Inspection on 16/02/06 for Pavilion Care Centre

This inspection was carried out on 16th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Pavilion Care Centre 04/10/07

Pavilion Care Centre 14/07/06

Pavilion Care Centre 13/09/05

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

CARE HOMES FOR OLDER PEOPLE Pavillion Care Centre North View Terrace Chilton Moor Houghton-le-spring Tyne And Wear DH4 5NW Lead Inspector Mr Steve Tuck Unannounced Inspection 10:30 16 and 27 February 2006 th th 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 Pavillion Care Centre DS0000063779.V270551.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. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pavillion Care Centre Address North View Terrace Chilton Moor Houghton-le-spring Tyne And Wear DH4 5NW 0207 0343220 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) European Care (England) Ltd Mrs Ann Marie Shillaw Care Home 40 Category(ies) of Dementia - over 65 years of age (15), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (40), Physical disability over 65 years of age (8), Sensory Impairment over 65 years of age (6) Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13/09/06 Brief Description of the Service: The Pavilion is a large detached building set in its own grounds in a small village near Houghton-le-Spring, near the boundaries of Durham. It was originally built in the 1960’s and is currently owned by an independent provider. The home provides personal care for up to 40 older people. The home is divided into 2 distinct units with 20 bedrooms on the ground floor, and 20 bedrooms on the first floor for older people with dementia care and mental health needs. Each floor provides a range of lounge and dining rooms, bathrooms and small kitchens. Set back from the main road the home is close to local amenities and bus routes. There are well kept gardens around all sides of the home and the large front lawn has a wishing well and other garden features of visual interest for the people who live here. The Pavilion is a large building but offers very comfortable and pleasant accommodation. The quality of decoration and furnishings is of a good standard. The home benefits from on-site maintenance and gardening staff. The home is a popular facility in this close-knit community and typically enjoys full occupancy. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days and was a scheduled unannounced inspection. The inspection process involved two inspectors spending time talking to a number of the people who live in the home, visitors and relatives as well as the manager and staff. A sample of records was examined including care plans and rotas. A tour of the building took place, which included all communal areas and a selection of service users bedrooms. One inspector joined service users throughout the day to see what life is like at the home and to ask service users and their families what they thought. Observations were made of the support the staff offered to service users and discussion took place with them about how they carry out their work. The judgements made are based on the evidence available on the day of the inspection. What the service does well: The people who live here had many positive comments to make about the service they receive. Service users and visitors described staff, as helpful and “calm, patient and sensitive to peoples needs,” One relative said that there is a “friendly atmosphere and good management style at the home. There is clearly a good rapport between service users, staff and visitors that adds to the ‘homely’ atmosphere at the service. The accommodation is bright, cheerful and well decorated. All bedrooms are spacious single rooms with en-suite facilities. The home is warm, comfortable and has a number of different lounges for people to use. There are also extensive gardens to the front and back of the house where residents can sit in good weather. The manager and staff have good working practices with community healthcare staff such as district nurses, which helps to ensure that service users receive prompt medical attention or monitoring should these be required. Staff training is good with almost all staff having achieved NVQ level 2 and 50 level 3. Additional training is in place for specialised topics which helps staff to develop the standard of their work at the home. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 6 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. Pavillion Care Centre DS0000063779.V270551.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 Pavillion Care Centre DS0000063779.V270551.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): 1 3 and 6 A range of information is available which enables service users to make a fully informed choice about where they would like to live. Each service user’s needs are assessed prior to their move to the home. This will help ensure that each service user’s needs are met at the home and inappropriate admissions are avoided. The home does not provide intermediate care. EVIDENCE: The home has a Service User Guide, which provides perspective service users, their relatives and referring social workers with information to help them make a decision about moving to the home. The information in the guide is accurate, appropriate and accessible to the target audience. Each service user has a social worker’s assessment undertaken prior to their admission to the home. The manager also carries out an individual assessment, which accurately details service users’ needs and ensures that theses can be met at the home. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 9 Records indicate that the manager has also involved other health and social care personnel where specialist assessment has been required and that service users and their representative are fully involved whilst carrying out the assessment. There are no service users who have been admitted to the home for intermediate care. Pavillion Care Centre DS0000063779.V270551.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 health and personal care needs recorded in the care plans do not fully reflect service users current level of need. As such their welfare is not fully promoted and safeguarded. Medication ordering, storage and recording procedures require improvement to ensure that service users’ health care needs are addressed and mistakes are avoided. EVIDENCE: The assessments that are used to plan the care for service users has been updated and improved and now describe their needs and the reasons they need this support in a registered care home. The manager has introduced a new care planning process for the home. However the information does not stipulate how the identified needs are to be met by the staff at the home. For example, one persons nutritional assessment identifies that she is significantly underweight, but the measures the home is taking to rectify this are not addressed by her care plans nor reflected in her catering needs record. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 11 The assessment forms are repeated as care plans whether there is a need or not. Care plans do not sufficiently describe the intervention, action or support needed to assist a service user with an individual goal. For example the intervention to support continence needs is referred only to a toilet programme – not when, how often, by whom, where, with what equipment etc. Care plans are not yet routinely reviewed at least every six months to determine when changes have occurred so potentially staff are supporting some service users whose needs have changed substantially without care plans which describe their physical and emotional interventions. The manager has been unable to carry out an evaluation of the new care plan system as yet so it is difficult to assess whether the new system will work in practice. Relatives commented about how the home supports service users to remain healthy. This involves promotion of a healthy lifestyle, for example: a balanced diet and taking regular exercise as well as the involvement of professional health care services when required. Senior staff who are responsible for administering medication have had training in Safe Handling of Medication. The medication trolley is securely stored when not in use away from areas used by service users, which helps to maintain a homely atmosphere. Records of medication stored and administered at the home were not sufficiently accurate to determine if service users had received medication. For some the medication had been signed for but stock balances indicated that medication was surplus and may not have been given. Also not all service users had plans in place which adequately describe the judgements which staff are to make when service users are to be administered occasional medication for example where service users have been prescribed medication to help them deal with stress. Additionally, one jar of prescribed cream was found in a bathroom cupboard. This means that it could be mistakenly used by different people which compromises infection control. Pavillion Care Centre DS0000063779.V270551.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 14 and 15 Service users are encouraged and supported to lead active lifestyles based on their preferences and choices but this is not always successful as some people cannot access their bedroom or the minibus may not be available for visits. The meals provided offer a good balanced diet, which contributes to the promotion of healthy eating, but service users do not always have support or a choice of meal EVIDENCE: Discussions were held with some service users, and time was spent in the home with several residents with dementia care needs. Service users and relatives said that they were very satisfied with the service at The Pavilion and feel it is well managed. Relatives described staff as calm, patient and sensitive to peoples needs. Several people said that they chose this home, above others in this area, because of its friendly atmosphere and good management style. The home benefits from having a full time Activities Co-ordinator in post and this has led to a fuller programme of activities for service users to choose from. On the day of this inspection 7 service users were enjoying a trip out to another home for a social event, others were using the hairdresser and Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 13 chiropody sessions. Regular in-house activities include manicurist visits, hand and foot massages, exercises, bingo, baking sessions and local shopping and walks. Service users said that they most enjoy visits out. The home can request the use of a minibus, which is shared with another home. However at this time there are no set arrangements, so trips for service users at The Pavilion are only on an ad hoc basis. Examination of some of the financial records indicates that there is no dedicated budget to finance activities at the home. Currently activities are paid for from charitable or fundraising means and their frequency dependant on the success of events or generosity of the public despite this being the legal responsibility of the home. Discussions with some service users indicated that they can continue to make their own choices about how they spend their day. Service users on the ground floor can choose to