Inspection on 03/05/06 for St Gregory`s House

This inspection was carried out on 3rd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Gregory`s House 02/03/06

St Gregory`s House 30/09/05

St Gregory`s House 29/03/05

St Gregory`s House 04/10/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE St Gregory`s House Preston Patrick Kendal Cumbria LA7 7NY Lead Inspector Jenny Donnelly Unannounced Inspection 09:00 3rd May 2006 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 St Gregory`s House DS0000022702.V291106.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. St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Gregory`s House Address Preston Patrick Kendal Cumbria LA7 7NY 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) 015395 67543 St Gregory`s House Ltd Mrs Tracey Diane Bindloss Care Home 29 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (29) of places St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 29 service users to include: up to 29 service users in the category of OP (Old age, not falling within any other category) up to 16 service users in the category of DE(E) (Dementia over 65 years of age) may be accommodated within the overall number of registered places. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2nd March 2006 2. Date of last inspection Brief Description of the Service: The home is a large detached three storey Victorian house, which was formerly the local vicarage. It is situated in beautiful open countryside on the edge of Preston Patrick, a small village between Kendal and Kirkby Lonsdale. Modern extensions have been added to provide bedrooms, communal living spaces and an office. An extension is currently being built to provide a new dining room for the residents. The house has a passenger lift to provide easy access to all floors including the basement, and there are assisted bathing facilities. There are two twin bedded rooms, with the remainder being for single occupancy. Some bedrooms have en-suite facilities. The home has its own attractive grounds with seating areas and car parking. Additional land adjoining the property has been purchased to create extra car parking spaces and a secure garden. The home is registered to provide personal care and accommodation to 29 older people, including up to 16 older people with dementia. The homes fees as provided on the date of inspection, varied on a scale of £422, £444 and £466 per week, depending on the level of care required. The homes’ statement of purpose, service user guide and last inspection report, could be seen at the home, or a copies requested from the manager. St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out during the morning and early afternoon. The manager and her deputy were present in the home, as were the directors of the company. The inspection comprised of a full tour of the building; inspection of care and medication records; inspection of staffing and maintenance records. Breakfast and lunch were observed being served in the dining room, and residents and staff were spoken with, both in groups and individually. As part of the inspection process, questionnaires had been issued to residents and written information was collected from the manager. What the service does well: What has improved since the last inspection? There were no requirements or recommendations made at the last inspection, and the manager and owners have continued with their ongoing improvement programme within the home. Work on providing a new dining room had continued, but was not yet complete. This work will also provide further car parking and garden space. St Gregory`s House DS0000022702.V291106.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. St Gregory`s House DS0000022702.V291106.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 St Gregory`s House DS0000022702.V291106.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, 2, 3, 4, 5 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. The home provides good information for prospective residents. Pre admission assessments are very throrough for both planned and emergency admissions. This ensures that prospective residents know about the home, and are assured the home can meet their individual needs. EVIDENCE: The home had an informative service users guide, which was issued to all prospective residents and their families. Copies of contracts of residency and pre-admission assessments for three residents were seen on file. These assessments were detailed and included relevant information from the persons social worker, mental health team and the hospital as applicable. In the case of a recent emergency admission, the manager had still done a home visit to meet the person and assess their needs prior to offering the place. This is excellent pratice as it ensures the home can meet the needs of any new residents, before they arrive. There was evidence that where social workers were involved in a persons admission to the home, a follow up reveiw took place with the outcome recorded in the care notes. St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 9 Visits to the home by prospective residents and their families were welcomed and encouraged. The first few weeks of stay was regarded as a “trial” period, to ensure the placement was suitable to all parties. The mananger and staff understood the pressures on new residents and their families when moving into a care home, and placed much emphasis on helping people feel settled. The home is registered to provide care for people with dementia, and in order to do this well, staff had attended a dementia care course run by St Gregory’s House, as well as periodic updates. St Gregory`s House DS0000022702.V291106.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 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. The health and personal care of residents was very well managed, with staff being pro-active in noticing and attending to problems as soon as they arose. This ensured people were not left to feel unwell unecessarily. EVIDENCE: The home had a good system in use for care planning. This followed a set sequence giving adequate space for all relevant informaiton to be recorded. Four care plans were studied in detail, and found to be up to date and fully complete. They gave staff clear information on exactly what level of care was required for each person, and when. There was evidence of residents preferences regarding their care recorded in care plans. Up to date risk assessments were on file, detailing any special care or additional monitoring required to maintain the persons safety. There was a good system of monitoring residents’ falls and other accidents, and evidence of satisfactory preventative safe guards in place. St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 11 Healthcare records showed input from the doctor, commuity nurses, mental health workers, and details of any hospital appointments. Staff were alert to residents health care needs and sought specialist intervention as soon as any problem was detected. The home had recently persisited in their request for a doctor’s home visit for one resident, who did subsequently require hospital admission. The deputy manager acted as a link person for continence and infection control, in the home, and as such attended study days and updates for these subjects, which she shared with the staff team. Residents appeared well cared for, being nicley dressed in clean clothing, with socks or stockings and shoes on. Residents hair was clean tidy, and dentures, spectacles and hearing aids were being worn as needed. There was evidence that residents’ privacy was being maintained. Bedroom and bathroom door locks were fitted and in use. Staff were observed treating residents with respect, and privacy and dignity ran through all training events. Inspection of the medicines system in the home, found the management of medicines to be safe. Staff demonstrated a good knowledge and understanding of residents’ medicines, and of the homes’ procedures for the ordering, storing and administering of medicines. Record keeping in relation to medicines was good, and the storage was safe and well organised. Staff confirmed thay had received training on the management of medicines, and there were systems in place to allow residents to safely manage their own medicines if they wished to. St Gregory`s House DS0000022702.V291106.