Care Home: Edinburgh House

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What the care home does well The service provides people living at the home with a warm and well maintained accommodation that meets their needs. There is a satisfactory pre admission assessment in place that ensures that people are assessed and the service can meet their needs prior to moving in. The meals at the home provide people with variety and choices that meet with their satisfaction. The management system and procedures in the home worked well including, dealing with complaints, staff supervision and the service users` money. There is a thorough recruitment process in place to safeguard people living at the service. There is an ongoing training programme to enable staff to maintain their skills. What has improved since the last inspection? The three kitchens in the unit have been refurbished and the ongoing programme continues to complete the one remaining kitchen. The hot water system had been upgraded. CARE HOMES FOR OLDER PEOPLE Edinburgh House Edinburgh House Sundridge Close Cosham Portsmouth Hampshire PO6 3JL Lead Inspector Anita Tengnah Unannounced Inspection 23rd May 2008 10:00 23/05/08 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Edinburgh House Address Edinburgh House Sundridge Close Cosham Portsmouth Hampshire PO6 3JL 02392 379 580 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) www.portsmouthcc.gov.uk Portsmouth City Council Miss Sara Helen James Care Home 32 Category(ies) of Dementia - over 65 years of age (32) registration, with number of places Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user under 65 years of age to be admitted for a period of respite 26th May 2006 Date of last inspection Brief Description of the Service: Edinburgh House is a Portsmouth City Council run home providing a service for older persons who have dementia. The home has the facilities to accommodate up to 32 residents providing long stay residential care as well as offering respite and short stay care. The service is in one building with the accommodation on 2 floors. Each floor has two units each with its own lounge/dining area and kitchenette. Service users’ bedrooms are within easy reach of each lounge, and there is a designated staff group for each unit. Edinburgh House is close to the shops and is on a bus route. The current fee charged is £510 per week. Edinburgh House DS0000044195.V363319.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 star. This means the people who use this service experience Good quality outcomes An unannounced visit to the service was undertaken as part of the inspection on the 12th of April 2007. The process included a tour of the service where a number of the bedrooms, communal areas, kitchen, and bathrooms were viewed. As part of case tracking 5 staff and 6 service users views and two visitors were sought and care records were looked at. Information gained from the Annual Quality Assurance Assessment (AQAA) was also used and included in this report, as was information gathered by the commission since the last inspection to contribute in assessing judgements in this report. Positive comments were received from the people using the service and interaction observed indicated that the staff and the residents had developed good relationship with each other. Care was provided in a respectful manner and the residents said that they were treated with respect. We sent out surveys to the residents and the staff, however we have not received any returned surveys from the residents and two staff have responded at the time of writing this report. What the service does well: The service provides people living at the home with a warm and well maintained accommodation that meets their needs. There is a satisfactory pre admission assessment in place that ensures that people are assessed and the service can meet their needs prior to moving in. The meals at the home provide people with variety and choices that meet with their satisfaction. The management system and procedures in the home worked well including, dealing with complaints, staff supervision and the service users’ money. There is a thorough recruitment process in place to safeguard people living at the service. There is an ongoing training programme to enable staff to maintain their skills. Edinburgh House DS0000044195.V363319.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. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre admission assessment process is satisfactory and ensures that service users’ needs are assessed and the home can meet them. The home does not provide intermediate care. EVIDENCE: The care records of three people living at the service who had been recently admitted were looked at as part of case tracking. A pre- admission assessment record was seen for one person recently admitted to the service for respite care. The record seen contained a care management’s assessment that the service received prior to admission. Assessments included dietary needs, dependency, continence and the support of one carer. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 9 Another resident who was admitted as emergency placement record was looked at, an assessment was completed on admission and care plan developed. The person in charge reported that the service users are offered the choice of visiting the home prior to admission. The service users’ family visited, as most of them were unable to do so due to their frailty. Information was available in the foyer such as the statement of purpose and the service users’ guide and details of how to raise a complaint. The provider has notified us that the statement of purpose had been updated recently to give details of current management arrangement. Staff reported that the service also catered for people on short- term respite care. The person in charge confirmed that the service does not provide intermediate care. