Inspection on 26/03/08 for Hobbs Field

This is the latest available inspection report for this service, carried out on 26th March 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hobbs Field 07/12/05

Hobbs Field 22/08/05

Hobbs Field 08/12/04

Hobbs Field 24/05/04

Hobbs Field 06/03/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hobbs Field Leechpool Lane Horsham West Sussex RH13 6AG Lead Inspector Nigel Thompson Key Unannounced Inspection 26th March 2008 10:30 Hobbs Field DS0000037439.V359363.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 Hobbs Field DS0000037439.V359363.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. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hobbs Field Address Leechpool Lane Horsham West Sussex RH13 6AG 01403 254114 01403 750915 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.westsussex.gov.uk West Sussex County Council Mr Paul Kelsey Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th March 2007 Brief Description of the Service: Hobbs Field is a care home for younger adults, registered to accommodate fifteen service users with a learning disability. The home consists of two houses named Longleat and Woburn, accommodation is provided in fifteen single occupancy bedrooms. The property is situated in a residential area close to Horsham town centre and has its own secluded garden. The Registered provider is West Sussex County Council, the Responsible Individual on behalf of which is Mr. John Dixon. The Registered Manager, responsible for the day-to-day running of the establishment is Mr Paul Kelsey. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection took place over four hours in March 2008. It found that the majority of key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. The focus of the inspection was very much on the quality of life for people living at Hobbs Field. The purpose was to assess compliance with requirements of the previous inspection and to generally monitor care practices within the home. On the day of the inspection there were fifteen service users (residents)living at the home. The inspection process involved a tour of the premises, observation of working practices, examination of records and documentation and discussion with four residents, two members of staff and the registered manager. Residents observed and spoken with during the inspection expressed overall satisfaction with the home, the staff and the service provided. It is noted that after almost 25 years at the home, the registered manager, Paul Kelsey, is leaving the service. He is clearly dedicated to his work, very popular and inevitably will be missed by residents, staff and everyone involved with Hobbs Field. What the service does well: Hobbs Field is an established, well-managed and generally well-maintained service that continues to provide good quality care and support for the people who live there. The comfortable, relaxed and welcoming environment has evolved over many years and reflects the stability and commitment within the staff team and the open and inclusive management style. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 6 Thorough policies and procedures are in place for the admission and ongoing care and support of residents. Effective communication and consultation systems enable residents to be directly involved in developing and reviewing their individual support plans as well as many decision making processes within the home. 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. Hobbs Field DS0000037439.V359363.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 Hobbs Field DS0000037439.V359363.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): 1, 2, 3 & 4 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The thorough admission policy and procedure ensures that residents are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents know that the home is able to meet their individual care and support needs. EVIDENCE: Comprehensive information relating to the service is made available to all prospective residents, their relatives and associated care managers. Relevant documentation including a ‘Statement of Purpose’ and ‘Service User Guide’ was examined and found to be satisfactory. Both documents, including the complaints procedure have also been produced in a ‘user friendly’ illustrated format. The manager confirmed that, prior to moving into the home, a prospective resident would be invited to visit the home to look around and get a feel for the place. During these visits the individual would also have the opportunity to meet with members of staff and existing residents. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 9 On moving in, a flexible trial period is provided to establish whether the individual’s assessed needs are able to be met and decide on their suitability for the home and their compatibility with existing residents. An admission policy made available for inspection contained details of the assessment procedure, undertaken to identify an individual’s care and support needs. Since the previous inspection there have been two residents admitted to Hobbs Field. However it was evident that, as both individuals were transferred from another local authority service and were well known to the manager and other members of staff, the formal assessment process had clearly not been as thorough as would normally have been the case. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 10 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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ care plans enable staff to meet assessed needs in a structured and consistent manner and individual plans, including risk assessments reflect changing support needs. Systems for consultation and participation remain effective and residents are treated with respect and encouraged and enabled to make decisions about their day-to-day living. EVIDENCE: ‘Person centred’ care and support plans have been developed and implemented for each resident. Individual plans that were examined contained personal risk assessments and comprehensive details of their physical, psychological and emotional support needs and were found to be accurate, up to date and well maintained. