Inspection on 20/04/05 for Cheney House

This inspection was carried out on 20th April 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

Cheney House 14/05/09

Cheney House 08/12/08

Cheney House 28/02/08

Cheney House 05/04/07

Cheney House 06/04/06

Cheney House 11/10/05

Cheney House 16/12/04

Cheney House 01/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Cheney House Rectory Lane Middleton Cheney Banbury Oxon, OX17 2NZ Lead Inspector Kathy Jones Unannounced 20 April 2005 09:35 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. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cheney House Address Rectory Lane Middleton Cheney Banbury Oxon OX17 2NZ 01295 710494 01295 712784 cheneyhouse@regalcarehomes.com Regal Care Homes Ltd 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) Vacant Care Home Only 34 Category(ies) of Older Person (OP) 34 registration, with number Dementia over 65 Years (DE(E) 34 of places Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16 December 2004 Brief Description of the Service: Cheney House is a care home providing personal care and accommodation to thirty four older people who may have a dementia related illness.Cheney House has been registered as a care home for a number of years and is now owned by Regal Care Homes Ltd. The home has been registered with Regal Care Homes since January 2004. The Home is situated within its own grounds and located in a village.The building was a former rectory and is a listed building. There are nineteen single bedrooms with nine having en-suite toilet facilities. Of the eight rooms which are shared by two people two have en-suite toilets. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over the morning and afternoon of a weekday. The inspection involved review of records relating to the assessment and planning of care needs, staff recruitment and training records. Discussions with Service Users and observations of the daily routines and care provided were made. The Inspector also met with Staff and the Deputy Manager to discuss the care provided. Comment cards were received from fifteen Service Users and three relatives/visitors prior to the inspection. The Deputy Manager advised that Staff had assisted the majority of the Service Users with the completion of the forms, as they were unable to complete them independently due to dementia. Inspector’s conversations with Service Users confirmed that the majority are unable to answer complex questions however observed them to be relaxed in the company of Staff. The Deputy Manager completed a pre-inspection questionnaire, which provided the Inspector with some information to inform the inspection. What the service does well: The home has a core of Staff who appears keen to work on improving the standards of care provided to Service Users. Comment cards received from Service Users confirmed that Staff treat them well and that they feel safe in the home. This was supported through Inspectors observations and comments received from Service Users during the inspection. The lunchtime meal on the day of inspection was freshly cooked and looked appetising. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: The high number of requirements contained in this report identifies many areas where improvements are needed and the requirements, which remain unmet from the previous inspection, are of particular concern. The Commission for Social Care Inspection will closely monitor compliance with requirements. Improvements in assessment, care planning and staff training need to be made to ensure that Service Users needs including health care needs can be properly met and Service Users are not put at risk. Staff training, recruitment and Staffing levels are all areas where improvements need to be made to ensure that Service Users are not put at risk and that they can be properly cared for. The condition of the environment is poor although recent re-painting has improved the appearance to some extent. The carpets, curtains and furniture are in very poor condition throughout the home and are in need of replacement. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 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. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home does not provide intermediate care therefore standard 6 is not applicable. The admissions process provides no assurances that Service Users needs can be safely met. EVIDENCE: Records’ relating to the admission process for a recently admitted Service User identified that the only information gathered was contact details for next of kin, General practitioner and care manager. Discussion with the Deputy Manager about the process for admission identified that the Service User had been admitted late one evening in an emergency however the result of this was that important information such as known medical conditions and allergies had not been received. The homes pre-admission assessment form was completed six days after the emergency admission, this contained only minimal information regarding the Service Users needs and no information had been received from Social Services Care Management or other Professionals. Review of an incident, which occurred in the home, identified a situation where insufficient information had been gathered regarding a Service Users needs Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 10 prior to admission and it was later found that staff did not have the necessary experience or training to meet them. A requirement was made following the last inspection about the need to gather sufficient information prior to admission to confirm that the needs of anyone admitted can be met. This requirement has not been met. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 10 The shortfalls in planning of care and instruction to staff have the potential to put Service Users at risk particularly in relation to meeting dietary needs. EVIDENCE: Thirteen of fifteen feedback cards received from Service Users state that they feel well cared for and the other two state sometimes. Three feedback cards from relatives/visitors confirm that they are satisfied with the overall care provided. Individual plans of care are in place for Service Users and more detail has been added in some areas following the requirement made at the last inspection. For example in one care plan seen more detail was included about the aspects of personal care the Service User was able to manage independently reducing the risk of staff taking away independence and dignity. Some areas of the care plan contain very general comments such as “ensure proper footwear” rather than considering the appropriateness of the individual’s footwear. This could increase the risk of falls. A care plan identified that a Service User could become aggressive when surrounded by noise however there were no instructions to staff as to how this Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 12 should be avoided. Instructions within the care plan about the management of aggression were not based on good practice and from discussion with the Deputy Manager about the Service User were likely