Inspection on 08/02/06 for Eastfield Nursing & Residential Care Home

This inspection was carried out on 8th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Eastfield Nursing & Residential... 11/10/07

Eastfield Nursing & Residential... 08/08/06

Eastfield Nursing & Residential... 07/02/05

Eastfield Nursing & Residential... 27/10/04

Eastfield Nursing & Residential... 19/11/03

Eastfield Nursing & Residential... 08/06/03

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The Cotswold Home

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

CARE HOMES FOR OLDER PEOPLE Eastfield Nursing & Residential Care Home Hillbrow Road Liss Hampshire GU33 7PB Lead Inspector Mrs Pat Trim Unannounced Inspection 8th February 2006 09:30 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 Eastfield Nursing & Residential Care Home DS0000011499.V281660.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. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eastfield Nursing & Residential Care Home Address Hillbrow Road Liss Hampshire GU33 7PB 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) (01730) 892268 Wenham Holt Homes Limited Mr Dennis Anthony Greenwood Care Home 37 Category(ies) of Dementia (7), Dementia - over 65 years of age registration, with number (37), Old age, not falling within any other of places category (37), Physical disability (7), Physical disability over 65 years of age (14), Terminally ill (7), Terminally ill over 65 years of age (37) Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. All Service Users in the DE, TI and PD categories must be 55 years old and over. A maximum of 7 service users in the DE, TI and PD categories can be accommodated at any one time. Service Users in the PD or PD(E) categories will be accommodated in single rooms on the ground floor A maximum of 10 service users in receipt of personal care can be accommodated at any one time. Staffing levels apply Date of last inspection 7th February 2005 Brief Description of the Service: Eastfield Nursing and Residential Home provides care with nursing for service users over fifty-five years. The home is also registered to accommodate service users who are terminally ill, have a physical disability or dementia. The home has thirty-five bedrooms. Twenty-nine of these are single and four shared. Communal space comprises a lounge, conservatory and lounge/dining room. The home has extensive landscaped gardens that service users are able to access. Eastfield is situated on a main road a short distance from Liss and is close to local amenities. The home is one of two family-run businesses. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second statutory inspection for the year 2005/2006, as the previous inspection was carried out on 1st September 2005. However, as that inspection did not generate a report, the purpose of this inspection was to assess all the key standards. The inspection was unannounced and completed by one inspector in six hours. During the inspection there was an opportunity to speak with seven residents, three staff and two visitors. A partial tour of the premises was undertaken and a random selection of documents reviewed. It was established that the people who lived in the home liked to be referred to as residents. This term will be used throughout this report. What the service does well: What has improved since the last inspection? A new pre-admission assessment tool had been developed that identified the needs of prospective residents. This enabled the provider to make a judgement as to whether the service can meet those needs. The installation of a bigger shaft lift has improved access to the first floor. Eastfield Nursing & Residential Care Home DS0000011499.V281660.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. Eastfield Nursing & Residential Care Home DS0000011499.V281660.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 Eastfield Nursing & Residential Care Home DS0000011499.V281660.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): 3. Standard 6 does not apply. The home has a robust admission procedure that ensures residents are offered a placement only when the registered manager is confident their needs can be met. EVIDENCE: The registered manager said that a more in depth pre-admission assessment had been introduced. This was seen completed on the files of three residents recently admitted to the home. The assessment gave detailed information about residents’ needs and enabled the registered manager to assess whether the home could support the prospective resident. The registered manager had visited the prospective residents to complete the assessment. Files also contained information obtained from relatives, previous placements or hospital wards. Information about the admission process was contained in the statement of purpose. This informed prospective residents that they could only move into the home after a pre-admission assessment had been completed, to ensure the home could meet their needs. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 9 Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 10 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 and 10 The system used to formulate care plans provides a holistic approach to identifying and meeting needs. Resident’s health care needs are well monitored which ensures residents may be confident they will be referred to health care professionals when necessary. Systems are in place that enable medication to be managed in a way that ensures residents’ safety is maintained. The management and staff are committed to upholding the core values so residents feel they are treated with dignity and respect. EVIDENCE: Three care plans were evaluated. These provided an in depth format for evaluating each need and providing a plan to meet it. Risk assessments were used to identify potential risks and plans put into place to minimise them. There was evidence that care plans were reviewed at least monthly and both qualified and unqualified staff used their developing knowledge of individual resident’s needs to add to or amend them. Relatives are invited to read care plans and to sign them to evidence they feel the care provided is appropriate to meet the needs of the residents. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 11 Information obtained from the pre-admission assessment was used to identify health care needs and systems put in place to monitor them. For example, supplying specialist mattresses for residents identified as having poor skin condition, or monitoring food and liquid intake where a resident had been identified as having nutritional problems. Residents said they could see their doctors whenever they wished and had regular visits from the chiropodist. One resident said she had recently visited her optician and had been accompanied by a member of staff. The registered manager said that the home had access to one who made home visits. Records showed that requests for visits were made to a wide range of health care professionals. The medication policy and procedure gave staff clear guidance on the management of medication. The policy stated that medication could only be given out by qualified staff. Both the registered manager and staff confirmed that the policy was followed. A qualified member of staff was able to demonstrate her knowledge of the policy and procedure. The medication administration records had been completed for the morning round. Residents said that staff treated them with respect and were very patient, allowing them to do things at their own pace. Staff were observed knocking on resident’s doors and waiting for permission to enter. All bedroom doors have locks fitted so residents may lock their rooms when they do not wish anyone to enter. Staff felt treating people with respect was an important part of their job. They said they only called residents by their first names if given permission to do so. Residents confirmed this was so. Many of the residents needed assistance with feeding. Staff did this on a one to one basis, sitting with the resident, talking to them and asking them when they were ready for the next spoonful of food. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 12 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 and 15 Residents are provided with a wide range of activities that provide mental stimulation and that they enjoy participating in. The welcoming atmosphere in the home enables relatives to feel comfortable about visiting residents whenever they wish. The culture of the home ensures that residents are able to make choices about how they spend their day. The meals provided are good and give residents a nutritional and well balanced diet. However, less able residents are not supported by the present system to make a choice about what they eat. EVIDENCE: Residents said they were very satisfied with the social activities offered by the home. Information about what has been arranged is given to residents and relatives in the home’s newsletter. Activities included regular visits by the hairdresser and several entertainers. A visiting minister takes Holy Communion each month. One member of staff runs an arts and crafts class every week, which residents said they really enjoyed. There is also a weekly exercise class and a multi-sensory relaxation class. The home has its own transport and residents said there were twice weekly trips out. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 13 Staff also ensure that residents have what they need to meet their social and emotional needs. For example, one resident said she could not exist without books to read. Since the mobile library service was stopped, members of staff bring books in to make sure she has access to sufficient reading material. One resident said how important it had been to her that her dog had been allowed into the home to visit her when she moved in. The home has its own dog that is very popular with residents. Staff said it was part of their role to spend time with residents. Residents confirmed that staff have time to sit and talk with them or give them a manicure. Residents said they were able to make choices about how they spent their day. Some preferred to stay in their rooms, reading, knitting or watching television. Staff bring their meals to them. Others like to spend some time in the lounge or conservatory, but return to their rooms to rest. Several residents said they enjoyed spending time in the garden when the weather was good and were looking forward to the spring. Many of the residents had difficulty in verbally expressing their choices. The registered manager said relatives were sometimes asked what they thought the resident’s choice would be. However, if it was felt this might not be appropriate, the home had access to an advocacy service and had used this in the past. Feedback from relatives evidenced they felt very much included by staff in the care of the resident. Some visited almost daily and said they were always made welcome. They also felt that staff communicated well and kept them informed of anything affecting the wellbeing of the resident. They were invited to contribute to the care plan by providing a life history and information about a resident’s particular needs, likes and dislikes. Comments made by residents and relatives demonstrated that the majority felt the meals provided were very good. The registered manager said residents were asked about the meals provided at residents’ meetings and alterations to the menus had been made following residents’ requests. A choice of main meal was not offered, but the registered manager said the menu was displayed in the dining room and residents could look at this and request an alternative if it was not what they wanted. Some residents did not seem to be aware they could do this, whilst a large number of them were not able to go into the dining room to see the menu. It was recommended that consideration be given to developing other methods of enabling residents to make alternative choices. Eastfield Nursing & Residential Care Home DS0000011499.V281660.