Inspection on 09/10/05 for Rocklee

This inspection was carried out on 9th October 2005.

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

Rocklee 08/07/09

Rocklee 18/11/08

Rocklee 10/07/08

Rocklee 06/11/07

Rocklee 09/05/06

Rocklee 18/04/05

Rocklee 08/10/04

Rocklee 12/05/04

Rocklee 13/02/04

Rocklee 19/09/03

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

CARE HOMES FOR OLDER PEOPLE Rocklee 341 & 343 Stone Road Stafford Staffordshire ST16 1LB Lead Inspector Dawn Dillion Unannounced Inspection 9th October 2005 12:45 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 Rocklee DS0000004995.V257456.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 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. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rocklee Address 341 & 343 Stone Road Stafford Staffordshire ST16 1LB 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) 01785 602347 baugha1@aol.com.uk Ms Jacqueline Downes Ms Jacqueline Downes Care Home 11 Category(ies) of Dementia (7), Dementia - over 65 years of age registration, with number (7), Mental disorder, excluding learning of places disability or dementia (4), Mental Disorder, excluding learning disability or dementia - over 65 years of age (4) Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 4 Mental Disorder (MD) - Minimum age 40 years on admission 7 Dementia (DE) - Minimum age 60 years on admission Date of last inspection 18 April 2005 Brief Description of the Service: Rocklee is a residential home that provides a service for older people, the homes is also registered to provide a service for individuals who suffer with dementia and other mental health problems. The home is located on the Stone Road (A34 leading to Stafford Town), having easy access to local transport and amenities. The property consists of two semi-detached houses, the interior structure of which has been altered to allow access throughout, the exterior of the property had been maintained as two semi-detached houses in keeping with the local community. Rocklee provides accommodation for eleven service users, having seven single occupancy and two shared bedrooms. En suit facilities were not provided. Bathrooms and toilets are located throughout the home and are in close proximity to bedrooms and communal areas. The home also consists of two lounge areas of which are equipped with essential furnishings and fitments to provide a comfortable area. There are two kitchens in operation, one of which is equipped with a large dining table. There was also a compact laundry area at the rear of the property. A garden is located at the rear of the property; limited car parking is also available. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of Rocklee was undertaken within three hours and consisted of the examination of documents and systems to establish the effective management of the home and the quality of care provided. The Registered Manager was not present during the course of the inspection, assistance for the facilitation of the inspection was provided by the Support Worker. The inspection process entailed discussions with a number of service users to gain knowledge of their experiences with regards to the service and facilities provided at Rocklee. Service users were complementary of the staff and the general census was a satisfaction with regards to the service provided. The home is registered to provide a service for seven individuals suffering with dementia; during the course of the inspection there was no evidence of a specialist service or skills with reference to this service user group. What the service does well: What has improved since the last inspection? With reference to the last inspection visit to the home, it was pleasing to see that a number of requirements identified, had been addressed accordingly. Discussions with four service users confirmed that community social activities had improved, they informed the Inspector of visits to the local pub and Blackpool and also informed the Inspector, that arrangements were in place to visit Walsall Illuminations. On the day of the inspection a number of service users were playing bingo, which they appeared to be enjoying, one service user was drawing and others were occupied with their own pastimes. Rocklee DS0000004995.V257456.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. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 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 Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 and 5 The homes procedure relating to the assessment of prospective service users prior to admission was very poor. There was a lack of information relating to the necessary intervention of specialist healthcare services/professionals within the care plans. EVIDENCE: Discussions with the Support Worker and examination of files pertaining to service users identified that the home had recently had a new admission. There was no evidence of the undertaking of a pre admission assessment to establish the homes suitability to meet the prospective service users needs. The care plan and risk assessment provided very little information with regards to the care needs of this individual, or to what support and assistance would be required to enable them to live a full and active lifestyle. Information relating to the intervention of relevant healthcare specialists was not identified within the care plan. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 9 There was a trail visit questionnaire in operation, which evidenced that prospective service users were able to visit the home prior to admission and had the opportunity to comment on their experiences with regards to the visit. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 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 Systems in operation relating to healthcare of service users were extremely disorganised, documents were not formalised in a systematic order to ensure consistency to the access of relevant healthcare services. Information contained within care plans were not up to date, medication practices were not robust to ensure that service users received their prescribed medication as directed by their General Practitioner. Staffs approach and manner promoted the rights and privacy of service users. EVIDENCE: Three care plans were randomly selected for examination, all of which provided comprehensive information relating to the individuals health history and their diagnosis on admission. Care plans did not provide in-depth information relating to the individual’s specific care needs or what support and assistance would be required. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 11 Due to the layout of the care plans, it was difficult to identify if service users needs were being met appropriately and to what specialist healthcare services were accessible to the individual. The Inspector acknowledged that the home was currently in the process of transferring information contained within care plans to a new format. Service users were involved in the review of their care plan and were able to comment with reference to the contents. The examination of records relating to one service user identified emotional issues with regards to bereavement. The Inspector raised concerns that there was no evidence to suggest that bereavement counselling had been obtained for this individual. Areas relating to alcohol abuse, eating disorders and other mental health issues identified within service users records, there were insufficient care planning or monitoring of these conditions and a lack of evidence of Community Psychiatric Nurse intervention. With reference to the homes medication system and practices, the home operated the Boots monitored dosage system. Records relating to the administration, disposal, recording and storage of medicines were examined. The Inspector raised concerns that medication blister packs identified that on two occasions, two service users did not receive their prescribed medicines, this was most concerning as one drug was for the control of diabetes. Medication for two service users were missing, records did not identify the reasons for this. There were also two signatory gaps evidenced on the medication mar sheet. With reference to respecting service users rights and privacy, discussions with service users confirmed that the staff were respectful of their privacy. One service user informed the Inspector that all mail correspondence was distributed to them unopened and where necessary staff assisted with reading. The service users informed the Inspector that they were registered on the electoral roll and were able to vote, one service user expressed her interest in politics. With regards to privacy a number of bedroom doors had been fitted with a locking devices since the last inspection visit to the home. There were two shared bedrooms provided within the home, the Registered Manager should ensure that a dividing screen is provided. The Inspector acknowledged that this was sometimes difficult due to behavioural problems displayed by one of the service user. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15 Social activities were varied with more emphasis focused on activities within the community. There was a positive approach in ensuring that service users were able to maintain contact with their family and friends. A healthy and well-balanced selection of meals were provided, little importance was focused on meeting the needs of individuals with special dietary requirements. EVIDENCE: Discussions with service users identified that more emphasis was now focused on social activities within their local community. Service users informed the Inspector that they attended the local pub and had recently visited Blackpool and were also looking forward to visiting the Walsall Illuminations. On the day of the inspection a number of service users were partaking in a game of bingo, which they appeared to enjoy. Other service users were engaged with their own pastimes. One service user informed the Inspector that she no longer attended day care services but had enrolled at college, which she preferred. Discussions with another service user identified that he enjoyed working in the garden. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 13 The Registered Manager should ensure that individual service users are provided with the necessary stimulation with regards to their specific needs. Service users confirmed that they were able to maintained contact with their family and friends and were able to receive visitors at anytime within reason. Service users were observed to have freedom of movement throughout the home within the realms of respecting fellow service users privacy. Discussions with the Support Worker confirmed that service users at Rocklee were able to manage their own financial affairs; records relating to finances were not available for examination. All meals were prepared and cooked within the home by the Support Worker; discussions with four service users confirmed their satisfaction with the quality and quantity of meals provided. Menus that were examined evidenced a varied and well-balanced diet being provided. The Registered Manager should ensure that service users are provided with an alternative choice every day and not just on selected days. The Registered Manager should ensure that all staff are aware of service users special dietary needs with regards to diabetes and individuals with an eating disorder. Where necessary professional advise should be obtained from a dietician. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 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): 17 The homes complaints procedure was located throughout the home and was accessible to all the service users. Service users also had access to an independent self-advocacy service for additional support. EVIDENCE: The homes complaints procedure was located throughout the home and was accessible to all service users. The document identified contact details for the Commission For Social Care Inspection. Discussions with service users confirmed their satisfaction with the service provided and they explained that if they had any problems they would inform the Registered Manager. Service users had access to a self-advocacy service; contact details were located on the notice board within the main corridor. With reference to the protection of the individual’s rights, Discussions with service users confirmed that they were registered on the electoral roll and were able to pursue their political interests. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 25 and 26 The general environment appeared suitable for its stated purpose, all areas of the home appeared reasonably safe and conducive in meeting the needs of the service users of whom had access to all areas within the realms of respecting fellow service users privacy. EVIDENCE: Rocklee is located in Stafford, Staffordshire having easy access to public transport and all local amenities. The large mature property consisted of two semi-detached houses of which the interior had been altered to allow access through both properties. The exterior of the property had been maintained as two separate houses in keeping with the local community. The home provided seven single occupancy and two shared bedrooms of which were located on both the ground and first floor. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 16 There were no passenger lift in place; hence the home would not be suitable to provide a service for individuals who have a physical disability. Two lounges were provided on the ground floor, equipped with essential furnishings and home comforts to provide a relaxing area. Two domestic style kitchens were in place, one of which was equipped with a large table and dinning chairs. Bathrooms and toilets were located throughout the home and were in close proximity to bedrooms and communal areas. The locking device on the toilet door located by the laundry was not locking appropriately and was needs of some attention to ensure the total privacy of service users. Lighting within the corridors and within the identified bedroom was very poor and this has been identified as a requirement within the contents of this report. The Registered Manager is required to ensure that all bedroom windows located on the first floor are fitted with a restrictor to ensure the safety of service users. A small garden area was provided at the rear of the property and was accessible to all service users. Exposed electrical wiring within the store cupboard located by the kitchen is required to made safe and removed. All service users at Rocklee were mobile, the property was not equipped with specialised aids or adaptations, grab rails were located in the corridor area. The cleanliness of the home was of a reasonable standard the Registered Manager should ensure that there is a cleaning programme within the kitchen to ensure that selves within cupboard are maintained to higher hygienic standard. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 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 Adequate staffing levels were not provided at all times to meet the needs of the service user group. EVIDENCE: On the day of the inspection ten out of eleven service users were in residence, discussions with the Support Worker and the examination of staff rotas evidenced that two Support Workers were on duty and one Day Worker who was involved in social activities with the service users. Rotas evidenced that from 6.00pm until 8.00pm one male Support Worker was provided to support ten service users with mental health problems, some of which displayed challenging behaviour and eight of who were female. Rotas did not provided clear information relating to staffing provided during the night, the Support Worker informed the Inspector that one night staff was provided. It has been identified as requirement within the contents of this report that the staffing levels within the home is reviewed to ensure that appropriate staffing levels are maintained to ensure the safety and wellbeing of service users. Records relating to staff recruitment were not available for inspection. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 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): 37 and 38 Record keeping within the home was poor, untidy and difficult to retrieve. Systems, records and practices in operation relating to health and safety were maintained, some areas needed to be reviewed to ensure the total safety and welfare of service users. EVIDENCE: The Registered Manager was not present during the course of the unannounced inspection. Discussions with the Support Worker confirmed that service users managed their own financial affairs; records relating to financial systems and procedures were not available for inspection. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 19 With reference to record keeping, there was a lack of consistency and information was difficult to retrieve. It was difficult to formulise a pattern of events due to untidy and poor record keeping. A number of records relating to service users were found to be out of date. Staff rotas did not provide information relating the night staffs working pattern, in compliance to Schedule 4 (7) of the Care Homes Regulations; the Registered Manager should ensure that a clear rota is maintained of all persons working within the home. With regards to the health, safety and welfare of both the service users and staff the following were identified: There was evidenced that fire fighting appliances and systems were checked on a regular basis. The fire risk assessment was out of date and this has been identified as a requirement within the contents of this report. Records were maintained of all accidents within the home and whilst in the community. In the interest of infection control the practice of storing toilet tissue on the back of cisterns should cease. To promote regular hand washing the Registered Manager should ensure that liquid soap is provided in all communal hand wash areas. The unguarded radiator within the toilet located by the kitchen should be guarded or identified with the homes generic risk assessment. To eliminate staff suffering the onset of dermatology problems, due to the effects of wearing powdered latex disposal gloves, the Registered Manager is required to obtain professional advise from the Infection Control Nurse with regards to the approach disposable gloves to be used. Ant killer located within the laundry should be maintained in a secure area. (This was removed on the day of the inspection). Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 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 x x 1 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 x 2 3 3 x x x 2 2 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x 2 3 Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 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 OP10 Regulation 12(4)(a) Requirement To ensure that a locking device is provided to all bedroom doors as standard. (Outstanding from 02/01/05) and as recommended by the Fire Officer. The Registered Manager should ensure that a pre admission assessment is undertaken with regards to all prospective service users, to establish the homes suitability to meet the individual’s needs. Written confirmation of which should be given to the prospective service user or their carer. Care plans are required to be reviewed to incorporate information relating to the necessary healthcare professional intervention to ensure that service users physical and mental needs are met appropriately. Medication systems and practices should be reviewed to ensure that all service users receive their medication as directed by the General Practitioner. The Registered DS0000004995.V257456.R01.S.doc Timescale for action 30/01/06 2 OP3 14 30/01/06 3 OP7 15 & 12 30/01/06 4 OP9 13(2) & 12 09/10/05 Rocklee Version 5.0 Page 22 Manager should ensure that all medicines are accounted for and that the appropriate actions are taken where medicines are found to be missing. 5 OP9 18 Training should be provided in relation to the safe handling of medicines to all staff that are responsible for the administration of medicines. The locking device on the identified toilet door should be repaired to ensure the total privacy of service users. Dividing screens should be provided within the shared bedrooms. The Registered Manager should ensure that staff have a greater awareness of the importance with reference to special dietary needs of services users. Adequate lighting should be provided within the corridor and the identified bedroom. Windows located on the first floor should be fitted with a restrictor as per Health &Safety Requirement. Exposed electrical wiring within the store cupboard located by the kitchen should be made safe and removed. The cleaning regime with regards to shelving in kitchen cupboards should be reviewed to improve hygiene standards. Staffing levels within the home should be reviewed to ensure that sufficient care hours are provided to meet the needs of the service user group and that male staff are not left alone on duty. 01/02/06 6 OP10 12(4)(a) 30/10/05 7 8 OP10 OP15 12(4)(a) 12(1)(a) & 18 01/12/05 30/10/05 9 10 OP25 OP38OP19 23(2)(p) 13 25/10/05 01/11/05 11 OP38 13 25/10/05 12 OP26 23(2)(d) 25/10/05 13 OP27 18 30/11/05 Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 23 14 OP27 Schedule 4(7) 13 15 OP38 16 OP26 13 17 OP38 13 18 OP38 13 19 OP38 13 The Registered Manager should ensure that a rota is maintained of all persons working within the home. The fire risk assessment should be reviewed on an annual basis or more frequent to reflect any structural changes to the property. In the interest of infection control the practice of storing toilet tissue on the cistern should cease. To promote regular hand washing the Registered Manager should ensure that liquid soap is provided within all communal hand wash areas. To prevent staff experiencing dermatology or allergery problems associated with the use of powered latex gloves, professional advice should be obtained from the Infection Control Nurse. The unguarded radiator within the toilet located by the kitchen should be guarded or identified with the homes generic risk assessment. 30/11/05 30/11/05 09/10/05 09/10/05 01/11/05 02/01/06 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 OP37 OP15 Good Practice Recommendations The Registered Manager should review the homes recording and retrieval of information methods to provide a more robust and systematic process. To ensure that an alternative choice of meals is identified on the menu on a daily basis. Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Rocklee DS0000004995.V257456.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!