to increase the level of aggression if followed by Staff. Staff advised that a record had been introduced to monitor the amount of food and fluid taken by a Service User experiencing consistent weight loss. The care plan had not been revised to reflect this change. Review of the food and fluid record identified up to seventeen-hour gaps between meals offered. Staff confirmed that no alterations to increase calories or the frequency of meals had been made. Appropriate action had been taken in requesting a visit from the General Practitioner; this had not taken place at the time of the inspection visit. The Commission for Social Care Inspection has received two complaints since the last inspection and one was in the process of investigation at the time of the last inspection. Two of these complaints raised concerns regarding weight loss. There was evidence that the General Practitioner had been consulted in both cases. There was no evidence that the weight loss was as a result of poor care in these cases however the findings of this inspection identify the need for the home to review how they are meeting Service Users nutritional needs. All of the fifteen Service Users who returned comment cards confirmed that their privacy is respected. The Inspector observed Staff to speak to Service Users in a respectful manner. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15. The homes routines particularly in relation to the timings of meals and provision of activities are not based on the needs of the individual. EVIDENCE: Six feedback cards received from Service Users said that the home provides suitable activities with nine saying that suitable activities are provided sometimes. An activity organiser has been appointed for twenty hours per week since the last inspection and information regarding Service Users interests is starting to be collated. This should enable activities to be provided which are of interest to Service Users. A visitor to the home has commented in a feedback card that they are pleased that residents have been encouraged to join in activities in the afternoons. There was limited time available for Staff to sit and talk with Service Users however they were seen to make use of opportunities available. Feedback cards from relatives/visitors to the home confirmed that they are welcomed into the home by Staff and have the opportunity to visit in private. Three Service Users said that they found the food to be good and had enjoyed their lunchtime, which was fresh salmon, salad and new potatoes with Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 14 semolina for dessert. The four week menu provided by the company has been adapted to suit the tastes of the Service Users in the home. Menus offer a good variety of foods, there is no choice of main meal on the menu however one Service User said they were a fussy eater and an alternative would be provided if they didn’t like what was on the menu. Lunch and tea are at set times with breakfast being served when Service Users are washed and dressed. In some cases there are long gaps between tea and breakfast, which gives concern about the adequacy of food and fluid intake. Advice has been given to review the needs and routines of each individual, which may have changed due to their dementia, and to adopt a more flexible approach to times of meals. The Deputy Manager was very receptive to the comments made and advice given and has told the Inspector following the inspection that arrangements are being made for a dietician to visit the home to talk to staff and give advice about meeting the dietary needs of older people particularly where weight loss is identified. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 15 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 Communication systems now enable any complaints or concerns to be dealt with at an early stage. EVIDENCE: The Commission has received two complaints for Social Care Inspection since the last inspection and another complaint was being investigated at the time of the previous inspection. The complaints all related to poor care practices and standards of care and were raised with The Commission for Social Care Inspection (CSCI) as a result of the concerns not being dealt with by the Manager. The complaints were referred to the Responsible Individual for Regal Care Homes Ltd for investigation and CSCI met with him and the directors of the company to discuss the findings and proposed actions. No further complaints have been received and The Commission for Social Care Inspection were satisfied that the company acknowledged the need to monitor how relatives concerns are dealt with and acted on to make sure Service Users are not receiving a poor standard of care. Feedback cards received indicated that relatives are aware of the complaints procedure and Service Users are aware of who to speak to if they are unhappy with their care. The Deputy Manager said she tries to make a point of talking to relatives to check if there are any areas of concern so they can be dealt with at an early stage. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 16 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 and 26 Re-decoration has improved the appearance of the home, however the environment remains poor due to the condition of the carpets, curtains and furniture. EVIDENCE: A limited tour of the premises was carried out. This demonstrated that the home was clean and tidy. Improved cleaning methods have reduced the odour noted on the previous inspection. The environment was in poor condition when the current owners purchased the home in January 2004 and various timescales have been discussed with The Commission for Social Care Inspection for the refurbishment of the home. The Deputy Manager said that all rooms in the home have now been painted and she believed that new carpets, curtains and furniture were on order and due to be delivered in about six weeks. The paint has improved the appearance of the home however carpets, curtains and furniture are in very poor condition throughout the home. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 17 Alterations to the premises have been made since the last inspection and the Managers office is now located on the ground floor making the management team more available to Service Users, Staff and visitors. The management team can also more easily monitor care practices. The Pre-inspection questionnaire confirms that relevant safety checks include checks on fire safety equipment, central heating system and the lift. Staff did not know if an electrical wiring certificate has been issued and a requirement is made that checks are made to ensure that all relevant checks have been made. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 18 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 and 29 Staff training, recruitment procedures and Staffing levels do not provide adequate care and protection for Service Users. EVIDENCE: At the time of the inspection there were twenty-seven Service Users with the majority having dementia and needing a lot of assistance, supervision, and support. Some of the Service Users need two staff to assist them to the toilet or to bed. Staff rotas identify that there are only two staff on duty from 8pm each evening, which means that any Service User needing the assistance of two carers has no choice but to go to bed before 8pm, or that other Service Users are left unsupervised while staff assist them to bed. Similar issues were identified at the previous inspection and a requirement was made to review staffing levels taking account of Service Users needs at all times of the day. This requirement has not been met. Files for staff who had recently started work in the home showed that criminal record bureau clearances are being received prior to staff starting work however the required two references had not always been received. The Deputy manager has taken on the responsibility for staff recruitment since the Manager left however has not received any training in this area. The Inspector gave advice about how to access up to date information on the information to be gathered before staff start work. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 19 Discussions with Staff and records show that Staff are keen to do National Vocational Qualifications however at present very few have enrolled on the training. The dementia care training undertaken by staff at present is less than half a days training which is insufficient to give staff a good understanding of how to meet Service Users needs. The Inspector was informed that more substantial training is planned initially for Senior Staff. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 20 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) 31 & 38 The appointment of a manager who will provide strong leadership and support to the staff team is required to ensure that regulations are fully met and Service Users are properly protected. EVIDENCE: The Registered Manager has left since the last inspection. The Deputy Manager is carrying out the management duties with support from the Company Directors. The Commission for Social Care Inspection have been informed that the Company are advertising for a new manager. The Deputy Manager has worked hard in improving the management and organisation of the home and in improving communication with Staff, Service Users and relatives. Staff said they were much happier and the atmosphere in the home was noticeably more relaxed than during the previous inspection, which makes for a pleasanter environment for Service Users. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 21 Directors from Regal Care homes Ltd visit the home on a regular basis and the Deputy Manager advised that they are always available for her to contact if she needs advice. Improvements have also been made in the organisation of records, which have been brought down to the new office on the ground floor, making the management team more accessible to Service Users, Staff and relatives. When watching Staff assisting Service Users into the dining room for lunch two Staff were seen trying to help someone off a low chair using incorrect moving and handling procedures. This could have caused an injury to the Service User or Staff. The Inspector found that five new members of Staff had not yet had moving and handling training. Staff carrying out movement and handling without training puts Staff and Service Users at risk of injury. An immediate requirement was made for Staff to receive training before they assist with moving and handling. The Commission for Social Care Inspection have received confirmation that the Staff rotas have been altered to ensure this happens. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 22 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 1 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x x x x 2 Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 23 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 3 Regulation 12 (1) (a & b), 17 (1) (a), 14 (1) (a &d) Requirement There must be evidence that a full assessment has been carried out prior to the admission of all service users and written confirmation of the homes ability to meet their assessed needs.(Previous timescale of 15.01.05 not met) Up to date care plans must be in place which contain specific information regarding the individual needs and the required actions of the carer. (Previous timescale of 15.02.05 not met) Care plans based on nutritional assessments must be implemented in all cases where weight loss is identified. Food and fluid must be provided to all Service Users at regular intervals with the gap between the tea time meal and breakfast being reduced. Appropriate activities and stimulation must be provided based on individual needs and choices. Details of how, what and when activities will be provided must form part of the care plan.(Previous timescale of 15.02.05 not met) Timescale for action 30.05.05 2. 7 12 (1) (a & b) 15.06.05 3. 7, 8 12 (1) (a & b), 13 (4) (c ) 12 (1) (a & b), 13 (4) (c ) 16 (2) (n), 12 (1) (a) 30.05.05 4. 8,15 30.05.05 5. 12 15.06.05 Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 24 6. 19 13 (4) (a & c), 23 (2) (c) 7. 19,20,24 8. 27 9. 29 10. 30 11. 30, 31 12. 38 An electrical wiring certificate must be in place to confirm that relevant checks have been carried out. 16 (2)(c ), The planned refurbishment 23(2) programme which includes (c,d) replacement of carpets, curtains and furniture must be completed. 12 (1) (a Staffing levels must be increased & b), 18 during the evening and be (1) (a) sufficient to meet the assessed needs of Service Users throughout the twenty four hour period. 19 (1) (a, A thorough recruitment b, c), 19 procedure is to be put in place, (5) (d) which includes obtaining appropriate references. (A previous timescale of 16.12.04 has not been met) 12 (1) (a More comprehensive programme & b), 18 of dementia care training must (1) (a), be provided. 18 (1) (c) (i) 12 (1) Sufficient training and support (a),18 (1) must be provided for Staff (c) (i) carrying out management duties prior to the appointment of a Manager to ensure that all regulations are met and Service Users appropriately cared for. 13 (4) , Staff carrying out movement and 13 (5) handling must have received up to date training.(A similar requirement with a timescale of 15.02.05 has not been met) 30.07.05 30.07.05 15.06.05 30.05.05 30.07.05 15.06.05 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. Refer to Standard Good Practice Recommendations C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 25 Cheney House 1. 8,15 2. 29 Consideration should be given to providing small meals with a high calorific value more frequently to Service Users with dementia experiencing weight loss and identified as small eaters. Training should be provided for Staff taking responsibility for Staff recruitment. Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Northamptonshire Area Office Newland House, First Floor Campbell Square Northants, NN1 3EB 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 Cheney House C51 C08 S12735 Cheney House V222473 200405 - Stage 4.doc Version 1.30 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!