Inspection on 20/07/05 for Aston House Care Home

This inspection was carried out on 20th July 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Aston House Care Home 02/06/08

Aston House Care Home 23/07/07

Aston House Care Home 29/01/07

Aston House Care Home 26/06/06

Aston House Care Home 15/12/05

Aston House Care Home 05/01/05

Aston House Care Home 14/06/04

Aston House Care Home 12/06/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Townley Road, 2-3

Chatsworth Care - Tudor Lodge

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

CARE HOMES FOR OLDER PEOPLE Aston House Care Home Angel Lane Hayes Middlesex UB3 2QX Lead Inspector Clare Henderson-Roe Unannounced 20 & 21 July 2005 09.45am th st 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 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. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Aston House Care Home Address Angel Lane, Hayes, Middlesex, UB3 2QX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 569 1499 0208 569 1488 Southern Cross Healthcare Services Ltd. CRH 48 Category(ies) of Learning Disability-Over 65 and Dementia-over registration, with number 65 of places Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. To comply with the Minimum Staffing Notice required by the previous regulator as at 31st March 2002. 2. One service user under the age of 65 may be accommodated at the home as agreed by the NCSC on 20.01.04. This applies to one specific service user and is not transferable. 3. One service user, date of birth 22nd December 1946, can be accommodated at the home, as agreed on 14th July 2004. 4. One service user, date of birth 1st November 1947, can be accommodated at the home, as agreed with the previous registering authority. Date of last inspection 05/01/05 Brief Description of the Service: Aston House is a modern purpose built establishment situated in a residential area of Hayes. It is registered for 48 service users who are accommodated on the ground and first floors of a three-storey building. Thirty-two of the bedrooms are single and 8 are double and most have en suite facilities. There are two communal rooms on both the ground and first floors, with an additional quiet room with snoozelen equipment on the first floor, and an additional small lounge on the ground floor not currently in use. There is an enclosed garden to the rear of the home with garden furniture and room for those in wheelchairs to sit out. The home is easily accessible by public transport. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. A total of 12 hours were spent on the inspection process. The Inspectors carried out a tour of the home, and inspected service user plans. 3 service users, 3 visitors and 11 staff were spoken with as part of the inspection process. What the service does well: What has improved since the last inspection? What they could do better: Although the home has been maintained in good decorative order in most areas, there are environmental issue that need addressing. The delay in upgrading the bathroom facilities to meet the needs of the service users is of concern. This has been an outstanding issue in past inspection reports and this matter needs addressing as a matter of priority. Although progress has been made, the provision of height adjustable beds for all service users with moving & handling needs also needs to be addressed. Processes for good two way communication between staff and management need to be regularly reviewed to ensure that any issues are identified for prompt action, for example, staffing shortages. The introduction of regular formal supervision would also assist with communication. Some health and safety issues were identified and the need to ensure that all Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 6 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. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3. The home does not provide intermediate care. Service users are assessed prior to admission to ensure the home can meet their needs. EVIDENCE: A pre-admission assessment is carried out for all prospective service users. Samples of these were viewed and had been clearly completed. In addition, copies of Social Services assessments are also obtained. Therefore the home can ascertain if it is able to meet the needs of prospective service users. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10. The health and personal care needs of service users had been identified and were being met. Overall the medications are being well managed, but some shortfalls could potentially place service users at risk. Staff are courteous to service users and generally personal support is provided in such a way as to promote and protect the service users privacy and dignity. EVIDENCE: Samples of service users plans were viewed. These were comprehensive and identified service users needs and the action to be taken to meet these needs. Monthly updates had been carried out and there was evidence of new care plans being formulated for new problems identified. Risk assessments for falls were in place and had been updated following any falls in the home. Documentation had been completed for the recording of accidents. There were no service users with pressure sores. Pressure sore risk assessments had been carried out. For one service user with wounds, individual care plans had been formulated for each wound and clear records of wound dressings and management had been maintained. In one service user plan viewed there was evidence of some unexplained bruising. The importance of ensuring that any unexplained injuries are investigated and addressed was Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 10 discussed. Nutritional assessments and care plans are in place, and monthly weights are carried out. Continence assessments had been carried out and care plans for continence care needs were in place. Moving & handling assessments were in place. Risk assessments for the use of bedrails had been clearly completed and written consents for their use had also been obtained. The home now has one GP practice providing cover and weekly and as required visits are carried out. There was evidence of input from other healthcare professionals recorded. It was evident that staff had worked hard on the formulation, review and updating of the service user plans. Medication records were sampled on each floor. On the first floor the medication administration record (MAR) charts were up to date and medications signed for or the correct reason for omission coding use. On the ground floor, there had been a time change of one medication, and there was no signature for administration for three days. The need to ensure that a new section of the chart is used to re-write the medication for clarity whenever there is a change in the dose or time of a medication was discussed. One topical application had been prescribed ‘as directed’ and this needed discussing with the GP to get full instructions for use included on the prescription. On both floors liquid medications had been dated when opened and receipts of medication had been recorded. The