Inspection on 26/10/05 for Millstream View

This inspection was carried out on 26th October 2005.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Millstream View 29/04/10

Millstream View 17/09/08

Millstream View 24/09/07

Millstream View 16/08/06

Millstream View 06/03/06

Millstream View 21/02/05

Millstream View 26/08/04

Millstream View 29/05/03

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Millstream View Mill Lane Adwick Le Street Doncaster South Yorkshire DN6 7AG Lead Inspector Ramchand Samachetty Unannounced Inspection 26th October 2005 11:00 Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 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 Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 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. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Millstream View Address Mill Lane Adwick Le Street Doncaster South Yorkshire DN6 7AG 01302 721408 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) Doncaster Metropolitan Borough Council Pamela Hankinson Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users with challenging behaviour can only be accommodated in the 8 bedded unit. 21st February 2005 Date of last inspection Brief Description of the Service: Millstream View is a Care Home registered to provide accommodation, care and support to up to 13 young adults with a learning disability (18-65 years of age). The accommodation is offered within two separate units. One unit, which is located on the ground floor, provides care for up to 8 young adults with learning disabilities and challenging needs. The second unit is located in a part of the building where the accommodation has been arranged into 5 individual and separate flats. Both units have separate access. They have designated staff groups. The Home is situated on Mill Lane, in Adwick-Le-Street village, Doncaster. It is close to local amenities, including shops, a post office, and a church. The ‘Adwick Social Education Centre’ is situated next to the Home, and is attended by the majority of the service users of Millstream View. Millstream View is owned and managed by the Social Services Department of the Doncaster Council. There is a registered manager, Mrs. Pam Hankinson, who is responsible for the day- to- day running of the Home. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 26 October 2005, starting at 11.00 hours and finished at 18.00 hours. The inspection included a tour of the premises, conversations with four service users. Four members of staff were also spoken to, and issues were discussed with the manager. Care documentation and other records were also checked. What the service does well: What has improved since the last inspection? The environment has been improved. Refurbishment work has been carried out in the Home. The first phase of a window replacement programme has been carried out. A new bathroom, including a ‘disabled’ toilet has been installed. A hoist has also been provided. The stairs has been improved to increase its safety. Facilities have been improved in the part of the building where the ‘flats’ are located. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 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. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 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 Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4. Millstream View offers information on its services, to assist potential service users to choose a care home, but in practice, it appears that few service users are given an effective choice of a placement. The Home’ s statement of purpose and its service user guide must be further improved to meet the regulations. The needs and aspirations of service users are assessed on admission and reviewed on occasions. However, such assessments did not always cover important areas of needs. Once needs are assessed, the Home does not confirm to service users and their representatives that such needs will be met. The assessment process must be improved. The way some service users are admitted to the Home does not allow for preadmission visits and for any familiarisation. The service must decide if it offers ‘emergency admissions’ or not, and if it does, it must make the necessary arrangements. EVIDENCE: A statement of purpose and a service user guide are available. They provide some information about the aims and objectives and philosophy of care of the service. However, they do not state whether the Home offers emergency admissions or not. The statement of purpose also fails to indicate what arrangements are in place, in order for the service to meet its aims and Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 9 objectives; for example, the arrangements it has for meeting privacy needs of service users, for consultation with service users and their representatives about the operation of the Home. There are also factual inaccuracies about the work of the Commission For Social Care Inspection. A sample of service users’ care files was checked. They showed that both placing social workers and staff at the Home usually carried out full assessments. Theses assessments did not always cover important areas of needs, including nutrition, behaviour issues and mental health. There was for example, no nutritional assessment for one service user who suffers from diabetes. One service user’s assessment was communicated to the Home in a short letter and did not address the challenging needs of the client. There was no indication that the assessment of needs had been shared and agreed with service users and their representatives. Service users, who had been recently admitted, had not visited the Home prior to their admission. Staff explained that one service user was admitted in an emergency. One resident had been transferred from another Council’s residential care home. In discussion, staff stated that they were not aware of any arrangements in place for emergency admissions to Millstream View. They were clear about the nature of residential care that the service provides. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Individual plans of care were developed on the basis of identified needs and agreed goals. However, the quality of individual care plans was not consistent, and in some instances, this has led to important areas of needs not being adequately addressed. Care planning must be improved. Care staff offer appropriate encouragement and support to service users in deciding how their daily living is organised, and risks are adequately managed, in an effort to promote choice and independence. EVIDENCE: Care records of two service users were checked. Individual care plans were based on needs assessments. However, important areas of needs, for example, nutrition and some aspects of challenging needs, were not fully assessed and therefore were also not addressed in care plans. Action to be taken to meet needs was not always clear and specific. In some cases, service users had problems with continence and episodes of wandering, but these were not addressed in their care plans. Care plans were not reviewed in a consistent way. Risks faced by individual service users, in their daily activities, appeared to be adequately identified and Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 11 managed. In one instance, a service user was being escorted, every weekday, to and from his day centre, by a staff member. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. The lifestyle aspirations of most service users are generally being met. Opportunities for service users to take part in social and leisure activities are promoted to ensure that they are able to improve their quality of life. The Home was providing an adequate catering service, and meals offered appeared to reflect the food preferences of service users. However, the use of a hot trolley to transport and serve cooked meals to service users in the ‘flats’ must be assessed for risks and the actual temperature at the point the food is served. EVIDENCE: Service users, who spoke to the inspector, stated that there were encouraged to take part in a number of indoor and outdoor activities. Most of them spend their daytime at the Social and Education Centre, which is next door to the Home. They commented on activities that they had taken part in. These include trips to the local shopping centre, the local pubs, outings in the Home’s minibus and outdoor games, like bowling. A few of them spend their time indoors, watching television/ videos and listening to music. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 13 Service users continue to take their main meals at the day centre. In discussion, the cook explained that there had been some changes in the catering service at the day centre and she did not have a copy of their current menus, which she would normally refer to, in order to avoid duplication of meals. Copies of menus from the centre should be obtained for use in planning menus. It was also noted that afternoon meals were served shortly after 16.00 hours, by care staff. This arrangement must be reviewed to ensure that service users needs and preferences are prioritised and to avoid institutional practice. In discussion, service users stated that they liked the food served at Millstream View. It was noted that cooked meals were transported and served to service users who live in the ‘flats’ by the use of a hot trolley. Although there are some cooking facilities in the flats, there were space constraints and their use by service users would require a risk assessment. Currently, none of the service users, in the flats appeared able to prepare and cook food. It was noted that the hot trolley was ‘parked’ and connected to an electric socket near a doorway along the corridor. The use of this hot trolley must be risk assessed. Its use must not obstruct the passage along the corridor. The temperature of the cooked meals, at the point of serving must be recorded and monitored, to ensure that such meals are served at the optimum temperature. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Staff at Millstream View, continue to provide personal care and support to service users in a flexible manner, to ensure that individual needs are met in their preferred way. Service users are well supported in taking their medicines, and in accessing health care services as necessary. This helps to maintain their health and wellbeing. EVIDENCE: Individual care plans and care records show that care and support is tailored to the specific needs of individual service users. In discussion, staff stated that they were familiar with the particular needs of individual service users. There is a system of key workers, whose role is to provide personal support to individual service users, on a one to one basis. Staff are proactive in ensuring that service users are able to access health care services as necessary. Visits by service users to GPs and other health care professionals, and their outcomes, are all recorded. There are policy and procedures on the storage, handling and administration of medicines. None of the service users, at the time of this inspection, were selfmedicating. Records of medicines handling, storage and administration were found to be satisfactory. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Staff maintain good communication with service users and their representatives. This allows for concerns, if any, to be addressed promptly. Complaints are appropriately handled and managed. Although, the service is part of the Doncaster Social Services Department and has use of its adult protection procedures, allegations of physical assaults/abuse between service users were not always referred to the adult protection team. The home’s procedures to deal with such instances should be reviewed. EVIDENCE: In discussion, service users stated that they were encouraged to air their views about the care they receive at Millstream View. They confirmed that staff had talked to them about the complaint procedures that they could use if it was necessary to do so. There is also information about a local advocacy service, which service users can contact. However, the home has not received any complaints since the last inspection. Copies of the complaint procedure and of the adult protection policy are available at the Home. Staff spoken to, confirmed that they had received appropriate training on adult protection and were aware of the local multiagency procedures in use. However, there were allegations, where a service user had physically assaulted other service users. Whilst every effort was made by staff to resolve the underlying problems, these incidents were not always reported to the adult protection team for investigations. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. The building, with the exception of its windows, appears in good state of repair. Refurbishment work has currently been carried out, to improve the Home and access to its facilities by service users with a physical disability. However, further work is needed to improve both the private and communal accommodation and the facilities used by service users. Adequate hygiene standards were maintained and this helped to make the Home more pleasant. EVIDENCE: The inspector, accompanied by a senior member of staff, undertook a tour of the Home. Most of the communal areas and some of the service users’ private accommodation, which were viewed (the latter with service users’ permission) were adequately decorated. It was noted that the first stage of a window replacement programme had been carried out. A new bathroom with a ‘disabled’ toilet has been installed on the ground floor. The open risers on the stairs have been closed and made safe. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 17 However, the following shortfalls in both the service users and communal accommodation were identified: The floor covering in various parts appeared worn out and was loosening up. Access and use of the new toilet for disabled people was hindered by the position of a low-level wash hand basin. One bedroom had not been provided with double electric sockets. There were no window restrainers in a few bedrooms. A safety mirror is required in bedroom 2. The bed in bedroom 1 is placed against a radiator and there is no headboard to give protection. Windows in bedrooms 7 and 8 were allowing air in, and were showing signs of increased deterioration. They must be repaired or replaced. The sink in the lounge upstairs must be removed and the lounge redecorated. A sink must be provided in all service users’ bedrooms, unless a risk assessment shows otherwise, and alternative arrangements are put in place. Some wall surfaces were found to be slightly damaged and required repair and redecoration. There were still problems with storage in some service users’ bedrooms. The use of shelving should be considered. Except for persistent malodours in one service user’ s bedroom, the Home was found to be clean and tidy. The grounds appeared tidy and it had been provided with bays for ‘disabled’ parking. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35. There is a good and effective staff team at Millstream View, and this helps to provide a good standard of service. Care staff are trained and have the ability to work, with this client group. Care staff undertake their work with diligence and commitment. However, the needs of service users who challenge the service cannot be adequately met, with the current level of staff deployed. A review of the staffing level, based on the dependency of service users must be carried out and the outcome shared with this office of the Commission. EVIDENCE: On the day of this inspection, there were four care staff and one officer in charge, on duty. Two care staff were assigned to work with five service users in the flats. Two other care staff were working with six service users, who have challenging needs. The officer in charge had supervisory tasks and other care duties, like medicines administration and responding to enquiries. There was one service user, whose needs were very complex and needed constant supervision, whilst at the Home. This service user was receiving day care at the time of this inspection. Care documentation checked, showed that staff were facing difficulties in managing his behaviour. There had been instances of physical aggression against other service users and staff. Two members of care staff were not sufficient to meet the needs of the service users with challenging needs. It was also noted that a request was made by the day services, for the service user in question to receive day care at the Home. A Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 19 member of the day services team was attending the Home to provide day care, because of difficulties in managing his behaviour at the day centre. This arrangement is contrary to the staffing regulations, as it involves somebody who is not a member of the staff team at Millstream View to work at the Home. The registered manager was advised to review this arrangement with a view to bringing it to an end. The duty rota was checked. It showed that the registered manager was working as an officer in charge for at least three shifts a week. The position of registered manager is a full time one. The registered manager must be allowed to work her contacted hours to discharge her duties and responsibilities. The duty rota must also show how the two units at the Home are staffed for the daily shifts. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42. The registered manager and her staff team are working well together, to ensure that the best interest of the service users, are secured. The Home is well managed within the resource constraints of the provider. Health and safety issues in relation to the physical environment are adequately managed, but a risk assessment was required for the new catering arrangement for the ‘flats’. However, the difficulties being encountered with respect to the behaviour management of a service user now appear to be compromising the safety and wellbeing of other service users. Action must be taken to ensure that appropriate supervision is provided for the service user in question and for benefit of other service users. EVIDENCE: In discussion, staff and service users stated that they were satisfied with the way the Home was managed, whilst acknowledging the role of senior managers in the Social Services Department. There was evidence of good joint working with other professionals involved in the care of service users. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 21 Health and safety issues regarding the building, working practices and the use of equipment, were adequately addressed. However, a risk assessment was required for the use of a hot trolley to transport and serve cooked meals to the flats, which are located on the opposite end of the main kitchen. (See notes on standard 17 in this report). The health and safety issues raised by the difficulties in the current behaviour management of a service user are noted. These were having repercussions on the safety and wellbeing of other service users. This matter requires a senior management response, in order to safeguard the safety and wellbeing of other service users. (See notes on standard 35 in this report) Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 2 2 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X 2 X 2 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Millstream View Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000032073.V260173.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? YES 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 YA1 Regulation 4, 5 Requirement Timescale for action 27/01/06 2 YA2 12, 3 YA6 12, 4 YA17 12, 5 YA17 12, The statement of purpose and service user guide must be improved so that they fully comply with the regulations. This must include whether the Home accepts emergency admissions or not. 14 Assessment of care needs must be improved to ensure all health, personal and social care needs are considered. The registered person manager must confirm that the Home is able to meet the assessed needs of the service user in question. 15 Care planning and care review must be improved to ensure that all identified needs are catered for. 13, 16 The use of the hot trolley to transport and serve cooked meals must be risk assessed and risk managed. The actual temperature of the food, at the point of serving, must be monitored and recorded. 16 The arrangement and timing for serving the afternoon meal must be reviewed. 27/01/06 10/02/06 27/01/06 27/01/06 Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 24 6 YA24 12, 23 7 YA33 12, 8 YA33 12, 9 YA33 12, 10 YA37 12, The registered manager and the registered provider must arrange for the all the shortfalls listed in standard 24 of this report, to be addressed. (Previous time scale of 31/03/05 not met.) 18 A review of the care staffing level, based on the dependency of service users, must be carried out and the outcome shared with this office of the Commission. 18 The registered manager must be allowed to use her contracted hours to discharge her duties and responsibilities. 17, 18 The duty rota must show separately the staffing arrangements for each unit at the Home. 18 Appropriate and adequate supervision must be put in place for service users who challenge the service. 24/02/06 27/01/06 27/01/06 27/01/06 27/01/06 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 2 Refer to Standard YA17 YA23 Good Practice Recommendations Copies of food menus should be obtained from the day centre, for use in planning the menus for service users at the Home. The home’s procedures to deal with allegations and instances of physical assaults/ aggression between service users should be reviewed. Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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 Millstream View DS0000032073.V260173.R01.S.doc Version 5.0 Page 26 - 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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