Care Home: Victoria

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What the care home does well There is a relaxed and homely atmosphere. The people who use the Service say that members of staff are kind and attentive. They say that they receive the support and assistance they need and that this is in line with their expectations. People are served with good quality meals. Sensible arrangements are in place to promote the health and safety both of the people who use the Service and the members of staff. What has improved since the last inspection? Various ongoing repairs to the premises have been completed. A number of training courses have been provided for nurses and care workers. CARE HOMES FOR OLDER PEOPLE Victoria 81 Dyke Road Avenue Hove East Sussex BN3 6DA Lead Inspector Mark Hemmings Unannounced Inspection 28th March 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Victoria DS0000014074.V359524.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. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Victoria Address 81 Dyke Road Avenue Hove East Sussex BN3 6DA 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) 01273-551355 01273 881627 Victoria Nursing Homes Limited Mrs Pauline Winbow Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24), Physical disability (24), Terminally ill (24) of places Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is twenty-four (24) Service users must be older people aged sixty-five (65) years or over on admission Service users may have a physical disability Date of last inspection 6 February 2007. Brief Description of the Service: Victoria 81 Dyke Road Avenue (the Service) is registered to provide nursing care and personal care for 24 older people. The premises are a detached threestorey property. The ground floor and the first floor are used to provide the accommodation. When full, two of the bedrooms are shared by two people each. The remainder of the people have their own bedroom. All of the bedrooms have a private wash hand basin, toilet and bath. There is a passenger lift that gives step-free access around the accommodation. There is a call bell system. This enables people to contact a member of staff if they need assistance. There are various items of equipment such as hoists to help people who experience reduced mobility. The property stands in its own gardens. It is set back from the main road. There are no shops within easy walking distance. Hove town centre is about one mile away. There is a bus stop just outside the Service and there is some off-street parking. The Registered Provider is a private limited company. It operates four other similar services in the area. People who might want to move in can get information from several sources. There is a Service Users’ Guide. This is a brochure that outlines the principal features of the facilities and services available in the Service. There is also a document called a Statement of Purpose. This gives a more detailed account of the provision in place than does the Guide. The Registered Provider ensures that a copy of the most recent Inspection Report from us (the Commission), is available for reference. The range of fees charged currently for each person’s residence in Victoria 81 Dyke Road Avenue runs from £512.00 to £750.00 per week. Daily rates are available for shorter stays. The actual fee charged depends upon the source of funding and the bedroom occupied. The fee includes the provision of accommodation, nursing care, personal care, catering and laundry. It does not Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 5 include items such as the purchase of toiletries and other services such as consultations with the hairstylist. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this Service is Two (2) Star. This means that the people who use this Service experience good quality outcomes. The commission since 1 April 2006, has developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 09.00 and was in the Service for about six hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Registered Provider. Further, it considered any information that the commission has received about the Service since the last inspection. What the service does well: What has improved since the last inspection? Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 7 Various ongoing repairs to the premises have been completed. A number of training courses have been provided for nurses and care workers. 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. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People who might want to move in have their needs and preferences identified so that they can be met. EVIDENCE: The Director of Nursing and the Registered Manager complete an assessment of each prospective person’s needs for assistance. This is done before a Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 10 decision is made about whether or not the Service is a suitable place for the person’s residence. The assessment is completed in consultation with the person concerned. As appropriate, members of their family are involved. When applicable, care managers (social workers) are also asked to make a contribution. One set of records relating to this matter was reviewed. They showed that suitable consideration had been given to important subjects such as the person’s mobility, health care needs, continence promotion needs, medication and preferred lifestyle. The Service offers residence to people who do not plan to make it their longerterm home. This might be because they have been in hospital and are not quite ready to go back to their own home. Or, it might be because they live at home and they want to give their carers some time to themselves. These people are assisted to recover their strength and they receive help with their rehabilitation before going home. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People are provided with the personal and health care they need. Medicines are dispensed in the correct manner. EVIDENCE: The people in residence say that the nurses and the care workers offer them all the assistance they need. There is a written individual plan of care for each person. These are important documents. This is because they form one of the means by which people can be informed about and can agree to the assistance they will receive. Also, the plans are a source of information for staff. This then helps them to provide nursing care and personal care in a consistent manner. We examined four of these plans. They were clear and suitably detailed. For Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 12 example, they contained relevant information about the assistance the people need in relation to personal hygiene, health care, medication, using the bathroom and getting about. There was evidence that plans are kept under active review so that they remain up to date. We spoke with two care workers. They have a good knowledge of the assistance to be provided. As part of this they are aware that people’s needs and wishes change from day to day and so their response needs to be flexible. Sensible steps are taken to ensure that people do not have any avoidable accidents. For example, someone can choose to have bed rails fitted if they are worried about rolling out of bed. People are assisted to maintain their health. Nurses and care workers are alert to the need to identify occasions when someone is becoming unwell. This is so that medical assistance can be sought promptly. There was