Inspection on 08/12/05 for Aspinden Wood Centre

This inspection was carried out on 8th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 19 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Aspinden Wood Centre 27/10/08

Aspinden Wood Centre 07/03/08

Aspinden Wood Centre 23/06/06

Aspinden Wood Centre 21/06/05

Aspinden Wood Centre 25/01/05

Aspinden Wood Centre 13/07/04

Aspinden Wood Centre 25/03/04

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

Rugby House Project

City Roads Crisis Intervention

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Aspinden Wood Centre 1, Aspinden Wood Road London SE16 2DR Lead Inspector Mark Stroud Unannounced Inspection 8th December 2005 10:00 Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 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 Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 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. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Aspinden Wood Centre Address 1, Aspinden Wood Road London SE16 2DR 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) 0207 237 0331 Equinox Care Home 24 Category(ies) of Past or present alcohol dependence (16), Past or registration, with number present alcohol dependence over 65 years of of places age (8) Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. eight of the service users may be over 65 years of age Date of last inspection Brief Description of the Service: Aspinden Wood Centre is a service providing personal care and accomodation to 24 people with past or present alcohol dependence. The home is part of the Equinox Care project, a voluntary organisation. The home is two-storey with a passenger lift between floors. It is located in Bermondsey, South London, close to local shops, social and leisure facilities, and public transport links. The home has off street parking. There is a garden. It has several well-maintained garden beds around the home. The home’s objective, as set out in its’ Statement Of Purpose, is to provide a safe, controlled and supported alternative environment for homeless people with dependency on alcohol, whom would otherwise be drinking on the street. The home also offers a care planning and key worker system, plus links with and support from various agencies, including health and social services. On the day of the inspection there were no vacancies. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A pharmacy inspector and a Regulatory Inspector visited the home over an afternoon and evening, speaking to service users, staff, and the deputy manager. What the service does well: 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. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 6 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 Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): At the last inspection the following judgement was made :Service users needs are known and understood. EVIDENCE: These Standards were not inspected this time. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 & 9 Service users have plans that describe the main needs they were referred to the home to meet, but plans don’t say much about their personal goals, or changing needs, and the support they need to achieve and meet them. EVIDENCE: The home write down plans with service users to agree how they will be supported. One service user who started living at the home six weeks before this visit still didn’t have a written plan though. One service user said ‘agreements feel more like ultimatums’. The written plans do need to say more about what service users already do, how the home can help them to keep doing things, and agree how the service user can work with the home to do new things. When things don’t go as planned, this is a chance to review, try to agree why, and agree to try something different. One service user didn’t get the minutes from their review with their Community Psychiatric Nurse, and a staff member agreed to make sure they did. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 9 Things that should be agreed by individuals according to their choice, like when they get their money, are done at a fixed time for everyone at the moment. This causes frustration for service users who feel they need to queue up at the office, and then don’t always get their money when they feel they should. Staff find difficulty when there are more urgent unplanned things to do, or when there are less staff around. Service users meet regularly as a group with staff and have a chance to have their say. This gives service users the chance to change the menu and say things they are unhappy about. They know what the home agree to do about things, and when. Service users have recently been supported to campaign for a zebra crossing to be added to a local road, which is difficult to cross safely. The home and service users do assess risks to their welfare and plans are written down to minimise them. In one case though this was not done, despite a service user being given notice to quit because of a dangerous incident. When staff write things down they get confused how to use forms, and don’t always say clearly whether risks are severe or not. When things are discussed and written down it should start from what service users do to keep themselves safe, and then say how the home will help them do this, and fill any gaps. When service users do something wrong they get verbal and written warnings, but sometimes, now matter how many they