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Inspection on 23/05/05 for Barleycombe Residential Home

Also see our care home review for Barleycombe Residential Home for more information

This inspection was carried out on 23rd May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Barleycombe creates a relaxed atmosphere in comfortable surroundings in which 14 young men with a learning disability live. Staff employed are friendly and approachable with a genuine interest in the people they support. Barleycombe offers interesting opportunities both on site with tasks such as animal husbandry and horticulture and opportunities off site in using local day services for people with a learning disability.

What has improved since the last inspection?

At the last inspection nine requirements were made of the home. Six of these requirements have been met or on the way to being met. Seven staff have received training in risk assessments. The environment had no odour in toilets seen and flooring had been replaced with tiles. Access to assessments and terms and conditions was facilitated. Currently the menu is being revised to ensure a more balanced diet is on offer to the residents. Consultation with residents was in progress.

What the care home could do better:

The home needs to have a manager as it has been without one since the promotion of the previous manager last year. All the requirements from the last inspection must be addressed. This includes development of procedures around relationships and sexuality and risk assessments. All staff need regular supervision and training in any procedures developed. At this inspection the locking of the gate was in response to a person leaving without notifying staff. This has made it impossible for any visitors to access the home, as was the case of one unexpected visitor and one expected visitor on the day. The response to close the gate was not one based on risk assessment, therefore the training received does not relate to practice and more importantly the locking of the gate has restricted all movement of all the residents. This restriction of liberty is unacceptable and must be reviewed immediately. The restriction of liberty and sanctions was another area explored within the inspection process. Both these areas must be further developed within the home to ensure no person has any undue sanction placed upon them and all areas of the home are accessible within the limits of agreed risk assessments.