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 11 Comprehensive guidelines for staff are in place, in respect of each resident, helping to ensure consistency of approach and continuity of care. The guidance, (Assist me to…..) relates to the delivery and provision of personal care and support, in accordance with the identified wishes of the individual. In addition, an informative ‘Passport’ has been developed and implemented for each resident. The document incorporates personal details including: ‘A brief personal history’, ‘Health needs and allergies’, ‘Likes and dislikes’ and ‘Personal plan goals’. The manager confirmed that residents and, where appropriate, a relative or representative continue to be directly involved in annual care plan reviews. Such reviews, (Personal Plan Meetings) are held to discuss and monitor an individual’s progress, review previous goals, as well as agreeing action points and setting goals for the future. Independence and individuality continues to be encouraged and promoted within the home and is reflected in the personalising of residents’ rooms, the choice of bedclothes and colour schemes and individual preferences for occupational and leisure activities. Staff, spoken with during the inspection, confirmed that residents are encouraged and supported to make decisions regarding many aspects of their daily living, including menu planning, what clothes they wear and how they spend their day. The manager emphasised the importance of staff developing close working relationships with individual residents. Despite the variable and limited verbal communication of some residents, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of residents being supported in a professional, sensitive and respectful manner. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Residents are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. However recreational and leisure activities and menus are not currently being well managed. EVIDENCE: The recreational and leisure interests of residents are identified and recorded in their individual care plan and the manger confirmed that they are supported to access activities and facilities, reflecting their individual needs, preferences and abilities. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 13 However, as discussed during the inspection, the minimal staffing levels that operate within the home inevitably impact on the opportunities for individuals to partake in such activities. It was noted that there is currently no structured programme of activities in place. Two members of staff, plus management cover routinely work across the two homes and have direct responsibility for all fifteen residents. From examination of individual care plans and through discussions with staff, it is evident that since the previous inspection, the care and support needs and general dependency levels of certain residents have increased. However this changing situation is not reflected in staffing levels, which have not been reviewed for ‘months if not years’. Community participation evidently remains a focus in the home and staff confirmed that, where practicable – often with the use of volunteers - residents are encouraged and supported to attend day services, work experience and college as well as visiting local shops, clubs and other amenities. Although a key worker system is in place, there is clearly little opportunity for 1:1 support and many activities and outings involve ‘group participation’. Residents are encouraged and supported to maintain family links. The manager confirmed that visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. From discussions with residents and staff it is evident that meals at the home are varied and balanced. They are based on identified likes and preferences and drawn up following individual consultation. An alternative to the main meal is always available. However on the day of the inspection, apart from a diary entry for the benefit of staff, no menu was displayed in the home or made available for examination. Following discussion, it is recommended that a daily menu is developed, possibly using illustrations or photographs, and is displayed for the benefit of residents. The current practice of residents walking outside from one house to the other, to collect their meals, is unsatisfactory and should be reviewed in light of the proposed alterations to both kitchens. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 14 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. This judgement has been made using available evidence, including a visit to this service. Staff have developed close and positive relationships with residents and demonstrate an awareness and sound understanding of their individual care and support needs. Residents are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. EVIDENCE: The manager emphasised the importance of staff developing close working relationships with individual residents and being aware of changes in mood or behaviour. In accordance with their personal care plan, residents are supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 15 As previously documented, during the inspection residents were observed being supported in a sensitive, professional and respectful manner. Documentary evidence was in place to demonstrate that the health and emotional care needs of residents continue to be met within the home. All residents are registered with local GPs and have access to other health care professionals, including district nurses, speech and language therapists and dentists, as required. All medical appointments with, or visits by, health care professionals are recorded. Up to date and detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. All staff responsible for administering medication have received training, as part of their comprehensive induction programme, and are individually assessed and authorised to do so. The manager confirmed that, following risk assessments, no resident currently self-administers their own medication. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 16 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. This judgement has been made using available evidence, including a visit to this service. The home’s complaints procedure ensures that residents, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Residents are protected, through updated policies and procedures relating to abuse and safeguarding vulnerable adults. EVIDENCE: A simple and accessible complaints procedure has been developed and implemented for the benefit of residents, staff and other visitors to the home. A copy of the procedure is displayed in the entrance hall. All complaints received are appropriately recorded, including details of any actions taken and outcomes achieved. Residents and members of staff confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. It was noted that there have been no concerns or complaints recorded by the home since the last inspection. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 17 The home has produced detailed policies and procedures, relating to adult protection and abuse, including a whistle blowing policy. These documents have evidently been reviewed and updated, in accordance with the recently implemented multi agency guidelines for safeguarding vulnerable adults. The manager, who has responsibility for delivering adult protection training, confirmed that all care staff have undertaken appropriate training regarding abuse awareness and procedures relating to ‘Safeguarding Vulnerable Adults.’ This was confirmed through discussions with members of staff and supported by training records examined. Hobbs Field DS0000037439.V359363.