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, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home provided a good varied range of in house and external acitivtes for social stimulation. There were good links with the local community and visiting by friends and family was encouraged. The provision of meals was very good, although choice could be improved at lunch time . EVIDENCE: An annual programme was on display for 2006 showing a visiting entertainer was booked at least monthly, and another event such as an outing also took place at least monthly. Many of these events were held in conjunction with another care home, and these comprised of tea dances, barn dances, meals out, a bonfire party and trips to a wildlife park and garden centre. There were also in house activities on two afternoons each week, when an extra carer was rostered for this purpose. Activity records showed who had attended and what the activities were. Examples included dominoes, walks outside, discussion on news stories or nail care. A notice advertised that the home operated an open visiting policy, at the convenience of residents. The manager said she received good input from St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 13 relatives and friends, who attended the social functions and generally supported the home. There were visits from the local schools, and religious ministers. Residents felt the daily routine within the home was flexible, and allowed them to state their preference in relation to bed times and rising times. Those residents’, who wished and were able, managed their own affairs, although most received assistance with this from family and friends. The home did not manage any residents’ finances, and there was information available on how to access a local advocacy service for independent advice and support. Some residents had been able to continue attending their day care centre whilst living at St Gregory’s. It is unusual for the day care centres to allow this, but it was proving very beneficial to those residents, and the home had liaised well with the centres to make this work smoothly. Residents said they enjoyed the meals, and breakfast and lunch were seen being served in the dining room. The tables were set nicely and all staff were in attendance to give assistance as needed. Residents said they could have meals in their bedrooms if they wished. Snacks and drinks were freely available throughout the day. Breakfast was seen being eaten at 09.30, although some people had eaten earlier and some later, as they preferred. Lunch was the main meal of the day, and was a set main meal with no visible choice. The chef said alternatives such as pasta, stir fry’s and pies were available if residents wanted. Those residents spoken with said they were very happy with the food, and felt the chef knew their likes and dislikes. The kitchen and kitchen records were well maintained. The chef planned the menu one week in advance, and this was written out daily for residents and on chalkboard. Special diets were satisfactorily catered for, with pureed meals being nicely presented. Although residents were happy with the meals, the home could make an improvement by offering a proper choice of main meal, rather than waiting for residents to ask for an alternative. St Gregory`s House DS0000022702.V291106.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): Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home had good systems in place for residents, relatives or friends to raise any concerns, be listened to and have their concerns acted on. There were robust systems in place to protect residents from abuse. EVIDENCE: The home had a clear and simple complaints procedure, which was handed out to residents and relatives, as part of service user guide on admission. There was also a copy prominently displayed in the home. The information stated how and who to complain to, and what response time to expect. It also gave the contact details of the homes’ inspector. Those residents spoken to were aware of how to complain, but all thought it unlikely to be necessary. Those resident’s who did not seem sure about the complaints procedure, felt they would speak to the manager about any concerns, which was the right thing to do. The manager stated that no complaints had been received since last inspection, and none had been made directly to the homes’ inspector. The home had policies and procedures in place on the protection of vulnerable adults (abuse) and staff had attended training sessions on this subject, as well as managing aggressive behaviour. The manager was aware of local multiagency adult protection referral procedures. No referrals had been necessary since the last inspection. St Gregory`s House DS0000022702.V291106.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, 20, 21, 22, 23, 24, 15 and 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home was well maintained and provided a safe, comfortable and clean environment for residents to live in. EVIDENCE: St Gregory’s House is a large detached three storey Victorian property, which was formerly the local vicarage. Modern extensions have been added to provide bedrooms, communal living spaces and an office. An extension is currently being built to provide a new dining room for the residents. Maintenance records show regular servicing of equipment and services had been maintained, by the homes handyman and by external contractors. Over last year much improvement work had taken place to upgrade the kitchen and food storage areas. There were plans in place to replace some windows and fascias at the rear of the building, and for pipe work to be boxed over in the kitchen. St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 16 Communal space comprised of a small but open plan television lounge, and a large lounge leading into a conservatory, currently used for dining. There was a further communal room, temporarily out of use, due to the building works for the extension, which will eventually house a new dining room. The addition of a new dining area will greatly enhance residents’ comfort, as the conservatory gets very hot in the summer months. The lighting and furnishings in communal areas was good, with the exception of the dining area, hence the building work. Residents had been involved in choosing the colour schemes and furnishings for the new dining room. There was a garden area for residents, and on completion of the