford Lodge DS0000067170.V367324.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 People who use the service experience excellent quality outcomes in this area. Prospective residents’ individual aspirations and needs are assessed in a person centred way and completed with respect to each individual’s diversity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the individual records for the two people currently living at Ashford House and the record of a prospective resident. The pre-admission assessment for the prospective resident was very detailed and contained information about preferences and also had a section entitled ‘key messages’ which identified what staff training would be needed, changes to the environment and proposals for improving lifestyle. The manager, a member of staff and the client placement manager for the organization were all due to visit the prospective resident the day following the inspection when they planned to gather more information to set up the initial care plan. Information had also been received from the placing authority. The assessment included information about the individual’s religion and cultural background as well as about any disability. The care plans for the two residents already living in Ashford House were person centred and based on up to date assessments. Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 9 Ashford Lodge DS0000067170.V367324.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 and 9 People who use the service experience excellent quality outcomes in this area. Residents can be confident that their changing needs will be noted in their plans. These are person centred and compiled with regard to their individuality. Residents are be supported to make decisions and take risks to enable as independent a lifestyle as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans for the two people living at Ashford House were seen during this inspection. They are based on detailed needs assessments. The assessments cover a range of subjects including communication, faith/belief, daily living skills and strengths. The plans both identified goals which the person concerned wants to achieve such as attending a college course, buying a new bed, getting a passport, getting fitter and preparing meals. Some of the goals relate to daily living and some to more long term wishes. Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 11 There are clear guidelines to staff about how to support a person in a particular activity and these support plans are cross- referenced with risk assessments where appropriate. Risk assessments are about reducing risks, not avoiding an activity, thus not limiting anyone’s opportunities. Residents have 1:1 time with their key workers (each person has two co key workers) to enable time to think about new goals and how they can be achieved. Each person living in Ashford House has an individual diary which staff said is read out to residents and completed with them. If someone is away from the home visiting relatives, then sometimes staff will write a message which can read when they return such as “I fed your fish today”. There are plans to get residents to indicate that they have been a part of the daily recordings such as signing or using a personal stamp. There are communication files with pictures and details available for staff to use with residents to ascertain choices about their daily lives, such as shopping, food preparation and activities. The format is very clear and staff confirmed that the pictures are very useful for encouraging people to make choices and decisions. These pictorial aids are used in residents meetings and in 1:1 sessions with keyworkers. One person’s finances are managed by a representative and the other person is involved in different parts of managing finances and personal expenditure but with the help and assistance of staff. Ashford Lodge DS0000067170.V367324.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 People who use the service experience excellent quality outcomes in this area. Activities and involvement in the local community, as well as support for personal relationships are provided for residents in a person centred way. They benefit from having a healthy diet and being involved in all aspects of meal preparation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An activity plan consisting of three choices has been put into place by the manager to determine individual likes and dislikes and to enable staff to offer new opportunities to residents. At certain times of the day residents are offered a choice of 3 activities which consist of going out, free time in, or an activity such as craft, art or pamper time. All plans/options are pictorial. Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 13 Activity boxes have been introduced to provide activities within the house and include colouring, pamper, indoor games, painting, cooking, CDs and DVDs, music, arts and crafts. These boxes are kept neat and tidy and accessible, always ensuring that staff can be responsive to any choice made. There is also some karaoke equipment and a TV games console. The cooker in the kitchen is one that has immediate temperature control which makes it safer when supporting residents with food preparation. There is a small kitchen garden were a resident is currently growing herbs, peppers and tomatoes. There is a ‘log cabin’ in the garden which has not yet been fully fitted out but will eventually be a learning centre reflective of the wishes and needs of the people living in the home. Each bedroom has a television with a DVD player. Activities within the community include trampolining, using a gym, swimming and bowling. Examples were noted of residents being supported to maintain their relationships with family members and this includes involving them in social events such as BBQs at Ashford Lodge. Everything that residents are supported to do is based on offering choices as much as possible and the staff use pictures and illustrations as well as things like Makaton to facilitate this. There is a vehicle at the home for taking residents out and about if needed. A menu planning sheet is used which also shows which resident has chosen something in particular. On the day of the inspection one of the residents made lunch, which she offered to all present. Residents are involved in planning meals, shopping for food and for preparing meals. Pictures are used of food items which show nutritional values as well. The following comment was included in a completed staff survey “…service users are learning more and becoming more independent with daily living skills…”. Ashford Lodge DS0000067170.V367324.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 People who use the service experience excellent quality outcomes in this area. Residents are protected by the home’s policies and procedures regarding medication and their physical and emotional needs are responded to in an individual way. Their preferences and requirements for support are known and respected. This judgement has been made using available evidence including a visit to this service. . EVIDENCE: The individual records provide staff with clear guidance on residents’ preferences with regard to personal care. There is a key worker system in place. The emphasis on encouraging and enabling people to do as much for themselves as possible is threaded throughout the care plans and this way of giving people some measure of control over their lives reflects that they are treated with respect and dignity. We observed staff treating people and talking to them in an encouraging and polite manner but also with firmness and consistency in keeping with the information in care plans. There are individual health care support plans and the records showed that health care Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 15 professionals are involved as required or on a regular basis. A ‘traffic signal’ format is used to identify essential, desirable and helpful information for hospital staff in the event of any admission to hospital. The home uses a monitored dosage system for medication. Storage and record keeping was satisfactory. The manager has introduced various new systems to underpin the good practice at the home such as guidance relating to homely remedies and going away with medications eg to visit family or on holiday. There is also a new assessment for staff to complete every three months with a mentor, relating to their competencies with medication. Information about any medication which a resident might be taken is available to staff. The manager explained that she intends to build on the systems and practice already in place to further personalise and individualise residents’ health plans. Ashford Lodge DS0000067170.V367324.