Inspection on 09/11/05 for The Jacob Centre

This inspection was carried out on 9th November 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Jacob Centre 09/06/08

The Jacob Centre 21/06/06

The Jacob Centre 16/05/05

The Jacob Centre 26/01/05

The Jacob Centre 08/09/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

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

CARE HOME ADULTS 18-65 The Jacob Centre High Wych Road Sawbridgeworth Herts CM21 0HH Lead Inspector Claire Farrier Unannounced Inspection 9:20 9 November 2005 th The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 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 Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Jacob Centre Address High Wych Road Sawbridgeworth Herts CM21 0HH 01279 600201 01279 721297 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) Capio Healthcare UK Ltd Rita McCarthy Care Home 60 Category(ies) of Physical disability (60), Physical disability over registration, with number 65 years of age (60), Terminally ill (60), of places Terminally ill over 65 years of age (60) The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th and 24th May 2005 Brief Description of the Service: The Jacob Centre is a care home with nursing, providing accommodation and care for sixty adults with a physical disability or terminal illness. The age range of the current residents is between 23 and 82, and five residents are aged over 65. Specialist services are provided for people who have survived a traumatic brain injury or spinal injury, including tracheotomy care and respiratory ventilator support, and for people with complex neurological conditions. The home is owned by Capio Healthcare UK, which is a private company. It was opened in April 2004 and consists of a two-storey pupose built building. It is situated in a complex of Capio services that includes a private hospital, The Rivers, and another home, The Gardens. The home is located in a rural setting on the outskirts of Sawbridgeworth, not far from the outskirts of Harlow. There is a shop for the service users in the home, and a pub that also serves food across the road from the Capio complex. Other community amenities, including shops, banks, cafes and leisure facilities, can only be accessed by use of the homes transport. All the bedrooms are single with en-suite facilities. The home has a patio garden accessed from the ground floor dining room. There is a passenger lift, and the home and garden are fully accessible. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two inspectors. Including preparation time, a total of 15 hours was allocated to this inspection. During their time in the home the inspectors spoke with six residents, three visiting relatives and eight members of staff, and discussion took place with the manager. The interaction between residents and staff was observed. The records were checked of residents’ care, medication and staffing. This was a positive inspection, and several areas of improvement were seen. All the residents spoken to were happy in the home, although some thought that there should be more staff available. Further improvements have been made, in particular with the involvement of residents in their care plans. New requirements have been made concerning medication, maintenance of equipment and privacy. This was the second inspection of the year. Core standards that were not inspected on this occasion were assessed to have been met in the previous inspection report, to which reference can be made. What the service does well: A new format has been introduced for care plans that places the residents at the centre of the care planning process. The aim of the new format is to get residents and their families more involved, and to record their likes and their views. Three residents and their partners who took part in the inspection said that they were involved in writing their care plans, and that their comments were included in the care plans. The staff continue to provide good quality personal care and nursing care, and many residents and visitors commented that the staff are very caring A new activities organiser has been employed in the home since July. She has made further developments to the programme of activities that was seen during the last inspection. She has consulted the residents and put activities and entertainments in place from their suggestions. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 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 Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 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): These standards were not inspected on this occasion. EVIDENCE: The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 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, 7 and 9 A new format has been introduced for care plans that places the residents at the centre of the care planning process. The care plans provide detailed information on the residents personal and healthcare needs. Residents and family members spoken to confirmed that they are fully involved in writing their care plans. EVIDENCE: The care plans of four residents were examined, some of which were completely in the new format and some were still being transferred, with information in both the old and new format. The aim of the new format is to get residents and their families more involved, and to record their likes and their views. Personal care needs are recorded from the resident’s perspective. In one care plan it states “X prefers a shower, likes to get up at 8am, go to bed at 8pm”. The best example seen had been written by the resident and his next of kin in the form of personal goals. For example, the goal for personal care was “for X to feel clean and comfortable and presentable at all times. For X and family to feel that all X’s needs are met”. The goal for communication was “for X to understand and be understood. For X not to feel frustrated”. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 10 The action required for each goal includes detailed procedures to enable the staff to meet all X’s needs. Two residents and their partners who took part in the inspection both said that they were involved in writing their care plans and that their comments were included in the care plans. The format includes regular reviews, which provide an opportunity for the residents to also monitor and record their views on the progress of their care plans. Appropriate risk assessments were seen in the care plans. They identify the risk and refer to a care plan for management of the risk. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 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): 14 and 17 The comprehensive activity programme seen during the last inspection has been further developed, with the involvement of residents and their families. The quality of meals provided in the home remains variable, the majority of residents spoken to expressed some dissatisfaction. EVIDENCE: A new activities organiser has been employed in the home since July. She has made further developments to the programme of activities that was seen during the last inspection. She has consulted the residents and put activities and entertainments in place from their suggestions. On the day of the inspection the programme included a communication group in the morning, and a film in the cinema lounge or massage in the afternoon. The sensory room is available whenever anyone wishes to use it. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 12 Most of the residents spoken to take part in the activities, and said that they enjoy them. One resident does not wish to take part in social activities with other residents. One finds it hard to join in with group activities as she finds it hard to hear other people in a group environment. She said that she gets bored, but she has 1:1 care at all times, and her care worker could assist her to be more involved. One resident said that she particularly enjoyed the Halloween activities, and several relatives were involved with organising this activity. A Remembrance Service and two minute silence was scheduled for Friday 11th November. There are no kitchen facilities in the home and all catering is provided by contract from The Rivers Hospital, which is part of the Capio complex. The meals are served in the ground floor dining room first, then in each of the two first floor dining rooms. The lunch timetable has been changed so that residents now go to each dining room at different times, so the residents on the first floor no longer have a lengthy wait for their meals. Lunch was observed, and a sample of the food was tasted. There was a choice of lasagne or fish with sauce and fresh vegetables or salad. One resident said that the meal was “OK”, and two said that it was terrible. The food sampled looked better than it tasted. The fresh vegetable (cauliflower) was tasteless, and the sauce on both the lasagne and the fish was unpleasant. The atmosphere in the dining room was sociable, and the staff assisted the residents who needed help. They talked to the residents while they were helping them and treated them with patience and respect, although it would be preferable for them to sit beside the resident they are helping rather than standing over them. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 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): 18, 19 and 20 The staff continue to provide good quality personal care and nursing care, and many residents and visitors commented that the staff are very caring. Action has been taken to meet the requirements made in the last inspection report concerning medication, but there was some further evidence of poor practice and poor audit procedures on the first floor. EVIDENCE: The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 14 The home provides care for service users with a high level of need, including PEG feeding and tracheotomy care. There are four trained nurses on duty in the home at all times, including the night, and the clinical managers on each floor are experienced in neuro care. The home has a physiotherapy gym and a team of physiotherapists. Equipment available for the residents includes environmental control units and specialised communication aids. Northwick Park Neuro Rehab Unit provide a specialist outreach service to the home. The GP visits the home every day. All healthcare needs were seen to be appropriately recorded, with detailed procedures for the care required. Good recording was seen for the treatment and monitoring of pressure sores. One resident had returned that day from having surgery at The Rivers Hospital. The care plans seen provide comprehensive details of each resident’s personal care needs, written by the resident or from their point of view (see Standard 6). Most of the residents and visitors spoken to said that the staff provide good personal and nursing care. Two said that staff often take a long time to respond to their call bell, and they also commented that there are not enough staff, or that the staff seem rushed. One resident and relative spoken to were surprised to hear that The Jacob Centre is a care home, as they consider it to be a hospital. It was reported that the response times for the call bells are monitored, and it rarely takes more than five minutes for the staff to respond. Staff are allocated according to each person’s assessed need of 1:1, 1:2 or 1:3 staff:resident ratio. The rotas seen showed that there are sufficient staff to meet the residents’ assessed needs, but the differing needs mean that the numbers of staff on duty also change from time to time, which may give the impression of a shortage of staff. It was reported that the care workers are currently receiving training in tracheotomy care. The intention is that this will free up the senior carers to be more available to the other residents, which may help to redress the feeling that there is a shortage of staff. The door to the therapy gym was open so not affording privacy throughout the time that the inspectors were in the home, with the result that residents having therapy could easily be observed by other residents and any visitors to the home. Medication is stored and administered separately for each floor, and is administered by a trained nurse. Action has been taken to meet the requirements made in the last inspection report concerning medication. On this occasion the storage and recording of medication on the ground floor was satisfactory, but there was some evidence of poor practice and poor audit procedures on the first floor. 1. The medication round was observed. Two nurses each took one trolley with individual locked boxes of medication for the residents. One nurse signed the MAR (medicines administration record) chart before the medication was administered. It was explained that there was no risk that these residents may refuse their medication. However this is poor practice, and may lead to errors. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 15 2. Liquid medications, including gaviscon, senokot, baclofen and phenytoin, are kept on top of the trolleys as they may leak and if placed in the residents’ medication boxes. A package of syringes and a loose syringe were also seen on top of one of the trolleys. It was explained that the trolleys are never left unattended, and when one nurse was called to attend to a resident, a care worker stayed with the trolley. However the trolleys were left unattended when the nurses went in to residents’ bedrooms to give them their medication. On one occasion the inspector was able to check and record the medication and syringes stored on top of the trolley without being observed by the nurse. The medication trolleys must be in sight of the nurse in charge at all times, and if necessary could be taken into each resident’s room while their medication is administered. 