Inspection on 06/01/06 for Claydon House

This inspection was carried out on 6th January 2006.

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.

Other inspections for this house

Claydon House 16/11/07

Claydon House 03/05/06

Claydon House 19/07/05

Claydon House 02/03/05

Claydon House 28/09/04

Claydon House 26/02/04

Claydon House 30/09/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Claydon House 8 Wallands Crescent Lewes East Sussex BN7 2QT Lead Inspector Elizabeth Dudley Unannounced Inspection 6th January 2006 10:00 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 Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 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. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Claydon House Address 8 Wallands Crescent Lewes East Sussex BN7 2QT 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) 01273 474844 01273 486175 Claydon House Limited Vacant Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is thirtytwo (32). Service users must be older people aged sixty-five (65) years or over on admission. 19 July 2005 Date of last inspection Brief Description of the Service: Claydon House is registered to provide personal care and assistance for up to 32 Older People and has been owned by Caring Homes Ltd since March 2000.The building consists of a detached Victorian house has been extended to provide accommodation over four floors. It is situated in a quiet private drive on the outskirts of Lewes. Lewes town centre is approximately half a mile away and there is access to all main transport links and local amenities. There is limited parking space outside the home but unrestricted parking in surrounding roads, Wallands Park is within five minutes walking distance. Accommodation is comprised of mainly single rooms, with a shaft lift accessing all floors. There are two lounges and dining rooms and a conservatory which allows easy access to a sheltered garden. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 6th January 2006 and forms part of the annual inspection programme for this home. In the absence of the manager it was facilitated by Mr Blaber, administrator, Ms G Bluck and Ms D Efford, senior care assistants. During the inspection a tour of the home was undertaken, care plans, medication records and personnel files examined and six members of staff and twenty-one residents spoken with. What the service does well: What has improved since the last inspection? The home has employed an activities person who is enthusiastic with innovative ideas for activities. The manager is now settled in post and has concentrated on improving the amount of training given to staff to ensure that residents have the best of care. The majority of the requirements made at the last inspection have been complied with. The cleanliness within the home has improved Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 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. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5 Residents have the opportunity to visit the home prior to their making the decision to move in. The manager undertakes a thorough assessment of each prospective resident to ensure that the home can meet their needs. EVIDENCE: The manager meets and assesses all prospective residents to ensure that the home can meet their particular needs and to allow the resident to be confident that Claydon House is the right home for them. The pre admission assessment forms the basis of the care plan. Prospective residents and their representatives can visit the home to look around and to meet the other residents and staff prior to making the decision whether to move into the home and all residents move in on a months’ trial basis. Residents are given a copy of the home’s terms and conditions on their point of admission into the home. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Review of care plans need to be undertaken on a monthly basis to ensure that staff are aware of the care needs of the residents. The system of medication administration ensures the safety of residents. EVIDENCE: Ten care plans were examined and identification of the care to be given to residents was good. Instructions were clearly written and all aspects of care including psychological, physical and spiritual needs have been identified. However many of the care plans had not been reviewed on a monthly basis and some had not been fully completed. This must be addressed. All care plans included evidence that the resident or their representative had been included in the planning of the care and some residents spoken with were knowledgeable regarding their care plans. There was evidence of Waterlow scoring and nutrition care plans, again not always reviewed on a monthly basis, and some care plans included a miniature biography of the resident. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 10 The manager must ensure that the care plan format is consistent and reviewed monthly throughout the home and that all senior staff are aware of the need to complete and review care plans. There was evidence of district nurse and GP involvement in resident care and an optician and dentist can be accessed if required. Staff stated that the needs of many of the residents have increased with greater continence and mobility needs being noted. Residents stated that they were treated with dignity and respect by staff. The majority of medications were seen to be signed for on administration with only one specific date showing lack of signature following administration. Self-medication risk assessments were in place and seen to be reviewed on a regular basis. It was previously recommended that clinic room temperatures be monitored with a view to ensuring that medications were being kept at an optimum temperature. This has not been done. A small fridge has been provided in the clinic room, staff must refrain from storing eye drops etc on top of the temperature sensor as this distorts the reading. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The provision of activities is now improved following the employment of an activities co-ordinator and this will benefit the residents by allowing them to pursue previous interests and to enjoy new ones. The standard of catering is at present, variable. Residents were disappointed with quality of food provided and this must be improved, as good nutrition is essential for the wellbeing of older residents. EVIDENCE: Residents stated that they were able to choose their times of getting up and going to bed and this information was also recorded in their care plans. Most people spoken with said that they could do what they wished during the day, making their own plans to go out and deciding whom they wished to see. Some residents felt sure that if they were out at a hospital appointment or elsewhere and unable to get back to the home in time for meals that one would be saved for them, but they were unsure about the flexibility of breakfast time, one person stated that they thought that asking for a later breakfast “ may put the cat amongst the canaries”. An activities co-ordinator has recently commenced work at the home and is at present compiling a programme of activities based on resident’s interests. Records of social interests and needs were being organised and some activities Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 12 including exercise sessions and one to one sessions have taken place. Plans are being made to commence flower arranging classes, baking, and an opera week. Previous activities undertaken include crafts, some musical entertainment and recently a Christmas party and carols. A small activities programme is in place. It is expected that Claydon House will now provide quality activities which are well planned and recorded, and which illustrate the past and present interests of residents. A current activities programme must be displayed within the home where all residents can access it. The programme presently displayed does not accurately reflect the activities taking place. The home has an open visiting policy and residents confirmed that visitors are welcome at any time. Catering within the home is at present provided by a series of agency cooks. The kitchen was clean but the cook on duty was unable to provide records or answer any questions about the catering. A catering student was employed in the kitchen to gain work experience, but was unable to provide information as she has only worked under temporary staff. The meal of the day was fish pie, broccoli, tomato and cheesecake. Although the fish pie appeared well cooked and nicely presented, the portions appeared small. Cheese cake was served as dessert. The Supper was to consist of soup, sandwiches and scrambled egg, care staff stated that they had to prepare the supper and wash up following this, they also said that at present they were responsible for most of the kitchen cleaning. A kitchen assistant is employed during the main part of the day. Cakes were being made for afternoon tea and there were supplies of fresh fruit and vegetables. Residents said that they were told of the choice of menu on a daily basis and were able to choose what they wished to have from specific alternatives to the main menu; the daily menu was also displayed in the dining room. The complaints record and minutes of residents meetings showed that there had been concerns raised about the food by residents and that the manager was aware of these. Residents spoken with on the day stated that “ The food is variable”, “ The food is not good, the cooks are no good at all”, “The food is alright but it depends what cook is on as they are from the agency and some weeks they are alright and some weeks not so good”, “ The cooks don’t seem to know what they are doing”. “ They seem to be cutting down on food”, “ The fees are the same but they are cutting down on food” Staff said that meal portions had only been small this week with this particular cook, and that on previous weeks there had been large portions and plenty of food. Residents looked well nourished and the range of food offered on the menu was good. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 13 The administrator stated that all staff including catering staff has the food hygiene course. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 16,18 The home has a complaints policy and staff are aware of their responsibilities relating to the protection of those in their care. EVIDENCE: The home has a complaints procedure, which meets the standard, and a complaints log is kept in the entrance hall. Any complaints relating to staff or residents must be kept confidential. Staff spoken with were aware of the complaints procedure, their role in the protection of those in their care and the whistle blowing policy. The majority of staff have attended training regarding the protection of the vulnerable adult and this forms part of the induction training on their commencement of employment in the home. Staff personnel files evidenced that CRB checks and POVA first checks had been obtained prior to the staff commencing duties at the home, thereby ensuring the safety of residents within the home. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 19,20,21.22,23,24,25,26 Communal areas and individual rooms are comfortable providing a pleasant environment for residents. EVIDENCE: The standard of décor and maintenance is variable, communal areas are very pleasantly decorated and maintained, but some of the individual rooms and corridors will need to be redecorated in the near future. Refurbishment of the ground floor is planned, which was scheduled for 2005 but has not been commenced. Minor maintenance issues seen included the application of re-sealant and regrouting of tiling in some bathrooms and over washbasins in some bathrooms. A plug requires fitting to the washbasin in the ground floor bathroom, the staff room requires re-plastering in places. Carpets in some bedrooms require replacing. Communal bathrooms on the upper ground floor looked uninviting and needed maintenance to their flooring and walls. However those on the two upper floors were pleasantly appointed and decorated. The home still has w.c stalls which are not acceptable for privacy or dignity and wc facilities should be domestic in Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 16 character. This was discussed at the last inspection and the inspector assured that these were due to be refurbished. Plans to address this need to be sent to the CSCI. The lounges are comfortable and the large conservatory is used as a sitting area, which gives access to the garden. This was a very pleasant area, comfortably furnished and with plants creating an open feel. Residents were seen to be using this. The main lounge requires an extension to the call bell so that residents can reach this without having to stand and stretch over chairs. Rooms that are occupied look comfortable and it is evident that residents can bring in their own possession. Lockable facilities and lockable doors have now been provided but there was no evidence of which residents have been given the choice of having keys to their doors Two residents commented on the lovely views from their windows, these look across the garden and one said that ‘there was always something to watch’. Water temperatures have been not been recorded since August 2005. Most residents said they found their rooms comfortable although some identified the need for redecoration and re-carpeted. The home needs to be assessed by an occupational therapist or other suitably qualified person to determine whether there are sufficient aids and equipment and determine the homes suitability for its purpose. The standard of cleaning in the rooms was reasonable and that around the communal areas was fair. There is only one member of domestic staff on duty for the whole home, and therefore she is to be praised on doing the cleaning as well as she does. The manager must employ domestic staff relevant to the size of the home. A comprehensive range of infection control policies is available and staff stated that they were aware of these. Latest infection control research advises against bar soap being left in communal bathrooms and this should be removed. This was a requirement on the last inspection but is still being left in bathrooms Staff said there were sufficient gloves and aprons available. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staffing levels need reappraising to ensure that there are sufficient staff on duty to meet the care, domestic and catering needs of the residents. Staff receive training to ensure that they are able to deliver knowledgeable safe care to residents. EVIDENCE: The administrator and staff stated that at present there are two care assistants, one senior care assistant employed in the mornings and afternoon and two waking night staff at night. There is only one member of domestic staff in the home at present, and all catering staff apart from one kitchen assistant are provided by an agency. Although the home has only twenty-one residents in the home at present (registered for 32). Nine of these residents require full hygiene assistance with personal care and eight residents are incontinent. The home is also large and spread out. All staff stated that the staff/ resident ratio was not enough at present given the needs of this group of residents, and also identified that they had to help with cleaning, help with meals and do the laundry. They felt tired, stressed and unsupported at times even though all felt that the manager did her best to support them. If the manager acts as senior carer, other management tasks call her away and they are sometimes left with two staff. There is a fair staff turnover and staff identified that the pressure of work is partly to blame, but also spoke of the lack of staff facilities such as a staff room where they could have a meal without residents being around. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 18 Care-plans evidence that needs of this resident group are high and it was seen that the size of the building adds extra time to tasks. It was evident that the one member of domestic staff is also feeling tired and undervalued. The home is large and therefore the member of staff finds it difficult to clean this completely. The home takes in student nurses on work placement. The student nurse on placement at this time said that she found working at the home interesting and that the staff worked hard The manager must address this staffing problem, the provision of staff must be needs led, rather than led by the numbers of residents in the home. However staff said that they enjoyed working at the home and felt that they had plenty of training. All staff undertake an induction course, two staff are in possession of NVQ2 and four are training for this qualification. Staff training files are in place and there was evidence that staff have attended all mandatory training and other training as relevant. Six personnel files were examined and these contained all information as required by Regulation 19 and Schedule 2 Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,36,38 Regular resident meetings are held for residents to make their views known. Some issues relating to health and safety need attention to ensure residents safety at all times. EVIDENCE: The home holds residents meetings on a bi monthly basis and staff meetings on a monthly basis. Minutes are held of these but these need to show evidence of interactive discussion to maintain viability. An external company undertakes quality monitoring on an annual basis and this includes sending questionnaires to residents. Staff now receive supervision on a six monthly basis and there was evidence that regulation 26 visits were being undertaken. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 20 Certificates relating to the maintenance of utilities and equipment were in place but there were some areas of concern relating to other health and safety issues. No testing of hot water outlets had taken place since August 2005. One resident had a kettle in her room, which was neither risk assessed or PAT tested. The laundry door and maintenance room doors must be kept locked, both these had notices on them stating this but were unlocked. A room used for storing unused furniture and equipment to be kept locked. The hairdressing room must have a bolt affixed to the door. No chemicals or toiletries to be left in communal bathrooms The fire door on the top floor must be made safe. The tape around the carpet by the lift on the upper ground floor must be renewed. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 21 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 x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 1 3 2 1 3 2 2 2 STAFFING Standard No Score 27 1 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x x 3 x 1 Yes Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Claydon House DS0000021410.V268761.R01.S.doc 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 2 Standard OP7 OP9 Regulation Reg 15(2) Reg 13(2) Requirement That care plans are consistent in the information provided and are reviewed on a monthly basis. That temperatures in the clinic room are monitored to ensure that medications are stored at an optimum temperature. That an activities programme relating to current activities is on display. That call bells in the lounge are provided with leads to enable them to be easily reached by service users. This was a previous requirement June 2005 That the quality of catering is improved and attention paid to the quantity of food served. Efforts to employ a regular chef to continue. That the home is assessed by a suitably qualified person This was a previous requirement June 05 Ensure that sufficient numbers of staff are employed as appropriate for the health and welfare of service users That sufficient domestic staff for the size of the home are employed. Students attending the home on DS0000021410.V268761.R01.S.doc Timescale for action 01/04/06 06/01/06 3 4 OP12 OP19 Reg 16(m) (n) Reg 23(2)(b)( d) (c) 01/03/06 06/01/06 5 OP15 Reg16(2)( i) 06/01/06 6 OP22 Reg 23(1)(a) Reg 18 (1)(a) Reg 23(2)(d) Reg 19 01/04/06 7 OP27 06/01/06 8 9 OP26 OP29 10/02/06 06/01/06 Page 23 Claydon House Version 5.1 10 OP34 Reg 25 3(a)(b) 11 OP38 Reg 13(4) 12 13 OP38 OP38 Reg 13(4) Reg 13(4) 14 15 OP38 OP38 Reg 13(4) Reg 13(4) work experience must have a current CRB in place. That a copy of the annual accounts of the care home including business plan for 2005/6 for Claydon House is sent to the CSCI. This specifically relates to the catering budget That measures are taken to ensure service users safety with regard to the top floor fire door. This was a previous requirement. June 05 That the water temperature for service user outlets are recorded regularly. That the laundry room door, maintenance room door, door to room used as store room, and hairdressing room doors are locked when not in use. That the tape around areas of carpet by the lift be renewed. That a risk assessment and PAT testing be undertaken for kettle in service users room. 30/03/06 06/01/06 06/01/06 06/01/06 06/01/06 06/01/06 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. 4. 6. Refer to Standard OP7 OP15 OP24 Good Practice Recommendations That all care plans include the past life history of service users and their past and current social interests. That the manager monitors the standard of catering when agency catering staff are employed. That the weight of the doors in some service users rooms are assessed, and if possible, measures taken to facilitate service users using these doors. Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Claydon House DS0000021410.V268761.R01.S.doc Version 5.1 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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