Care Home: The Rivers

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What the care home does well The staff are good at assessing the needs of prospective service users and whether they could have all of their needs met at this home. The manager ensures they get the views of the service users, their families and any health professionals or social workers. The home has a range of materials such as the statement of purpose that would help prospective service users know what the home could offer. These are written in simple text and they have picture symbols. The staff are good at getting the service users involved in developing their care plan/support plan. This plan covers all aspects of a persons care and how the staff can support an individual to achieve their goals and develop their skills. The staff are trained to support people to maintain their health and to access appropriate health services. The staff have supported a service user to develop their meal planning, shopping and cooking skills, so they have been able to increase their independence. This person said they always have a choice and they like making their own food. By speaking to the staff and the service user and by reviewing the support plan it is clear that the staff are offering choices about daily routine and supporting people to access education and leisure opportunities. The service user said they choose how to spend their time and they can participate in the activities they enjoy. The staff have developed files that are available to the service users, these describe in simple word and picture symbols what a person can choose from both in the home and in the community. The service user and the staff have built up positive relationships. The person living at the home said they liked all the staff they were kind, helpful and a `good laugh`. The home has been designed specially for a group of up to six younger adults with learning disabilities and the facilities are suitable and safe. The home is well furnished, decorated and equipped. There is a separate activities room where a range of electronic and games equipment is available. The person living in the home had identified on their support plan that they enjoyed a certain board game and this was seen in the activities room. The person living in the home said they liked their room and they had it just the way they wanted it. The manager and the provider have safely recruited a staff team and they all have checks such as criminal records bureau and jobs references on their files for the protection of the service users. The staff have had a wide range of training and they continue to attend courses. This means they have the skills and the knowledge to support the service users. A person living at the home has a specific health condition and the staff records showed that all the staff have attended training so that they can support the health care of that person. The manager has made sure that all of the policies and procedures are in place to enable the staff to work safely and for the benefit of the people who live in the home. What has improved since the last inspection? This is the first inspection since the service registered in October 2008. What the care home could do better: The manager needs to contact the fire service again to have the fire doors checked as it was noted that these do not fully close unless manually shut. CARE HOME ADULTS 18-65 The Rivers 88 Rectory Road Farnborough Hampshire GU14 7HT Lead Inspector Kima Sutherland-Dee Unannounced Inspection 23rd March 2009 09:50 The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Rivers Address 88 Rectory Road Farnborough Hampshire GU14 7HT 01206 224100 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.concensusupport.com Consensus Support Services Ltd Mrs Victoria Jane Bedwell Care Home 6 Category(ies) of Learning disability (0) registration, with number of places The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 6. Date of last inspection New Service. Brief Description of the Service: The Rivers is a newly refurbished building in a residential area of Farnborough. The home has been designed to suit the needs of up to six people who have learning disabilities. There are four ensuite bedrooms on the ground floor and two upstairs as well as communal areas and an enclosed garden. The home is within walking distance of local amenities and within easy reach of bus and train routes. The service aims to support people to develop their daily living and decision making skills with the intention that people will be able to move on to more independent living situations. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection is the first assessment of the service since the home registered with the commission in October 2008. In preparation for the visit to the home we reviewed any information that we had about this service including the AQAA ,the homes own assessment of how they are meeting outcomes for the people who use the service and four completed staff surveys. The visit to the home took place on the 23rd March 2009 and lasted for 2hours and thirty minutes. During the inspection we spoke with the manager, a member of staff and the only person living at the home at the moment. We also reviewed a sample of the documents and records and saw around the home and garden. The current fees for this service start at £1900.00 per week and additional costs are based on individual needs. What the service does well: The staff are good at assessing the needs of prospective service users and whether they could have all of their needs met at this home. The manager ensures they get the views of the service users, their families and any health professionals or social workers. The home has a range of materials such as the statement of purpose that would help prospective service users know what the home could offer. These are written in simple text and they have picture symbols. The staff are good at getting the service users involved in developing their care plan/support plan. This plan covers all aspects of a persons care and how the staff can support an individual to achieve their goals and develop their skills. The staff are trained to support people to maintain their health and to access appropriate health services. The staff have supported a service user to develop their meal planning, shopping and cooking skills, so they have been able to increase their independence. This person said they always have a choice and they like making their own food. By speaking to the staff and the service user and by reviewing the support plan it is clear that the staff are offering choices about daily routine and supporting people to access education and leisure opportunities. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 6 The service user said they choose how to spend their time and they can participate in the activities they enjoy. The staff have developed files that are available to the service users, these describe in simple word and picture symbols what a person can choose from both in the home and in the community. The service user and the staff have built up positive relationships. The person living at the home said they liked all the staff they were kind, helpful and a ‘good laugh’. The home has been designed specially for a group of up to six younger adults with learning disabilities and the facilities are suitable and safe. The home is well furnished, decorated and equipped. There is a separate activities room where a range of electronic and games equipment is available. The person living in the home had identified on their support plan that they enjoyed a certain board game and this was seen in the activities room. The person living in the home said they liked their room and they had it just the way they wanted it. The manager and the provider have safely recruited a staff team and they all have checks such as criminal records bureau and jobs references on their files for the protection of the service users. The staff have had a wide range of training and they continue to attend courses. This means they have the skills and the knowledge to support the service users. A person living at the home has a specific health condition and the staff records showed that all the staff have attended training so that they can support the health care of that person. The manager has made sure that all of the policies and procedures are in place to enable the staff to work safely and for the benefit of the people who live in the home. What has improved since the last inspection? What they could do better: The manager needs to contact the fire service again to have the fire doors checked as it was noted that these do not fully close unless manually shut. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 7 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. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users can be assured that all of their needs will be assessed to make sure the home is suitable. People will have an opportunity to spend time at the home and to get to know the staff. The home will provide all the information a prospective service users needs to make an informed decision about this home and the information will be available in a suitable format. EVIDENCE: The home has a statement of purpose and this gives information about the service in both in writing and symbols. The records show that staff spend time explaining the home to any prospective service users and they visit on a number of occasions to give a gradual introduction, this can also involve their family or carers. The manager also spends time meeting any social workers or other professionals during the assessment process to ensure that they decide to offer a home to a service user based on all of the available information. The manager explained the assessment and admissions process and this was confirmed by reviewing the records. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 10 One person who moved in recently said they had visited and that the staff had been to see them at their family home. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality in this outcome area is good. The service users can be confident that they will be supported to develop a support plan that identifies all of their needs. The staff do support the service users to make decisions and those decisions are respected. The service users are encouraged to be as involved as they choose in tall aspects of the home. The service users are supported to take assessed risks to develop their independence. The service users can be assured that their information is kept confidential and handled appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The support plan for the service user was seen and it was clear that the plan had been developed with the full involvement of the service user. The plan was The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 12 person centred and it gave the staff all of the information they needed to support the service user and for them to understand that persons needs and wishes. The plan included health information and details of any appointments. The service user was aware of the support plan and that they had access to this information. Reviews of the plan had been scheduled and changes had been made. The staff also kept records of any agreements between themselves and the service user so these could be used to support them to develop an understanding of their behaviour. The service user said the staff were helpful and kind and they choose what they wanted to do. The staff were assisting them to make appropriate decisions. The service user said they had been asked if they wanted to be involved in staff interviews for new staff and they were asked their opinion on the running of the home. The manager said that when more people move in they will have regular meetings to gain the views of the people living in the home. The support plans included risk assessments for both the environment and individual activities. The person living in the home said that they were able to do the activities they choose. The assessments aimed to support people to develop their skills without unreasonable restrictions, and the staff had consulted the persons family to get their views about a particular risk. The staff are also working with the person living in the home to develop more independence and to understand any risks and how to manage these. An example is that the person wishes to travel more independently to local shopping areas, so the staff are supporting them to gradually build up their skills. All of the records are kept confidentially and securely and the staff have been trained to maintain confidentiality. The person living in the home knows where their records are and they can access them with staff support. The manager has developed a confidentiality policy which the staff can access. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is good. The service users benefit from a staff team who are skilled at supporting them to develop their independence and to take part in appropriate community activities. The service users rights are respected and they are supported to maintain contact with their family and friends. The service users are offered choices regarding their food and they are supported to develop their independent living skills. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff have developed ways in which they can support people to express their feelings and thoughts when these may be expressed non verbally. These include symbols throughout the home and a keychain with symbols so that the service users can take these with them outside the home. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 14 The person living at the home talked about how the staff had supported them at difficult times and how they now knew staff well enough to express their thoughts and seek their help. The person living at the home spoke about what they liked to do and how they spent their time. These were also written in their support plan. The staff have supported this person to explore local opportunities for leisure and education. People who come to live at the home will be able to use the folders that are in the hallway. These contain words and symbols of activities inside and outside the home so they can indicate their choices to the staff. The person living at the home described how they have regular contact with their family and how the staff support them with these relationships. Their family visit them in the home or they go to stay at their family home regularly. The support plan includes the service user wishes and needs regarding friendships and relationships and how the staff can support this person. The person living at the home described their routine and what they liked to do each day. The staff support and guide the service user to maintain their preferred routine but also to develop new opportunities in their local community. The staff are also skilled at discussing the service users responsibilities with them and assisting them to meet those responsibilities and to understand the consequences of their own behaviour. A symbol weekly diary displayed in the hall will enable future service users to understand their routine and plan ahead. The support plan describes a service users food preferences and the person at the home confirmed that they make their own choices. A member of staff described how they have assisted this person to increase their skills and how they are working towards independent planning, shopping and cooking of meals. The dining room is well decorated and furnished and the staff eat with the service users when this is appropriate. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. The service users can be assured that they will receive support in a way that suits their preferences and that their emotional and physical needs will be met. The staff support the service users to safely store and administer their medication, and to develop their self medication skills. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The support plans describe any personal care needs and how the service user would want staff to help them. The service users views are regularly sought along with those of family members and care managers when appropriate. The staff keep a daily record of all support or changing needs and these are used to update the support plans. The plans include the service users preferred routines and how they wish to be supported as well as any restrictions that have been agreed. These may include a preferred waking time being changed so that staff can support a person to attend and agreed activity. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 16 The home has the policies that enable staff to assess when a person is able to administer their own medication so they can develop their independence. The staff have been trained to store, administer and record medication and this is being carried out safely. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. The service users can be assured that their complaints will be listened to and acted on. The staff are trained to protect the service users from abuse and they have the policies to guide them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The person living at the home said they were happy to speak to any staff and they felt the staff would help them. The home has a comprehensive complaints policy and the staff have been trained to put this into practice. There is a complaints record but none have been received since the home was registered. The AQAA states that each service user will have a ‘How to make a complaint’ section in their support plan and this will be explained to people. A member of staff could describe how they would respond to any suspicions of abuse, and all staff have attended a training course. The home has policies to guide the staff and to protect the service users. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28,30 Quality in this outcome area is good. The home is well designed, decorated and furnished and it meets the needs of the current service user. The home is clean and homely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This home has been specifically designed to meet the needs of the service users and it is fully accessible. The home has been extended and refurbished and it was well designed, decorated and furnished. The service user said they really liked their bedroom and they had their own belongings around them. All of the bedrooms are ensuite with large wet room showers and toilets. The downstairs bedrooms have patio doors which lead to the enclosed garden. Individual agreements will be made as more service users move in about the security and independent access to the garden. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 19 The communal areas were comfortable light and well furnished with appropriate equipment. The activities room had a selection of games and entertainment systems. The home was clean and the staff support the service user to take an active part in keeping their home clean and tidy. As more service users move in this responsibility will be shared. The staff have had training in infection control and substances hazardous to health and appropriate equipment is provided. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 Quality in this outcome area is good. There are enough safely recruited, effectively trained and supported staff to meet the assessed needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff are clear about their roles and responsibilities and they all have a copy of their job descriptions. The staff team have been recruited since last year and they have had time to get to know each other and to understand what they are aiming to achieve by supporting the service users. The staff team meet every month to discuss their roles and to support each other. Each member of staff has a handbook and the general social care councils code of practice and they have a comprehensive three week induction training period when they start work. The AQAA states that all staff will be encouraged to gain a National Vocational Qualification in care to at least a level 2. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 21 The staff numbers will increase to meet the assessed needs of each service user when they move in. Currently there are eight staff and there is a mix of male and female staff which enables people to choose the gender of their carer for any personal care roles or for emotional support. The staff have a range of skills and experience but they have all attended the same training courses. A sample of the staff files demonstrated that all the required information and checks were in place for the protection of the service users. The service users are offered the opportunity to be involved in staff recruitment such as interviewing staff. The provider is committed to training the staff team and a record of all courses is kept. The staff spoken with demonstrated knowledge of how they could support a service user to gradually increase their independent daily living skills. The AQAA states that staff will be supervised monthly and the records confirmed that staff had regular supervision with their manager. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is actively seeking further referrals and the home has all the systems in place to ensure that people living at the home have good outcomes. The manager is experienced and qualified to manage the home effectively. The manager is well liked by the staff and the service user and the staff said they work well as a team and support each other. The manager and the staff seek the views of the current service user through their daily contact and support. When more service users move to the home the manager states in the AQAA that a suggestion box will be set up and The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 23 meetings will take place to gain peoples views. Given the intended service user group this should meet their needs more appropriately than written questionnaires or surveys. The manager stated that the responsible individual who represents the providers was due to visit the home in the coming week to seek the views of the service user and the staff and then produce a report to be kept in the home. A visit followed by a report should then take place monthly to ensure the home is being managed effectively and in the best interests of the service users. The manager has the health and safety policies in place and the staff know how to access these. The staff have had health and safety training and the manager states in the AQAA that insurances are in place and equipment testing happens regularly. It was noted that all of the fire doors throughout the home do not shut effectively and fully on their closures and they need to be manually closed. The manager was advised to seek the advice of the fire officers and to take any actions they recommend. The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 X X 2 x The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 23 (4) Requirement The registered manager must after consultation with the fire authority, take adequate precautions against the risk of fire, including the provision of suitable equipment and make adequate arrangements for containing fires. Timescale for action 30/05/09 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 The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Rivers DS0000072457.V374511.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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