Care Home: Lee House

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What the care home does well What has improved since the last inspection? The manager has ensured that all the requirements made at the last inspection have been addressed. This demonstrates that the service is committed to providing a service that meet requirements, and ensures positive outcomes for people using the service. The service has identified increased dependency levels for some of the residents, and has responded in a positive way by ensuring that staffing levels are increased to meet these needs. There has been an ongoing programme of renewal and decoration in order to maintain the environmental and physical standards in the home. This will ensure that residents benefit from a pleasant environment where they can live, and entertain their relatives and friends. What the care home could do better: No requirements or recommendations were made following this inspection. CARE HOMES FOR OLDER PEOPLE Lee House Longley Lane Northenden Manchester M22 4HT Lead Inspector Ann Connolly Unannounced Inspection 11:00 10 January 2008 th 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 Lee House DS0000021557.V349586.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. Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lee House Address Longley Lane Northenden Manchester M22 4HT 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) 0161 945 5204 0161 945 7635 www.harvesthousing.org.uk Manchester and District Housing Association Jacquelyn Shaikh Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th August 2006 Brief Description of the Service: Lee House is a care home providing personal care and accommodation for 25 older people (65 and over). The home is owned by Manchester and District Housing Association and is a member of Harvest Housing Group. The home was opened in 1986. The home is located in the town of Northenden, close to shops, pubs, a post office and other amenities. The home consists of a purpose built two-storey building that stands in its own grounds, surrounded by mature trees to the rear of the property. There are parking facilities at the front of the home. All of the bedrooms are single and 18 of the rooms have en-suite facilities. There are adequate toilet, bathroom and shower facilities. The home has two lounges/dining areas, a treatment room and a self-service kitchen for use by the residents and their relatives. The current scale of charges is £373.54 to £378.54. In addition to this there is a £25.00 top up fee. Lee House DS0000021557.V349586.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 the service experience good quality outcomes. This was an unannounced inspection that took place on 10 January 2008, starting at 11:00. During the site visit a selection of records, care plans, and policies and procedures were examined. Discussions took place with the manager, staff working in the home, and some relatives who were visiting. Prior to the inspection, questionnaires were sent out to the people who live in the home, asking them to comment on how the home is run and managed, and for their views about how the staff supported them. A percentage of these were returned and their comments have been included in this report. Several residents living in the home were spoken to in private during the visit, and discussions took place with them to find out what they thought about the home and what they felt about how the staff supported them. Before the inspection, we also asked the manager of the service to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This is one of the ways that we get information from the manager of the service, about how they are meeting outcomes for people using their service. Information that was provided in the AQAA for this service, was detailed and comprehensive, and provided evidence of a service that was committed to focusing on positive outcomes for the people who use the service. Since the last inspection visit, which took place on 4th August 2006, the Commission for Social Care Inspection has not received any concerns about this service. The service has not received any formal complaints over the last twelve months. What the service does well: From observations made during this visit, and from information provided by the manager in the AQAA, there was evidence that the manager and staff in this home are constantly working towards improving the service. There is a low turn over of staff. A number of staff in the home have worked there for several years. This means that residents benefit from a stable staff team that offer continuity in the services provided. All the residents spoken to were extremely positive about their experiences in the home, and about the way the home was run and managed. All written feedback from residents stated satisfaction with the services provided. They Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 6 were very complimentary about the way in which staff provided care and support. Some of the comments from residents were as follows: “It’s quite good here. The staff do what they can for you and we can ask them for anything”. “You can bring your own furniture, and make your room homely”. “The meals are excellent”. “Overall, it’s excellent, the food is great, A1. Staff are charming, they never grumble, they take everything in their stride”. “There are very good, the staff here. I’m so happy here”. Comments from relatives and visitors were also positive, and mirrored the experiences and comments made by residents in the home. One visitor said she had visited numerous homes before choosing Lee House. She said that staff cared about even the smallest detail, and said that staff recognised that this was important in helping residents to settle, and to feel at home. There was a relaxed and welcoming atmosphere noticeable during this visit. Families and visitors were made welcome