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 and 18 The home has robust complaints procedure that enables residents to be confident their concerns will be listened to and addressed. Residents are protected from abuse by the use of training, policies and a robust employment procedure. EVIDENCE: The home had a complaints policy and procedure. The registered manager said a copy was given to everyone on admission. Residents and relatives said they were aware of the complaints procedure and would feel able to use it if necessary. They were confident they could take any concerns to the management of the home and that they would be resolved. The home had a system for recording complaints. This showed that one complaint had been received in August 2005 which had been dealt with using the complaints procedure. The commission had not received any complaints in respect of the home. The home had an in house policy and procedure for the protection of vulnerable adults. The registered manager said it had been based on the guidance given in Hampshire’s adult protection procedure. The home had a copy of this in the office. Training on adult protection procedures was included in the training calendar and the majority of staff had attended some courses. The registered manager Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 15 confirmed he was arranging for further sessions later in the year. Staff said some training was included in the National Vocational Award (NVQ). Three staff were asked about adult protection issues. All were aware of their responsibility to report any incident of abuse and knew about the whistle blowing policy. All felt they needed further training and were looking forward to the opportunity to revisit this difficult subject. The registered manager said all new staff had to complete a Protection of Vulnerable Adults (POVA) check as well as a Criminal Records Bureau Disclosure. Evidence to support this statement was seen on staff files (See standards 27-30). Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 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 the following standard(s): 19 and 26 The home provides a safe, well-maintained environment that meets the needs of the residents who live there. It is clean and the systems in place make sure residents are protected from the risk of infection. EVIDENCE: The home was warm, well furnished and comfortable. Residents said they were very satisfied with their surroundings and that the home was kept very clean. The home employs domestic staff who are responsible for all heavy duty cleaning. There was a cleaning schedule for the kitchen. The registered manager said that part of the quality audit process monitored the environment and made sure that repairs were carried out. The quality of décor in bedrooms is assessed when each becomes vacant. On the day of the inspection, one had just been repainted, prior to a new admission. Since the last inspection a new shaft lift had been installed that was larger than the old one and would make it easier for staff to assist residents going from one floor to the other. The registered manager said work was being completed that Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 17 would provide more communal space, so that residents had another small lounge to use as a quiet area. The home had a policy and procedure for preventing infection and staff were able to demonstrate their knowledge of them. They said they had training in infection control and the training programme identified that more had been arranged for this year. Stores of disposable gloves and aprons were seen throughout the home where staff could easily get them. Staff were seen using these when necessary. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 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 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 and 30 Qualified staff and care staff are provided in sufficient numbers to be able to meet the needs of current residents. They are actively encouraged to achieve qualifications that enable them to develop their abilities to meet residents’ needs. The home has a robust employment procedure that ensures residents are protected. A good induction programme, regular supervision and in house training opportunities means residents may be confident they are cared for by well-trained staff. EVIDENCE: Residents said they felt there were sufficient staff on duty at all times to meet their needs. Staff said they had time to carry out their daily duties. On the day of the inspection there were two qualified and six care staff on duty from 8 a.m. to 2 p.m., and two qualified and four care staff on duty from 2 to 8 p.m. The registered manager said that at times there were more qualified and less care staff on duty, but the numbers of staff remained the same, i.e. eight staff in the morning and six staff in the afternoon. The night shift was staffed by one qualified and two care staff. All three work waking nights. Three staff were interviewed during this inspection and their records seen to assess the recruitment, induction and training procedures of the home. Two of these staff had worked at the home for more than two years. They were clear Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 19 about their role within the home and had a good understanding of residents’ needs. They confirmed they had been interviewed for