Care Home: Timber Grove

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What the care home does well Residents living at this home had a wide range of complex social care and health care needs. All residents had limited or non-verbal communication care needs. Many also had physical care needs. The manager and the team of staff had worked hard to ensure that as far as practicable and possible, all care needs were being met. This had not been easy because of the noncompatibility issues amongst some residents. Staff worked well as a team. The recording and administration systems within the home were good. Records were readily available and the information was current. Management in the home was positive and visionary. Residents were supported and enabled toexperience a wide variety of social, occupational and community activities and events. What has improved since the last inspection? Since the last inspection, residents` personal risk assessments had been updated and now include an assessment around the use of lap straps when they are in their wheelchairs. Medication administration and recording practices had improved and further work is current. A review had taken place concerning staff recruitment practices. CARE HOME ADULTS 18-65 Timber Grove Whitepost Farm London Road Rayleigh Essex SS6 9DT Lead Inspector Ann Davey Unannounced key Inspection 1st October 2008 09:00 Timber Grove DS0000018036.V372296.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 Timber Grove DS0000018036.V372296.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. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Timber Grove Address Whitepost Farm London Road Rayleigh Essex SS6 9DT 01268 780233 01268 784385 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.efitzroy.org.uk Elizabeth Fitzroy Support Ms Deborah Housman Care Home 15 Category(ies) of Learning disability (8), Physical disability (7) registration, with number of places Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2007 Brief Description of the Service: Timber Grove provides care for up to fifteen younger adults that have a learning and physical disability. Timber Grove is situated 3/4 of a mile from Rayleigh train station and buses stop outside the home. The home is approximately 1.5 miles to Rayleigh town centre and there are some local shops nearby. Timber Grove also has its own vehicles for transporting residents. The home is set in large grounds and car parking is available. It is understood by the CSCI that the registered provider is considering plans for rebuilding the home. This will improve services and facilities. The new build will be on the same site and be more appropriate and conducive in meeting residents’ needs. Plans were submitted in April 2007 and it is understood that planning permission has now been agreed. The proprietor is advised to contact the registration team to ensure compliance at all stages with registration issues. The main area provides accommodation for twelve service users in single bedrooms on two corridors. There is also a self contained flat that accommodates three residents. All areas used by the residents are on the ground floor. There is a Statement of Purpose and Service User’s Guide available. A copy of the last inspection report was displayed. The weekly charges range from £895.22 - £ 1222.75. The exact fee depends on assessed care needs criteria and individual arrangements with the appropriate funding authority. There are additional charges for day care facilities and items of a personal nature. Funding arrangements and charges should be discussed directly with the manager. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key unannounced site visit that took place over one day. The visit started at 9am and finished at 3pm. The manager assisted us throughout the inspection. The last key inspection took place on 26th October 2007. The home had completed and returned their Annual Quality Assurance Assessment (AQAA) to us prior to this inspection. This document gives the home the opportunity of recording what they do well, what they could do better, what has improved in the previous twelve months and their future plans for improving the service. We have sent surveys to the manager asking that they be distributed and returned to us so that we can have an understanding of how residents, staff, relatives and health care professionals feel about the care provision within the home. Comments from these surveys will be included within the next report. The day in the home was very pleasant and all staff were co-operative and helpful. A tour of some areas of the home took place. Throughout the inspection, care practices were observed and a random selection of records viewed. We spoke and spent time with residents and staff. A notice is normally displayed advising any visitors to the home that an inspection was taking place. On this occasion following discussion with the manager, the notice was not displayed as no visitors were expected. All matters relating to the outcome of the inspection were discussed with the manager who took notes so that development work could be started immediately where necessary. What the service does well: Residents living at this home had a wide range of complex social care and health care needs. All residents had limited or non-verbal communication care needs. Many also had physical care needs. The manager and the team of staff had worked hard to ensure that as far as practicable and possible, all care needs were being met. This had not been easy because of the noncompatibility issues amongst some residents. Staff worked well as a team. The recording and administration systems within the home were good. Records were readily available and the information was current. Management in the home was positive and visionary. Residents were supported and enabled to Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 6 experience a wide variety of social, occupational and community activities and events. 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. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 7 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 Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 8 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ care needs are fully assessed before admission to make sure they can be met by the home. EVIDENCE: There was a current ‘user friendly’ style Statement of Purpose and Service User’s Guide available. This means that prospective residents, relatives and interested parties and can read and understand what the home can offer. No residents have been admitted to the home since the last inspection. There were robust admission policies and procedures in place which would be used should any new residents be admitted. Systems were in place to ensure that no resident would be admitted unless the manager was sure that the assessed care needs could be met. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 9 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents care needs and choices are met by the home. EVIDENCE: Three care plans and associated documentation such as risk assessments and accident records were looked at. Each resident had a person centred plan in place. These plans had been developed with the respective resident, key worker and other professionals. Documentation was in a ‘user friendly’ style that means that where possible and according to personal limitations and ability, individual residents were able to understand what had been written about them. We could see that residents had been consulted about their personal wishes and preferences according to their individual ability. Care plan reviews had taken place, which means that the information held on each care plan was current and relative. Each resident had a named key worker. Records confirmed that suitable risk assessments were in place. This means that residents can experience a wide variety of day-to-day activity Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 10 within a safe framework of an assessed risk. There is a staff communication diary/book. We noted that staff had made personal social care and health care entries about named residents. Such information and detail is not acceptable in a communal book. Each resident had a record of their daily activity. We noted that the recording is not consistent i.e. there were gaps where no entry had been made. Some terminology used by staff within these records to describe residents’ behavioural patterns was not considered by us to be dignified. We discussed these matters with the manager. We spoke to various members of staff about care practices within the home. Those we spoke with had a good understanding of individual resident’s needs. We noted that the rapport between residents and staff was warm, natural and supportive. Residents’ had little or no verbal communication ability. We saw staff using a variety of alternative communication skills and aids. For example, sign/symbol communication, Makaton and pictorial aids. We were unable to verbally communicate with individual residents. We spent time in the company of residents in the presence of staff. From residents’ demeanour and their response to staff (and us) during those times, resident indicated that they were content and happy. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 11 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): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents experience a varied and interesting lifestyle, and enjoy a good diet. EVIDENCE: The home had a full and varied activities/occupational programme. This was supported by the three activity co-ordinators. Some activities are corporate, some undertaken in small groups whilst other are on a one to one basis. Key workers also play an integral part in the provision of activities. Residents enjoy a vast range of social, occupation and community activity depending on the assessed needs and individual requirements. Activities include horse riding, wheelchair dancing, day centres, evening social clubs, church activities and swimming. The home has two vehicles so transportation to these events is possible. The manager reported that all residents had family and/or friends that play an active part in individual residents lives to some degree. Some residents go back ‘home’ to their families for weekend breaks on a regular basis. All residents had either had a holiday this year, or one was booked. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 12 Systems were in place to promote individual residents’ rights. This continues to be a challenge to staff in the home as most residents had little/no understanding of other residents’ rights. The manager had partly addressed this by providing bolts/ locks on some bedroom doors to prevent residents going into other resident’s bedrooms. This practice although practical is not without risk as there is a danger of residents being accidentally locked in or out of a bedroom. Risk assessments were in place. Residents have access to most areas of the home. For health and safety reasons, some areas such as the laundry and kitchen were not accessible. We saw unsupervised boxes of latex gloves in at least two areas that were accessible to residents. The manager agreed that this practice presents a risk to residents. Most residents would not realise the potential danger to themselves if they used these gloves inappropriately. Meal times within the home were flexible depending on individual residents daily activity. We saw a pictorial menus system from which residents could choose what they would like to eat. We saw a small group of residents having lunch. Lunch looked very appetising. We noted that staff were sensitively assisting some residents to eat. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 13 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide good personal and healthcare support for residents. EVIDENCE: With the documentation we saw, there was evidence to support that wherever possible, residents (or their relatives) had been consulted about their personal wishes, preferences and the way they wished to be cared for. We could see that sometimes decisions had been made based on previous knowledge and history together with the current views of relatives, funding authorise and the manager. This was because some residents had not been able to formulate an opinion about such matters. We saw systems in place to demonstrate that where possible, residents had been able to choose which members staff assist them with their personal care needs. There is an established key worker system in place that helps to provide some continuity of care for residents. We could see that residents had access to all health care professionals. Medical and health care records were current and informative. The manager reported Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 14 that the home has a good professional relationship with all social care and health care professionals. We are aware that there have been some poor medication practice issues since the last inspection. We discussed this with the manager. The manager was able to demonstrate that the situation is being managed well. There is now a robust system of medication administration/recording audits in place. This quickly identifies any future poor practice. The manager explained the processes in place should further errors be made. We sampled various aspects of the current medication administration, storage and recording system. Each resident had a MAR (medication administration record) sheet in place. There were no unexplained gaps. Medication is stored in a secure area. There was no overstocking of medication. The home had a PRN (a medicine to be administered as/when necessary) procedure in place for individual residents. At present, the home does not hold any controlled medicines. The manager was advised to ensure that the current storage facility for controlled medicines is fully compliant with the new requirements. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that residents’ wellbeing is protected and to ensure their concerns would be managed appropriately. EVIDENCE: Residents had access to a pictorial complaints procedure. The procedure was also detailed in the Statement of Purpose and the Service User’s Guide. Many residents would not have the ability to formally raise any concerns. Systems were in place to address this. For example, all residents had access to family or friends, outside agencies and/or professional social and healthcare workers. Each resident had a named key worker. The manager reported that work continues in obtaining a suitable advocacy service. The manager hopes that this service will assist the home in finding out what residents think about their care (according to ability) in an independent manner. The home had an established complaint recording system in place. Staff we spoke with had a good understanding of safeguarding adults from harm reporting procedures. Training had been provided. Two referrals to the local authority’s safeguarding unit had been made by the home since the last inspection. One was in connection with a poor care practice and the other was in connection with poor medication administration practices. The manager reported that both matters had been resolved, but Essex County Council has not informed the Commission of that decision. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 16 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): 24,25,28 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and functional environment that is in need of an upgrade to ensure that all care needs can be fully met and the environment is comfortable and homely. EVIDENCE: The report on the outcome of above group of standards remains relatively unchanged since the last inspection. The manager reported that plans remain in place to build a new home on the same site possibly in the next 12 months. Within the last inspection report, the registered provider was advised to consult with our registration team before any decisions are made about the new build. This advice remains to ensure that any proposed building is in line with current registration requirements. The manager agreed that the current premises are not suitable to meet the needs of all the residents. Bedrooms although very personalised were in need of refurbishment and redecoration. The communal areas such as the main lounge and dining area remain bare and uninviting. These areas serve a functional and practical use only. As reported Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 17 in the last inspection report, ‘for vulnerable and immobile residents these open areas of the home can be unsafe. This is due to other residents that are mobile displaying challenging behaviour in these areas, which can cause damage to the furniture or anyone unable to move themselves out of the way’. Interim measures are currently being put in place to create some smaller communal areas for residents to use. For example, the office has been moved to the site in the grounds previously used by the day centre and another room is being cleared. This will provide residents with an extra two smaller communal rooms that can be used by residents who prefer to sit in a quieter area. The registered provider should provide us with a document showing the new layout as significant changes are being made. It is also important that Fire and Rescue are aware of the new layout should their services be needed in an emergency. The home was clean and free from any offensive odours. We saw various pieces of equipment that were used to move and support residents. There were records in place to demonstrate that staff are trained in the use of moving and handling equipment and risk assessments were in place. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 18 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): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A team of well recruited and trained staff look after residents. EVIDENCE: A current staff rota was available. The manager reported that there was a minimum of five support workers (inc deputy management staff) between 7am – 10pm and two awake/one asleep members of staff at night. The manager is supernumery to these levels. In addition, the home employs a handyman, cleaning/domestic staff and three activity co-ordinators. The manager reported that staffing levels vary during the day depending on routines or activities planned, but do not go below these minimum levels. The manager reported that agency staff are used for periods of staff absence such as holidays and sickness. The manager reported that currently there is a regular staff sickness issue particularly at weekends, but this is being addressed. There are no staff vacancies. This means that in the main, a team of regular committed staff provide care and support for residents. We looked at the recruitment records for two members of staff who had recently been recruited. These were in good order. We saw records to Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 19 demonstrate that staff had been provided with good training opportunities and had received supervision. The manager reported that 55 of the current staffing establishment have obtained NVQ level 2 or above. There were records to demonstrate that staff have regular team meetings. We spoke to staff about current practices. All those spoken with reported that they felt well supported and trained to do their job. All intimated that they enjoyed their work and worked well together as a team. Staff did however express their frustration about the staff sickness issue at weekends. We were unable to talk to residents about staffing. However, from observation, we saw a natural rapport between all residents and staff. During the early afternoon, the lounge area became very noisy as several residents were presenting some very challenging behaviour patterns that were distressing other residents. We saw two members of staff sensitively direct two vulnerable residents away from the immediate area and sit quietly with them until the situation was under control. One of these members of staff was from an agency. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 20 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): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home where administration is good and their care needs are managed well. EVIDENCE: The manager had suitable qualifications and experience to manage the home. The manager demonstrated a positive and visionary style of management. Staff members spoke well of the manager. We experienced no difficulty in locating the documentation and reports requested as part of the visit. This was particularly commendable as the office was in the process of being relocated to another part of the home. The manager’s office that accommodated the majority of the records was orderly and demonstrated good management skills. Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 21 The manager reported that there was environmental and safe working practice documentation in place. We did not ask to see them on this occasion. There were safety notices displayed around the home. There was a current fire risk assessment in place. Fire and Rescue Service have recently carried out a satisfactory visit to the home. There were records in place to demonstrate that fire drills and checks on fire fighting/emergency lighting systems had been made. There was a maintenance diary that demonstrated that maintenance issues had been identified and addressed. We have been kept informed about notifiable incidents (for example, errors in medication administration) that are required through Regulation 37 reports. We also saw the records of the Regulation 26 reports that require the owner (or representative) to complete monthly. This record demonstrates that the owner knows about the day-to-day management of the home and is satisfied that compliance with the Care Homes Regulations is being achieved. If shortfalls have been identified, the report gives the owner the opportunity to address them. The home was looking after residents’ personal monies. The system for these financial transactions had a good audit trail. We sampled a couple of service/maintenance documents and found them to be current. There was a current quality assurance process and a business plan in place. Timber Grove DS0000018036.V372296.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 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 X 2 3 3 X 4 X 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 2 25 2 26 X 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Timber Grove DS0000018036.V372296.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. 1 Standard YA24 YA25 Regulation 23 Requirement Residents must be able to live in an environment that is safe, suitable, decorated and furnished to suitable standard and which meets individual assessed needs. The timescale reflects the period of time by which proposed plans to meet the requirement should be submitted to us. In the meantime, it is the provider’s legal responsibility to ensure that the home is maintained to registration standard and is suitable and safe to meet all assessed needs. Timescale for action 31/03/09 Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 24 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 Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Timber Grove DS0000018036.V372296.R01.S.doc Version 5.2 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!