Care Home: Jesmund

What the care home does well Having reviewed all of the information that was available and undertaken our visit we considered that the home provides good quality outcomes for the people who are living there. The Jesmund provides clean, comfortable and well-maintained accommodation for up to twenty-three residents with dementia or other mental health problems. As an older home some of the rooms would not comply with current standards however, the premises are suitable for their purpose and ramps and a lift make all areas accessible to residents including those who rely on wheelchairs. The majority of rooms are used for single occupancy and have ensuite facilities. Our "Expert by Experience" had never been to The Jesmund before and said, "It had a pleasant and welcoming appearance" and that "it felt inviting". They liked that fact the residents had been able to personalise their own rooms saying that it "gave a homely feel". There are pleasant gardens to the rear of the property, which are enjoyed by residents in the warm weather and the resident cat enjoys strolling around the home. The local authority funds the majority of the residents in this home and they are subject to their assessment and review processes. In addition they all have an individual care plan, which describes the support that they require. Verbal communication is difficult with many of the residents who on the day of the inspection, all looked clean and well cared for, although those who were able, commented that "staff were kind" and "it was nice living in the home" A relative, who was visiting at the time, agreed that they considered the residents were well looked after in the home and that they were always made to feel welcome when they visited. Other people have held this view when we have visited the home before. The Registered Manager has many years experience in caring for this client group and several of the staff members have worked in the home for some time, providing continuity of care and familiarity for the residents. The incidence of complaints about the service is low. What has improved since the last inspection? Over the last year the redecoration and refurbishment programme has continued, carpets and some furniture has been replaced and the overall appearance of the home is now much brighter and fresher. Staff training has been increased with sessions concerned with control of infection and nutrition. This is in addition to the mandatory training that we consider must be updated yearly, such as moving and handling and fire safety. The majority of the people who live in the home have dementia or mental health problems and would need to be assessed with regard to their mental capacity. There has recently been training to help staff to understand the issues that need to be considered. Staff supervision is now occurring on a regular basis to help monitor performance and to identify any further training needs. The home is implementing a quality assurance programme designed to gather the views of residents and their relatives and give them the opportunity to influence how the home is run. A questionnaire has recently been distributed and a meeting was held for them. The management team are aware of the need to continue to develop this to ensure that care is being delivered in a way, which suits those who are using the service. What the care home could do better: We did not issue any requirements during our inspection visit. However, we did discuss some issue with the Registered Manager, which we considered would improve life for the people who live in the home. We felt that the activities programme could be expanded in order to offer more stimulation and our expert by experience suggested that perhaps music could be played rather than having the television on all the time, which nobody seemed to be watching anyway. People who live in the home tell us that they enjoy the food that is served however, it was suggested that some alternative dishes might be provided for those people who are not used to eating English meals. The cook does make curry occasionally but perhaps some of these could be prepared and put in the freezer for those people who might prefer them. CARE HOMES FOR OLDER PEOPLE Jesmund 29 York Road Sutton Surrey SM2 6HL Lead Inspector Alison Ford Unannounced Inspection 14th October 2008 10:00 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 Jesmund DS0000019100.V372852.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. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jesmund Address 29 York Road Sutton Surrey SM2 6HL 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) 020 8642 9660 020 8642 9662 jesmund@uk2.net Mrs Abbie Shiels Mrs Abbie Shiels vacant Care Home 25 Category(ies) of Dementia - over 65 years of age (0), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (0) Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow two specified service users, under the age of 65 years, to be accommodated in the home until such time that the home is no longer able to provide the care they require. 16th October 2007 Date of last inspection Brief Description of the Service: Jesmund is a nursing home, registered with The Commission for Social Care Inspection, to provide care for up to 25 residents with a history of dementia or mental disorder. It is situated on a quiet residential road in Cheam Surrey about 1.5 miles away from the station and the shopping facilities of central Sutton. There is a substantial well-kept garden to the rear of the property and off street parking to the front. Ramps at both the front and rear doors provide wheelchair access. Bedrooms are arranged over the ground and first floor and most of them have en-suite facilities. There is a large sitting room on the ground floor with an additional dining room, kitchen and office facilities. At the time of this inspection fees for the home range from £550 - £600 per week. Extra charges may be payable for services such as hairdressing and chiropody and would be discussed prior to admission. Copies of the homes Statement of Purpose and the latest inspection report would be available from the home or, in the case of the latter, directly from the Commission for Social Care Inspection via their website. Jesmund DS0000019100.V372852.