Inspection on 20/01/09 for Weybourne

This inspection was carried out on 20th January 2009.

CSCI found this care home to be providing an Good service.

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

Weybourne 21/12/07

Weybourne 27/02/07

Weybourne 24/11/05

Weybourne 25/05/05

Weybourne 06/12/04

Weybourne 02/07/04

Weybourne 25/02/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOMES FOR OLDER PEOPLE Weybourne Finchale Road Abbeywood London SE2 9AH Lead Inspector Janet Pitt Unannounced Inspection 20th January 2009 11:20 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 Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 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. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Weybourne Address Finchale Road Abbeywood London SE2 9AH 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 9 No. of places registered (if applicable) 020 8310 8674 020 8310 1953 jeanette.dwyer@kcht.org.uk www.kcht.org Kent Community Housing Trust Vithanage Vijitha Padmini Piyatilake Care Home 40 Category(ies) of Dementia (20), Old age, not falling within any registration, with number other category (20) of places Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP 2. Dementia - Code DE The maximum number of service users who can be accommodated is: 40 Date of last inspection Brief Description of the Service: Weybourne is a Home for 40 older people that is run by Kent Community Housing Trust (KCHT). The Home specialises in the care of people with dementia and the majority of the residents are in this category. Weybounre is purpose-built over two floors in Abbey Wood. There is a parade of shops nearby, and Abbey Wood Station is a short distance away. There are thirtythree rooms on the ground floor and a further seven on the first floor. Seven rooms have ensuite facilities. There are four lounge areas, a large dining room, a small visitors room and a central courtyard garden that has flowerbeds designed for colour and scent. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. One inspector undertook this unannounced inspection. A site visit was made that lasted a total of six and a half hours. During the site visit records relating to care planning, staffing and auditing were examined. A tour of the premises was made and lunchtime was observed. We spoke with the manager, members of staff and people that live in the home. Weybourne provided an Annual Quality Assurance Assessment (AQAA) and information from this has been included in this report. Surveys were received from people that live in the home and staff who work there. However, surveys received from people that live in the home, there was evidence that some had been completed with the assistance of a carer. Therefore this information has not been included. The weekly fee currently starts from £491-00 dependant on need. What the service does well: Information from staff surveys indicates that the areas they consider the home does well in are as follows: ‘The service identifies the need for training and provides it.’ ‘For the most part there is good rapport between staff and resident families’ ‘Efforts made to accommodate likes/dislikes and preferences of residents are made to ensure they maintain their personal identity.’ ‘Most staff deliver care with the kindness and understanding needed.’ ‘Activities. Sing along with music when played. Love going on outings, love watching television. Some love knitting, painting and decorating and gardening and also reminiscence, saying things that has happened to them in the past and their lives experiences.’ ‘They love their meals. Some like to dance to music, some like to chat with staff and other service users.’ Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 6 ‘Cater for all service users needs where possible.’ ‘Service users lead as normal life within the home.’ We found evidence throughout the inspection to support what staff had said. We found that the atmosphere in the home was calm and staff showed awareness of how to deal with challenging behaviour and involve other health professionals when needed. The staff team were willing to talk about the strengths and weaknesses of the home. What has improved since the last inspection? What they could do better: The home’s AQAA indicates that they could improve in the following way: ‘We could do better in relation to the choice of home if the rooms were all ensuit. This would give more privacy and dignity to residents not having to use communal toilets and bathrooms’ Staff survey respondents identified the following areas they considered improvement could be made: ‘To provide more hours for activity and activity staff. More one to one activities with residents.’ ‘Going on holidays in countryside, social leave with families.’ Going out to see places or visits shops.’ We found that improvements are needed in respecting individual’s dignity at meal times and involving people in their assessment of need. Care is needed to make sure that language used in documentation is appropriate. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 7 We witnessed tea being served with the milk already added; this does not evidence individual choice. 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 summary of this inspection report can be made available in other formats on request. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 8 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 Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Each person has an individualised assessment of need upon moving into the home. Care is needed to make sure that they are fully involved in the process. EVIDENCE: Weybourne stated in their AQAA that: ’a full assessment by either the Home Manager or the Assistant Manager.’ Assessments of people that live in the home were examined. We selected those people that had moved into the home since the previous inspection. The assessment documentation is person focused and titled ‘my Assessment of needs.’ There was evidence of information from the referring placing authority and the visit made by the assessor from the home. People’s hobbies and interests were noted along with what personal care needs assistance was Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 10 needed with, for example: ‘I used to paint and I still like to play with colours.’ And ‘support and guidance’ to maintain personal hygiene. The documentation was phrased in a positive way and detailed what individuals are able to do and promoted retention of independent living skills. Personal preferences for modes of dress and other people that an individual would like to interact with had been noted. Spiritual need had also been addressed in the assessment. One area that needs improvement is in involving the person or their representatives in the assessment process, as we found that this was not consistently done. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individuals’ care plans lead form their assessments and they can be confident that health needs will be addressed. People that live in the home are treated with respect and their dignity maintained. Staff should be aware that person’s who have a diagnosis of dementia need highly individualised care. People can be confident that medications are handled and administered securely. EVIDENCE: Individuals who reside at Weybourne are living with Dementia and are in varying stages of the illness. The home states in its AQAA that: ‘A new Service User Plan has been devised’. [The plan] uses personal pronouns.’ Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 12 Weybourne also indicates that privacy and dignity are respected in the home: ‘All existing staff and new staff have received training in the principles of care i.e., Privacy, Dignity, Independence, Personal Space.’ People are addressed by their ‘preferred’ name. We have received a concern that is currently being investigated at the time of the report into a person’s privacy not being respected on one occasion. During the site visit we did not observe any staff behaving inappropriately and individuals were addressed politely and called the name that they chose, i.e. Mr S or their first name. We examined care plans; these were seen to lead from the assessment and were person centred. There were good details on how often an individual wished to be checked at night and what continence products were used. Body maps had been completed when needed if a person had a wound or cut. It is recommended that the size of the wound is also documented. The lunchtime medication round was observed. The procedure was carried out in a safe and unhurried manner, with each person being given the opportunity to take his or her medicines safely. Medications records were accurate and up to date. We found that the storage facilities for medications were satisfactory. A local pharmacist carries out an audit of medications in the home every three or four months. Records relating to this were inspected and we found that no issues had been identified on these audits. A record is maintained of visits by other health professionals, for example the general practitioner. The AQAA states that: ‘If someone is unwell, the doctor is contacted either for advice or to make a home visit.’ We found that people had individualised risk assessments, such as behavioural and emotional needs. One plan had recorded: ‘I know my memory is terrible these days and sometimes see things that upset me. Please try and understand why I am upset.’ Other entries included: ‘I would like one carer to give me help, reassurance and guidance.’ We observed the afternoon handover of staff. During this time we were able to discuss with staff language used in care planning and we commented that individuals do not ‘refuse’ to do an activity, they decline to do it. The staff demonstrated a good knowledge of each person and their needs. We also discussed routines within the home and being as flexible as possible, for example when a person is restless at night and wants to walk around this could be facilitated. Also, a person might have no awareness of the time and therefore night staff could assist in meeting personal hygiene needs at night. Staff told us that they had received training on Dementia care, but did not Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 13 indicate the length of the course. They must endeavour to put this training into practice in order that individuals needs can be met. None of the care plans we examined had information on death and dying. The manager reported that there is a new form to address end of life care, which is currently being implemented. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are able to participate in activities of their choosing and the home reviews what is on offer routinely. Mealtimes are a sociable occasion and individuals are able to eat foods they want. Weybourne welcomes visitors and contact with the community. EVIDENCE: The home’s AQAA states: ‘Residents are encouraged to exercise as much independence, autonomy choice as they can. There is a very good activity program that covers all levels of ability and physical. Residents can have friends and family visit at any reasonable time. There are two Activity Coordinators and a varied programme is devised to meet the varying levels of ability of the residents. Visitors are always welcomed and offered hospitality and courtesy. Previous community links are encouraged and maintained wherever possible. The visitors Book that is always signed by the visitors, bears witness to the number of friends and family visiting the home.’ Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 15 During the site visit we spoke with one of the activities co-ordinators who said that they write down the activities a person has undertaken and also makes sure that all individuals have one to one sessions with staff. We noted that planned activities reflected individuals’ interests. For example one person enjoyed Country and Western music and when we looked at the CDs available in the home there was a good mix of styles, including Country and Western. On arriving at the home we saw one person having a cup of tea in the manager’s office. The manager said that this person normally spent time with her in the mornings. A member of staff came into the office and spoke with this individual about going to get their morning paper from the shop. One person who lives in the home was kind enough to check that the inspector was alright during the afternoon whilst they were examining paperwork. Some people who live at Weybourne attend day centres and visit their family members. The home holds an in house Church service for those individuals who wish to practice their faith. At the time of the inspection the home was accommodating an individual whose spouse would visit and spend time with them. A member of staff informed the inspector that a Bowling trip for the following week had been planned and a DVD game on horseracing had been purchase, as some of the gentlemen enjoy the races. The home has use of a minibus on Mondays, which makes excursions into the community possible. We found on the day of the site visit that there were many visitors to the home who were made welcome by staff. We heard visitors being greeting by the manager and her team. Refreshments were offered. The lunchtime meal was observed on the site visit. The dining room tables were attractively laid with cloth tablecloths, cutlery and condiments. Easy listening music was playing and some people were singing along to it. People were seated in small groups and were able to choose where to sit. We do not recommend the use of plastic aprons in place of suitable napkins. Individuals must be treated with respect and alternative arrangements to protect clothing are sought to make sure that people’s dignity is maintained. Staff serving the meal were describing the food to individuals and making sure that they wanted the particular dish that was being served. We noted that one person changed their mind about the choice of meal and this was replaced with an alternative. The meals were well presented and look and smelt appetising. There was a range of foods available on the menu. Second helpings of the meal was offered prior to pudding being served and second helping of pudding was also offered. We saw staff sitting to assist Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 16 people with their meals. Throughout the meal individuals were able to wander around the dining room if they chose and staff did not force anyone to sit down to eat their meal. The atmosphere in the room was relaxed and unhurried. Staff would check that a person had finished their meal prior to removing plates. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in the home are able to access a complaint procedure, which makes sure that their concerns will be listened to and acted upon if needed. Individuals are protected from harm by staffs’ knowledge of Safeguarding procedures and awareness of when these need to be implemented. EVIDENCE: The AQAA states that: ‘Staff are fully trained in relation to Adult Abuse, with periodic refresher training. The Management Team at the home is alert quality of care and the responses that staff make to residents. ‘ The complaints policy is available within the home. We examined the complaints book and noted that no complaints had been received by the home since September 2008. Actions were present for the complaints received prior to that date. As stated previously CSCI has received one complaint. From the information we have it does not appear that the complainant has approached the home directly. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 18 Staff surveys received indicated that they considered that they had received adequate training in complaint handling and knew who to approach if they had any queries. We spoke with some staff members who said that they had received training in Safeguarding Adults and were confident that they would be able to deal appropriately with potential situations. The home has not been subject to any investigations at the time of writing this report. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that is suitable for their needs and has adequate communal and private space. The home was generally clean and tidy. EVIDENCE: We had a walk around the home. The majority of the rooms are on the ground floor. There has been a rolling program of decoration. The home has suitable communal space, which is being utilised well. The AQAA states that: ‘Weybourne is a very comfortable home and is easily accessible by bus and local transport. The home is well maintained and is able to meet individual and collective needs. Hygiene of the home is very good and well maintained by an efficient domestic team……In addition to this the laundry area including Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 20 carpets are to be replaced and refurnished. The fire alarm system is also to be upgraded.’ The home was clean and tidy apart from a slight smell of urine in the entrance area. We did not clarify whether that area had received attention from a domestic, as these staff members were busy in the rest of the home. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individuals can be confident that staff are recruited safely and appropriate training is offered to enable to fulfil their caring role. Improvements continue to be made in training offered to staff to develop their skills further. EVIDENCE: At the time of the site visit there were adequate numbers of staff available to meet needs. The staff includes catering and domestic staff, as well as care staff. The manager reported that staffing levels had been reviewed and there was to be an increase in staff numbers in April 2009. We looked at staff training records and found that suitable training is in place to enable staff to develop their skills. The AQAA indicated that: ‘All staff will be encouraged to under-take training that explains other cultures and traditions, including different religious faiths. The ethnic balance of the staff group, as a whole, has improved. This would accommodate the needs of an influx of ethnic residents.’ Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 22 We inspected staff recruitment files. All the information required by the Regulations was present. However, the application form needs to be amended for new employees to make sure that a full employment history is obtained. A good procedure is followed and interview notes were available on the person’s file. References had been taken and each file had a copy of the employment contract and job description. Staff surveys indicated that appropriate checks had been carried out and respondents considered that training provided was suitable. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use this service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager of the home is proactive at promoting a well run home. She demonstrates good awareness of where improvements are needed. All staff work together as a team and are focused on outcome for the people that live in the home. Good systems are in place for maintaining health and safety. EVIDENCE: We found the manager to be proactive in her approach. She was open about improvements made as a result of requirements from the previous inspection and further improvements that the home required. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 24 The AQAA provided was comprehensive and detailed how improvements were to be made. It gave a clear picture of how the home is meeting the Standards and areas they considered needed improvement. The AQAA states: ‘As KCHT is registered with ISO 9001 and we are required to have a Monthly audit where, over the months, all aspects of the home are checked for compliance with the Work Instructions. CSCI Inspections. Contract Compliance, Commissioners Inspections- to ensure that placement compliance is maintained.’ Examination of records relating to audits confirmed this. On the day of the site visit the area manager had come to undertake that month’s audit. The manager confirmed that individuals’ monies are held securely and records maintained. Systems were in placed to make sure that the health and safety of people is maintained and protected. There were no obvious hazards within the home. Records relating to equipment checks had been carried out. One survey respondent said about the manager: ‘Just to encourage the manager to keep doing the good job she is doing.’ Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 26 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. 1 Standard OP3 Regulation 14 (1) (c) Requirement Assessments of need must be undertaken with the involvement of the person or their representative. This will make sure that individuals are involved in the process and can be confident that need will be identified. Care in the type of language used in documentation is required. This will make sure that there is evidence of individuals’ wishes on how they spent their time. Appropriate arrangement must be in place to make sure plastic aprons are not used in place of napkins. This will make sure that individuals’ dignity is maintained. Beverages must not be prepared. I.e. milk should not be present in tea when it is served. This will make sure that people are able to exercise choice. Timescale for action 30/08/09 2 OP7 12 (1) (a) 30/08/09 3 OP14 12 (4) (a) 30/08/09 4 OP15 12 (2) 30/08/09 Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 27 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 OP12 Good Practice Recommendations It is recommended that nighttime routines are reviewed to enable individuals to exercise choice. Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Weybourne DS0000006862.V373958.R01.S.doc Version 5.2 Page 29 - 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!