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Inspection on 10/01/08 for ICS 2 Laurel Drive

Also see our care home review for ICS 2 Laurel Drive for more information

This inspection was carried out on 10th January 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The home consistently meets most of the key national minimum standards, thus ensuring positive outcomes for the people living there. People`s care plans reflect their assessed needs. Care plans are detailed and informative, ensuring that staff are able to support them service users. Comprehensive risk assessments enable people to take meaningful risks in a safe manner. People continue to be supported to make decisions about their lives both on a daily and more long term basis by staff who work hard at ensuring that they areable to recognise and interpret the limited verbal and the non verbal communication skills of the people living in the home.

What has improved since the last inspection?

Since the last inspection the manager has successfully completed the Registered Managers Award and the National Vocational Qualification level IV in Care.

What the care home could do better:

One person who lives in the home uses a wheelchair on a permanent basis. The home needs to be more proactive in seeking the advice of a physiotherapist with regards to this person spending time out of her wheelchair, and making sure that this advice is documented within her care plan. Although the staff were able to say that this person spends time out of her wheelchair either on the floor or in her arm chair, and the manager was able to produce photographs to demonstrate that she does, there were no records to confirm this in her daily diary, therefore staff need to ensure that this is recorded on a daily basis. Three of the people who live in the home do not have any verbal communication. Staff said that they don`t really participate in choosing the menu for the week in a meaningful manner because of this. Staff need to be more proactive in how to support people who do not communicate verbally with making meal choices. It was not possible to look at the recruitment records for the newest member of staff as the manager advised that they were not kept in the home. The manager and registered provider are reminded that it is a legal requirement for staffing records to be available in the home for inspection in order to be able to determine that robust recruitment practices are in place to safeguard the people who live there.

