Care Home: The Garth Care Home

What the care home does well What has improved since the last inspection? A member of staff has qualified as a manual handling trainer so that instruction and guidance can be readily available to other staff without dependence on external trainers. Mr. and Mrs. Prior have consulted residents, relatives and staff and are building a sun lounge as a result of their suggestions. What the care home could do better: It may be a good idea to check with residents that they are happy with the current evening leisure opportunities. CARE HOMES FOR OLDER PEOPLE Garth Care Home The The Square Kington Herefordshire HR5 3BA Lead Inspector Wendy Barrett Key Unannounced Inspection 16th April 2008 09:30 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 Garth Care Home The DS0000027690.V362767.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. Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Garth Care Home The Address The Square Kington Herefordshire HR5 3BA 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) 01544 230502 01544 231638 garthcare@hotmail.com Mr Alan Joseph Prior Mrs Patricia Jane Prior Mrs Patricia Jane Prior Mr Alan Joseph Prior Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32), Physical disability over 65 years of age of places (32) Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2007 Brief Description of the Service: The Garth is a Georgian property situated in the centre of the small Herefordshire market town of Kington. It has been extended and is registered for 32 places, with a maximum of 22 places for service users requiring nursing care. It offers accommodation for service users of both sexes over the age of 65, who are frail or physically disabled. It is privately owned and managed by Mr Alan Prior and Mrs Patricia Prior. The Home was first registered in 1988 and consists of a two-storey building with a purpose built two-storey extension. The Home has 22 single en-suite bedrooms, two double en-suite bedrooms. There are a further two single bedrooms and two double bedrooms without an ensuite facility. There is a passenger lift in the new building and a stair lift in the original Georgian property. The gardens are well maintained and easily accessible for service users. Copies of the home’s Service User Guide are available at the home. A copy is given to enquirers and potential residents. There are also copies distributed to local hospitals and social work teams. In January 2007, the fees ranged from £385 per week to £415 per week for personal care. Nursing fees ranged from £500 per week to £525 per week. Additional charges are made for hairdressing, aromatherapy massage, toiletries and personal newspapers and magazines. Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on information gathered from the Commission’s service file, an annual quality assurance assessment report (AQAA) completed by Mrs. Prior, feedback survey forms from residents, relatives and staff employed at the home, and an inspection visit to the service. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. What the service does well: What has improved since the last inspection? A member of staff has qualified as a manual handling trainer so that instruction and guidance can be readily available to other staff without dependence on external trainers. Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 6 Mr. and Mrs. Prior have consulted residents, relatives and staff and are building a sun lounge as a result of their suggestions. 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. Garth Care Home The DS0000027690.V362767.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 Garth Care Home The DS0000027690.V362767.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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Potential residents are fully consulted in decisions about the suitability of the home. The way that admissions are managed helps new residents feel safe and comfortable because the staff make sure they know what things are important to the individual. EVIDENCE: Before anyone is admitted to the home the senior staff gather as much information as they can about the individual’s needs and expectations. They usually do this by visiting the prospective resident in their own home or in a hospital. Sometimes reports are obtained from other care professionals e.g. community care assessment reports written by social work staff. Information about the residents’ life experience and current interests is collected to help staff understand how to work in a way that will help the new Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 9 resident to feel comfortable e.g. a resident enjoyed chatting to a care assistant about her life in the local area. When a request for admission cannot be accepted the potential resident is told why this decision has been made. Mrs. Prior tries to involve a key worker in pre-admission contact so that the new resident will have a particular staff member to help them settle into the home. There is a lot of emphasis on spending time chatting to new residents and checking that they are settling in all right. A formal meeting is also arranged after the first month with the resident and their relatives to decide if the placement is working. Two residents remembered how their admissions were organised. Although their families had made the arrangements the residents had an opportunity to visit the home and see their new bedroom accommodation. One of them commented on the informal atmosphere-‘no rules’. She liked this impression and said she had, indeed, found the home to be friendly and relaxed. Garth Care Home The DS0000027690.V362767.