CARE HOMES FOR OLDER PEOPLE
Charterhouse Residential Care Home Second Drive Dawlish Road Teignmouth Devon TQ14 8TL Lead Inspector
Fiona Cartlidge Unannounced Inspection 10:40 5th July 2007 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Charterhouse Residential Care Home Address Second Drive Dawlish Road Teignmouth Devon TQ14 8TL 01626 774481 01626 774481 margaretbrett@btinternet.com 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) Margaret Louise Brett Stephan Barry William Brett Margaret Louise Brett Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (20), Old age, not falling within any other category (20), Physical disability over 65 years of age (20) Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th July 2006 Brief Description of the Service: Charterhouse is a registered Care Home that provides personal care for up to 20 people over the age of 60. It is able to accommodate elderly people and those with a physical disability such as mobility problems perhaps through arthritis or as a result of a fall. The home also has the category of DE (Dementia) so as to meet the needs of those with minor memory problems. The home is not registered to provide nursing care. The home is a large detached property situated on a quiet road about half a mile from the centre of the Devon seaside town of Teignmouth. It has been adapted to cater for some disabilities having a shaft and stair lift to aid residents to move freely between each floor. There are also assisted bathing and toilet arrangements using mobile hoists. The home has mainly single room accommodation with en-suites. Although there are two double rooms, both with en-suites, available for those who prefer to share. There is a lounge, a conservatory (sun room) and a separate dining room that are used daily by the residents. The Home has well kept grounds and being in an elevated position enjoys good views of the town, sea and surrounding countryside. Information provided to the Commission at the time of this inspection visit indicates fee levels range between £372 - £425/week, the actual fee depends on the assessment of individual residents and room occupied. Additional charges include chiropody £12, Hairdresser from £6.50 and paper/magazines at price charged. Information about the home including a copy of the last inspection report can be obtained on request from the administration office. A file containing information about the home was available in the entrance hall and a brochure is prospective residents and or their representatives. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The site visit took place over 4 hours it started at 10:40hrs and was unannounced. A partial tour of the home took place when some bedrooms and all communal areas were viewed. Two residents had their care case tracked this means their records were examined in detail and they were both spoken to in depth about the care and services they receive. Five other residents were spoken with during the visit, as were, the new manager and the registered providers. The Commission received completed surveys from 2, people who live at the home, 3 visitors/relatives and 8 staff members. Personnel records of 3 members of staff and policies and procedures were also inspected. What the service does well:
People who use this service have sufficient information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s needs are identified and planned for before they move to the home. People who use this service confirmed they receive a good level of care. Documented care plans had been regularly reviewed and updated to reflect changing needs, this is good practise because Staff use these records to inform them about how to meet peoples care needs; if the information is correct needs should be consistently met. People who use this service enjoy a peaceful, pleasant yet varied life, with family and local community links maintained and encouraged. During our visit, visitors were seen coming and going; visits were seen to take place privately in peoples own rooms and socially in one of the lounges. A family member took out one resident for the afternoon. It was evident through observation throughout our visit that people who live in the home are able to choose how, and where they spend their time. Comments on the returned surveys included: ‘ I have found very good friends indeed here’; ‘there is plenty of food’. One visitor commented ‘ I am always made very welcome and offered cups of tea’ The environment remains clean, warm, safe and comfortable. The home has been adapted over several years to provide accommodation for older people who require care. A shaft lift and stair lift is provided for residents who are Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 6 unable to use the stairs. The adaptations provided in the home appear to meet the needs of the residents. The residents spoken with during our visit said they felt there was sufficient staff to meet their needs they told us that the staff are ‘kind’ and ‘attentive’ and we observed staff being respectful and helpful to residents during our visit. What has improved since the last inspection? What they could do better:
To ensure people are aware of the current services available, information provided about the home should be updated to reflect recent changes in the management structure and staff available in the home. One recently admitted resident had not had their medication recorded as required. Any controlled medication brought into the home needs to be recorded in the homes ‘controlled drug register’ on its arrival. This will provide a system that can be readily checked to make sure that medication cannot be abused or used for people it is not prescribed for. There is limited choice of meals; at lunchtime on the day of our visit all of the residents ate stew, vegetables and potatoes no other option appeared available or was advertised. The cook and the provider told us that people could have had a salad if they did not want the stew but there was no evidence that this option had been communicated to people living in the home on the day. A choice of meals should be advertised/offered in written or other formats to suit the capacities of all people who use the service, this should be consistently (for every meal) given read or explained to ensure everyone is aware they have a choice of meals. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have sufficient information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s needs are identified and planned for before they move to the home. This home does not provide intermediate care. EVIDENCE: Prospective residents from within the locality have their needs assessed by senior staff from the home, this we were told ensures as far as is possible that their needs will be ably catered for and that they will (as far as is possible to ascertain) fit in to the existing community of the home. People admitted from further a field have their assessments performed by statutory social and or
Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 10 health care professionals and the information they supply allows the staff in the home to make a judgement about if and how their needs will be met. Prospective residents and or their representatives we were told are invited to visit the home and meet existing residents and staff, all are provided with a brochure introducing them to Charterhouse, informing them of the homes philosophy of care, visiting specialists, facilities, meals, visiting, staffing and care provision. More formal information about the home was found in a folder held in the entrance hall which included a Statement of Purpose and Service user guide, both of these documents need reviewing to account for recent changes in the management team at the home. People spoken with during our visit were not sure how they had chosen to live at Charterhouse but confirmed they had settled in well and were pleased with the service they receive at the home. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are provided with a good level of health and personal care and, they are protected by the homes policies and procedures for medicines. EVIDENCE: Residents spoken with confirmed they receive a good level of care. Personal records held on behalf of 2 Residents were examined; in those seen there were documented assessments and plans to meet peoples needs based on their daily activities of living. The care plans seen reflected the care plans provided by statutory authorities responsible for the contracting of their care. The plans of care are securely held and people who use this service can be assured the records held on their behalf are safe. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 12 The plans had been regularly reviewed and updated to reflect changing needs, this is good practise because Staff use these records to inform them about how to meet peoples care needs if the information is correct needs should be consistently met. All Residents are registered with a GP. At the time of our visit a GP arrived to perform a post admission assessment of a new resident the consultation took place I privately in the residents own accommodation. Records provided evidence that as well as visits from General Practitioners, specialist nurses and chiropodists visit. Records of outpatient appointments show that visits to community and hospital health resources are enabled. The medication system is generally well managed, we looked at storage and recording and checked balances against records of controlled medication stored in the home. One recently admitted resident had not had their medication recorded as required in the homes controlled drug register. The medication administration records were well maintained. Staff were seen and heard knocking on doors before entering rooms and were carrying out personal tasks in private. Staff observed in conversation with residents were heard to be courteous and respectful. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service enjoy a peaceful, pleasant yet varied life, with family and local community links maintained and encouraged. Various formal and informal impromptu activities are made available on a regular basis. Good quality meals are provided. EVIDENCE: During the site visit, some residents were seen sitting in the lounges in conversation, reading or watching the television. Other residents were seen spending time in their rooms, reading, listening to music, or watching television. Staff were seen encouraging and enabling residents to engage in meaningful conversation.
Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 14 During our visit, visitors were seen coming and going visits were seen to take place privately in residents own rooms and socially in one of the lounges. A family member took out one resident for the afternoon. There were no organised activities on the day of our visit. The records seen did not contain information about people’s life experiences their interests or hobbies. Failure to record this information may mean that the staff are unable to provide a ‘person centred’ approach to meeting the individual social and psychological needs of people living in the home. Organised activities are advertised on a notice board situated in the entrance hall and the staff informed us that they communicate these verbally to the residents. Advertised activities included general activities on Tuesdays and Wednesdays and hairdressing and manicures on Thursdays and shopping trips in the afternoons – subject to staff availability. When people attend activities this is recorded in a diary. Videos, games and books were seen to be available in the lounges. At the time of our visit all the residents living in the home were of British origin and white. They were predominantly of a Christian faith; People told us that they are able to attend religious services both within the home and in the local parish. The feedback about food was positive all of the residents spoken with said how good it was; Most residents ate lunch in the dining room. The food served at lunchtime looked and smelt appealing. There is limited choice of meals at lunchtime on the day of our visit all of the residents ate stew, vegetables and potatoes no other option appeared available or was advertised the cook and the provider told us that people could have had a salad if they did not want the stew but there was no evidence that this option had been communicated to people living in the home on the day. It was evident through observation throughout our visit that people who live in the home are able to choose how, and where they spend their time. Comments on the returned surveys included: ‘ I have found very good friends indeed here’; ‘there is plenty of food’. One visitor commented ‘ I am always made very welcome and offered cups of tea’. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 15 Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for protecting people who use this service and responding to their concerns are satisfactory. EVIDENCE: This service has a complaints procedure it is clearly written and easy to understand and was seen advertised in the guide about services. Residents and visitors confirmed that they felt comfortable discussing issues with the staff and manager. One complaint had been received by the Commission this had been passed to the provider and had been investigated fully and action taken to minimise the risk of a reoccurrence of the issue. A Suggestions box was situated in the entrance hall of the home. Records seen show that the Staff are made aware of and attend training on the recognition and reporting of incidents or allegations of abuse or neglect, 7 of the 8 staff who returned surveys to us indicated they are aware of adult protection procedures. The homes policy and procedures for safeguarding adults gives guidance about referring to external agencies. Residents said they feel safe living in the home.
Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 17 Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment remains clean, warm, safe and comfortable. EVIDENCE: Charterhouse has been adapted from a large private detached house. It is set with in it’s own grounds. The front rooms of the home have views towards the sea. The home is attractively presented and was fresh and clean during the inspection visit. The residents asked said the home is always fresh and clean. Redecoration of individual residents rooms has continued since the last inspection. Some rooms whose occupancy has not changed looked in need of redecoration and refurbishment, the provider said that the resident in one room which is particularly in need of attention has refused to move and therefore the work needed cannot be carried out.
Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 19 One WC off a corridor adjacent to a bedroom (without an en suite) lacks handwashing facilities. One bathroom which is used for people living in the home who need assistance to get in and out of a bath contained a hoist with a chair, it was noted that the seat was in need of repair or replacement as the covering had been damaged over time. Notices on the hoist confirmed it had been serviced recently. The home has been adapted over several years to provide accommodation for older people who require care. A shaft lift and stair lift is provided for residents who are unable to use the stairs. The adaptations provided in the home appear to meet the needs of the residents. All bedroom doors have been fitted with locks this facilitates peoples individual choice about their privacy and security. Individual risk of scalding from hot water outlets in wash hand basins have been completed and were seen in the records of the 2 residents who had their care case tracked. During the inspection the residents were using both lounge areas and the dining room. Two of the residents said they liked watching the birds in the garden and the occasional squirrel. The small laundry area is set away from the resident’s rooms. The laundry flooring is made of concrete that has been painted. The kitchen was clean and is well equipped. The new manager has introduced a safer food system since starting at the home. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are well trained and supported, and employed in sufficient numbers to meet the service users’ needs at all times. EVIDENCE: Three Personnel files were examined, these records generally showed a commitment to safe recruitment practises, the files either contained detailed application forms or Curriculum Vitaes. Two of the files seen indicated the staff had been employed through an employment agency references were on file from employment they had had in their previous country of residence. Work permits were available for both of these people. There was evidence of Criminal Record Bureaux checks, and each file held proof of the person’s identity. Training and development records provided evidence that training is provided and ongoing. Of the 8 Staff who returned surveys to us 5 indicated they receive sufficient training to enable them to meet the needs of those living in the home. All new members of staff have to work through an in house
Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 21 induction programme this has not been validated as being equivalent to the nationally recognised training - the ‘working in care induction standards from the Skills for Care Scheme’. One member of staff commented on their returned survey ‘they gave us a good induction training to help us to understand the way a care home works’. Other comments received on the staff surveys included ‘ we need more staff in peak busy times’, ‘we need an increase of 1 staff member on each shift to provide more time to be spent with people who live in the home’, ‘ we should not have to use supper and laundry staff as carers’. The residents spoken with during our visit said they felt there were sufficient staff to meet their needs they told us that the staff are ‘kind’ and ‘attentive’ and we observed staff being respectful and helpful to residents during our visit. Two comments on returned surveys from visitors to the home about the staff, included ‘there appears to have been a high turnover of staff’. The provider told us that ‘some staff that had been employed through an employment agency, had not fulfilled their contractual obligations and had left leaving the home in a difficult position. This employment agency is no longer used by the home and staffing in the home is now stable’. Information provided in the pre-inspection questionnaire suggests that 8 care staff (60 ) have obtained a National Vocational Qualification (NVQ) in care at level 2 or above. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home is managed well and run in a safe way, which also takes into account the best interests of service users. EVIDENCE: The home’s current manager is also registered as one of the providers of this home. Mrs Brett is a registered nurse with several years experience. A new manager has been employed who has experience of managing another registered home the process of her registration under the Care Standards Act 2000 has recently begun.
Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 23 The home uses both formal and informal modes of communication. There are clear lines of accountability. We looked at the records of a recently held staff meeting and a notice indicated that another meeting is planned in the near future. The provider told us they had recently sent out satisfaction surveys to residents and their representatives but none of these had been returned. We were shown the blank survey forms and the new manager told us they plan to develop a system for feedback, which will be recorded and reported on. Comments on returned surveys to us from staff included ‘the manager always give us support’. During this inspection examination was made of the arrangements for dealing with service users independent finances. The home has a robust system, which ensures that service users’ monies, are safeguarded and protected. Purchases are receipted, and examination of the system demonstrated that references could be cross-referenced with purchased items. Safety notices were displayed throughout the home including action to be taken in case of fire and how to Control Substances hazardous to health. Written information provided to the inspector by the provider before the inspection indicates that all equipment is regularly maintained and tested. This was verified during the visit with records held within the home. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP1 OP9 OP15 Good Practice Recommendations Information available about the home should be updated to reflect recent changes in the management structure and staff available in the home. Any controlled medication brought into the home needs to be recorded in the homes ‘controlled drug register on its arrival. A choice of meals should be advertised/offered in written or other formats to suit the capacities of all people who use the service, this should be consistently ( for every meal ) given read or explained to ensure everyone is aware they have a choice of meals. Charterhouse Residential Care Home DS0000053232.V338949.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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