spend time in the privacy of their own room, and many were in their rooms during this inspection. However the doors to bedrooms on the first floor are kept locked by staff. This means that service users cannot access their own bedrooms, or choose to spend time in private, without staff support. (The relatives of 3 service users have keys so that they can use the rooms when they visit.) The people accommodated on this floor have dementia care needs and may not be able to ask staff for support to use their own rooms for a lie down or some quiet time. Staff and relatives stated that this practice was intended to prevent service users from entering the wrong rooms. However it also prevents service users from choosing how and where they spend their time, and compromises their right to privacy. There are still few signposts for service users on this floor to support their orientation and no signage on bedroom doors for them to recognise their own rooms. Service users on the ground floor commented positively on the good food and confirmed that there are choices, and that they can ask for something else. However service users on the first floor still do not have information in suitable formats about the choices that would help them to make a decision. Relatives commented that the food seems to be good quality and looks appetising. However some people also commented that the service users who get staff support at mealtimes seem to be getting better nutrition intake than those that eat independently. Some people may need a degree of encouragement or assistance such as cutting up meat, or guidance to use a spoon instead of knife and fork, if this supports their intake. New nutritional assessments are being completed for each service user but these do not then direct staff in how to support people. Pavillion Care Centre DS0000063779.V270551.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 Service users are able to make complaints if they wish and are confident that these will be properly responded to fairly and quickly by the manager. The home has arrangements in place which should protect service users from abuse. EVIDENCE: Service users and relatives said that they would feel very comfortable about approaching the manager if they had any comments or concerns about the service and said they were confident that she would take the right action. There have been no reported instances where an allegation of abuse has been made. The home uses a set of procedures known as MAPVA (Multi Agency Protection of Vulnerable Adults) to offer protection to service users. All staff have completed training to ensure that these procedures are adhered to and work effectively. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 24 and 26 The home is clean, warm and generally well maintained offering service users a homely and safe environment in which to live. EVIDENCE: The Pavilion is a large building and benefits from on-site maintenance staff to address any minor repairs and redecoration. In this way it is generally in a good state of repair and decoration. The home was bright, warm, comfortable and safe for the people who live here. Since the last inspection one small lounge has been provided with new laminate flooring. There are plans to provide new carpet to the first floor corridor. A sample of the building was examined and a small number of minor premises issues noted during this visit. These included: communal WCs are ready for redecoration; the hot water to one bath is too cool; the linen store was left unlocked; and no wastepaper bins to some WCs. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 16 Service users on the ground floor said that they were very pleased with their accommodation. All commented positively on their spacious rooms and their own large en-suites. Many service users were enjoying the privacy of their own rooms. One service user said, I love it here. I made the right choice, and I love my room because it looks out over the gardens. Some service users did comment that they were unable to access the radiator temperature controls due to the radiator covers. In this way they are currently unable to control the level of heat in their rooms. Service users and relatives described the home as very clean. There was a good standard of cleanliness and very good odour control around this large building. However there were some personal toiletries in bathroom cupboards, including a comb and sponges. These could be mistakenly used by other people and this could present a risk of cross-infection. Also the light pull cords to communal WCs and bathrooms are becoming grubby. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 The deployment and number of staff on all shifts ensures that at all times service users are supported by an experienced group of staff. However recruitment arrangements do not ensure that staff are safe to work with vulnerable people EVIDENCE: There are sufficient staff available to meet the needs of service users at the home. Staff were noted to spend quality time with service users, listening to their opinions and experiences and taking part in discussions and demonstrating good humour. Staff turnover at the home is very low which promotes good staff relationships with service users, which helps staff to work well as a team, and they are knowledgeable of service users personal histories and needs. The manager has recently recruited one member of staff without having a full CRB carried out prior so that their suitability to work with vulnerable people could not be assessed. There is a good record of staff training at the home and staff are motivated and enthusiastic about NVQ and specific training which helps them to support the needs of service users. Records indicate that a high proportion of staff at the home have undertaken NVQ level 2 and over 50 also have achieved NVQ level 3. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 18 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 35 and 38 The manager offers clear leadership and direction to the staff so that they can consistently meet the needs of service users. The manager takes steps to ensure that service users’ money at the home is accounted for so that their best interests are safeguarded. The manager takes steps to ensure that support and environment offered to service users most appropriately meets their needs. Arrangements to ensure that the health safety and welfare of service users and staff are in place and are usually successful. EVIDENCE: The Registered Manager has attained NVQ level 4 in Care, a Diploma in Business Studies and has also completed the Registered Managers’ Award. She has been responsible for the day-to-day management of the home for around 7 years. She is assisted by a Deputy Manager and a team of senior staff. Since the last inspection a new senior manager is now in post who visits the home Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 19 regularly and carries out visits on behalf of the owner. There are clear lines of accountability within the home and within the organisation. Because of their needs, some service users prefer the home to support them with their day to day finances. There are detailed records which are kept to ensure that this is appropriately managed which can help if service users or their families have a query. A maintenance log is kept to ensure that the building is properly maintained and that service users and staff are not at risk. There are maintenance staff at the home to ensure that regular repairs and refurbishment takes place. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 20 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 3 X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 21 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 OP7 Regulation 15 Requirement Service users’ care plans must include details of how staff are to support their needs and evaluation records must state what support has actually been given. (Previous timescale 1/1/06) Service users’ assessments must be reviewed to show any changes in their needs at least every six months. Accurate records of all medication entering into and leaving the home must be kept. (Previous timescale 15/10/05) Prescribed creams must be kept in the residents own bedrooms or in a designated medication cupboard. (Previous timescale 15/10/05) Care plans must be in place which indicate to staff when they should administer emergency or irregularly given medication. (Previous timescale 15/10/05) The manager and proprietor must ensure that funding is available so that service users can engage in social and community activities without reliance on charitable donations. DS0000063779.V270551.R01.S.doc Timescale for action 29/05/06 2 OP7 15 29/05/06 3 OP9 13 01/04/06 4 OP9 13 01/04/06 5 OP9 13 01/04/06 6 OP12 16 01/04/06 Pavillion Care Centre Version 5.1 Page 22 7 OP12 16 8 OP14 12 9 OP15 16 10 OP15 16 11 12 OP19 OP24 23 23 13 OP26 13 14 OP26 23 The manager must ensure better organisation of the shared minibus so that service users can plan visits, and to allow more opportunities for more service users to go on visits. Service users’ must be able to use their own accommodation for privacy whenever they wish, or if they are unable to do so then the reasons for this must be recorded in an individual’s plan of care following an assessment. (Previous timescale 15/10/05 not met) All service users must have information in a suitable format about the alternative meal time choices, and steps must be taken to ensure that those people with memory loss are supported to continue to choose their preferred diet. (Previous timescales of 1/6/05 and 15/11/05 not met.) The home must ensure that all residents are supported, guided and equipped to take sufficient nutritional intake, and nutrition must form part of their care plan where identified as a need. The minor premises issues must be addressed as reported to the Manager during the inspection. Service users must have access to the radiator temperature controls so that they can regulate the level of heating in their own rooms. Service users toiletries and personal grooming equipment must be kept in their own rooms, not in bathrooms, to prevent possible cross-contamination. Light pull cords to communal WCs and bathrooms should be thoroughly cleaned, and form a part of the cleaning programme. DS0000063779.V270551.R01.S.doc 01/04/06 29/04/06 15/04/06 01/04/06 15/04/06 29/05/06 01/04/06 01/04/06 Pavillion Care Centre Version 5.1 Page 23 15 OP29 17 The proprietor must ensure that all staff have appropriate checks carried out to ensure that they are suitable to work with vulnerable people prior to commencing employment at the home. 01/04/06 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 3 Refer to Standard 9 14 15 Good Practice Recommendations The amount of medication kept at the home should be minimised to help staff accurately control stock. There should be suitable signs on bedrooms doors to let people know which is their own room. Consideration should be given to other ways of helping service users to make an informed choice about their meal, e.g. photographs and large print menus. Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Pavillion Care Centre DS0000063779.V270551.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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