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans and records of care given were detailed for most of the residents. However the care plan was inadequate for one resident and there was a lack of information about the support required with their care. The health care needs and access to external agencies are well managed. The medication management was good and ensured that the service users were protected. The service users are treated with respect and dignity and their right to privacy maintained EVIDENCE: Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 11 The care plans of 3 service users were seen as part of this visit, to look at how the home plans to meet the needs of the service users. The two care plans were detailed and contained good information about the assessed needs of the service users and actions required in order to meet them. These included assessments such as manual handling, dietary needs, continence, medication, and the psychological needs. Care plans including night care were put in place to demonstrate how these needs would be met. There was evidence that people were involved in the formulation of their care plans as needed. The care record for one person who was recently admitted for respite care was looked at and we found that although an assessment was completed; there were no care plans to demonstrate how their needs would be met. As discussed the assessments for moving and handling, skin integrity and diet should also have been fully completed and care plans put in place regarding support needed to meet these needs. Detailed care plan must form part of information for staff in order to ensure that care is provided in a consistent manner and care needs are appropriately met. The person in charge stated that this would be addressed. Daily records of the care given were maintained. Comments from the people receiving care included “ it is good living here.” Comments from relatives indicated that they were satisfied with the care that people were receiving. The care plans were reviewed regularly to reflect any changes in the needs of the service users. Other comments included: “I visit nearly every day and have always had support from the staff. “ “I watch very carefully how my mum is looked after and how the staff support her and if I am not happy about anything I tell them and it is soon sorted”. All the service users are registered with the local surgery. The staff in charge reported that the home had good relationship with the local primary care trust and the service users were supported to access health care services as required. The GP did not undertake regular visits to the home but was available on request. Advice was sought as required from external healthcare professionals as needed. All the records contained pressure risk assessments. Pressure relieving mattresses and cushions were available for the prevention and treatment of pressure ulcers. The home has a medication policy and procedure and record showed that staff adhered by these. A sample of the Medication Administration Record (MAR) seen at the time of the visit showed that all prescribed medications given were recorded appropriately. The staff reported that only those who had completed medication management training were responsible for the residents’ medication. The home maintained good records of medication received and Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 12 discarded. All medication was stored safely and included controlled drug. The record seen showed that the service users were assessed for self- medication and there was no one administering their own medication at the time. There was a good internal daily audit process in place to monitor that all prescribed medications are recorded when administered. The checks ensured that any medication that is missed/not recorded is picked up at the handover and action taken as appropriate. Comments and the people spoken with confirmed that the home provided a good service and they had autonomy and choice regarding the activities of daily living. Comments included ” it is a very good home”. Another person said “everyone is very kind”. Interaction observed at various time of the visit indicates that the staff respond in a calm and understanding manner to the residents when attending to them. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The social and recreational facilities for the service users are very good. The service users are supported to maintain links with the community and their family and friends. The service users autonomy and choices are respected in their activity of daily living. The meals offer choices and variety and meet with the satisfaction of the residents. EVIDENCE: Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 14 The home has a planned activity programme that included games, puzzles, bingo, external entertainers and trips out to the sea front. At various times of the day staff and the residents were seen involved in reading the newspapers and magazines, having a chat and a cup of tea and watching television in the afternoon. Staff were available to supervise and assisted with reading from the various magazines and discussion about topical issues. The service has a room at the front of the building where organised activities are undertaken. The carers stated that they usually spent times in the afternoon as part of activities for the residents. The person in charge discussed that the support workers organised activities. Two relatives spoken to were not aware of any activities for the residents. This was brought to the attention of the person in charge and would benefit for the programme of activities to be available to the residents