their current posts, and had supplied references. Information contained in their files included application forms, evidence of prior learning, references and mandatory checks i.e. criminal record bureau checks (CRB) for those employed before July 2004, and CRB and protection of vulnerable adults (POVA) checks for those employed after this date. Files also contained contracts and job descriptions. One member of staff had only just been appointed, although she had worked at the home before. Her file contained the same information as the other two staff. The new member of staff said she had been shown round the home on her first day and had been introduced to the residents. She was shadowing a more experienced member of staff and had a workbook to complete during her induction programme. Staff said they received regular supervision and files contained records and work sheets relating to these sessions. The registered manager had a training programme for the year which enabled him to monitor staff training needs and to identify when refresher courses were needed. Training for the previous year included basic courses such as moving and handling, food hygiene and first aid, as well as courses designed to meet the needs of the client group such as pain control, dying and cultural and spiritual awareness. The registered manager said that unqualified staff were encouraged to complete a National Vocational Award (NVQ). It is the expectation of the home that staff wishing to become senior carers must have completed an NVQ 3. Five staff had achieved this level and eight more were working towards it. The home employs twenty care staff so when all these staff have completed their training standard 28 will have been exceeded. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 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 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): 31, 33, 35 and 38 The registered manager has systems in place that enable him to provide a well-managed service that meets the needs of residents. The current systems in place to audit the quality of the service are well developed and enable residents and relatives to give feedback about the service they receive. The practice of the home in respect of managing resident’s money ensures they are protected against the risk of financial abuse. Systems are in place that ensure the health and safety of residents are protected. EVIDENCE: The registered manager has a nursing qualification, a number of educational qualifications and extensive management experience. He has been responsible Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 21 for the day-to-day management of Eastfield since 1994. Residents, relatives and staff felt he managed the home well and was always available to talk to. During the inspection he was observed giving information to residents and relatives face to face or by telephone and dealing with numerous issues relating to the day to day running of the home. Mr. Greenwood said he was supported by a management team and devolved responsibility for some of the day-to-day running to them and to senior care staff. There were systems in place to audit the quality of the service and to enable residents and relatives to give feedback. Residents’ meetings were held monthly and relatives’ meetings two monthly. Minutes of these meetings were kept, together with any action taken as a result of issues raised. Questionnaires were sent to relatives at least once a year to seek their views of the service. These were used as the basis for a quality audit report. Copies of this report were sent to relatives and staff together with feedback about what action had been taken in respect of any issues identified. Staff meetings were held regularly, both for care staff and qualified staff. Bimonthly management meetings were held to monitor and review the service. Monthly inspections of the service were completed as required by Regulation 26. A written report of these inspections was kept. The registered manager said information from all these sources was used to prepare an annual development plan. The policy of the home was not to hold any money on behalf of residents, although the registered manager said if there was no alternative, appropriate recording systems were used. He said he was not holding any resident’s money at the time of the inspection. The preferred option if a resident could not manage their own money was that relatives were invoiced monthly for any expenditure made on behalf of the resident. For example, invoices were sent for hairdressing, newspapers and chiropody. Staff training records evidenced that they received regular training in health and safety. For example, recent training included infection control, moving and handling and food hygiene. On the day of the inspection a fire drill was carried out by the company employed by the home to manage fire safety. The fire log book showed that fire fighting equipment was monitored in accordance with Hampshire Fire and Rescue Service guidance. A random selection of certificates and contracts were seen. These demonstrated that the provider ensured all equipment and utilities were regularly serviced to protect residents and staff against the risk of injury. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 23 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 Refer to Standard OP15 Good Practice Recommendations That consideration is given to developing a system that enables service users who are frail to be able to choose an alternative to the main meal. Eastfield Nursing & Residential Care Home DS0000011499.V281660.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Eastfield Nursing & Residential Care Home DS0000011499.V281660.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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