CARE HOME ADULTS 18-65 ICS 2 Laurel Drive 2 Laurel Drive, The Bridleways Hartshill Nuneaton Warwickshire CV10 0XP Lead Inspector Justine Poulton Key Unannounced Inspection 10th January 2008 10:30 ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 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 ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service ICS 2 Laurel Drive Address 2 Laurel Drive, The Bridleways Hartshill Nuneaton Warwickshire CV10 0XP 02476 393496 01527 546888 allan.smith@individual-care.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Individual Care Services Frank Michael Barnes Care Home 5 Category(ies) of Learning disability (5) registration, with number of places ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: 2 Laurel Drive is a purpose built bungalow situated in a small residential estate in the village of Hartshill, near the town of Nuneaton in Warwickshire. The home is registered for five younger adults with learning disabilities. The home is within walking distance of local facilities and amenities. The home has use of its own transport, which can accommodate wheelchairs. The shared space in the home consists of a lounge, dining room, kitchen, two bathrooms and shower room. There are six bedrooms, one of which is used as a sleep in room for staff. There is also a utility room housing the laundry facilities. There are well-maintained gardens to the rear and sides of the property. Service users receive all services necessary to deliver personal care and the promotion of independent life skills. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was carried out to establish the outcomes for people living in the home, and to confirm whether they are protected from harm. Identified key standards were looked at, along with a review of the organisations progress towards meeting any requirements made at the previous inspection of this service. The pre fieldwork inspection record was completed, as well as a site visit to the home, during which time staff, people living in the home and the manager were spoken with. A completed annual quality assurance assessment was received from the service prior to the inspection along with 3 completed surveys from staff working at the home. One relative was also spoken with via a telephone conversation. Comments received in the surveys and telephone conversation included: • Training is relevant to my role • We offer dignity, choice and respect • It is a clean, safe, homely environment • We were provided with enough information • We liked what we saw • It has been a positive experience • Two people were identified for close examination by reading their care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for people. Records, policies and procedures were examined and the environment was looked at. One of the people living in the home was at home for all or part of the inspection. The remaining three were out at their various day services. The inspector would like to thank the person who lives in the home, manager and staff for their hospitality and co-operation during the inspection. What the service does well: The home consistently meets most of the key national minimum standards, thus ensuring positive outcomes for the people living there. People’s care plans reflect their assessed needs. Care plans are detailed and informative, ensuring that staff are able to support them service users. Comprehensive risk assessments enable people to take meaningful risks in a safe manner. People continue to be supported to make decisions about their lives both on a daily and more long term basis by staff who work hard at ensuring that they are ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 6 able to recognise and interpret the limited verbal and the non verbal communication skills of the people living in the home. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 Quality in this outcome area is good. Prospective service users are provided with information about the home, visits are offered and their needs are assessed prior to them moving in. The prospective service user can be confident that their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection one new person has moved into the home. This person was referred via the community learning disability team who provided the home with a comprehensive health and needs assessment, from which the manager was provisionally able to confirm that they could meet this persons needs. Once this provisional decision had been made the manager said that the potential service user and their family were offered a series of visits to the home which included introductory visits a meal visit and an overnight visit in order for both the home and the person concerned to determine whether they thought that it was an appropriate placement. Once the placement was confirmed a social services care plan was provided, which the manager said he is using in conjunction with information from the relatives of the person and ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 9 observations made by the staff, to compile a person centred plan for this individual. A relative of one person that lives in the home spoken with, said that when their relative moved into the home they were provided with enough information to make a decision about whether it was potentially the right place, and that they liked what they saw when they visited. Their relative settled in well, the staff were and are very helpful, and overall it was a very “positive experience”. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. Comprehensive care plans and risk assessments continue to ensure that the well being and safety of the people living in the home are promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person that lives in the home has a comprehensive person centred care plan in place. Two people were chosen for case tracking as part of this inspection and their care plans and documentation were looked at as part of this process. Review dates were in place to confirm that care plans are reviewed on a 6 monthly basis and updated as necessary. Information contained within the care plans looked at was detailed and covered most aspects of identified need, aspirations and care. It was noted however that one of the two people chosen for case tracking purposes uses a wheelchair on a ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 11 permanent basis. Although the staff were able to advise when and how this person spends time out of her wheelchair and the manager was able to provide photographs to back up this information, there was nothing recorded within her care plan to confirm that the advice of a physiotherapist had been sought with regards to this. Similarly there were no recordings within this person’s daily diary to confirm the time spent out of her wheelchair. This was discussed with the manager during the inspection who undertook to contact the physiotherapist for advice, up date the care plan accordingly and ensure that staff record time spent out of her wheelchair on a daily basis. Staff spoken with said that they support the people that live in the home to make decisions about their lives within their abilities. Examples given of this included what they wear, what they eat and drink and what time they get up or go to bed. Incorporated into the care plans looked at were risk assessments. These included a manual handling assessment, the use of bed rails, mobility, skin care and epilepsy. They reflected the care plans that were in place, and contained information that would enable the service users to take risks within a safe framework. Records were available to confirm that the risk assessments were being reviewed on a 6 monthly basis in line with the care plans. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. People are offered a variety of age, peer and culturally appropriate activities that make best use of in house and community facilities. Relationships with families and friends are promoted. A healthy, nutritious diet is provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three of the four people that live in the home attend formal day centres for five days each week. The remaining person chooses not to attend any kind of formal day services. Instead she accesses a local college twice a week, where she participates in a flower arranging course and an arts and craft course. This person had attended the first flower-arranging course the day before the inspection and was very proud of the arrangement that she had made which ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 13 was on show in the centre of the dining table. She said that she enjoyed going to college and also liked to spend time knitting, drawing, going horse riding, out for a meal or to the pub and spending time with the staff and other people who live in the home. In addition staff spoken with said that the people living in the home go on at least one holiday of their choosing each year, visit local theatres and the cinema regularly, enjoy listening to music or watching the television, going shopping or out for a ride in the homes vehicle. The organisation considers family involvement and relationships to be of paramount importance to the people who live in the home and provides any support that they may need to maintain these. One person goes to visit her parents every weekend, whilst others have regular contact either by visiting or being visited. The home has a large, clean and functional domestic kitchen, which was again well stocked with plenty of fresh produce available. Individual menu records of foods eaten were maintained for each person, which demonstrated that a varied and healthy diet was offered. Staff spoken with said that one person requires her food mashed to prevent choking. This was confirmed in the records looked at for this person. Staff spoken with said that they support the people living in the home with choosing their meals, however they also said that only one person can realistically verbalise her choice, so this tends to be the meal cooked for everyone. This was discussed with the manager and staff on duty during the inspection and it was recommended that the team think proactively about how to support people who do not communicate verbally with making meal choices. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. People receive personal support in line with their assessed needs. Their healthcare needs are monitored and addressed. Medication is managed safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The needs of the people case tracked during the inspection in relation to their personal care and support were clearly identified in their personal documentation. The personal care needs of the person who had recently moved into the home had been provided by her parents in the homes pre assessment documentation. Staff spoken with during the inspection were able to say how they ensured that peoples privacy and dignity were maintained and promoted. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 15 Records looked at confirmed that people are supported to attend routine healthcare appointments at the recommended intervals. In addition, the services of specialist healthcare professionals such as a physiotherapist, and dietician continue to be used. As recorded earlier in this report the care of a person who uses a wheelchair on a permanent basis was discussed with the manager. This was in relation to time spent out of her wheelchair. The manager made a commitment to seek the advice of a physiotherapist regarding this and also to ensure that the staff record when this person is out of her chair, and for how long. The manager said that there had been no change in the way medication is supplied, stored and managed at the home. A staff member was able to talk through the procedure for medication administration and staff spoken with said that they had received training in medication administration, and underwent two yearly refreshers. There were no areas of concern noted with regards to medication during the inspection. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. The homes policies on complaints and protection from abuse ensure that people’s views are listened to and acted upon, and that people are safeguarded from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure is available in the home for the people that live there, their relatives, advocates and friends. Information provided in the annual quality assurance assessment states that the home received one complaint since the last inspection, which was resolved within 28 days. We also received one complaint since the last inspection. Staff were able to advise how they recognised whether people with no verbal communication were happy or distressed with something. One person who was at home during the inspection said who she would talk to if she was unhappy. The home has a policy on the protection of adults from abuse. Staff spoken with said that they had received training in the protection of vulnerable adults and were aware of their responsibilities should abuse be disclosed or suspected. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 17 ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. The appearance of this home continues to create a pleasant, comfortable and homely environment that is well maintained. The home presents as clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a large bungalow in the north Warwickshire town of Hartshill. The shared space consists of a pleasantly decorated lounge and separate dining room, a large kitchen, two bathrooms and a shower room. There are six single bedrooms, one of which is used as a sleep in room for staff. There is also a utility room housing the laundry facilities. There has been no change to the environment since the last inspection, with the exception of the décor of one ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 19 person’s bedroom. Peoples bedrooms looked at were nicely decorated and personalised to individual taste. The home presented as clean and tidy throughout with no unpleasant odours apparent. There are well-maintained gardens to the rear and sides of the property. The laundry area is away from the kitchen. An infection control policy is in place, and personal protective clothing is available for staff to use. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is adequate. The inability to check staff recruitment records potentially leaves people vulnerable and at risk. People benefit from sufficient numbers of competent, knowledgeable staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to employ seven support staff including the registered manager to provide care and support to the four residents who currently live there. One staff member has left the home since the last inspection, and a replacement has been recruited. It was not possible to look at the recruitment records for the newest member of staff as the manager advised that they were not kept in the home. The manager and registered provider are reminded that it is a legal requirement for staffing records to be available in the home for ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 21 inspection in order to be able to determine that robust recruitment practices are in place to safeguard the people who live there. Staffing levels continue to be satisfactory to meet the needs of the four people currently living in the home. This will have to be reviewed however one the remaining vacancy has been filled. The manager said that the arrangements for training remain the same as at the last inspection. The organisation has a training manager in post, with the manager being responsible for ensuring that staff receive appropriate training at the required intervals. The annual quality assurance survey reports that the home exceeds the required 50 of staff that have achieved NVQ II or above. Both the manager and staff confirmed this. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42 Quality in this outcome area is good. The home continues to benefit from a competent, experienced manager. Health and safety continues to be managed effectively. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An experienced manager, who has successfully completed the Registered Managers award and NVQ IV in Care since the last inspection, manages the home. Positive relationships were seen between the manager, staff on duty and the person that was at home during the inspection. There was light hearted banter and a jovial atmosphere between all concerned. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 23 The home continues to operate the same quality monitoring system as others within the organisation. The data set provided with the annual quality assurance assessment gave the dates of the most recent health and safety checks undertaken in the home. Thee were all within the required timescales. A small sample of these records confirmed this information was correct. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x x x x 3 x ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA34 Regulation 17(2)(3)(a)(b) 19(1)(a)(b)(1) Schedule 2 17 Requirement Records must be held on the premises of all care staff employed at the care. This is to ensure the home operates a robust system of recruitment for the protection of the people who live there. Timescale for action 07/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 2 Refer to Standard YA6 YA19 YA6 YA19 YA17 Good Practice Recommendations It is recommended that advice be sought from a physiotherapist with reference to permanent wheelchair users and time spent out of their chair. It is recommended that the advice obtained for the physiotherapist regards time spent out of wheelchairs be recorded within individual care plans as appropriate. It is recommended that the team think proactively about how to support people who do not communicate verbally with making meal choices. ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 ICS 2 Laurel Drive DS0000004249.V352082.R01.S.doc Version 5.2 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!