CARE HOME ADULTS 18-65 Barleycombe Residential Home Sudbury Road Long Melford Sudbury CO10 9HE Lead Inspector Claire Hutton Unannounced 23 May 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Barleycombe Address Sudbury Road Long Melford Sudbury Suffolk CO10 9HE 01787 880203 01787 310809 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) West Regent Limited Vacant Care Home 14 Category(ies) of Learning Disability LD (14) registration, with number of places Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17/02/05 Brief Description of the Service: Barleycombe is a care home for adults with a learning disability and currently only has male residents. In December 2000 the home became registered under Exceler Healthcare Services (trading as West Regent Healthcare Ltd.) The home consists of a two storey building situated in extensive grounds, which had been cultivated to produce vegetables and maintain livestock. The home was set back from the main road running between Sudbury and Long Melford. Both towns were accessible via public transport, with Long Melford within reasonable walking distance. The owners of the home had produced plans to extend the service by providing a five bedroom “moving on” facility. Copies of the plans were submitted to the National Care Standards Commission in 2003, these have since been revised. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours on a week day in May. One additional unannounced inspection, because of a complaint, had been made since the last announced inspection. The letter and report sent to the registered person following that visit can be obtained from the CSCI office on request. The owners have applied for a major variation to extend the home. The CSCI is processing this request. Upon arrival, entrance to the home could not be obtained due to both gates being locked. These had been locked over a week previously and details are reported fully in this report. During the inspection 4 staff were spoken with, discussions were had with 1 visitor and 3 residents, some in private. One feedback card from a relative was received after the inspection. The home currently does not have a registered manager and the post is vacant. The person in charge on the day was very helpful with the inspection process. Records inspected included all care records for three residents, recruitment records for three staff, the roters, the complaints records and evidence of staff training. What the service does well: What has improved since the last inspection? At the last inspection nine requirements were made of the home. Six of these requirements have been met or on the way to being met. Seven staff have received training in risk assessments. The environment had no odour in toilets seen and flooring had been replaced with tiles. Access to assessments and terms and conditions was facilitated. Currently the menu is being revised to ensure a more balanced diet is on offer to the residents. Consultation with residents was in progress. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 6 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. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 5 People who use this service can expect to have their needs assessed by the home, and to have written terms and conditions in place. EVIDENCE: Documentation from three individuals was examined. In the case of a new person to the home this included information on assessed needs form three different sources. These included information from a Social Worker, a previous service and an assessment undertaken by the home. Two other records examined were more historical as the residents had been at the home for sometime. There was evidence that each individual had terms and conditions agreed between the resident and the home. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 New people to the service can expect individual plans based on assessed needs, however residents may not be supported to make decisions and take risks as part of an independent lifestyle. EVIDENCE: In one new plan examined, this was directly developed from the assessment information provided. The primary objective was to develop independence around every day living tasks. This was very appropriate, however there were no risk assessments in place to support the individual to take risks as part of an independent lifestyle. At the last inspection the kitchen area was completely off bounds to residents and this still remains the case. With no access to the kitchen by any individual resident, no one is able to develop independent living skills in any meaningful way. Individual assessments of risk must be put in place to avoid the restriction on others or the individuals preferred activity or choice. One other care plan had been developed from an historical assessment when the person first came to the home. In the plan it clearly stated that the individual was ‘not allowed in the kitchen at ANYTIME’, however in a review with the Social Worker in April 2005 there was an objective to develop cooking Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 10 at home. This absolute restriction on liberty must be reviewed along with the instruction to staff to state ‘stay in your chair or I will take lunch away’. A multidisciplinary group must review this level of sanction and restriction. The plan of care must clearly demonstrate that decisions are in the best interests of the residents and are the least restrictive on basic rights and freedoms. All individuals should be supported to make and retain the right to decisions. Two residents were asked what they did when they wanted a drink. Both replied they had to ask a member of staff who would go into the kitchen and make them one. A member of staff explained the cookery sessions were conducted in the dining room and therefore this restricted what could be achieved. A discussion was had with a staff member about sanctions and restriction. The member of staff understood the principle, but thought the safety of residents must come first and could not see any solution other than to lock the kitchen door. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14, 15, 16 and 17 People who use this service can expect a lifestyle that offers opportunities for leisure and community participation, but currently freedom has been restricted due to staffs desire to protect one individual. EVIDENCE: The amount of appropriate activities on offer to participate in the local community was varied and based around residents preferences. Throughout the week there is an evening activity roter that shows trips to the local pub, the Legion, Gateway, shopping at a weekend and swimming. Residents spoken to were pleased to have the opportunity to go shopping and buy their individual purchases. The member of staff in charge said this was something that they would always ensured happened, as the residents liked it so much. Other opportunities for leisure included shiatsu, video night and take away night. At the previous announced inspection to the home a requirement was made to develop a policy around all aspects of relationships as this was particularly Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 12 relevant to a group of young men. Staff and residents should have been consulted on the development and staff trained. At this inspection this was explored with care staff and the person in charge. No developments had been made. Discussions with one member of care staff revealed they did not believe there was any issues of this nature within the home. One relative responded to a questionnaire confirming they were welcome ant time at the home and could visit in private. Daily routines at the home could not currently promote independence. Upon arrival at the home, both gates at the entrance were locked and no way of summoning anyone was available. A passing resident was eventually hailed. The resident could not open the gate and did not know the combination lock to the bicycle chains used to secure the gates. Ten minutes passed before a member of staff came. The person in-charge explained that one resident 8 days previously had left the home and not notified any member of staff of his absence. In order to keep him safe senior staff had decided to lock the gates with bicycle chains. This action had prevented all other residents from entering or leaving the home freely. This level of restriction on all residents is unacceptable. Any restriction upon an individual should be clearly in a care plan, no evidence was found. A similar restriction on movement was noted and made a requirement at the inspection in February 2005. This was in relation to restricting access to a bedroom. Visitors were expected that day and they had difficulty in summoning staff to open the gate. The menu for residents was in the process of being changed. The amount of bread on offer was reduced to form a more balanced diet. Consultation with residents on individual preference was still in process and the person in charge agreed to consult a dietician with the final four weekly menus to ensure a wholesome balanced diet was on offer. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 People who use this service can expect to receive a level of personal and healthcare support that is in line with their needs and preferences. EVIDENCE: The support offered to residents at Barleycombe is at differing levels. The differing approach dependant upon ability and preference was clearly expressed by staff, who appeared to know individuals well. The documentation in daily statements by staff was factual and positive. Residents spoken with about personal care expressed satisfaction and said staff knew what to do to help. Resident’s appearance was casual, but also appropriate for the tasks undertaken around Barleycombe. Residents knew they had an allocated Keyworker. Residents were registered with a G.P. in Long Melford. This was also the route that service users accessed other health care services such as the District Nurse. The person in charge was aware of mental health, learning disability and social care teams from whom they could seek clinical guidance. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 14 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 standard(s) 22 People who use this service have a procedure open to them to complain, but they cannot be fully assured that a similar occurrence will be prevented. EVIDENCE: The home had a Complaints Procedure which was contained within the comprehensive Service User Guide and also displayed within the home, accessible to all service users, staff and visitors. The log of complaints held at the home was examined and found to be appropriate. Since the previous inspection, the CSCI had received one complaint in relation to this service that was investigated by the CSCI on 10th February 2005. Two elements were upheld and three requirements were made. A similar requirement is made again in relation to freedom of movement and access to all parts of the home. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24,27,28 and 30 Barleycombe is suitable for the stated purpose. EVIDENCE: Barleycombe is sited in extensive grounds which had been converted to accommodate livestock and the cultivation of vegetables. Most of the communal areas on the ground floor were viewed. Barleycombe is a comfortable home that is showing signs of wear and tear. The lounge could do with a coat of paint and the recent Regulation 26 report (Monthly management report) stated that the settee in the smoking room needs replacing. The person in charge was aware of the need to replace and upgrade the home. Dining room chairs were on order and plans of the new development were being discussed. Staff and residents knew about the development and were all positively looking forward to the planned changes. A photo diary of the changes had been started to show before and after. Accommodation is sited on two floors which are accessed via two staircases at either side of the building. In addition to the communal facilities, the home has fourteen bedrooms, all of which were offered for single occupancy. Whilst only one bedroom had the benefit of en-suite bath and toilet facilities, the home has an adequate number of communal bathrooms and toilets. Two of the Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 16 fourteen bedrooms were sited in a self-contained flat to the side of the building accessible by an exterior metal staircase. The flat is occupied by two service users and had its own lounge, kitchen and bathroom facilities. A handy man is around most days mending parts of the home. The home had no odour and was clean. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 33, 34, 35 and Recruitment of staff is robust and offers protection to residents. There are sufficient staff to meet the needs of residents. Regular formal supervision of staff cannot be assured. EVIDENCE: The roter for the previous 2 weeks, the current week and the planned week ahead were examined. Staffing levels were generally kept to five staff on duty during the waking day. Agency staff had been used on occasions. This enabled the planned activity roter to go ahead. On the day of inspection one member of staff had gone off sick, the Cook had recently left and one member of staff had to accompany a resident to Norfolk. Recruitment records for two new members of staff were examined. These contained all the relevant checks required. Evidence of TOPPS induction was seen for these two individuals. And said to have been completed in a further 5 other cases. Staff interviewed were asked about supervision, those interviewed said formal supervision does happen, but not frequently. The person in charge was able to Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 18 evidence that 4 staff members had been supervised recently, but on the plan of supervision there were gaps. Staff spoken with talked about training received, this included, safe handling and restraint, first aid, fire training, basic food hygiene and responding to abuse. One individual staff member spoken with was currently doing their NVQ 3 in Care. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40 and 41 People who use this service cannot be assured they will benefit from a well run service, but one that is trying to protect all who live there at the cost of independence of others. EVIDENCE: Currently the home is without a registered manager and has been without one since last year. The organisation had written to the CSCI and explained the difficulty in recruitment. The home is being managed by Ms Val Martindill in the position of Care Manager with the support of the regional manager Sandra Bishop, who was on sick leave at the time of this inspection. The lack of action on the previous requirements is a concern as these relate to policies and procedures that the home should have in place, as is the recent management decisions to lock the front gates. Lack of formal supervision of staff and the areas highlighted in the care plans around sanctions and restrictions of freedom to use the kitchen are a concern. Regulation requires the registered person to keep records on any limitation agreed with a resident Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 20 relating to freedom of choice, liberty of movement and power to make decisions. All these matters lead to the conclusion that the home is currently not always run in the best interests of the residents and needs a permanent qualified manager in post to bring the home to its full potential. Ms Val Martindill was very helpful throughout the inspection process and was working hard to ensure the home was running safely. It is believed this desire to keep residents safe was the motive in the limitations set at the home. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 21 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 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 2 2 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Barleycombe Residential Home Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 1 2 x 2 2 x x I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 22 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 6 Regulation 14 15 Requirement Care plans must be developed from up todate assessment of need and in agreement with the individual resident and their representatives. The care plan must describe any restriction or sanction on choice and freedom and must be made inagreement with the resident. Residents rights to make decisions are only restricted through assessment and must be recorded in their individual care plan. (This is repeat requirement from 10/02/05) Residents must be supported to take risks as part of an lifestyle. Individual risk management strategies must be in place for each individual following discussion with the resident and relavant specialist. The home must consult with residents and staff and develop a policy and procedure on relationships and sexuality. Staff must receive training. (This is a repeat requirement from 04/11/04) Freedom of movement must not be routinely resticted and should Timescale for action Immediate 2. 6 and 7 17(1) Immediate 3. 9 14 15 17(1) Immediate 4. 15 and 40 12(2) 17(2) 01/08/05 5. 16 12(1)(a) (2) 13(7) Immediate Page 23 Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 6. 36 18(2) 7. 37and 38 8(1) 8. 40 17(2) 9. 41 13(8) 17(1)(a) be the least restrictive option unless risk assessed and stated in an individual care plan. This is specific to the locked gates. Staff must receive regular, recorded supervision at least 6 times a year with their senior/manager. (This is a repeat requirement from 04/11/04) Residents must benefit from a well run home that relate to the homes stated purpose, therefore a competent, qualified and experienced person must be recruited and the current acting up position better supported. Staff must understand policies and procedures and relate them to their practice. This is in particular reference to risk assessments. Record keeping must safeguard the residents. This is particularly in reference to maintaining and keeping up to date assessments, care plans and any restriction placed upon any resident must be documented in detail. Immediate 01/09/05 01/08/05 Immediate 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 17 22 Good Practice Recommendations A dietician should be consulted in regard to the newly developed 4 weekly menu to ensure a wholesome balanced diet is on offer. Where a complaint has resulted in action required, lessons should be learnt to try to aviod a similar complaint or requirement being made of the home. Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ 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 Barleycombe Residential Home I54-I04 S24331 Barleycombe V232019 050527 Stage 4.doc Version 1.30 Page 25 - 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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