Inspection on 10/03/06 for Safeharbour

This inspection was carried out on 10th March 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Safeharbour 09/09/09

Safeharbour 14/08/07

Safeharbour 12/07/06

Safeharbour 28/09/05

Safeharbour 17/03/05

Safeharbour 06/09/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Safe Harbour 52 Corbett Avenue Droitwich Spa Worcestershire WR9 7BH Lead Inspector Jean Littler Unannounced Inspection 10th March 2006 4:00 Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 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 Safe Harbour DS0000018672.V286213.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 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. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Safe Harbour Address 52 Corbett Avenue Droitwich Spa Worcestershire WR9 7BH 01905 796214 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) Dr Anjani Kumar Mr Geoffrey Moultire Copeland Jolene Lisa Riggs Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is for people with a learning disability but the Home may also accommodate people with an additional mental disorder. 28th September 2005 Date of last inspection Brief Description of the Service: Safe Harbour is situated in a quiet residential area within a short distance of Droitwich Spa town centre and a wide range of amenities. The premises are in keeping with the environment and the local community. Accommodation is provided on two floors. All the service users have their own single bedroom. The home provides a service for six people with learning disabilities who have high support needs, some of whom may also have an additional mental disorder. The age range of the current service users is 34 to 45 years. One of the stated aims of Safe Harbour is to provide a comfortable and secure home for as long as the individual service users need it and to encourage and enable them to develop to their maximum potential. The home also seeks to promote within each individual, the belief that their life and activities are of value and as valid as other peoples. Safe Harbour Care Homes operated as a partnership and has two registered proprietors namely, Dr. A Kumar and Mr. G Copeland. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection was carried out on a weekday between 4.30pm and 7.45pm. The deputy took the inspector around the premises and then handed over to the manager and her line manager who both returned to the Home shortly after the inspection began. The inspector met all the residents and observed them interacting with staff before and during the evening meal. It was not appropriate to interview any of the residents as this would cause anxiety and would be unlikely to provide reliable information as they do not know or trust the inspector. Two staff were interviewed in private and the deputy and one worker were observed administering the early evening medication. A sample of records for residents’ monies, medication and care plans were seen. The providers monthly visit reports to the Commission, and other communication with the Home since the last inspection were all considered as part of the assessment process. What the service does well: What has improved since the last inspection? The manager has continued to make improvements in several areas including the environment, staffing levels, staff recruitment, training and supervision. As a result less agency staff are being used and team morale has lifted. The residents and their families, and staff are benefiting from her approach as their ideas are being listened to e.g. for new activities. There is better daily planning for each resident and the role of an activities worker has been created to further improve activity arrangements. A complaint was taken seriously by the manager and promptly addressed. The level of monitoring from the providers has increased covering areas such as medication and money management. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 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 Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not assessed, however there have not been any changes in the resident group and there are no vacancies. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 9 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, 10. Arrangements for planning and reviewing the residents care needs have been improved and staff are working consistently. Systems for ensuring care plans and risk assessments are always comprehensive and accurate need further development. Residents’ personal information is being kept securely and staff are aware of the need to keep this confidential. EVIDENCE: Two residents’ care plans were sampled. The information in some areas was comprehensive and was up to date. In other areas gaps were noted or information was out of date e.g. health needs had changed. Risk assessments were not comprehensive e.g. those relating to a residents behaviour. The folders would be improved if old information was archived. The manager had already identified the need to reorganise the care plans and wants to streamline the system. Keyworkers are now being asked to complete monthly summary reports on their key residents. This is good practice and does allow information to be collated more easily for the six monthly review meetings. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 10 Three care folders seen showed evidence of recent review meetings being held. Minutes are taken at the meetings and an action plan produced. Family and other parties involved in the resident’s life are being invited. Work is continuing towards developing care plans in a Person Centred way. The local Person Centred Planning coordinators have provided staff training and are supporting initial work on the plans. This approach and format should be considered when the manager is deciding how to alter the current care plan format. Residents’ personal files are held in the office that is secured when not in use. Both staff spoken with had been made aware of their duty to keep personal details confidential and had seen the policies relating to this. Staff reported that the team works constantly with each resident in line with their care plan and because of this no physical intervention is needed. If a resident does become anxious or distressed staff defuse the situation by a variety of approaches depending on the individual e.g. giving them some space, changing the tone of voice, reassuring them etc. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 11 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): 13, 16, 17. Opportunities for residents to go out regularly into the community are being increased. Residents’ rights are being safeguarded. A healthy and enjoyable variety of meals are provided that the residents enjoy. EVIDENCE: A new member of staff reported that residents had a good quality of life and are given opportunities to go into the community regularly. A sample of daily planning sheets were seen, which showed staff are allocated to support each resident and personalised activities are planned for the daytime hours. The resident’s frame of mind and health are considered during the day and the plans are changed if need be. One worker spoken with had worked on and off in the Home since 2001 through an agency. She reported that new activities were now being tried with the residents e.g. eating a meal in the pub. She felt the residents’ had all made personal progress in the time she has known them. The deputy reported that one resident’s speech has greatly improved recently and he is now better able to express his needs. A senior member of staff is due to take the role of activities coordinator and will be responsible for further developing activity opportunities including those offered in the evening. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 12 Holidays have been arranged for the year and there was an air of excitement about these. Great effort has gone into finding accommodation that is suitable for each resident. They will be supported to have a break by the coast either on a one-to-one or small group basis with a high staffing ratio. The residents’ rights are being promoted through normal good practice e.g. ensuring their privacy is maintained, supporting them to manage their own money if they are able. The level of support the residents need mean they are unable to vote or exercise some normal rights e.g. going out alone. Some discussions about residents were held between staff and managers in the lounge in front of the residents concerned and others. The manager should monitor this and ensure residents are included in any conversations about them or alternatively that discussions are held in private. A well-qualified and experienced cook works three days a week. She is currently undertaking the advanced food hygiene training. Food is purchased locally, some of it with the residents help, and the meals are prepared fresh each day. Meals are eaten in a relaxed atmosphere and staff eat with the residents. Three areas of the house are used for dining so the groups are small and residents are better able to concentrate on their meals. Residents’ food preferences are known and their views sought as much as possible when the weekly menu is planned. The current menu contained a good variety of flavoursome meals. Taster sessions are held to find out if new foods will be enjoyed. One resident’s cultural needs are being accommodated. One resident regularly cooks and she was justly proud of her apple bakewell tarts that were for pudding on the evening of the inspection. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 13 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): 20 Suitable systems for managing medication are in place. Recent evidence indicated that these had not been consistently followed. EVIDENCE: The deputy and a support worker were observed carefully administering medication. A double-checking and signing system is used to reduce the risk of errors, and a senior is always involved in the administration process. The staff spoken with reported that this procedure is normal practice. Secure storage and key management systems are in place. The storage arrangements would be improved in each resident’s boxed medication were stored in a separate labelled container or section of the cabinet. Currently all the packets are held in a large container because medication is carried downstairs for administration. It is very positive that along with the brief medication administration training given by the supplying pharmacist staff are also now having to gain accredited training. A distance-learning workbook is being piloted to assess its suitability. Residents’ photographs are now in front of their section of medication charts to help avoid identity errors. A situation had recently occurred when a change in one resident’s medication had not been implemented following a health appointment. This was picked up during the monthly providers’ monitoring visit and staff were alerted to the Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 14 error. Corrective steps were not taken until much later when the error was picked up again. The providers took the error seriously and carried out an in depth investigation. Disciplinary action was taken again all staff involved in breaching medication recording and management procedures. Additional training was also provided for those concerned. The incident was reported to the CSCI but only when the error was noted on the second occasion. The first error was mentioned briefly in that months regulation 26 providers’ report, however it was not reported in a clear and transparent manner. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 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, 23. Suitable procedures and arrangements are in place to resolve any complaints made and to help protect residents from abuse. EVIDENCE: A complaints procedure is in place and a version is displayed that is in a format more easily understood by the residents. It is positive that the manager has made it a priority to respond positively to the concerns raised by a neighbour during the last inspection. Communication between both parties is now productive and any issues are being resolved as they arise. Suitable policies are in place regarding abuse and staffs’ duty to report concerns to protect residents. Staff training in abuse and protection is being provided. No adult protection issues have been reported since the last inspection. A long running vulnerable adults multi-agency procedure has been concluded since the last inspection. The providers co-operated with this process when allegations of staff and management misconduct came to light in January 2005, and they took steps to ensure the safety of the residents. Following initial police enquiries the providers commissioned an external investigation and shared the findings and with the multi-agency group. They acknowledged that lessons needed to be learnt from the events and have now developed an action plan. One worker was dismissed and referred to the Protection of Vulnerable Adults (PoVA) list and appropriate action was taken against other staff involved. The recruitment procedure has been reviewed and training and monitoring arrangements improved. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not fully assessed, however the Home was clean, comfortable and homely. Since the last inspection the manager has consulted with Environmental Health and Fire departments to clarify some grey areas about the arrangements in the Home e.g. the laundry door was confirmed as not being a fire door. The manager reported that all necessary action has been carried out. Improvements in the environment have been made since the last inspection including the provision of new sofas and dinning room chairs. More equipment for the sensory room is currently being ordered. The unused sluice room has been cleared and is now used for storage. The laundry has been fitted with pump soap and paper towel dispenser to improve infection control arrangements. Other improvements are planned and some decoration is due to be carried out when the residents are away on holiday. The downstairs shower room is in need of refurbishment to make it more homely and to make good tiling and rusty metal work to enable thorough cleaning to take place. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 17 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): 32, 33. The staff team are working effectively with the residents and with each other. Staff are benefiting from better training opportunities and appropriate staffing levels are being maintained. EVIDENCE: Staffing arrangements have improved due to ongoing efforts to recruit and retain competent staff. Two new staff have recently started and are learning the role and getting to know the residents’ needs. The care staff are still supported by a part time cook, and housekeeper. The waking night staff also assist with domestic tasks. High staffing levels are provided during the day with the usual number on duty being seven. The manager and deputy can be on duty in addition to this. Staff reported that these levels are needed due to the high support and health needs of the residents. They confirmed these levels are being maintained and the rotas also evidenced this. The manager reported that once the new staff are fully trained there should not be any need to use agency staff. New staff are being supported to learn the role progressively. A new worker spoken with had attended training for the administration of emergency medication for epilepsy. She knew she would not be required to perform this procedure until she had observed it and felt confident, as more experienced staff were always on duty with her. An agency worker reported that the agency provided the majority of her training but that she was invited to attend any Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 18 specialist training arranged by the Home and would be paid if she did attend. The staff meeting minutes are shared with her to keep her fully informed on relevant decisions. Training arrangements are being improved in several areas including first aid, medication and understanding challenging behaviour. LDAF and NVQ awards are still being promoted. Both staff spoken with reported that team morale was good and the staff team was working consistently. A new worker said she had been made very welcome. Each shift was reportedly well planned and handover sessions between shifts used in a professional and helpful way. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 19 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): 39 Arrangements to develop quality assurance and self-regulation systems have been improved and a more formalised system is due to be introduced shortly. EVIDENCE: The manager continues to work to develop the service and improve the quality of life for the residents. It is positive that she is making time to attend courses that will assist with her own personal development e.g. disciplinary procedures. She continues to show a willingness to co-operate with the CSCI and has worked hard to address the requirements and recommendations made at the last inspection. The level of monitoring from the providers and line manager has been increased. This has proved effective in identifying areas of good practice and shortfalls. Positive steps have been taken to address any shortfalls when these have been identified e.g. additional training. A formal quality assurance system has been decided upon but not yet implemented. The providers are aware that the legal responsibility to directly monitor the service now lies predominantly with them rather than with the CSCI. Incidents have been reported to the CSCI in a timely manner since the last inspection with the exception of the recent medication error. The registered persons must Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 20 ensure that the Home operates in a transparent manner if the CSCI is to have confidence in their ability to self regulate. A sample of records were seen as detailed throughout the report. Record keeping systems have been improved and the manager is aware of areas where further development is needed e.g. care plans. A sample of residents’ monies was inspected. Records were up to date and the majority of entries were for small amounts for personal items e.g. toiletries. Staff check the balances of cash tins are correct at each shift handover. The manager is planning to redesign the recording format to allow staff to write more detail about each item of expenditure. It was noted that one resident had been charged for the purchase of a piece of equipment used to monitor his wellbeing during the night. Meals taken after 5pm in the community or evening takeaways are also charged to the resident concerned. A discussion was held about appropriate charging and the manager and line manager undertook to review the policy and ensure it is consistent with what has been agreed with each resident and their representative in the Terms and Conditions of Residency. Caution should be taken when spending residents’ personal monies on meals when they are not able to fully understand the implications of the expenditure and give their genuine consent. If staff support a resident to eat a meal or have a drink while in the community they are not provided with any funds to have a meal or a drink themselves. This practice should also be reviewed. Members of the senior management team hold appointee-ship for some residents. Records relating to these arrangements were not seen on this occasion but safeguards were described e.g. two signatures needed for bank withdrawals. Appropriate consultation had been carried out regarding how best to spend some of one resident’s finances that had accrued and would soon be over the limit that would affect his benefit entitlements. It is very positive that one resident is being supported to manage their own money. Health and Safety (H&S) arrangements were not fully assessed, however improvements were noted. Both staff spoken with reported that H&S matters are well managed and they were not aware of any current faults or hazards. H&S issues are covered in the induction programme for new staff and videos are used to provide essential information. One worker described how bath water is checked using a thermometer in a jug, prior to any resident getting into a bath. Other regular checks such as fire equipment were also reportedly being carried out and the providers monthly visit reports indicate that these are monitored closely. Records were not inspected in detail due to the time the inspection had continued to. The manager needs to ensure risk assessments are comprehensive for the management of environmental, employment and residents’ care related hazards. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 x STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 X 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 x 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x X 2 X X X 2 X X X x Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA38YA41 Regulation 37 Requirement All incidents affecting service users’ wellbeing must be reported to the Commission without delay. (Brought forward, not fully actioned. Previous compliance date 16/9/05). Timescale for action 30/04/06 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 YA27 YA18 YA6 Good Practice Recommendations Refurbish the shower room to improve the look of the room and to enable appropriate hygiene standards to be met. Review the practice of staff sharing information about residents in communal rooms. Ensure care plans contain accurate information about care needs and how risks are being managed. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 23 4 YA41YA5 Review what residents are charged for out of their personal monies and ensure it is consistent with that detailed in contractual information agreed with the residents and their representatives. Consider funding staff to eat with residents when they support them to eat out in the community. Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Safe Harbour DS0000018672.V286213.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!