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. This key inspection visit was unannounced and contributes to the inspection process of the home for the year 2008/2009. In compiling this report consideration has also been given to information received about the home throughout the year such as comment cards, complaints, and the notification of any incidents. In addition, the Registered Providers sent us their Annual Quality Assurance Assessment. This is a document that they have to return to let us know about their service, how well they consider that they are meeting the needs of those people that they are caring for and their plans for the future. We were accompanied on our visit by an “Expert by Experience,” a person who has had experience of using social care services. They were able to spend time with the residents to try and find out what is like for them living in the home. They also joined them at lunchtime. During the visit all we assessed all of those standards considered, by The Commission for Social Care Inspection, to be key to the inspection process. We undertook a tour of the premises and spoke with many of the residents and members of staff. We looked at a sample of care plans and various records and documentation that the home has to keep as evidence of their commitment to the health and safety of their residents. We also looked at the files of those staff who have been employed since the last inspection, to ensure that appropriate pre - employment checks had been completed. This helps to make sure that people who live in the home are protected from those who should not be working with vulnerable adults. What the service does well: Having reviewed all of the information that was available and undertaken our visit we considered that the home provides good quality outcomes for the people who are living there. The Jesmund provides clean, comfortable and well-maintained accommodation for up to twenty-three residents with dementia or other mental health problems. As an older home some of the rooms would not comply with current standards however, the premises are suitable for their purpose and ramps and Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 6 a lift make all areas accessible to residents including those who rely on wheelchairs. The majority of rooms are used for single occupancy and have ensuite facilities. Our “Expert by Experience” had never been to The Jesmund before and said, “It had a pleasant and welcoming appearance” and that “it felt inviting”. They liked that fact the residents had been able to personalise their own rooms saying that it “gave a homely feel”. There are pleasant gardens to the rear of the property, which are enjoyed by residents in the warm weather and the resident cat enjoys strolling around the home. The local authority funds the majority of the residents in this home and they are subject to their assessment and review processes. In addition they all have an individual care plan, which describes the support that they require. Verbal communication is difficult with many of the residents who on the day of the inspection, all looked clean and well cared for, although those who were able, commented that “staff were kind” and “it was nice living in the home” A relative, who was visiting at the time, agreed that they considered the residents were well looked after in the home and that they were always made to feel welcome when they visited. Other people have held this view when we have visited the home before. The Registered Manager has many years experience in caring for this client group and several of the staff members have worked in the home for some time, providing continuity of care and familiarity for the residents. The incidence of complaints about the service is low. What has improved since the last inspection? Over the last year the redecoration and refurbishment programme has continued, carpets and some furniture has been replaced and the overall appearance of the home is now much brighter and fresher. Staff training has been increased with sessions concerned with control of infection and nutrition. This is in addition to the mandatory training that we consider must be updated yearly, such as moving and handling and fire safety. The majority of the people who live in the home have dementia or mental health problems and would need to be assessed with regard to their mental capacity. There has recently been training to help staff to understand the issues that need to be considered. Staff supervision is now occurring on a regular basis to help monitor performance and to identify any further training needs. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 7 The home is implementing a quality assurance programme designed to gather the views of residents and their relatives and give them the opportunity to influence how the home is run. A questionnaire has recently been distributed and a meeting was held for them. The management team are aware of the need to continue to develop this to ensure that care is being delivered in a way, which suits those who are using the service. 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. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 8 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 Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 9 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): Standards 3, 6 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. No one is admitted in to the home without having a full needs assessment carried out by a senior member of staff to make sure that the home will be suitable for their needs. This home does not offer intermediate care so this standard does not apply. EVIDENCE: Most people who use this service are admitted through a Care Management arrangement and funded by the local authority. They would have an assessment undertaken by their care manager to outline the support that they would need. These were seen in their care plans. In addition a senior member of staff from the home would visit them to undertake their own asessment. The home was expecting to receive two new residents and we were able to see their assessments. They had been carried out by the Registered Manager and Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 10 were both comprehensive and informative. For one resident it had been recognised that they were particularly likely to be anxious about the admission and we could see that their family had visited the home and there were plans about how these concerns might be managed. All prospective residents are given a copy of the Service User Guide so that they and their relatives are aware of the sevices and support that will be provided. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 11 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): Standards 7,8,9,10 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use this service have their healthcare needs met in a way which suits them and individual care plans are in place which reflect the care, and support that they currently need Medication policies and procedures are in place to ensure that residents are protected and they can be confident that they will be treated with respect and in a way that respects their privacy and dignity. EVIDENCE: All residents have an individual plan of care based on their initial assessment and reflective of the support that they now need. The home uses a commercial recording system “Standex” and completion of the documentation continues to improve. We looked at four care plans and they were comprehensive and contained evidence of regular review to assess skin integrity and the risk of residents developing pressure sores. Visits from other healthcare professionals were recorded and the home uses specialist equipment such as pressure releiving matresses where necessary. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 12 The homes GP visits on a weekly basis or if needed and we were able to speak with him during the inspection. At the time of writing this report he did not have any concerns about how people were being cared for in the home. Information regarding residents past lives and acheivements is beginning to be added into care plans, giving staff an insight into their present behaviour and their interests.This will also help staff to plan activities which suit their preferences. Medication records and storage were asessed and were in order. A monitored dosage scheme is used which makes it easier to check that administration of medication is in order.Photographs of residents are on most of the record sheets and nurses signatures are recorded on the front of the records. If residents do not have any allergies to any medication the space on the MARS for this is left blank. It was recommended that an entry should be made to this effect anyway, in order to show that due consideration has been given to this issue. During our visit we watched the interactions between residents and the staff that were looking after them. Carers were cheerful, polite and respectful. Our “expert by experience” spent some time in the lounge and said “staff had a caring attitude” and noticed that they made sure that those who needed help were getting it when it was time for morning drinks. Jesmund DS0000019100.V372852.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): Standards12, 13,14,15 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The daily life in this home suits the people who live there. They are encouraged to make choices, where possible, and they are able to participate in a limited range of activities, arranged to stimulate and interest them Meals are well presented and generally suit them. Their relatives and friends will always be made welcome when they visit. EVIDENCE: Our expert by experience spent some time with the residents in the lounge. It was difficult to hold a conversation with most of them due to their dementia although one lady did say that she was a bit bored. A record book shows that there are organised activities twice a week and care staff also spend some time undertaking various pastimes with them. We still consider that this is an area which could be improved upon. The information that we have received from the home shows that they have recognised this shortfall and there are plans to increase social activity. Our expert by experience suggested that the home might introduce old time music sessions in the morning rather than just leaving the television on. Some residents are able to go out shopping if they are accompanied by a staff member. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 14 The home tries to encourage residents to excercise choice in their daily lives as much as they are able. They are asked about the clothes that they wish to wear, the food that they eat and how they would like to spend their day. We were told that they were able to get up and go to bed when they wanted to and not just to suit the routines in the home. Visitors are always made welcome and the one that we spoke with agreed that they are able to visit at any time and always greated warmly and offered refreshments. Our expert by experience was able to join residents for lunch and also spent some time with the cook in the kitchen. She showed them the menus and there were lists to remind staff about the portion sizes that the residents liked. The expert considered that the food was of an “adequate” quality and quantity, and nicely presented. People who could feed themselves sat together in the dining room while others, who needed help, stayed in the lounge with the carers. One lady was not eating very much and it was suggested that English food might not be to her taste and that a different menu choice could be considered for her. A vegetarian option is provided for one resident and the cook does occasionally make curry. It was suggested that some of these could be kept in the freezer so they would be available at other times for those people who might prefer them. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 15 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): Standards 16,18 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in the home are unaware of the complaints procedure however, there is evidence that concerns raised on their behalf are taken seriously and addressed appropriately. The policies and procedures that are in place within the home will ensure that people who live there are protected from abuse. EVIDENCE: There is a complaints policy in place although the cognitive impairement of those living in the home means that it would not be easily understood by most of the residents. One complaint has been received since the last inspection and this was addressed by the home appropriately. We are always notified promptly of any untoward incidents that occur in the home. All staff receive regular training in the recognotion and reporting of suspected abuse and this has been discussed at supervision sessions. Those staff spoken with displayed an understanding of the relevant issues. Pre-employment checks are in place to ensure that residents are protected from those people who have been judged as being unsuitable to be caring for vulnerable people. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 16 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): Standards19, 26 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for its purpose and it meets the needs of the people who live there in a clean, comfortable and homely way. EVIDENCE: We undertook a tour of the premises. Our expert by experience reported, “The home is situated in a quiet residential street. It has a pleasing and welcoming appearance and wheelchair access is available. There are no unpleasant odours. On entering the premises the lighting is good and the home feels inviting. The lounge is well equipped with comfortable chairs and there are tables in front of the chairs for people to put their cups of drink on. Residents have photos and mementos on their rooms which give them a homely feeling”. Over the last year the redecoration and refurbishment programme has continued and the home is bright and airy. The home is well maintained with due regard to the requirements of the fire service and environmental health inspector. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 17 Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 18 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): Standards 27,28,29.30 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are always sufficient numbers of appropriately trained staff available to support the people who live in the home and robust recruitment procedures are in place to ensure their protection. EVIDENCE: Staff rotas were seen and complied with previously agreed standards. There are always trained nurses on duty in the home as well as care staff. Staff turnover in the home is low and this provides continuity of care for residents who appreciate seeing the same people all the time. Nurses and carers that we spoke with demonstrated a good understanding of the needs of the people that they were caring for. All care staff are currently qualified to at least NVQ level 2 standard or are undertaking the course. Some are working towards a level 3 qualification. Staff training is ongoing in the home and aimed at meeting the needs of the residents and all mandatory trianing has been completed. Personel files were seen relating to new staff members and, in line with regulations, all the information relating to recruitment procedures and providing the evidence required to ensure the protection of residents was present. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 19 Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 20 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): Standards31, 33,35,38 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. This service is run by an experienced person, in the interests of the people who live there. Residents can be assured that their safety and financial interests are protected and that policies and procedures are in place to ensure their health and safety. EVIDENCE: The Registered Provider / Manager, Mrs Sheils, is a trained nurse with additional qualifications including The Registered Managers Award, and has worked within health and social care for over 30 years. She has many years experience in managing the home and working with this client group and always displays a great depth of knowledge about the problems experienced by residents in the home. Over the last year a quality assurance tool has been developed to enable people to voice their views and influence the running of the home. Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 21 Questionnaires are distributed to residents and their relatives and the home now holds relatives meetings. The home is aware of the need to continue to develop this area in order to ensure that care and support is always given in a way which suits those who are using the service. Some money is held for two residents and the records were available to see and easy to understand. Other residents have relatives or representatives who handle their finances on their behalf. All staff have regular appraisal and supervision in order to monitor and manage their performance and to identify any future training needs. The Annual Quality Assurance Assessment tells us that equipment and services are appropriately maintained and serviced to ensure the safety of residents however, it was noted that servicing for gas appliances and systems was overdue. The manager has agreed to address this. Jesmund DS0000019100.V372852.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 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 3 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 Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 Jesmund DS0000019100.V372852.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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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