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 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The way that the care is planned and delivered is leading to considerable satisfaction in people who use the service. The staff pay a lot of attention to working in a way that suits the individual’s needs and preferences. Training programmes are designed with regard to the particular care needs of the resident group and staff have regular opportunities to update their knowledge. Medication is safely managed with effective auditing procedures to check that this situation doesn’t change. EVIDENCE: The staff show a detailed understanding of individual residents e.g. a care assistant described the importance for one lady of having paper tissues and a bottle of water readily accessible. The care assistant also knew what time the Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 11 resident liked to get up in the mornings but how she was happy to ‘go with the flow’ in respect of her bedtime. Another resident described how she felt able to spend her days as she wished. She did, however, appreciate that staff were managing her medication for her as her eyesight was not too good now. A personal profile is completed as part of pre-admission assessment work. The information helps staff work in a way that respects the individuality of each resident. For instance, one resident spoke about her pleasure at going out into the local community. Another resident had a dementia that meant she couldn’t manage some activities safely. The staff had written a care plan based on what she could do rather than what she couldn’t do. Safety was being addressed by defining the type of possible activity, when and where in the home it could safely take place. Sometimes residents don’t want to share certain personal information and this is respected. An entry seen on one brief profile confirmed this. People who use the service are very happy with the attention given to physical care needs- ‘care manager, nurse in charge, senior team always act in best interests and source G.P’s when needed-also chiropodist, hospital visits’, ‘I was very pleased (with medical support)’. Only one resident had developed a pressure sore after admission to the Garth during the past year. This is commendable because people who are admitted to the service are often extremely frail. The home’s training co-ordinator was due to undertake a training course on palliative care that would equip her to cascade knowledge to the rest of the staff team. It would also lead to the home’s accreditation for providing this type of care although ‘end of life’ care programmes are already being used. The husband of a resident who was cared for at the home until her recent death made the following comment in a thankyou card to the staff -‘I would like to thank the staff for their caring and selfless attitude, with some of them extraordinarily caring. You did your best. Thanks again’. The records of care showed how the staff at the home had worked closely with local G.P’s to manage pain relief. A hospice nurse had also been asked to advise towards the end of the resident’s life. The home manages medication well. The Commission pharmacy inspector has been consulted twice since the last inspection for specific advice and there has been one incidence when a medication error had been identified by the staff and action taken to keep residents safe. These examples suggest that the home keeps a close eye on the way medication is being handled. Medication records at the home were being fully completed. Staff were recording the information they needed to account for all movements of medication. A controlled drugs register was also properly used and this, together with other records, showed that the staff had a robust method for using, and evaluating the effectiveness of pain relief drugs prescribed by the doctor for use ‘as required’. This involved close communication with local G.P’s. Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 12 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 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home understands the importance of recognising the things that are important in the life of each resident. The staff take note of this in the way they work with each resident, and activities are arranged to suit each resident’s interests and abilities. People who use the service enjoy their meals and they feel they are good quality and varied. The staff clearly understand the importance of good nutrition and they take appropriate action to help residents eat a well balanced diet. EVIDENCE: Comments from people who use the service suggest that there are good social and leisure opportunities at the home- ‘enjoyed the seed planting’, ‘she enjoys the activities even if she can’t take part (due to disability)’, ‘I really enjoy the freedom of The Garth. There are no restrictions and I appreciate that.’ There was one comment that evenings are ‘rather quiet’ but the majority of feedback was complimentary about ‘the structured programme of activities for a variety of interests’. Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 13 Mrs. Prior recognises the importance of residents being able to contribute as well as receive support, and they had been given the opportunity to put together ‘shoe boxes’ for disadvantaged children. There are also plans to improve the activity options for residents who have to spend their days in bed. Care staff were able to describe the small, but important things they need to know to help residents live the way they prefer e.g. things like a particular resident’s preferred bath routine, favourite television programmes, food likes and dislikes, type of activities enjoyed e.g. craft, trips out, opportunity to attend Holy Communion. Senior staff hold informal ‘let’s talk’ groups so that residents can make suggestions about the everyday running of the home. All the survey responses from people who use the service confirmed that meals were always or usually enjoyed. There was reference to the use of freshly prepared dishes prepared from wholesome ingredients. Many of the residents are very frail and their diet has to be carefully monitored to avoid any risk of malnutrition. Staff deal with this through the use of a special assessment tool as part of the care planning. Their careful attention to this aspect of care was demonstrated when a guidance book was seen out on a table in the training room during the inspection visit. It was explained that staff had been checking the guidance because the condition of a resident admitted the previous day meant they couldn’t use the usual assessment tool. The staff were looking for alternative ways to make sure they could monitor the resident’s nutritional condition. Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 14 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 and their relatives know how to raise any concerns and they are confident they will be listened to. The residents are protected through the open management approach and staff who are informed about protection issues. EVIDENCE: Mr. and Mrs. Prior have an open approach and welcome comments to help them get good outcomes for the people who use the service. This was illustrated in a file of information displayed in the hallway at the home for anyone to read. The file contained guidance to help people identify good and bad practice e.g. rights, expected staff attitudes, the various staff roles. There has been one complaint referred to the Commission during the past year. This was still under investigation at the time of the inspection visit. The home has recorded 4 complaints-two received the day prior to the inspection and being investigated. There are detailed records of action taken by the home to investigate complaints e.g. interviews with staff. The home investigates and records all concerns raised, however small. All residents receive written guidance about the home’s complaints procedure Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 15 and this is also advertised in the home. All survey forms returned by residents confirmed that they knew who to talk to if they had a complaint or a concern. Staff receive training in abuse awareness and adult protection as part of their induction programme. The subject is also covered in National Vocational Qualifications. Separate training in protection has been included in general training programmes at the home. Garth Care Home The DS0000027690.V362767.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): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a comfortable, clean environment and they are included in decisions about future improvement work and refurbishments. Residents are encouraged to personalise their bedrooms and to maintain their privacy through the use of fitted safety locks on bedroom doors and bathrooms and toilets. EVIDENCE: The annual quality assurance report submitted by Mrs. Prior listed various examples of refurbishment and decoration undertaken in the past year. A care assistant described how residents are consulted when their bedrooms are being refurbished. She gave an example when a resident was able to select Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 17 her curtain material from some swatches take into her by Mrs. Prior. A sunroom is currently being built following consultation with residents, relatives and staff. This work has been made possible through a Dignity of Care grant. People who use the service are happy with their accommodation and consider that it is always kept clean and fresh-‘it is beautifully presented yet retains a homely atmosphere’. Hygiene arrangements are well addressed at the home e.g. staff have a file of information to tell them how to handle potentially hazardous cleaning materials etc. The file also contained information to help domestic staff carry out their tasks in a safe way. Soaps/disinfectors and paper towels are provided around the home so that staff and visitors can wash their hands, and the minutes of a staff meeting referred to the need to make sure stocks do not run out. Garth Care Home The DS0000027690.V362767.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): 27,28,29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staff work schedules are regularly monitored and reviewed so they respond to the changing needs of the people who use the service. New staff are carefully selected to be sure they will be suitable to work with vulnerable adults, and Mrs. Prior recognises the importance of the views of the residents as part of this process. The home has a particularly well-developed training resource and it is able to demonstrate the quality of this through approval and involvement from various external bodies. There is good attention to the diverse needs of the staff group. Staff are very satisfied with the way they are introduced into the work and the future training opportunities they receive. They are well supported by the senior personnel. EVIDENCE: People who use the service are very happy with the staff-‘all staff make a conscious effort to listen to what is expressed to them and do their best to act upon this in a positive manner’, ‘the staff nurse (J) is very quick to respond to my mother’s needs’, ‘all the staff-carers, nurses, administration are all very caring’. Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 19 Mrs. Prior uses a recognised tool for assessing if there are enough staff to deal with nursing tasks. There are examples of her response to indications of shortages at certain times of day e.g. managers’ tasks were re-organised so that they could work out in the home and help other staff at mealtimes. Additional kitchen staff had been brought in following feedback from care staff that evening periods were very busy. New staff are carefully selected, with all necessary checks of their suitability to work with vulnerable adults. A sample of recruitment records and interviews with staff confirmed that this practice is reliable. Mrs. Prior has future plans to involve residents in selecting new staff. Once recruited, staff benefit from a particularly well-developed training resource at the home. A training co-ordinator is employed and she has a designated area at the home to undertake training sessions and keep records and professional guidance literature. There are links with external training bodies e.g. it is a recognised Btec Awards Assessment Centre. A European University in Poland also uses it for social work placements. The training coordinator was due to complete a training course on palliative care. She would then be able to teach junior staff at the home as part of the home’s accreditation with a Gold Standard Framework. Some staff come from abroad and they are offered support in attending local evening classes to develop their English language skills. There has been work to increase the number of younger staff during the past year and any staff who have difficulty coping with the training e.g. with literacy difficulties, receive help from the training co-ordinator so they can evidence their competence in alternative ways e.g. oral presentations. More than half the care staff have a national vocational qualification (NVQ) at level 2 or above. Training plans for 2007/08 reflected a broad range of subject areas. Teamwork and customer services were included in the programme as well as the standard health and safety instruction. A staff member had just completed a course to equip her to instruct other staff on manual handling techniques. This would allow the home to make sure staff received guidance quickly without having to wait for an external trainer to be arranged. Interviewed care staff described good support systems –‘they have staff meetings and I can talk to management at any time’, ‘they’re very understanding’. There is a staff appraisal system in place. Garth Care Home The DS0000027690.V362767.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): 31,33,35 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is an open management approach and everyone who has involvement with the service is encouraged to participate in decisions and improve the residents’ quality of life. The way that the business is run inspires the confidence of people who use the service and the staff who work in it. There is a history of consistently high performance at the home and this continues to be demonstrated within a service that is always working towards even better outcomes for the residents. Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 21 EVIDENCE: Mr. and Mrs. Prior established The Garth home in 1988 and both have considerable experience and relevant qualifications in the caring profession. They have developed a strong management team so that all aspects of the service receive thorough attention. There is now a training officer, a personal care manager, and a catering manager. Mrs. Prior is the registered manager and leads on the nursing service. Mr. Prior takes responsibility for health and safety. The Service User Guide reflects an open management approach. It contains useful information to help members of the public understand what they could expect from the service e.g. there is a section about ‘choosing the right home for you’ and a ‘frequently asked questions’ section. There are examples of thorough auditing procedures to make sure the people who use the service always receive a high standard of care and are kept safeMrs. Prior identified discrepancies in paperwork presented by a staff member that was meant to confirm suitability for a post at the home. The success of this auditing work meant that residents were not exposed to someone who would potentially be unsuitable to have access to vulnerable adults. There are random night spot checks of the home by managers, and a member of staff has been dismissed for sleeping while on night duty. Staff express confidence in Mrs. Prior, -‘it’s a lovely run home. Problems sorted straight away. She listens to us’. ‘She’s always about’. A relative commented that the ‘care manager, nurse in charge, and senior team always act in the best interests (of residents)’. There is reference in this report to the use of internal feedback questionnaires to inform quality assurance exercises. The annual quality assurance assessment report was completed well. This contained a lot of relevant information together with examples of the way the service demonstrates its high level of performance. The report also showed that the management are not complacent and are constantly looking for new ways to further develop the experience of the residents. Mrs. Prior prefers that relatives and other representatives offer any support needed with personal financial management e.g. many residents have Power of Attorney arrangements. When small amounts of cash are held in safekeeping, records are kept of all transactions. Mr. Prior regularly audits the state of the premises so he can identify any shortfalls. There are computerised records of this work and these show a comprehensive, reliable approach. Garth Care Home The DS0000027690.V362767.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 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 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 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 3 x x 4 Garth Care Home The DS0000027690.V362767.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 Garth Care Home The DS0000027690.V362767.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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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