get, nothing really happens. The home need to be clear what the process is, whether something more serious happens when someone gets lots of them, when service users should get them, why, and for what purpose, and how this fits into working in partnership, managing risks together and setting goals. Service users have regular meetings with a staff member they know better, normally every month, where they can say what they think, and what they want. This gives a chance to get different food for instance. All of the service users are at the home because they drink, but they also have other important needs. When they have other needs like a visual impairment or difficulty walking and moving around, there should be regular discussion about how they are supported, and this doesn’t always happen, one service users needs only discussed once over four monthly key work meetings. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 17 Service users get the support they need at the home but need more planned support in the community. EVIDENCE: The staffing at the home cannot provide support to most service users away from the home. The home has arranged extra funding for one service user so they can be regularly supported to go out in the community. Service users do go into the community alone. One service users last review with their social worker decided they needed more support to be involved in activities, but the written notes from meetings with their key worker just said they participate ‘mostly in home based activities’ but didn’t say what goals they agreed to work towards. Six service users went on holiday to Ireland this year and enjoyed it. Service users have regular food prepared by a cook, and can have fruit and snacks when they want. When staff are not around, food can run out. Service users have been keeping food in their rooms to make sure they have something when this happens, or just for their own preference. This can go off, and could encourage pests. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 & 21 Service users don’t have enough say in how they are supported and spoken to. EVIDENCE: Service users feel that support they prefer and agree with staff isn’t always provided when staff change. Service users are unhappy about the quality of communication with staff in general. When staff have the opportunity to write down how service users like to be spoken to this is not done. When service users have trouble moving around the home this was not described in one service user’s plan. During this visit, staff spoke to service users around the office mainly, where service users came to collect their belongings, or waited to be spoken to. All medication items, including returns and food supplements, are now kept in a locked cabinet, and the home now has a separate medication fridge. An immediate requirement was left in June 2005 to start a Returns Log as no returns had been logged since December 2003. This has now been done. It is good practise to return medication at the end of each month. Some unused Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 12 items from October and November were still at the home. Unless returns are done every month, it is not possible to carry out a justified stock check (to ensure that the quantity received minus quantity used ties up with the quantity remaining). Receipts are being recorded on the MAR chart in almost all cases, except where an item has come in mid-cycle. Receipts must be recorded for all items. Recording on Medication Administration Record (MAR) charts has improved. There were a significant number of missing signatures at the last inspection. At this inspection, recording was good. One area which requires improvement is documenting why a resident has missed a dose. One resident had been missing from the home for 5 days, so there were blanks on the MAR chart but no explanation given on the back of the MAR chart as to the reason. Six residents were not taking medication regularly, e.g. 10 out of 48 doses of an antidiabetic not taken, 3 out of 10 doses of an antiepileptic not taken, 7 out of 10 doses of a sleeping tablet not taken. The reasons for this must be recorded on the back of the MAR chart, together with what is being done to address this. All staff have received medication training, however some new starters/temporary staff received this before joining Aspinden Wood in their previous employment. The Manager was not present at the inspection, however the Deputy Manager confirmed that an authorised signature list has been drawn up of those members of staff who have received training and are authorised to administer medication. It is important that no new members of staff or agency/bank staff administer any medication unless they have had medication training and have been authorised by the Manager as competent to do so. A recommendation was made to obtain Patient Information Leaflets for each medication item kept at the home. These are now available for most items. Staff must use these to familiarise themselves with the medication they are administering in order to monitor any change in condition which may be due to medication, and to be aware of the significance of missed doses. The use of patient information leaflets is important, as medication reference books at the home are several years old and although a requirement was made for the home to obtain an up to date reference book, this could not be located. Service users sometimes self-administer, and this needs to be developed, particularly for those moving out to less supported accommodation although this rarely happens. All residents have been offered a flu vaccination and most have accepted. Service users still don’t have written agreements regarding death and dying. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Service users know they will be listened to, but need more help to resolve issues before they become more serious. EVIDENCE: The home writes down complaints made by service users and other people, and write back when they have investigated. Some complaints are informal and the home doesn’t need to write back. One complaint highlighted risks to service users, but these had not been assessed and planned for, to keep service users safe. The home now ensures staff returning from secondment are CRB checked again. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, & 30 Service users are happy with the home environment but can’t rely on the safe or reliable delivery of hot water to bathrooms. EVIDENCE: Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 15 Service users say they like the environment at the home, which they find clean and spacious. Service users do worry about security though, after recent break ins. The home is decorated in homely colours in the communal areas, with plants, and up lighting, except for the bathrooms, which are plain white and cold in appearance. There are a lot of items temporarily stored in the conservatory, some belonging to service users no longer at the home. The deputy manager confirmed these would be removed within a week of this inspection. The supply of hot water to the bathrooms is inconsistent, one bathroom with no hot water, and other hot water too hot, or not hot enough. There was a water leak from a radiator in an upstairs bedroom before this inspection damaging the ceiling in the wet lounge, which is now out of use. Plans were in place to repair this quickly, and an alternative lounge area provided. Service users were very understanding of this. Service users can’t control the heating in their rooms, and feel that staff adjust the general heating in the home according to how hot or cold they feel, or after individual service users ask them to. Some service users don’t have a key to their room, and the home agreed to make sure they had one. The light cords in bathrooms are very dirty, and two didn’t have a pendant. Service users are still triggering fire alarms when they are smoking, despite agreement from the home for them to do this. In one case a service user got a written warning for this. The home says the London Fire and Emergency Planning Authority have told them there is no solution to this problem but this wasn’t in writing. There are still no alarms in the toilets in case service users need help, but the home has got quotes to put them in, and work is planned. The bread bin in the service users kitchen had no lid, and there was no light tube in the laundry room, both of which the deputy manager agreed to put right within a week. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35 Service users need more say in the way staff are organised and trained. EVIDENCE: There are times when there are two staff on duty. Given that staff currently have to ensure always one staff stays in or around the office to monitor the entrance doorway, this means that staffing is very low at times. A group of service users expressed concern that staff often go to the sleep in room around 10pm, and that it feels difficult to get the support they need after this time. Staff are skilled and knowledgeable about the needs of service users with alcohol dependency but do need more training regarding visual impairment and physical disability, particularly around mobility in and outside of the home. Staff key work three service users each on average. Service users are able to change their key worker when they find it hard to relate to them. There was a staff meeting the day before this visit. Staff feel well supported by the manager. There is a new deputy manager, who worked at the home before, and feels the home need to call the police less frequently now. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 & 42 Service users know that staff are supported to keep them safe. EVIDENCE: The home still doesn’t have a plan for the service. The home are displaying a photocopy of an old Registration Certificate, and need a new one so service users and relatives know the home is properly Registered. The home have written down procedures for staff to follow to try to avoid things going wrong, and to put things right when they do. Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 2 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 2 x 2 2 LIFESTYLES Standard No Score 11 X 12 2 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score x x 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Aspinden Wood Centre Score 2 x 2 3 Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x DS0000007058.V266206.R01.S.doc Version 5.0 Page 19 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 Requirement Timescale for action 31/01/06 2 YA7 12(2)(3) 3 YA8 16(2)(m) The Registered Person must ensure that service users agree a Service Users Plan before they move into the home, and agree one without delay with the service user described. Plans must include individual arrangements to support service users with their money, and support to each service user affected where violence or aggression is exhibited. 