Inspection on 23/05/06 for The Dell

This inspection was carried out on 23rd May 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Dell 10/07/07

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Dell Kithurst Close Southgate Crawley West Sussex RH11 8TD Lead Inspector Mrs M McCourt Unannounced Inspection 23rd & 26th May 2006 10:30 The Dell DS0000066068.V289806.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 The Dell DS0000066068.V289806.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. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Dell Address Kithurst Close Southgate Crawley West Sussex RH11 8TD 01342 714581 01342 714581 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) Evesleigh Care Homes Limited Ms Gwendoline Dale Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: A maximum of 4 service users in the categories listed above may be accommodated at any one time. Date of last inspection New registration Brief Description of the Service: The Dell is a care home registered to accommodate up to four Service Users with learning disabilities. The Registered Provider is Evesleigh Care Homes Ltd and the Registered Manager’s post is currently vacant. The current weekly charge is between £1,486.50 and £2,201.10. This information was provided on the pre-inspection questionnaire. Additional charges are made for personal items, such as; toiletries, clothing, hairdressing, and so on. Should Service Users wish to go on an expensive holiday, they would contribute half of the cost towards it. The home is a detached property in a cul-de-sac. It is situated within the town of Crawley, and therefore is accessible to all community facilities, including rail and bus stations. Accommodation is provided over two floors. Each resident has their own bedroom, with a bedroom located on the ground floor, and the remaining three rooms on the first floor. On the ground floor there is a kitchen that includes a dining area and utility room. In addition there is a nice size living room that leads into a small multi-functional room. Outside, to the rear of the property there is decking and well-kept flowerbeds. The Service Users Guide and Statement of Purpose, which incorporates inspection reports, are both located at the home and are accessible to Service Users, staff, relatives and anyone else interested in the service. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection was undertaken by one Inspector over two days on Tuesday 23rd and Friday 26th May 2006 and lasted a total of eight and a half hours. Pre-inspection planning took approximately two days. A full tour of the building took place and included the observation of Health and Safety matters, hygiene issues, decorative order and a general overview of the atmosphere created within the home. Three staff members, two residents, the company’s Training Manager and the Responsible Individual were spoken to at the time of inspection. Case tracking was carried out by examination of relevant records and information held on the staff and residents spoken with during the course of the inspection. What the service does well: What has improved since the last inspection? The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 6 Service Users meetings have taken place regularly during this year. Some of the minutes read were very staff orientated and focused on management issues. However, the most recent meeting reflected a new style and was more inclusive and Service Users lead. Service Users were asked direct questions around their happiness, how content they were with their rooms, clothing, etc and how they think staff care for them. The Inspector noted that this is an improvement on previous meetings, but evidence is required to ensure that requests made by Service Users will be followed up. 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. The Dell DS0000066068.V289806.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 The Dell DS0000066068.V289806.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): 2, 4 and 5 The outcome for Service Users was found to be good. Service Users are consulted about where they choose to live prior to moving, and are confident that the home will meet their individual needs. The home can demonstrate an excellent opportunity for Service Users to ‘test drive’ the home. Each Service User has an individual written contract, and the home should ensure that they are signed by both the Service User, or representative and the manager of the home. EVIDENCE: An admissions/referral procedure is in place at the home and has been reviewed recently. The procedure is detailed and sets out the process to be followed when considering a service user for the home. A policy is also in place. A Service User, new to the service was admitted recently, and the Inspector was able to case track his admission to the home. He had a resettlement plan on his file that was detailed in describing a step-by-step process of introducing him to the home, through to actually moving in. It included staff training in The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 9 matters pertinent to his needs, decoration of his room, visits, meetings with the Martyn Long Centre and staff from his previous care home. Finally the plan described how staff would physically move him into the property. Discussion with staff revealed that several people had been considered for the vacancy, but the home had been careful to place a suitable person due to the complex needs of the three Service Users who already live at The Dell. Two contracts were looked at. One did not include the fee charged and had not been signed by the home or service manager, although the service user had signed it. The other contract had not been signed by either service user or manager. It does record the fee charged, although this is very different to what was recorded on the pre-inspection questionnaire. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. The outcome for Service Users was found to be good. Service Users needs and personal goals are reflected in their care plans. Service Users are assisted to make decisions about their own lives, which includes taking responsible risks. Service Users are consulted on, and participate in, all aspects of life in the home. EVIDENCE: The Inspector examined two personal files for Service Users. Care plans were in place for independent skills, such as; budgeting, road safety, shaving, communications and so on. In addition files include risk assessments and care plans on health issues and on specific hazards. They are reviewed every three to six months depending on the particular risk. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 11 Monthly review reports have been carried out consistently, dating back to Aug 2005. One Service User also attends a workshop, for which there were review notes on his progress. These are carried out every six months. There are personal daily diaries provided for each Service User in symbol form. It requests Service Users to write down what they have been doing during the day and another section on the page asks them to write how they are feeling. It is in a bright, easy to follow format that enables staff to discuss with Service Users what they have been doing during the day and how they feel about it. This was considered by the Inspector to be a good example of and effective communication aid. Staff are required to sign a confidentiality contract on commencing work. There is also a policy on confidentiality within the policy file. Service Users meetings have taken place regularly during this year. Some of the minutes read are very staff lead and focused on management issues, although it was noted that the most recent meeting reflected a new style and was more inclusive and Service Users focused. Service Users were asked direct questions around their happiness, how content they were with their rooms, clothing, etc and how they think staff care for them. The Inspector noted that this is an improvement on previous meetings, but that evidence is required to ensure that requests made by Service Users will be followed up. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. The outcome for Service Users was found to be good. Service Users have opportunities for personal development. Service Users are able to take part in a range of appropriate activities within the local community. Service Users are supported with family relationships and guided to develop personal friendships. Meals are varied and nutritious, although a consistent approach must be in place for Service Users who have specific dietary requirements. EVIDENCE: A large activity board is on display in the kitchen for all four Service Users. There is also a laminated card system indicating when various household chores are undertaken (ironing, room cleaning and cooking) for each Service User. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 13 Activity timetables are on personal files and include workshop timetables, college courses, house chores, travel training, walking and so on. Care plans are in place to help Service Users achieve various goals, such as; opportunities to develop social, educational, recreational and occupational activities, bathing, household chores, communication, family and social contact and so on. Service Users have recently finished planning for their holiday, staff confirmed that it was discussed within Service Users meetings. One of the Service Users told the Inspector that he is planning on going on holiday very soon and is looking forward to it. There is a lot of emphasis around healthy eating at the home due to some of the complex health needs, and this has resulted in meal planners and menus being displayed around the kitchen. However, the Inspector noted from staff meeting minutes that there were references made on two separate occasions regarding concerns that staff were not being consistent with menu plans. Neglect in this area could have serious consequences for one particular individual. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. The outcome for Service Users was found to be adequate. Service Users receive personal support in an appropriate manner and suited to individual need. The home is able to provide physical and emotional care to individuals. Policies and procedures are in place to ensure the correct administration of medication. EVIDENCE: The Inspector examined two personal files and these contained risk assessments for epilepsy, tripping/falling, behaviour, hazards within the home, road safety and so on. These are reviewed every three to six months depending on the issue. Care plans regarding health issues are in place and have been reviewed. Behaviour charts, epilepsy records, guidelines on insulin administration, dietary The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 15 needs and so on are all available. There is a good clear list of contact details for all health professionals, and there are notes incorporated into the file from physiotherapists, chiropodists, occupational therapists, blood testing, renal info, dental, dietician, diabetic nurse, optician, hospital visits and the GP. An annual review took place in August 2005. This was very thorough and detailed health issues as well as behaviour and general well-being. Medication is stored in a locked cupboard. Homely remedies for staff are kept in a separate cupboard with a log-book used for recording when staff take any of the remedies. The medication storage and administration system was looked at by the Inspector in the presence of the organisations Training Manager and a senior support worker, who is currently in day-to-day charge of the home. Service Users medication is stored in a locked metal cabinet, fixed to the wall. The home uses the Boots dispensing system. On examination of the medication administration records (MAR), there were some signature gaps. One Service User had recently been discharged from hospital and it was not clear if all his medication had been given as some tablets remained in the blister pack. The Inspector considered that the home should have checked medication when it returned. Another medication should be administered once a week, but on examination of the stock, there was one tablet left, despite records showing that all the tablets had been given and signed for. The Inspector looked at the medication for the new Service User admitted to the home and found that senior staff did not know what he had been admitted with, or the quantity. There had not been a stock take of the medicines and therefore it was difficult to look for any discrepancies. A cough medicine had been prescribed by another Service Users’ GP on 19th May 2006, but had not been given or entered on a MAR sheet by the time the Inspector examined the medication. The Inspector looked at the storage of insulin and found it to be appropriately kept. However, the sharps bin was almost full and had not been dated and there was no name on it. In addition to used needles it contained gloves, tissue paper and foil. This is unacceptable and not in keeping with guidelines. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 16 The Inspector asked if the medication is reviewed or checked on a regular basis. Staff said that it was not. It was suggested that they consider implementing a system of reviewing in order to prevent problems escalating and/or going unnoticed. The registered provider must ensure that appropriate steps are taken to remedy this situation and a requirement has been made in respect of this. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The outcome for Service Users was found to be good. Procedures are in place to ensure complaints are dealt with appropriately. Systems are in place to protect Service Users from abuse, neglect and selfharm. EVIDENCE: The Commission has not received any complaints in respect of this service. The complaints policy and procedure were both available and are up-to-date. A complaints log book is in place with a leaflet on procedures. There were no complaints logged. Records examined during the inspection demonstrated that all staff had received training in recognising signs of abuse and how to report any concern. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 and 30. The outcome for Service Users was found to be excellent. The home is clean, bright and in good decorative order throughout. Service Users live in a comfortable and safe environment. Service Users bedrooms suit their needs and promote independence. EVIDENCE: The Inspector carried out a tour of the premises. The home was found to be in an excellent state of decoration. Fixtures and fittings are in very good order and the environment is very homely and comfortable. The kitchen floor has recently been fitted. The kitchen is bright and colourful and includes a dining area. There is a utility room leading from the kitchen, housing the laundry equipment. The hallway incorporates a signing in book. The lounge is large and comfortable and leads into a new annex that doubles up as a staff sleep-in room or a quiet room The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 19 during the day. Outside the house there is decking and patio with well maintained flower borders. Upstairs the bathroom was clean and tidy, two Service Users bedrooms looked at were very tidy and decorated to personal taste. Many health and safety signs/notices are up around the kitchen area detailing guidelines on food hygiene, fire procedures and so on. Food in the kitchen fridge had not been labelled, including spreads, marmalade, ketchup and so on, and therefore there was no way of knowing how long they had been there. Fire records and procedures were examined and showed drills and equipment checks are up to date. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 20 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, 34, 35 and 36. The outcome for Service Users was found to be good. A competent and qualified staff team is appropriately trained to meet the individual needs of Service Users. Recruitment policies and procedures are in place and sufficient to ensure Service Users are protected from harm. EVIDENCE: Staff meetings are held each month and issues discussed include; Service Users’ welfare, inspections, health & safety matters, management and/or staff changes, and so on. The Inspector noted from these minutes that staff must be prepared to help with the care of a Service User from another home at any time. The Inspector was concerned that this may have a detrimental impact on the level of care experienced by the Service Users living at the Dell. The Inspector looked at four staff files. These were found to contain job descriptions, 2 references, CRB’s, disciplinary notes and supervision notes. Staff spoken with confirmed that they receive regular supervision and that they have received all the training that they have asked for. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 21 A keyworker system is in place. Staff are assigned to work with a designated Service User, assisting with health appointments, activities and personal and/or family relationships. The home’s training profile is on display and this covers mandatory training and specific training subjects, such as; epilepsy, challenging behaviour, Autism, Diabetes and so on. Staff said that they were looking forward to the new manager starting. The previous manager left earlier this month and the new manager is due to start on Monday 5th June 2006. The home states that five members of staff hold an NVQ. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 and 43. The outcome for Service Users was found to be adequate. The home is in need of a permanent manager to ensure accountability of the service. The home should devise a system for acknowledging and/or following up concerns and complaints from Service Users. EVIDENCE: The Registered Manager’s post is currently vacant. A new home’s manager has been employed and will be starting on June 5th 2006. Due to the complex needs of the Service Users living at the home and because one of the Service Users has recently been discharged from hospital, the Inspector was of the opinion that the home needs to be managed closely, and suggest a temporary manager is put into place prior to the new manager starting. The registered The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 23 provider must ensure that appropriate steps are taken to remedy this situation and a requirement has been made in respect of this. A quality Assurance survey has just been conducted for Service Users, staff, care managers and next of kin. The results have been compiled and published for the conference held on 2nd May 2006. A copy of the report is has been received by the Inspector. The home also conducts its own survey, asking for feedback from service users. The Inspector noted that there did not appear to be any record of how issues are then dealt with. Information on health & safety, 1st Aid appointed person, weekly safety checks for fire alarms, car checks, 1st Aid stock checks and water temperature checks are carried out and recorded on a form that was seen by the Inspector. Employers liability is in place. All policies and procedures are in place at the home, and a statement informing the reader that all policies and procedure are being adopted by the new company is in place. The company now employs a Central Policy and Procedure Review Forum that meets every four weeks to implement and/or revise where necessary. The fire log book was looked at and showed drills and equipment checks are up to date. The accident book was looked at. It showed that there had been a number of needle-stick injuries sustained by members of staff administering insulin to a Service User. The Inspector discussed this situation with the Company’s Training Manager who agreed that a training issue had been highlighted. The Responsible Individual spoke with the Inspector and agreed to look at the matter and ensure the risk is assessed and where possible, reduced. The Inspector suggested that the home looks into acquiring a specialist piece of equipment that helps to reduce needle-stick injuries. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 24 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 3 3 x 4 3 5 2 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 4 25 4 26 3 27 x 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x 3 2 2 x x 3 1 The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 25 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 YA20 Regulation 13(2) Timescale for action The registered person shall make 30/06/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the car home. The registered provider shall 30/06/06 appoint an individual to manage the care home where – (a) there is no Registered Manager in respect of the care home, and (b) the registered provider is an organisation or partnership. Requirement 2 YA43 8(1) 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 The Dell Refer to Standard YA5 YA8 YA17 Good Practice Recommendations The service user has a copy of the contract, which has been signed by the service user and the registered manager. Service Users receive feedback about the outcomes of their involvement and participation. The registered person promotes Service Users’ health and DS0000066068.V289806.R01.S.doc Version 5.1 Page 26 4 YA39 5 YA43 well being by ensuring the supply of nutritious, balanced and attractively presented meals. Feedback is actively sought from Service Users (with support from independent advocates as appropriate) about services provided through e.g. anonymous user satisfaction questionnaires and individual and group discussions, as well as evidence from records and life plans; and informs all planning and review. The overall management of the service ensures the effectiveness, financial liability and accountability of the home. The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 The Dell DS0000066068.V289806.R01.S.doc Version 5.1 Page 28 - 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!