evidence to show that family practitioners and other medical services have been contacted as and when necessary since the last Key Inspection. None of the people in residence manage their own medication. The Registered Manager said that this option is actively considered and that people will be assisted to do this if this is their wish. There is a system to check that the correct medicines are received from the pharmacist. Once in the Service, they are stored securely. There is a procedure for administering medicines that is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is dispensed. We examined three sets of these records. They were correctly completed and they corresponded with the medicines remaining in storage. The people in residence unreservedly praise the members of staff. They say that they are courteous and attentive. Two people summed up the general mood in their comments. One said, “I have no concerns about coming here because I know that I will be well treated. The staff here are really kind and attentive. They give me all the care that I need and they do so with good cheer. This is not a sad place at all, it’s cheerful and that makes a big difference when you are away from home”. The other said, “in the short time I have been here I’ve got to know the staff as individuals and they are sort of friends. Nothing is too much trouble for them and I mean nothing. They’ll always have a chat and I’ve only got to ring if I need help”. We noted how nurses and care workers chatted with the people in residence and how they were respectful in their manner. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There is only a limited calendar of social activities. People are free to spend the day as they wish. Good quality meals are served. EVIDENCE: There is a calendar of social events held in the Service. This involves an activities coordinator who calls one day a week to do small group and one to one activities. As and when the weather permits, some of the people are accompanied for short walks outside to get some fresh air. In the summer, there are events such as a garden party and at Christmas there are the normal festivities. About once every three months, there is an entertainer who calls to the Service to play music. Apart from this there are no other organised activities. The people in residence have not been actively consulted in detail about the adequacy of the social calendar. The Registered Manager is now Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 14 going to address this oversight by asking each person if they would like to see any additional social opportunities provided. This exercise is going to be completed by 1 June 2008. The people in residence say that the pace of daily life in the Service is relaxed and unhurried. They say that they are free to decide what to do each day. One person said, “it’s not regimented at all, the matron always says ‘this is your home’ and you can do what you like as you would before you came”. People are assisted to keep in touch with members of their families, if this is necessary and if it is their wish. Family members and friends are welcome to call to the Service at any reasonable time. The Registered Manager keeps in touch with family members so that they know how things are going. We saw the Registered Manager speaking with three visiting relatives. She knew the people concerned and plainly the conversations were part of an ongoing dialogue with the people concerned. People say that they receive good quality meals and that they have enough to eat. They consider meal times to be a relaxed and pleasant experience. There was written evidence to show that there is a choice dish at each meal time. The menu provides people with a normal healthy diet. One person has a particular preference. This has been accommodated by the chef specially liaising with her about the dishes she would like to receive. This is an example of good practice. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There is a complaints procedure. The wellbeing of the people in residence is safeguarded. EVIDENCE: There is a written complaints procedure. This explains how the people in residence and other interested parties can go about raising a concern. Neither the Registered Provider nor ourselves, have received a complaint about the Service since the last Key Inspection. The people who use the Service say that they feel quite free to raise a matter with the Registered Manager if there is something on their mind. There is a written statement of the Registered Provider’s commitment to promote the wellbeing of the people in residence. The nurses and care workers are aware of how to go about safeguarding in practice the interests of the people who live in the Service. This includes being alert to things that are not obvious, such as someone becoming anxious or withdrawn. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 16 All of the people with whom we spoke say that they feel safe living in Victoria 81 Dyke Road Avenue. They are confident that staff will look after their best interests. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 22, 25 and 26. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The people in residence live in a comfortable setting that promotes their independence. EVIDENCE: The accommodation is presented to a good domestic standard. The communal rooms and the bedrooms are decorated and furnished in a homely and comfortable way. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 18 The premises are fitted with an automated fire detection system. This provides a high level of fire safety protection. The Registered Provider has prepared a fire risk assessment. This has been done to ensure that there are no particular hazards that might undermine the level of protection in place. Most of the food preparation for all of the Registered Provider’s services is done in the central kitchen at another of the Registered Provider’s local service. Prepared food is then taken around to the other services. The kitchen in Victoria 81 Dyke Road Avenue is used to keep food hot and for the preparation of light snacks. The local Department of Environmental Health has accepted the suitability of this arrangement. The main kitchen and the smaller kitchen are clean and well organised. The staff who are directly involved in food preparation and handling follow the principles of good food management. For example, they are aware of the importance of maintaining hygiene and they know how both cooked and uncooked foods should be stored. Suitable provision has been made to support those people who experience difficulties with getting about. There is a bathroom that is equipped with a special rise and fall bath. There is also a walk-in shower located in a wet room. There are mobile hoists that can be used in people’s bedrooms. There are banister rails and at key places there are assistance poles. These are fitted to the wall and they are there for people to hold onto for extra support. People say that they receive the assistance they need. Nurses and care workers consider that enough equipment has been provided to support them when helping people to get about. The people who use the Service say that they receive the help they need to use the bathrooms and generally to get about. The people in residence say that the accommodation is comfortably warm. The accommodation was warm on the day we called. There is a reliable supply of hot water. Sensible steps have been taken to help reduce the chance of someone being burnt or scalded accidentally. The radiators are fitted with guards and hot water taps are temperature controlled. The people in residence say that their clothes are well laundered in that they are returned to them promptly and they are in a clean and presentable condition. The laundry is equipped with a commercial grade washing machine that has an extra cycle for items that need an especially hot wash. There is also a large dryer. The Registered Provider is going to check with the local water supply company to make sure that it complies with new regulations about preventing used water from leaking back into the main pipe-work. This will be done by 1 July 2008. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The Service is adequately staffed by trustworthy people who know what they are doing. EVIDENCE: In the morning and until the early afternoon, there are four care workers and one nurse on duty. This number reduces to two care workers and one nurse until the night staff begin. At night, there is one care worker and one nurse on waking duty. As noted earlier, most of the catering is completed by the chef in the main kitchen. The care workers based in the Service do straightforward things such preparing porridge and toast for the breakfast. There is a server who serves the lunchtime meal and then washes up. There are housekeepers who do most of the cleaning. There are 12 care workers employed in the Service. Five of them have acquired a National Vocational Qualification (NVQ) in health and social care. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 20 This Award is useful because it provides care workers with a range of opportunities to confirm elements of good care practice and to extend their range of skills. The Registered Provider says that it is hoped that another care worker will begin studying for the Award this year. The Registered Provider completes a number of security checks in relation to new nurses and care workers. This is done to ensure that they are trustworthy people who are suitable to have unsupervised access to the people in residence. Two sets of the records relating to this matter were reviewed. They showed that the necessary checks had been completed. New nurses and care workers receive introductory training before they work without direct supervision. This is done to make sure that they have the skills and knowledge they will need in order to support effectively the people in residence. After that, the nurses and care workers are provided with ongoing training. This is designed to develop further their ability to provide a high quality nursing and residential care experience. Some aspects of the way in which this training is planned, delivered and recorded are not as clear as they might be. The Registered Provider is recommended to address this by introducing a competency assessment model that we think is very helpful. We spoke with two of the care workers to assess their understanding of the personal care needs of the people using the Service. For example, they were familiar with their roles in relation to the promotion of continence, to helping people get about and to enabling people to avoid conditions such as pressure sores. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The Service is well managed. There is a quality assurance system. Sensible provision has been made to promote the health and safety of the people in residence. EVIDENCE: Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 22 The Registered Manager is a Registered General Nurse. She has a good understanding of how the Service runs in practice. Various things are done to promote good team-work. There are staff meetings. Also, there are handover meetings at the beginning and end of each shift. These are important because they help individual nurses and care workers to keep up to date with how things are going for each of the people who use the Service. Several things are done to consult with the people in residence about how well the Service is running. These include informal discussions with each person. All of the people with whom we spoke, emphasised how much they feel themselves to be involved in things. One person summarised the mood when he observed, “there is a real family atmosphere here. You talk to people about how things are going without knowing it really. Just like you would at home. There’s no them and us with staff, quite to the contrary it’s everyone together”. There is also a more organised system that involves people being invited to complete questionnaires. We examined four completed questionnaires. They expressed a high level of satisfaction with the Service. The Registered Provider is now going to develop further the quality assurance system. This will be done by extending the process of consultation to include members of staff. Also, it will mean that the results of the consultation exercise will be summarised in an annual quality report. This report will explain what action is to be taken in relation to any suggested improvements. The Registered Provider is going to complete the first of these quality reports in time for its results to be notified to us in 2009 when it submits its next Annual Quality Assurance Assessment. The Registered Provider assists some people to manage their personal spending allowance. This is done for the convenience of the people, so that they have enough funds to hand to purchase everyday goods and services. We examined two sets of the records of the transactions involved. They showed that people’s monies are being retained and spent in a suitable manner. People say that they are satisfied with this aspect of the assistance they receive. Each of the nurses and care workers meets regularly with someone senior to review their work and to plan things such as attending training courses. Regular checks are completed to ensure that the Service’s fire safety equipment remains in good working order. The monthly visual checks of the fire extinguishers are not being recorded in the correct manner. The Registered Manager said that this oversight will be put right without delay. Members of staff know what to do if there is a fire emergency. Items of equipment such as the passenger lift, the hoists and gas appliances are being inspected and serviced in the correct manner. The Registered Provider says that the electrical wiring installation has been certified as being safe-worthy. However, the certificate to demonstrate this could not be located. The Registered Provider is going to submit to the Commission a new certificate when the installation is reinspected later in the year. Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 23 There have not been any significant accidents or other unwelcome events in the Service since the last Key Inspection that are a cause for concern. The Registered Manager examines the circumstances surrounding anyone having an accident such as a fall. This is done so any steps necessary can be taken to help prevent it happening again. The Registered Provider checks the premises and the accommodation to ensure that there are no hazards that might cause someone to have an accident. Victoria DS0000014074.V359524.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Victoria DS0000014074.V359524.R01.S.doc Version 5.2 Page 25 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 Victoria DS0000014074.V359524.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. 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