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, 26, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The service is accessible, safe and clean and remains clearly suitable for it’s stated purpose. Residents benefit from accommodation that is comfortable, reasonably well maintained and decorated to a satisfactory standard. EVIDENCE: During my ‘guided tour’ of the premises it was evident that the generally well maintained décor and adequate furniture and furnishings continue to provide a comfortable, safe and pleasant environment for residents. The manager confirmed that independence and individuality continue to be promoted within the home and, as previously documented, this is evident from the personalising of residents’ rooms, reflecting individual taste, preference and interests. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 19 As previously documented, the manager is due to retire shortly and it is hoped that proposed building work will still go ahead and be completed after his departure. Planned alterations include converting a ground floor shower room, extending and refurbishing a kitchen and transferring at least one of the laundry rooms to the first floor. Infection control policies and procedures are in place and clearly adhered to. Residents, with key worker support as necessary, are evidently responsible for keeping bedrooms clean and tidy and on the day of the inspection, levels of cleanliness and hygiene throughout the home were found to be satisfactory. Hobbs Field DS0000037439.V359363.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): 32, 33, 34, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. There is not always sufficient trained and competent staff on duty to meet the assessed needs of the residents. Residents are protected by satisfactory staff recruitment policies, procedures and documentation. EVIDENCE: Through discussions with staff and residents and from examination of duty rotas, concerns were raised during the inspection regarding the minimal staffing levels currently operating within the home. This evidently has a potential impact on the care and support of residents, and as previously documented, an inevitable affect on their social and recreational opportunities. The fifteen residents at Hobbs Field are accommodated in two separate houses, Longleat and Woburn, with seven people living in one and eight in the other. For the majority of the time, there are two care staff and one manager or officer working across both sites. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 21 Through discussions with staff and residents during the inspection, it is evident that these numbers are not sufficient to meet the increasingly complex care and support needs of some of the residents, particularly at ‘peak times’: ‘The mornings are the worst time. We rely on the night staff to get some residents up but we’re still very busy rushing around. And of course while we spend time with certain people who need more help and support, others are kept waiting’. ‘Mornings and evenings are very busy, getting people up and off to where they’re going. Then it’s all go again later on, when everyone comes back and wants to tell you about their day!’ ‘The staff are all very kind but sometimes they are too busy to spend time with you.’ Formal and structured staff supervision is provided on a regular basis and is appropriately recorded. The manager is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of residents. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Hobbs Field DS0000037439.V359363.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, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users benefit from a competent management structure. They are protected by satisfactory health and safety procedures and their best interests are safeguarded by effective quality monitoring systems. EVIDENCE: As previously documented, the registered manager is due to retire soon and will be leaving Hobbs Field after almost twenty five years at the home. It is evident from discussions with residents and staff that he has been very popular and will be greatly missed. Hobbs Field DS0000037439.V359363.R01.S.doc Version 5.2 Page 23 Another manager is yet to be appointed however it is hoped there will be an effective handover period, to ensure a smooth transition and continuity of care practices. Despite people’s understandable apprehension, there is evidently a positive mood within the home regarding the ‘new era’. ‘Although he (the manager) has been brilliant – and he will certainly be missed, most people feel that the time is right for a change and they are looking forward to it’. As part of the home’s quality monitoring system, the manager explained that satisfaction questionnaires are sent to residents, their relatives and relevant health and social care professionals. Feedback is also obtained as part of the care plan review process. Positive comments received from relatives and visiting professionals indicate a high level of satisfaction with the manager, staff and services provided within the home: ‘The manager and staff I find to be very approachable and helpful’. ‘Thank you all as ever for what you do for ……… and putting up with me!’ ‘I have been coming here on and off for years and have always been madder to feel welcome by both staff and residents’. The manager confirmed that the health, safety and welfare of residents and staff remain of paramount importance within the home. He added that training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. Hobbs Field DS0000037439.V359363.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 3 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 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 2 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 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Hobbs Field DS0000037439.V359363.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. 1. Standard YA33 Regulation 18 (1) (a) Requirement It is required that sufficient qualified and competent staff are on duty at all times to meet the assessed care and support needs of residents. Timescale for action 30/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA14 YA17 YA17 Good Practice Recommendations It is recommended that staffing levels are sufficient to ensure residents have opportunity for appropriate social, educational and leisure activities. It is recommended that an illustrated menu be developed and clearly displayed for the benefit of residents. It is recommended that the current practice of residents walking outside from one house to the other, to collect their meals, should be reviewed. Hobbs Field DS0000037439.V359363.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 Hobbs Field DS0000037439.V359363.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. 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