building work, an additional garden area will be created. St Gregory’s House had ample bathroom and toilet facilities situated throughout the home to serve the 29 residents. There were three bathrooms and a shower room, and three of the bedrooms had en-suite facilities. The home had suitable adaptations to assist elderly and infirm people in getting about. The passenger lift provided easy access to all floors including the basement, for the delivery of supplies. There were handrails fitted where necessary in corridors and stairways, and overhead hoists fitted in some bedrooms and bathrooms. The home was well equipped to assist with the safe moving and handling of residents, with four mobile hoists and five bath lifts. There was adequate wheelchair access throughout the home. There were two twin bedded rooms, with the remainder being for single occupancy. The shared rooms had screens to ensure individuals’ privacy, and the sharing was done on the basis of agreement. All residents were encouraged to bring some of their own treasured possessions with them, to make their rooms more homely. This included pieces of furniture where possible. The heating, lighting and ventilation were satisfactory throughout the home, with residents saying they were most comfortable. The issue of the hot conservatory will be alleviated once the new dining room is completed, as residents will have more choice of whether to use the conservatory. The home was clean and tidy despite a housekeeper vacancy. Residents said that the housekeeper worked hard to maintain high standards and “it’s always nice and clean.” There were no unpleasant odours around the home. The laundry worked efficiently with residents stating their clothing was returned to them promptly and nicely laundered. The laundry floor was in need of repainting, but the manager said that a complete new floor covering had been ordered. St Gregory`s House DS0000022702.V291106.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 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. Residents benefitted through being cared for by a stable, committed, well trained and competent staff group. EVIDENCE: Staff rotas showed the home to be adequately staffed at all times. There were usually seven care staff during the morning and early afternoon, reducing the four later on. The rotas showed a good skill mix of carers and senior carers on duty, with back up from the manager and her deputy. On the day of inspection, there were only six care staff on duty as one person was ill. Care staff said they were happy with workload and staffing levels. Saying when they were short like today, residents’ care was still fully attended to although bathing might be slower. There were sufficient ancillary staff; kitchen, housekeeping, administrator and handyman, to ensure the home ran smoothly. The home had only one vacancy for a part time housekeeper, meanwhile the one housekeeper was working extra hours, to maintain a good service. There was very little use of agency staff, to cover holidays and sickness, which provided good continuity for residents. Over 50 of the care staff had completed an NVQ level 2, or above, in care. A further two staff were currently completing this. St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 18 The home had thorough staff recruitment procedures in place, which prevented unsuitable persons from working in the home with residents. A review of staff files showed these procedures had been adhered to. Files contained evidence of all the necessary checks having been carried out including references, and criminal records bureau checks. Staff confirmed that they had attended for interview and felt they had been properly vetted before being offered a job. The home had a full staff-training programme in place, which started with an induction period. Staff completed a formal induction programme made up of many elements, and signed by a senior once the person was deemed competent. After that, there was ongoing training and mandatory refresher sessions. The training programme for the year showed a good mix of topics, with many areas highlighted as mandatory. Suitably qualified people, both employed and external to the company provided the training. Training records were excellent and the emphasis and resources put into training, demonstrated the homes’ commitment to continual improvement and excellence. St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 19 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, 32, 33, 35, 36 and 38 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. The home has a strong management team, who demonstrate clear leadership skills, and focus on positive outcomes for residents. EVIDENCE: The registered manager had the necessary qualifications and experience in residential care to enable her to manage the home effectively. There was evidence that the home was run in an open, positive and inclusive manner. The manager valued the opinions of residents and their views and those of their representatives were regularly sought through a customer satisfaction questionnaire. The results of the latest survey were seen at the last inspection, and were very favourable. The manager had since conducted a staff survey, as part of the homes work towards an “Investor in People” award. St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 20 Other quality assurance work undertaken by the manager included regular audit checks on care plans, and accident and incident records. This monitoring of accidents led to some impressive work on falls prevention and reduction, which had a positive impact on residents’ safety and well being. The manager also met monthly with the chef, handyman and housekeeper to review and plan their workload. There were regular care staff meetings and the minutes of these were available and showed good communication of any changes and sharing of ideas amongst the staff team. The home did not manage any residents’ finances, but would hold small amounts of cash for safe keeping if asked. There was a system to maintain accurate records of this. There was a process for formal staff supervision to take place bi-monthly. The timetable for this was planned out in advance. Supervision records were detailed and showed that these sessions covered training needs and care practices, as well as personal issues. The health, safety and welfare of residents and staff was given a high priority. The building was well maintained, and up to date service records were seen for fire alarms, nurse call, lifts, hoist safety and the heating system. Mandatory staff training was up to date for moving and handling and fire safety. Eight staff held a first aid certificate. The home owners had daily contact with St Gregory’s House, and provided the inspector with a monthly monitoring visit report of the conduct of the home. St Gregory`s House DS0000022702.V291106.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 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 3 4 4 3 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP15 Good Practice Recommendations It is recommended that residents be offered a positive choice of main meal at lunch time. St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 St Gregory`s House DS0000022702.V291106.R01.S.doc Version 5.1 Page 24 - 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. 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