by staff, and professionals commented on how well the staff team supported them. Healthcare professionals commented on how good the staff were at picking up any changes in care needs, and reporting them to the appropriate person. She said they were good at using their initiative, which ensured that care needs were met in a timely manner. One relative said that staff always made sure that medical needs were attended to. Staff and residents in the home expressed confidence in approaching the manager with any issues of concern. Lee House provides a ‘homely’ atmosphere in a purpose built environment. Décor, furnishings and hygiene were of a good standard, and there was evidence of an ongoing programme of maintenance and renewal. Communal areas had been decorated, including the lounge and dining room. A number of rooms had new floor coverings. Some of the rooms were fitted with non-slip porous floor covering. The manager said that residents had the opportunity to discuss the décor and floor covering, and that every effort was made to provide an alternative if this was not to the satisfaction of the individual. Care plans provided staff with information on how residents wanted to be supported. There was evidence during this visit that residents and their families were involved in making decisions about the way support and care was provided. Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 7 The home continues to provide training for all staff. There was evidence of ongoing training opportunities for all staff working in the home. Although there had been no recent complaints about the home, the manager demonstrated an open and transparent approach to managing complaints. Visitors expressed confidence in going to the manager with any concerns. 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. Lee House DS0000021557.V349586.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 Lee House DS0000021557.V349586.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): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are given sufficient information about the home to help them in making a decision about their care arrangement. Residents’ needs are assessed prior to admission to the home so they are confident their needs will be met and the home is sure it can meet their personal needs. EVIDENCE: The home has a Statement of Purpose and a Service User Guide which provides existing and prospective residents with information about the service. This means that people can make an informed decision about their care and support arrangements. The guides are well presented, and are available from the manager. Copies of these documents are provided in each bedroom. Three care plans were examined and they contained assessments carried out by the care manager from the placing authority. In addition, an assessment of care needs was carried out by the manager, or representative from the home. Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 10 The information obtained was used to develop a detailed care plan for each resident. The documentation used to record assessments was being reviewed to include the headings as detailed in Standard 3 of the Care Homes for Older People, National Minimum Standards. When the assessment and care plan are completed, the resident and a representative from the home sign a document confirming that: 1) The resident is happy with the assessment and care plan, and 2) The service is able to provide care and support as agreed in the plan. During this visit, a new resident was admitted. It was noted that staff allocated time to spend with this resident and his family. Arrangements were made for a member of staff to spend one to one time with the resident, and filling in relevant documentation. A family member was spoken to in order to obtain their perspective of the admission process and how the service had managed it. The family were complimentary about the service. One family member said the welcoming atmosphere, and the way in which staff had taken time to carry out the assessments had impressed her. She added that it had been noticeable that staff had taken the time to make note of small details which they recognised would be of importance to their relative. It was evident from this discussion that the new resident and his family were benefiting from a positive experience. Intermediate care is not provided at Lee House. Lee House DS0000021557.V349586.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): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provided staff with the information they need to meet and monitor the resident’s needs. Medication practices ensure that residents receive their medication safely. EVIDENCE: Three care plans were examined during this visit. The care plan documentation included a content checklist which detailed general background information, daily living/needs assessment, risk assessments, reviews, and the working care plan. Care plan documentation included an agreement signed by the resident and a representative from the home. This demonstrates that the resident has been involved in the discussion about the care plan, and has agreed to its contents. Overall, the care plans were detailed and informative and provided staff with guidance and instruction on how the resident wanted to be supported. However, it was noted, that, when a new care need was identified in the monthly review, or the daily care recordings, these were not always Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 12 transferred to the care plan document. This was discussed and addressed at the time of the inspection. The manager held meetings with the senior staff with responsibilities for developing the care plans, and arranged for all care plans to be reviewed, so that the information in them was current and up to date. It was evident from discussions and observations of staff during the course of their duties