Inspection on 31/07/08 for Windmillbanks

This inspection was carried out on 31st July 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Windmillbanks 30/08/06

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOME ADULTS 18-65 Windmill Banks 1 Windmill Banks Higham Ferrers Northants NN10 8JF Lead Inspector Judith Roan Unannounced Inspection 31st July 2008 10:30 Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 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 Windmill Banks DS0000065013.V369422.R02.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 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. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Windmill Banks Address 1 Windmill Banks Higham Ferrers Northants NN10 8JF 01933 315321 01933 317321 info@windmillbanks.com 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) Mr Claude Fonseka Mrs Viola Fonseka Manager post vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The registered provider is registered to provide personal care to male and female service users who fall within the following categories: Learning Disability LD 18-65 years at Windmill Banks care home. The maximum number of people to be accommodated at Windmill Bank is 18. No person over the age of 65 years who falls within categories LD should be admitted to Windmill Banks Care Home. 29th August 2007 Date of last inspection Brief Description of the Service: Windmill Banks is a registered service for 8 people with a Learning Disability. The home is situated in a residential area of the village of Higham Ferrers close to local amenities and on a bus route. Full information on the service is available from the Registered Owner in the Statement of Purpose and the Service Users Guide and various policy documents. The range of fees at the home at the time of the inspection was around £895 to £1212 per week depending on the level of service required. This is assessed and agreed during the preadmission process. Windmill Banks DS0000065013.V369422.R02.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 1 star. This means the people who use this service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. This process considers the services capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 3 people who use the service and tracking the care they receive through review of their records, discussion with the care staff and observation of care practices. Several people using the service have limited communication skill. The Inspector also received questionnaires completed by 8 people who use the service and five relatives. The questionnaires provided mixed feedback of the quality of care and service. One family said that ‘they would like to see more activities, outings and more staff’. Another said that ‘this home does everything, I’ve nothing but praise’. A third said that there had been ‘a lot of staff changes and this has made their relative unhappy’. In the surveys from people who use the service we noted the following comments – ‘ I enjoy the meals’. ‘Staff can understand me in the way I communicate’. ‘I join in with activities’. ‘I visited the home for tea before I moved in’. ‘Sometimes staff sickness makes it difficult for me to go out as often as I would like’. ‘ I will make staff understand when I am not happy’. ‘Staff are there to meet my personal needs’. The homes acting manager also completed an Annual Quality Assurance Assessment (AQAA) a questionnaire required to be completed by CSCI. The inspection was unannounced and was undertaken during the morning and afternoon lasting 6.5 Hours. This report also includes information from a random inspection that was carried out in August 2007 when safeguarding concerns were raised. An annual service review was also undertaken in March 2008 that changed our views of the service and prompted an earlier key inspection. What the service does well: Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 6 Care needs are assessed prior to admission. Care plans are in place and provide clear information on how support workers are to meet individual needs. Most support workers have achieved National Vocational Qualifications at level two or above. The induction programme is recognised by the British Institutes of Learning Disability. (BILD) Support workers support people using the service in a sensitive and positive way. What has improved since the last inspection? What they could do better: Individual plans should be maintained on how people using the service are to be supported with daily/weekly leisure, recreational and educational routines. Missed medication errors must be reported using the safeguarding protocols to ensure that people using the service are fully protected. The provider must monitor medication administration systems more effectively. Incidents affecting the well being of people using the service must be reported using the safeguarding protocols and CSCI Regulation 37 reporting system. The provider must ensure that environment is safe and meets the needs of people using the service. People using the service must be provided with the minimum of facilities within their rooms that are safe and appropriate to their needs. The homes shared environment must be fit for purpose and enable people using the service to have access to a range of comfortable, safe and fully accessible shared space for activities. The provider must demonstrate how levels of staff have been calculated to meet the needs of people using the service. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 7 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. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 8 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 Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Quality in this outcome area is good. People using the service are fully assessed to ensure that the service can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All people living at the service have their needs fully assessed prior to their admission. At the random inspection carried in August last year after a concern had been raised about lack of information being available the visiting inspector found that: Two people had been admitted to the home the day before the inspection visit, staff were asked about what information they had been provided with on the needs of each person, they said that basic information had been provided from the previous home where they had lived, and that information had been handed over verbally. Staff confirmed that the new people had visited the home for a trial visit prior to moving in that had involved an overnight stay. On checking the written information available, there was a ‘statement of need’ for each of the new individuals. This had been provided from the local placing authority and outlined each person’s personal, social and health care support needs. New people using the service had an individual care plan that had been provided from the previous care home that outlined their personal, emotional and healthcare needs. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 10 There has been no change to the statement of purpose & service users guide that have been inspected on previous inspections. The admission procedures ensure that people are given time to test-drive the service to ensure that needs can be met. The acting manager states in the AQAA that ‘We have updated our pre assessment form to be more person centred and to give more emphasis on the person’s hobbies, interests and social needs so we can better get to know the person and have a better idea if we can meet all their needs. The needs assessment will also include information about the kind of behaviours people wishing to move in may display to help us decide if they are suitable for those currently living in the home’. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. Care plans ensure that individual preferences are identified and recorded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We case tracked three people using the service during the inspection. Within the care plans looked at there was information available that covered aspects of the each person’s individual personal care, social and emotional support and healthcare needs. Work has been undertaken to ensure that all care plans include comprehensive risk assessments. Care plans were found to be detailed and accessible for staff to use. The requirements therefore made at the random inspection have been met The AQAA confirms that ‘Risk assessments are updated monthly and new risk assessments are regularly added as new activities are tried and new risks become apparent’. Incidents are recorded but do need to be notified to the CSCI as required under the Care Home Regulation 37. A requirement is made. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 12 In observation of practice during the inspection people were seen to be given choice and request respected. In discussion with support staff it was clear that they were fully aware of people needs Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is adequate. People using the service are not always able to undertake scheduled activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the random inspection in August 2007 and key inspection 2008 people using the service were observed during the course of the inspection visits spending time watching television, reading magazines, helping with household tasks with the support of the staff, such as vacuuming the lounge and helping prepare snacks in the kitchen. There was evidence that people using the service had unrestricted access to the garden and were observed spending time in the garden. Towards the rear of the garden there was a large log cabin that serves as an annex, and is used in the main as an activity room. Some people were observed to spend time in this facility, which had a pleasant outlook onto the landscaped garden and fishpond that was very well maintained. The garden fence has been secured and now makes a safe environment Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 14 In discussion with the staff and from the information provided within the care records one of the service users attends formal day care or educational settings; two service users attend a local club for people with learning disabilities, where social activities are provided although this was not attended on a regular basis. Staff confirmed that they were limited in accessing community resources as staffing levels restricted what was safe and achievable There were some records within the care plans and daily notes of people using the service having a holiday and some outings within the local community. However there is not individual ongoing record of how preferred lifestyles are met. There is regular contact with their families and friends. Family comments expressed that they would ‘like to see more outings’ and another said that they is ‘no evidence that staff try to entertain or stimulate the residents’. Yet another states that they ‘have nothing but praise for how they support my relative’ The inspector was informed that people who use the service participate in planning a menu for a varied, healthy, nutritious, and balanced diet. Meal times are relaxed with no fixed time so that support staff can work around individual needs and activities. According to the AQAA there are ‘no daily fixed routines’ which gives people using the service’ freedom to do what they wish whenever they wish to do it’. However activities are dependent on staff numbers and availability, which is limited when support workers need to take on other roles within the home. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate. Health care needs of people using the service are not fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People using the service are supported to have regular health checks and there is evidence on files that healthcare appointments are made. The AQAA confirms that people using the service have ‘support to access health care professionals and any recommendations are implemented within the home. Any aids and equipment that service users may require are provided within the home.’ The AQAA and visits provided evidence that people using the service ‘are given a choice of who supports them with their personal care and other support throughout the shift. Support workers provide sensitive and flexible support when the people who need support require assistance with personal care. A review of the medication system during the random and key inspection identified that there continues to be issues with the administration of medication. Errors of medication not being signed for or being missed were found on both visits. All medication errors must be notified to CSCI as required under ‘The care Homes regulation 37’. The AQAA acknowledges these shortfalls and confirms that steps have been taken to address the matters Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 16 Physical and emotional health needs of people using the service are not always well met by the staffing levels at the home. The AQAA confirms this and also identified that policies and procedures in relation to Continence promotion and disposal of clinical waste need to be developed. All medication is stored in a locked facility. Only shift leaders who have undertaken certificated training administer medication take on this role. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate. Practices within the service do not fully protect people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure is in place but would benefit from being in an easy read format. Relatives confirmed that they knew how to complain on behalf of their relatives. Incidents that affect the well being of people who use the service are being recorded within the home and on individual files. These incidents are not being reported to the safeguarding team using the local protocols or to CSCI. One person has repeatedly damaged their room as a result of their behaviours not having adequate intervention. Support staff demonstrated whilst on holiday and having 1-1 support that they have the skills to provide positive intervention. Staffing levels within the home restrict the strategies needed. The person now has poor facilities within their room. Two concerns have been made to CSCI over the past twelve months and been investigated. At the random inspection undertaken in August 2007 requirements were made in relation to medication administration and staff recruitment. Practices in relation to staff recruitment are now meeting National Minimum Standards. Errors are however still recurring in the administration of medication. Further requirements have been made as a result of this inspection. Staff records confirmed that they have all undertaken abuse awareness training. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 18 The home does not have policies and procedures for dealing with violence & aggression and what to do if a person using the service goes missing. These policies must be developed to assist staff in these areas. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,28,30 Quality in this outcome area is poor. The homes environment is not providing a comfortable and safe place for some people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes interior décor is poor and presents as in need of refurbishment. Additional work that was discussed at the random inspection has not been undertaken which limits the shared space on the ground floor for activities. One relative commented that ‘the home has a small lounge which is also used as a dining room. It seems impractical to use this room for both purposes.’ In viewing the room of one person using the service it was found that their room had suffered considerable damage. The provider must seek advice on appropriate facilities within the room that protect the equipment, the personal property of the person using the service and them. The relatives expressed that they were unhappy with this aspect of the service and were distressed when they visited. The fence to the property has been repaired to minimise the risk of people using the service leaving the property unsupported. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 20 People using the service are encouraged to tidy their own rooms and clean up after themselves with staff support. Care staff presently become involved in daily cleaning, as there is a domestic vacancy. It is recommended that the provider reviews the number of days that domestic support in available which is presently for three days a week. Alcohol gel dispensers are available within the home to prevent the spread of infection Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 Quality in this outcome area is adequate. People using the service are protected by recruitment practice but levels of staff place them at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the random inspection it was found that staffing levels were inadequate and that recruitment practices were not robust. Improvements in recruitment procedures and practice have improved and it is evident that the service is meeting national minimum standards. Staffing levels do not however enable people using the service to have appropriate intervention that promotes their lifestyle and protects them from harm. In discussion with support workers they informed the inspector that of people who challenged there was insufficient staff to meet their needs and to minimise negative behaviours. Support workers are expected within their role to take on domestic duties and meal preparation that reduces direct time with people who use the service. Staff and records confirmed that 10 of the 11 support worker employed hold a national Qualification at Level two/three and that 1 person is taking the qualification at present. In viewing the training undertaken by staff all had completed abuse awareness courses and were up to date with basic health & Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 22 safety training. The staff team are benefiting from additional training in relation to people with a learning disability and people who have limited communication skills. The AQAA confirms that ‘A new induction programme has been introduced. This training is recognised by BILD’. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,40 Quality in this outcome area is adequate. The service needs to develop the monitoring systems in relation to quality that reflect the views of people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has not had a registered manager since registration and the provider needs to ensure that action is taken to meet regulations. The acting manager has worked well in improving areas identified at previous inspections. Their role would be further supported if staffing levels reflected the needs of people using the service. Since their appointment the manager has introduced ‘customer satisfaction surveys to the family and friends of people using the service’. The findings from the customer questionnaires are used to address any issues and are available to everyone. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 24 There is a need to develop policies & procedures relating to dealing with violence & aggression and what to do if a person using the service goes missing. The AQAA confirmed that these policies are not yet in place. Windmill Banks DS0000065013.V369422.R02.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 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 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 1 26 1 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 1 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 X 2 2 X X X Windmill Banks DS0000065013.V369422.R02.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 YA12 Regulation 15 (1) Requirement Individual plans should be maintained on how people using the service are to be supported with daily/weekly leisure, recreational and educational routines. Monitoring of the Administration of Medication needs to be robust to ensure that errors are addressed and people using the service are protected. Missed medication errors must be reported using the safeguarding protocols to ensure that people using the service are fully protected. Incidents affecting the well being of people using the service must be reported using the safeguarding protocols and CSCI Regulation 37 reporting system. The provider must ensure that environment is safe and meets the needs of people using the service. People using the service must be provided with the minimum of facilities within their rooms that are safe and appropriate to their needs DS0000065013.V369422.R02.S.doc Timescale for action 30/09/08 2. YA20 13 (2) 26 30/09/08 3. YA20 12 13 (2) 30/09/08 4. YA23 12 13 17 37 13 (4) 23 16 30/09/08 5. YA24 30/11/08 6. YA26 30/09/08 Windmill Banks Version 5.2 Page 27 7. YA28 13 16 23 8. YA33 18 (1) (a) 9. YA40 12 13 The homes shared environment 30/11/08 must be fit for purpose and enable people using the service to have access to a range of comfortable, safe and fully accessible shared space for activities. The provider must submit the plans that have been made to extend the communal area. The provider must supply to 30/09/08 CSCI evidence that demonstrates how levels of staff have been calculated to meet the needs of people using the service. The provider must have Policies 30/09/08 and Procedures in place for dealing with violence and aggression that protects the well being of people who use the service. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA17 YA6 YA30 Good Practice Recommendations A weekly menu should be in place based upon the nutritional needs and preferences of the service users. Care plans in an accessible format would promote the involvement of people using the service. That the provider reviews the present levels of domestic support. Windmill Banks DS0000065013.V369422.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Windmill Banks DS0000065013.V369422.R02.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. 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