28/02/06 The Registered Person must ensure that service users do not receive warnings unless service users and staff are clear what it means, what will happen and why, and that staff always review written and agreed Service User Plans, taking into account service users wishes and feelings, enabling them to make positive decisions, and minimising risk. The registered manager must 28/02/06 ensure that service users care plans include statements of how each individual service user will be offered opportunities to be involved in the activities of the DS0000007058.V266206.R01.S.doc Version 5.0 Aspinden Wood Centre Page 20 4 YA9 13 5 YA33YA12 18(1)(a) 6 YA17 16(2)(i) 7 YA29YA18 23(2)(n) day to day running of the home, and that there are adequate monitoring and recording systems in place to demonstrate that these opportunities are being offered, taken up or refused. Where there are any restrictions placed on individual service users being offered particular activities, this must be reflected in the care plan and agreed with the placing authority and with the service user (timescale of 31/05/05 and now 31/08/05 not met). Enforcement action may be considered if this Requirement is not met. The Registered Person must ensure that staff are trained to minimise risk by supporting service users to keep themselves safe, and recording the level of risk and what is being done accurately. The registered provider must ensure the home is adequately staffed at all times to help ensure service users receive the required support according to their assessed needs. (timescale of 30/10/04 and now 31/08/05 not met). Enforcement action may be taken. This must include provision of staff after 10pm Service users who want food outside of meal times must have access to food, unless agreed otherwise, agreed in the Service Users Plan.(timescale of 31/08/05 not met). The registered provider must ensure that service users can call for assistance from toilets and bathrooms, following the occupational therapists recommendation for pull cords in DS0000007058.V266206.R01.S.doc 31/01/06 28/02/06 28/02/06 28/02/06 Aspinden Wood Centre Version 5.0 Page 21 8 YA20 13(2) 9 YA20 13(2) 10 YA22 22(2) Schedule 4(11) 11 YA26 23(2)(p) 12 YA27 23(2)(j) 13 YA30 23(2)(n) 14 YA24YA42 12 & 13 toilets and bathrooms and call points in each room. The Registered Person must ensure that the reasons for all non-administration of medication are documented on the back of the MAR chart, together with the action taken if there are any prolonged periods of nonadministration. The Registered Person must ensure that all receipts of medication are logged, including items that come in mid-cycle, and that all unused medication is returned at the end of each month after a justified stock check is carried out, with investigations of any discrepancies. The Registered Person must ensure that staff listen to and act on the informal complaints of service users without demanding these are written down, and record these in the complaints log as informal, with action taken, by whom, and when. The home do not need to confirm receipt or action to informal complainants in writing. The Registered Person must ensure that service users have individually controlled heating in their bedrooms. Hot water, according to risk assessments, must be supplied to upstairs bathrooms.(timescale of 30/09/05 not met). The Registered Person must ensure that light cords are kept clean, and suitabel pendants fitted so that service users can use them easily. The Registered Person must ensure that they have written confirmation of consultation with DS0000007058.V266206.R01.S.doc 28/02/06 28/02/06 28/02/06 31/03/06 28/02/06 28/02/06 31/03/06 Aspinden Wood Centre Version 5.0 Page 22 15 YA35 18(1)(c) 16 YA39 24 the London Fire and Emergency Planning Authority regarding strategies to avoid false calls and a lack of dignity and privacy to service users as a result of bedroom fire sensors being triggered by authorised smoking. The Registered Person must 31/05/06 ensure that staff are trained to support service users with a visual impairment and restricted mobility, and all other needs. The home must draw up an 28/02/06 annual plan for the service, showing how the growing mental health needs of service users, and the break down of existing contracts around drinking, will be met.(timescale of 31/08/05 not met) 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 Refer to Standard YA6 YA21 Good Practice Recommendations The Registered Person should ensure that service users are regularly consulted about all their needs in key work sessions, and plans revised accordingly. The home should support service users to make clear plans in the event of serious illness and death, inlcuding any legal arrangements such as a will, or where they are worried their wishes may not be respected. The Registered Person should ensure that service users are supported to personalise and make bathrooms more homely. Service users should be consulted and involved in the training of staff, so that they know they will be supported according to their wishes and feelings, and staff are able to work with them in partnership. 3 4 YA27 YA35 Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH National Enquiry Line: 0845 015 0120 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 Aspinden Wood Centre DS0000007058.V266206.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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