that they had a good knowledge and understanding of individual care needs. One relative who was visiting said that the care staff were always ‘on the ball’. She said, “ They (the staff), always make sure medical needs are attended to, and they are very efficient”. A visiting professional was spoken to during this visit. She said that the staff were very good at following instructions and that they seemed to know what they were looking for and were quick to respond. She said that they request District Nursing and General Practitioner support when appropriate. The visiting professional said, “ The home has established a good working relationship with the General Practice. The staff take initiative if they identify a care need that requires looking at”. The home maintains records of any medical intervention and involvement of health care professionals to ensure that resident’s health care needs are met and that they are supported appropriately. Medication was administered using a monitored dosage system. Medication administration records (MAR), presented as predominately appropriately maintained. However, some of the stock levels of medication did not balance with the written records. It seems that stock balances are not always carried forward or added to the receipt of monthly medication received into the home. This shortfall was addressed at the time of inspection, and the manager added the requirement to check stock levels of all medication on to the audit which she carries out regularly. This will ensure that when the monthly audit takes place the manager and senior staff will be able to track medication and provide a full audit trail for all medication received into the home. This will minimise any risks, and ensure that medication is handled safely. Lee House DS0000021557.V349586.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): 11, 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to engage in the social activities and daily life in the home. The home supports and encourages residents to maintain links with their family and friends, which allows residents to exercise as much choice and control over their lives as they can. Meals served to residents were of a high quality, providing a well presented and nutritionally balanced meal EVIDENCE: The home has an open visiting policy and information about visiting arrangements was included in the statement of purpose and service user guide. Residents who were spoken to confirmed that they could receive visitors at any time, and a number of visitors were seen coming and going during the course of this inspection visit. It was noted that visitors were made welcome on arrival, and from discussions with some of them, it was evident that visits to Lee House were seen as a positive and pleasant experience. There was evidence that residents were helped to exercise choice and control over their lives. A resident committee is held regularly where they are Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 14 encouraged and supported to express their views and ideas on the running of the home. The home employs an activities organiser four days a week. The notice board advertised a wide range of activities including Bingo, sing-along, outside entertainers, quizzes. During this visit, a flower arranging session was going on and a number of residents were actively involved. Information in the AQAA stated that the home plans to develop the allotment, and grow fruit and vegetables. This will provide a wider variety of interests and activities for residents to become involved in if they so wish. Feedback in the form of surveys was extremely positive about the meals served in the home. All residents spoken to during this visit were complimentary about the meals. Comments included: “The meals are excellent”. “The meals are super”. “Overall it’s absolutely excellent. The food is great, A1”. “If you don’t like something, there is always an alternative”. Residents confirmed that there was always a choice of meal. On the day of this visit, the menu included, chicken curry or quiche and salad, followed by apple pie or fruit and yogurt. Lee House DS0000021557.V349586.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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ rights are protected by robust polices and procedures and there is an open transparent approach to managing complaints. EVIDENCE: There is a complaints procedure in place, which is displayed prominently around the home. This gives details and timescales by which a complainant can expect a response and also provides the contact details of the Commission for Social Care Inspection. There is a complaints record, which logs all complaints which are brought to the attention of the manager. It details the nature of the complaint, the action taken and the outcome for the complainant. Since the last inspection the home has not received any complaints. The Commission have not received any complaints about this service. Some of the staff who were spoken to had a good understanding of issues around abuse and what to do in the event of an allegation of abuse. Some staff had a more in depth knowledge that others, and were fully aware of the procedures. The manager stated that all staff were being updated on adult protection and safeguarding, to ensure that all staff have a detailed knowledge Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 16 base so that they know what happens when an allegation has been reported to the manager. Residents who were spoken to during this visit indicated that they felt confident in approaching the staff and the manager with any concerns. Relatives who were spoken to said they felt they could talk to the manager or a member of staff at any time with a concern because they were , “So approachable”. Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately maintained, decorated and cleaned to ensure that residents are provided with a safe, pleasant and hygienic environment. EVIDENCE: This was an unannounced visit to the home. As part of the visit, a tour of the building took place. All communal areas and bedrooms were found to be cleaned to a high standard. Information provided by the manager in the AQAA stated that all staff have received training in infection control and that protective clothing was provided and used by staff. All staff are provided with portable hygienic hand rubs to minimise the spread of infection. All the feedback from residents and their families was very positive about the environment at Lee House. All people spoken to said that the home was always Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 18 tidy and very clean. One health care professional said that the home never had an unpleasant smell and that it was always cleaned to a high standard. There was evidence of an ongoing rolling programme of decoration and refurbishment. The newly decorated areas and furnishings were of a good standard, providing a pleasant environment for residents and visitors. The external patio areas provided an extremely pleasant and safe external area for residents to enjoy all year round, making good use of the external space. There was evidence that bedrooms had been personalised with personal effects and furnishings. Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by a well-trained staff team, and are protected by robust recruitment procedures. EVIDENCE: During this visit there was sufficient staff on duty to meet the needs of the residents. Staff were seen spending one to one time with residents and providing support for those residents with high dependency needs. The manager said that staffing levels were constantly reviewed, and the dependency levels of the residents were taken into consideration when setting the rota. Information from the manager indicated that 100 of staff had achieved a National Vocational Qualification (NVQ), at level 2 or above. In addition to this, the manager has obtained the Registered Manager’s Award. All new staff undertake induction training in accordance with the Skills for Care council training. Staff who were spoken to confirmed that they had received induction training, and that there were ongoing opportunities for training and development. Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 20 There is a training matrix in place, which helps the manager to monitor staff training and development. All staff had received training in safeguarding adults, however, it was some time ago, and there was a need to ensure that they were updated in current policies and procedures. The manager confirmed that training was scheduled for this year, and that in the interim, staff received updates during induction, and in supervision sessions, which were used as an opportunity to address training needs and to re-in force good practice. Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 21 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This service is run in the best interests of the residents, and the management ensure that the safety and welfare of residents and staff are promoted. EVIDENCE: The registered manager has completed the Registered Manager’s Award. Staff who were spoken to said that they found the manager approachable and that they could talk to the manager about any concerns. One of the relatives, and visiting healthcare professionals who were spoken to during this visit, said that they found the manager approachable and responsive to any problems or concerns. Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 22 There was documentary evidence of regular staff and residents meetings. The meetings were used as a forum to exchange views, and to seek the views of residents about how the service could be developed. Information in the AQAA provided evidence that good standards were maintained for the maintenance of equipment for health and safety including fire prevention equipment. During this visit, the manager said that dependency levels of some residents had increased and that as a result, the need to use hoists and lifting equipment had increased. The manager said she had ordered additional lifting equipment, which included a new tracking system in some areas of the home, and additional slings. This would ensure that the safety and well being of residents using this equipment would be promoted. The possibility of cross infection would be reduced, by ensuring that each resident requiring this equipment had their own individual sling. The organisation completed an internal quality assurance audit, which ensures that the views of residents are sought formally and informally on a regular basis. The manager said that there were plans to produce a formal report to record the findings of quality assurance exercises, so that the people using the service were kept fully informed. Staff in the home confirmed that they were in receipt of regular supervision sessions, and there was documentary evidence available to support this. There was a of any monies held on behalf of residents and maintained a balance sheet of all monies received and issued for individual residents. Receipts for individual items were kept with the individual resident’s financial record. Information provided by the manager in the AQAA, provided evidence of a manager who was committed to developing the service so that residents experienced positive outcomes. Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 23 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 3 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 Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 24 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 Lee House DS0000021557.V349586.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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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