3. A spot check was made of one resident’s medication. This person has a large number of prescribed medications, which are stored in two locked medication boxes. Two bottles of one medication were in use, one held in each box. One bottle stated a dosage of 1 bd (twice a day), and the other stated ½ nocte (at night). The MAR chart stated 1 bd. For another medication the MAR chart stated 2 qds (four times a day). For both of these the amount given for each dose was not recorded on the MAR chart, and the number of tablets in the bottles did not tally with the amount recorded as administered. The MAR chart should state clearly the amount of medication that is prescribed, and the nurse should record clearly how many have been administered each time, in order that an accurate and effective audit can be carried out. 4. An audit system has been introduced, and it was reported that the procedure is for a thorough audit to be carried out of the medication of one resident on each shift. Each resident’s medication should therefore be audited at least once a month. The forms for recording the audit were completed effectively on the ground floor, but on the first floor there was no evidence of any audit taking place since August and the records for those were not fully completed. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 16 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): These standards were not inspected on this occasion. EVIDENCE: The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 17 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): 29 Specialised equipment is available for the residents, to assist with their care and promote their independence. EVIDENCE: The environment standards were not fully inspected on this occasion. Equipment available for the residents includes environmental control units and specialised communication aids. Many residents have custom made seating systems. A variety of hoists are available, including track hoists. A relative of one resident reported that the track hoist in the bedroom had not been working for some time, and members of staff also mentioned this. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 18 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): 33 and 34 The home is staffed with employees who are experienced and competent to care for younger adults with physical disabilities. The staff spoken to are confident of their knowledge of the needs of the residents and feel well supported in their work. There is a thorough recruitment procedure in place, that ensures that the staff recruited are fit to work with vulnerable people. EVIDENCE: All the members of staff who were spoken to were enthusiastic about their work and felt well supported by their colleagues and the management. Several residents commented that there are not enough staff, or that the staff seem rushed. Some staff also gave their opinion that they work under pressure. There are four trained nurses on duty in the home at all times, including the night, and care staff are allocated according to each person’s assessed need of 1:1, 1:2 or 1:3 staff:resident ratio. There are six or seven care workers on each shift. The staffing levels and skill mix are regularly reviewed to ensure that they are appropriate for the needs of the current residents. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 19 The rotas seen showed that there are sufficient staff to meet the residents’ assessed needs, but the differing needs mean that the numbers of staff on duty also change from time to time, which may give the impression of a shortage of staff. It was reported that the care workers, including some regular agency workers, are currently receiving training in tracheotomy care. The intention is that this will free up the senior carers to be more available to the other residents, which may help to redress the feeling that there is a shortage of staff. There is a thorough recruitment procedure in place, that includes taking up references and CRB (Criminal record Bureau) disclosures in order to ensure that the staff recruited are fit to work with vulnerable people. The staff files of three members of staff were inspected. They contained all the required information, including references, proof of identity and evidence of satisfactory CRB disclosures. All the members of staff spoken to were enthusiastic about their work and felt well supported by their colleagues and the management. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 20 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 and 42 The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. The quality assurance system ensures that views of the residents and their families underpin all self-monitoring, review and development of the home. EVIDENCE: Separate residents and relatives forums take place on a quarterly basis, issues raised are taken up and acted on. The Acting Managing Director of Capio Healthcare UK is frequently in the home and he carries out monthly monitoring visits as required under regulation 26, during which residents are consulted. Internal audits are carried out, for example of accidents and incidents and infection control, the results are given to Capio Healthcare UK and discussed in the home at senior management meetings. A residents’ satisfaction survey has been drafted, and it is intended that the first survey will be carried out by the end of March 2006. It is intended that The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 21 whenever possible the resident should complete the survey themselves rather than a relative on their behalf, and advocates from PoWher are available to assist if required. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. No health and safety concerns were found during this inspection. The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 3 X X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Jacob Centre Score 2 3 2 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 3 X DS0000060010.V271996.R01.S.doc Version 5.0 Page 23 NO 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 YA18 Regulation 12(4)(a) Timescale for action The door to the therapy gym was 31/12/05 open throughout the time that the inspectors were in the home. Personal and health care, including therapy, must be provided in private. 31/12/05 All medication must be administered and recorded in accordance with the Royal Pharmaceutical Society guidelines. In particular: 1. The MAR chart must be signed after the medication is administered. 2. Medication trolleys must be kept in sight of the administering nurse at all times. 3. The MAR chart must record accurate details of the amount of each medication that is prescribed, and the amount that is administered. 4. The procedure for carrying out regular and thorough audits must be fully implemented to ensure that discrepancies in the recording of medication are investigated and corrected without delay. DS0000060010.V271996.R01.S.doc Version 5.0 Page 24 Requirement 2 YA20 13(2) The Jacob Centre 3 YA29 23(2)(c) The track hoist in one bedroom had not been working for some time. All equipment provided for the use of residents must be maintained in good working order. 31/12/05 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 YA17 Good Practice Recommendations Several residents described the food served at lunchtime as terrible, and the sample tasted was not appetising. Further measures should be taken to improve the quality of the food provided in the home. The staff treated residents who need help to eat their lunch with patience and respect, but it would be preferable for them to sit beside the resident they are helping rather than standing over them. 2 YA17 The Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Jacob Centre DS0000060010.V271996.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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