and the visitors. Other comments were: “Usually there is something going on like games”. “A structured activity programme would be good instead of this happening in afternoons”. One staff said that the carers do activities and this was occurred in the afternoon when they had finished doing other things. Staff reported that the provider was looking into the development of the support workers’ role being responsible for activities. The residents are supported to access religious service from the community. One of the newly admitted resident had fortnightly service from Portsmouth Cathedral. The home has an open visiting policy and it was evident from the record of visitors, as kept by the home that there was no restriction on visiting. Comment received and the residents confirmed that they have autonomy to receive their visitors in private. Comments were that “visiting our mother has never been a problem”. The home has a planned menu that is rotated on a regular basis. Comment cards received and the service users spoken with said that the meals were “ very good” and hot and cold drinks were available at all times. Comments included “very nice food” and “plenty of food and very nice “. Staff reported that the service users are provided with a daily menu and staff supported them in choosing from the menu. Meals were sent to the units in a hot trolley from the main kitchen at lunchtime. The lunchtime meal was observed and it was evident that choices were offered and included special diet such as gluten free for one of the residents. Meals Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 15 were well presented and looked appetising and balanced. Staff were observed to offer support with meals in a sensitive manner. The lunchtime meal was not rushed and allowed people to eat at their own pace. Each of the unit had a small kitchenette attached to it, where meals were served, hot and cold drinks facilities were available and included a sitting area with easy chairs. This appeared to be where the residents spent their time. Comments were that “you can have a cup of tea anytime in here”. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaint management is good and people spoken with are confident in raising any concerns. Staff spoken with have clear understanding of adult protection and ongoing training ensures that the service users are protected. EVIDENCE: The home has a complaint policy and procedure that staff and people spoken with said that they were able to use. Comments included “we would go to the office” and “things are all right”. The service maintained a complaint log of complaints received. These also included a number of compliments from relatives regarding the care that people had received at the service. The home had received two concerns since the last visit. Record seen showed that both of these had been resolved. One concern was raised on the day of the visit and this was recorded. Staff took action by contacting the gardener for the home to deal with this concern. The staff spoken with had clear understanding of adult protection issues and what they need to do if any allegation is reported to them. The staff reported Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 17 that training in the prevention of abuse was provided as part of their induction process and further training at a later stage. Staff spoken with said that they would not hesitate to approach the manager if they had any concerns. Observation of care practices and support that people received indicated that residents and staff interacted well and had developed good relationships with each other. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the residents with a homely, clean and well-maintained accommodation that meets their needs. The infection control procedures at the home are good and ensure that the service users are protected. EVIDENCE: A tour of the premises was undertaken as part of the visit and a number of bedrooms, communal areas, bathrooms, and kitchen were viewed. It was evident that the home has an ongoing programme of refurbishment. Recent refurbishment included the bathrooms and some of the resident bedrooms. The hot water system has also been upgraded. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 19 The three kitchenette attached to the unit had been renovated to a high standard with large handles to cupboards. These areas were bright and airy where the residents spent a lot of their times. The home was warm, bright, clean and homely. Furnishing was of very good standard and appropriate to the needs of the residents. There was adequate communal areas where a variety of activities are undertaken. Most of the bedrooms seen have views of the garden. The service users’ bedrooms were highly personalised with pictures, televisions, small item of furniture and family photos. It was evident that the residents are encouraged to bring in items of personal belongings on admission. The person in charge stated that every effort is made to personalise their bedrooms, this was particularly evident for one of the residents who had recently moved into the service. The home kept an inventory of the items in the service users’ files. Comments from the service users included ”this is a lovely home” and “I am happy to be living here.”” The service has large and secure gardens that were accessible to the residents including wheelchair users. Seating was available on the raised decked area and sunny position. The home has a laundry where all the service users laundry is undertaken internally. The laundry room was not inspected during this visit. Information on infection control was available. Staff practices observed indicated that they were aware of them and used protective gloves and aprons as needed. There was no adverse odours in ant part of the home when we looked round. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing numbers are adequate to meet the present needs of the residents. The home has system in place to ensure that staff have the skills to deliver care safely. The recruitment process is good. All checks are undertaken prior to employment to ensure the safety of the service users. There is a good training programme in place to ensure that staff are supported in their work. EVIDENCE: The home has a duty roster for the carers and a separate roster for ancillary staff. The person in charge and other staff spoken with sated that that there is a duty manager and 4 carers on to cover the day shifts. The night staff included 2 carers and one sleeping in manager. Staff and service users spoken with confirmed that they felt that there were adequate staff in order to meet their needs. Comments from the service users were that there was “always” Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 21 staff available when they needed assistance. These included chefs, kitchen assistants and laundry staff who supported the residents living at the service. The staff reported that there is a support worker that assisted the carers and the development of the support worker’s role, responsible for activities would be beneficial. The person in charge discussed that the provider has been looking into employing an activity coordinator but there was little interest to the recent advertisement. “I think the care is first class”. “She is happy and well cared for” Comments we have received from the staff included: “I feel E.H. provide a high standard of care to service users, encouraging them with the freedom to choose their every day life decisions and acting on them” Information received from the AQAA and records looked at during the visit indicated that there is an ongoing training programme inn place. All new employees were expected to complete the company’s six weeks induction programme that included safe moving and handling prior to starting work. In house training incorporated health and safety, infection control, dementia, first aid and prevention of abuse. The person in charge stated that training in mental capacity act was being developed at present. Staff reported that “training was good” and they felt supported. The home has a recruitment procedure and the manager interviewed all the applicants. A sample of newly recruited staff seen indicated that the home had a good recruitment process that staff followed. Checks were undertaken and references secured prior to employment. Induction records were maintained. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear management process in place and staff are supported in their work. The financial interests of the service users are safeguarded through good accounting. The process of seeking the service users’ views is satisfactory. There is a satisfactory procedure in place to ensure the health and safety of the service users is promoted. Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 23 EVIDENCE: The home has a registered manager who has a number of years experience in the care of the elderly. The provider has informed us that the registered manager will be away from the service for a period of time and has kept us informed of management arrangement in the interim. Staff spoken with reported that the acting manager was very supportive and they would not hesitate to approach if they needed any help. The acting manager assisted us with the visit and demonstrated good knowledge of the management and processes for the service. Comments received from the relatives a included “I am very satisfied with everything that the home does” “Always been informed if mum is poorly” “I visit nearly everyday and always have the support of the staff”. “More money would allow more facilities, but I still think I picked the best home for mum”. One comment was that the wheelchairs did not always have their footrests attached and these would benefit from regular cleaning. This was brought to the attention of the person in charge and remedial action will be taken. However during the visit we noted that both people in wheelchairs had footrests attached. The home has an internal audit process in place and this included monthly regulation 26 visits. Records of these were maintained at the service. A sample of the personal allowance as managed by the home on behalf of the residents indicated that there is a good accounting system in place to ensure that their financial interests are safeguarded. Receipts were maintained of all transactions and invoices raised as appropriate. The person in charge stated that the provider also undertook regular auditing of the residents’ finances that the service managed. Information received indicated that there are regular reviews of policies and procedures to ensure that they meet current legislation/ guidelines. These Included servicing of equipments such as hoists, lifts, emergency lightings and fire safety equipments. All substances that are classed as COSHH and detrimental to the health and safety of people were stored securely. Edinburgh House DS0000044195.V363319.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Edinburgh House DS0000044195.V363319.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement The registered person must ensure that a service user’s plan is developed that set out in details action needed to meet the health, personal and social care needs of people receiving care. Timescale for action 15/07/08 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 Edinburgh House DS0000044195.V363319.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 Edinburgh House DS0000044195.V363319.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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