system for the disposal of medications in Nursing Homes has recently changed, but the dispensing chemist is continuing to take responsibility for this at this time. The Operations Manager was aware of the need for clarity in this area. The medication fridge was not functioning correctly and there was evidence that this had been reported and seen by an engineer, and a new fridge ordered, which arrived on the second day of inspection. There was overstocking of one refrigerated medication, and the need to audit the stock levels was discussed. It is acknowledged that the medication had been brought in with the service user. The lancing devices being used for blood glucose monitoring were only suitable for individual service user use. This was discussed and on the second day of inspection individual lancing device systems had been purchased for each diabetic service user and staff were to receive instruction on their use. Medication audits are carried out each week and management medication audits had also been carried out with action taken to address any shortfalls identified. Staff were seen to speak with and care for service users in a gentle and courteous manner. There was a good atmosphere on both floors of the home and service users looked well cared for and appropriately dressed. Visitors spoken with expressed their satisfaction with the home and said that they were always made to feel welcome. Staff spoken with said that there is good teamwork in the home. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 The meal provision is generally good, but service users were not being offered meal options and therefore were unable to choose their preferred meal. EVIDENCE: The kitchen was clean and tidy. For the breakfast and lunchtime meals the menu was being followed, with alternatives available as required. The lunchtime meal sampled was well presented and tasty. The choice lists that had been introduced were not being completed and this was discussed and staff are to recommence completion of these forms. The evening menu was not being followed and only one option was being prepared. The evening cook said that four evenings a hot meal is provided and three evenings soup and sandwiches are provided. Also, that there are limited sweet options available for service users. For service users on a pureed diet, The lunchtime meal equates to the meal being provided for other service users, and the evening meal is a thick soup. On viewing the store cupboards and fridges/freezers various options for both main courses and sweets were seen, to include diabetic alternatives and fresh fruit. Discussions with the catering staff identified the need to discuss and address any issues regarding the food provision in the home, to ensure that the published menu is being followed and that the options offered are available to service users. The Operations Manager said that the menus would also be reviewed to reflect the meals and options available to service users. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has clear complaints procedures and service users said that any concerns are promptly addressed. Staff have knowledge and understanding of adult protection issues to safeguard service users. EVIDENCE: The home has a clear complaints procedure and complaints are promptly addressed. Correspondence relating to each complaint is maintained and shows the progress and outcome. There had been no complaints received in the last year. Staff had received POVA training and those spoken with were clear that they would report any concerns of this nature and also understood the Whistle Blowing procedure. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22 and 24 Overall the home is in a good state of décor, thus providing a homely environment for service users. Ongoing shortfalls with some environmental aspects of the home in relation to service users moving & handling needs pose a potential risk to service users and staff. EVIDENCE: There was evidence of ongoing redecoration of areas of the home, with some areas still in need of redecoration. The carpets in the corridors and communal rooms were worn and marked, and needed reviewing. The need to carry out a full audit of the home to include all areas of decoration, furnishings and floorings, with an action plan with timescales to address any shortfalls identified, was discussed. The home was clean and tidy. The home has two assisted shower rooms, but there had been no further development on the updating of any of the bathing facilities to meet the needs of the service users. All the baths are standard and have a fixed hoist for assisting service users in and out of the bath. The enamel on one of the baths was badly chipped in places. Some of the tiles in the bathrooms were chipped Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 14 and there were areas where holes had been drilled through the tiles and these needed making good. The bathroom provision has been an ongoing issue with the Southern Cross Healthcare and this needs to be addressed as a priority. Seven additional height adjustable beds had been purchased since the last inspection, but there was no evidence of an up to date audit of bed provision in conjunction with service users moving and handling needs having been carried out. The need to carry out this audit and to draw up an action plan for a rolling programme of bed replacement with timescales was discussed. This issue has been identified at previous inspections, and whilst it is acknowledged that some progress has been made in the provision of adjustable beds, this needs to be addressed fully by the home. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 Issues with shortages of staff have had a detrimental effect on staff morale and could have a detrimental effect on the service users care provision. Good teamwork amongst the staff has helped to minimise this effect at this time. The vetting and recruitment practices are robust, thus safeguarding service users. EVIDENCE: Several of the staff spoken with identified staff shortages over the past few months, on both day and night shifts. The rosters were viewed and there was evidence to uphold this. On further discussion with staff it was clear that they had worked hard as a team to provide the best care they were able whilst short of staff, but that this situation was not satisfactory. It was unclear if this had been brought to the attention of the interim management, and the Operations Manager was informed on the day of inspection and action was taken to provide appropriate staffing levels to meet the service users needs. The staff shifts have been altered, providing fewer staff between the hours of 8-9pm and 7.30-8am. The Operations Manager said that she was very clear of the need to ensure the home is staffed appropriately at all times. The need to clarify the consistency of approach with the kitchen staff was also discussed and a meeting was to be arranged. Samples of the staff employment records were viewed. Some documentation was not immediately available on the files but was found in the administration office. The staff employment files viewed contained details of the applicants Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 16 completed application forms, Criminal Record Bureau checks, medical declaration, 2 references, photographs plus terms & conditions of contract. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, 36, 37 & some aspects of 38. Action has been taken to provide improved systems for the banking of service users funds, assisting in the ongoing safeguarding and management of service users monies. There is still a lack of formal supervision for staff, which limits the forum for discussion and professional development. Records are held securely thus safeguarding service user information. Some issues identified could pose health and safety risks in the home. EVIDENCE: Southern Cross Healthcare has carried out work to address the issue with the pooling of service users funds. Under the current system all the service users monies handled by the home are paid into one ‘z’ account. Some of the service users have substantial amounts of money, and a system has been worked on with a banking facility to provide individual bank accounts for service users with more than £500. The Regional Administration Manager for Southern Cross Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 18 Healthcare was present at the inspection and said that the system should be in place for the home by the end of August 2005. This standard will be revisited at the next inspection to view the progress made in this area. The Administrator is the Appointee for 10 service users, and progress is being made gradually with Hillingdon Social Services for them to make Power of Attorney arrangements in these cases. The Administrator has a clear system of record keeping for all income and expenditure, with a running total being maintained for each service user. Copies of receipts for expenditure are kept and any interest on the ‘z’ account is apportioned according to the amount of money each service user has in the account. The formal supervision for all care staff was discussed. The Operations Manager explained that this had not been progressed and they are aware of the need to have the system up and running for all care staff to include nursing staff. This standard will be revisited at the next inspection to assess the progress made in this area. Records are held securely in the home. There was some delay on accessing some of the records required to view at the inspection, in relation to staff records and other records held. The need to implement an orderly system for maintaining all records has been discussed. Staff spoken with said that they had received mandatory training and updates. The member of staff responsible for carrying out moving & handling training required a full training update prior to being able to carry out any further training with staff. This was discussed with the Operations Manager, who said that she would arrange for another qualified moving & handling instructor to carry out this training for staff. The water geyser in the kitchen had been out of order for some weeks and kettles were being used to boil water. This was not a satisfactory arrangement and the Operations Manager took action to address this finding. Two of the homes mobile hoists had been out of action for some weeks. This had been reported to the Management on the day of inspection and action was taken to address the problem. The importance of staff reporting any concerns to the management, and for the management to be available to address issues promptly, was discussed. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x 1 x 2 x x STAFFING Standard No Score 27 2 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 3 2 2 2 Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 20 YES 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 8 Regulation 12(1)(a) 13(6) 13(2) 13(2) 13(2) 13(2) Requirement All incidences of unexplained injuries to include bruising must be reported and investigated and correct procedures followed. Any changes must be clearly rewritten on the MAR chart. Full instructions for administration must be recorded for all medications. Arrangements must be reviewed for the collection of waste medications. Stock levels of medications must be kept under review and action taken to address overstocking issues. The correct multi-patient lancing system must be used to test blood glucose. A record of the meal choices made and partaken by the service users must be maintained. The meals must reflect the menu choices available. The menus must be reviewed to show the actual meals being offered to service users. An audit of the home must be carried out to identify the areas in need of redecoration and Timescale for action 12/08/05 2. 3. 4. 5. 9 9 9, 26 9 01/08/05 01/08/05 10/08/05 12/08/05 6. 7. 8, 38 15 13(3) 17(2) 22/07/05 12/08/05 8. 15 12(1)(a) 20/08/05 9. 19 23(b)(d) 01/09/05 Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 21 10. 22 23(2)(a) (f)&(j) 11. 24 16(c) 12. 27 18 13. 35 20 14. 36 18 15. 37 17 16. 17. 38 38 12, 18 13 refurbishment, to include flooring. A copy of the audit plus an action plan with timescales to complete the work identified must be forwarded to the CSCI. The timescales must not exceed 01/12/05. Assisted bathroom facilities must meet the assessed needs of the service users. (previous timescale 01/04/05 not met). An action plan to address the shortfalls with timescales must be forwarded to the CSCI. A full audit of beds must be carried out in conjunction with service users moving & handling needs. An action plan with timescales to provide adjustable beds for all service users with moving & handling needs must be formulated and a copy forwarded to the CSCI. The home must be appropriately staffed to meet the assessed needs of the service users at all times. Service users monies must not be pooled. Confirmation that the new banking system is in place must be forwarded to the CSCI. All care staff must receive formal supervision six times a year. (previous timescale 01/02/05 not met). An action plan to implement formal supervision must be formulated and forwarded to the CSCI. All records in the care home must be maintained in such a way as to allow for easy access for the purposes of review and inspection. All staff must receive annual moving & handling training and updates. Equipment must be maintained in working order. If any 20/08/05 20/08/05 01/08/05 20/09/05 01/09/05 01/09/05 01/09/05 12/08/05 Page 22 Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 equipment is out of order, this must be reported and prompt action taken to address the situation. 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. Refer to Standard 15 Good Practice Recommendations Regular meetings be set up for the kitchen staff for good communication and continuity of meal provision. Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST 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 Aston House Care Home G61-G10 S10924 Aston House V232972 20.07.05 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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