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 People who use the service experience good quality outcomes in this area. Residents’ views are drawn out, listened to and acted on. There are systems in place to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have all been made aware of how to make a complaint. They are supported in the right way to use this procedure, as it is available in easy read. Key workers remind people of their right to complain when residents meetings take place. It is clearly displayed on the information board in the entrance. There has been one complaint in the last 12 months, and this was successfully resolved within the homes policy timescale of 28 days. There is a log book to chart complaints and concerns, and this helps the manager keep on top of any issues as they arise. The home is familiar with the Kent and Medway agreed protocols for safeguarding vulnerable adults. This is a multi-agency agreement, between the police, social services and CSCI. The staff have had training in recognising and responding to signs of abuse and a whistle blowing policy is in place. This makes sure that staff know the Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 17 right route to take if they have concerns about service users wellbeing, and gives them reassurance that they will be protected if raising any non-malicious allegations. The manager has identified that an advocacy service would improve residents support to make independent concerns and complaints known. She aims to seek this support. Ashford Lodge DS0000067170.V367324.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 and 30 People who use the service experience good quality outcomes in this area. Residents live in a home which is homely and comfortable as well as clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is maintained to a high standard both inside and out. People living at the home choose how they want their own bedrooms to look and purchase their own furniture if they wish. When communal areas were redecorated and refurnished, service users looked through paint charts and furnishing catalogues to debate what would look good. The staff team narrowed the final choices down by making posters, so all were able to debate and agree how rooms would look. Every bedroom has a private en suit bathroom and lockable storage is also Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 19 provided. All parts of the home are fully accessible. We saw that the garden was well maintained and was easily accessible. Service users enjoyed growing plants and using the log cabin for creative activities. There is garden furniture available so, in good weather, all can enjoy outdoor life. The home is clean and hygienic throughout, and staff are aware of infection control procedures, having received this training. Ashford Lodge DS0000067170.V367324.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 People who use the service experience good quality outcomes in this area. Sound recruitment procedures and staff training make sure that residents are supported by people who can meet their needs at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a well qualified staff team of 13 staff, 8 who hold an NVQ 2 or greater qualification. Two flexi staff also hold an NVQ qualification. The Deputy Manager has completed the NVQ4. Between June 2007 and June 2008, a total of 8 staff have left. Five new starters are working thought the Common Induction standards to lead onto NVQ2, as well as additional training for those who have no previous experience in learning disability. There is a system of making sure staff attend the right courses and remain up to date for all training types. This includes health and safety training like food hygiene, safe moving and handling and fire precautions as well as special courses that are about supporting the people who live in the home. The Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 21 manager keeps the original training certificates in the home. A regular supervision system is in place, which allows the manager to meet with staff and discuss their learning needs so they can continue to give a good quality service to the residents. Additionally, staff meetings take place each month, so whole service issues can be discussed and any changes put into place with continuity. The home operates an equal opportunities policy for staff promotion and employment. Using their own human resources department, support is given to the home to make sure all the right pre-employment checks are in order before staff start work. The manager tells us that the police checks and 2 written references, 1 of which from last employer are always in place before staff are allowed to work unsupervised in the home. Ashford Lodge DS0000067170.V367324.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 People who use the service experience good quality outcomes in this area. Residents benefit from a well run home where their health and safety is promoted and protected. The manager must apply for registration with CSCI without delay. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is managed on a daily basis in a competent manner that shows that decisions are being taken that are in the best interests of the people who live in the home. The manager holds an NVQ4 and Registered Managers Award, which are work based competency qualifications. She has not yet registered with CSCI and should proceed with putting in an application without delay, and Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 23 this is a required action. Details about this process are available on our website. We were told that the home manager completes self – audits and service development plans, and is currently reviewing and developing key policies & procedures. We were pleased to see how person centred this service was, and that changes that take place are often because of resident input. Daily and weekly checks take place around the home. These include testing the bathing water delivery temperature, the general safety of fixtures, fittings and the environment and fire testing. These are documented and action is taken to put things right. Ashford Lodge DS0000067170.V367324.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 4 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 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 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Ashford Lodge DS0000067170.V367324.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 YA37 Regulation 8, 9 Requirement To comply with the regulations and to give stability to the service, the manager in situ must make an application for registration with CSCI. Timescale for action 01/11/08 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 Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Ashford Lodge DS0000067170.V367324.R01.S.doc Version 5.2 Page 27 - 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. 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