Care Home: Capricorn Cottage

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What the care home does well People who might want to come and live at the home, or stay for respite care are given lots of information about the home. This helps them to make a choice about whether the home can meet their needs. They can also visit the home and meet other people who live there before making their choice. Staff are very good at helping people to make choices and decisions about what they want to do with their time, and they make sure that everyone gets the chance to be involved. People can choose from activities such as horse riding, day trips, relaxation or music sessions; and they can say what they think at house meetings or by filling in questionnaires. People get excellent support to stay healthy. They can see doctors, nurses, chiropodists or dentists whenever they need to, and everyone can have a yearly health check with their GP. Staff get good training to make sure that they know how to support people in the right way, and staff keep good records to make sure that people stay safe. What has improved since the last inspection? Since the last inspection the registered manager and staff have made sure that important information in care plans is highlighted so that it is easier to find. They have also made sure that there is more information in the care plans for staff, about how to meet service users needs.Capricorn CottageDS0000069535.V341216.R01.S.docVersion 5.2There is now a car available to service users as well as a mini bus, and they can go horse riding if they wish. What the care home could do better: Although service users already get a good standard of support, some suggestions have been made to help improve things even more. For example, it is suggested that care plans include more information about social and leisure needs, so service users know they will be supported to do the things they want to do. At the moment, service users can choose from lots of activities, but it is suggested that they get the chance to make up their own weekly programme so that they know what they are going to be doing each day, and they have more control over the use of their time. Lastly it is suggested that daily notes include more information about how the care plans have been followed, so that service user`s progress can be reviewed more easily. CARE HOME ADULTS 18-65 Capricorn Cottage 88 Eastgate Fleet Spalding Lincs PE12 8ND Lead Inspector Wendy Taylor Key Unannounced Inspection 25th July 2007 09:00 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 Capricorn Cottage DS0000069535.V341216.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 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. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Capricorn Cottage Address 88 Eastgate Fleet Spalding Lincs PE12 8ND 01406 425067 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) Capricorn Cottage Limited Mrs Susan Ebbage Care Home 18 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (8) of places Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The Annexe may provide only short-term respite care to service users for periods not exceeding eight weeks in length. Service users must only be admitted to the Annexe on the basis that the placing practitioner has agreed that the room size is adequate to meet the individual’s assessed needs. The Annexe must not be used to accommodate service users who require moving and handling aides such as hoists. The home is registered to accommodate service users of both sexes whose primary needs fall within the following categories: Learning disabilities (LD) - 7 places within the main building and 3 places in the Annexe. Learning Disabilities, over 65 years of age (LD(E)) - 8 places. Maximum number registered 18. 5. Date of last inspection New Registration Brief Description of the Service: Capricorn Cottage is a purpose built, single storey home situated in the village of Fleet Hargate, which is approximately two miles from Holbeach town centre. The village has facilities including a pub, village store, post office church and chapel. The home has a mini-bus with a tail lift and a car to assist service users in accessing community facilities. The home is registered to provide services to people who have a learning disability, some of whom may be over 65 years of age. Respite care accommodation is provided for up to three people, in a separate annexe, which has it’s own driveway and entrance. There is also a day centre within the grounds of the home, adjacent to a paddock with a goat, ducks, chickens and a vegetable plot, which residents help to cultivate. The current fees for living at the home are £407:00 per week. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during July 2007. Fifteen people were living at the home on the day of the visit, and there were three people staying in the respite accommodation. Some service users were going out to do activities, some attended health appointments and some were engaging in in-house activities. The care received by four service users was followed in detail, using a method called case tracking. This includes talking to the service user, and looking at their care plans, medical records and daily notes. Some general house records and staff records were also looked at. Service users, staff and the registered manager were spoken to and the care being provided was observed. Information already held by the commission was also used as part of the inspection process. A service user said ‘I love it here, and the staff are great’. Other comments made by service users can be seen in the body of the report. What the service does well: What has improved since the last inspection? Since the last inspection the registered manager and staff have made sure that important information in care plans is highlighted so that it is easier to find. They have also made sure that there is more information in the care plans for staff, about how to meet service users needs. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 6 There is now a car available to service users as well as a mini bus, and they can go horse riding if they wish. 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 summary of this inspection report can be made available in other formats on request. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 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 Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is accessible information about the home to help people make a choice of where to live. Good assessments make sure that all needs are clearly identified. EVIDENCE: Pre inspection information shows that there are policies in place for referrals and admissions; and there is also a policy that sets out the procedures for introductory visits to the home. Staff clearly described the process of assessing potential service users, and how they involve the person, their families and other professionals in that process. Three people were using the respite care service at the time of the visit and one person described how they were able to visit and meet people before coming to stay for the first time. There is an up to date statement of purpose and service user guide in place, which is also available in a tape-recorded format. Records show when the service user guide has been explained to the service user and what format was used. The use of picture based formats for information was discussed with the registered manager, who said that she would look into the issue. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 9 Assessments are in place to cover needs such as nutrition, moving and handling, social/relationships, and general health. They identify cultural and religious preferences; and they clearly cross reference to care plans and risk assessments (see Standards 6-10). There are also assessments in place, which have been carried out by placing authorities, and which form part of the information gathering process carried out by staff at the home. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are fully supported to make choices and decisions about their daily lives, and they benefit from clear care plans which reflect their assessed needs. EVIDENCE: Care plans, which reflect the assessed needs of the service users, are in place. The plans refer to needs such as maintaining privacy, dignity and choice; however discussion took place with the registered manager regarding the plans containing more detail about social and leisure needs. Discussion also took place with the manager about making reference in daily notes as to how the care plans have been implemented. There is evidence that service users are involved in developing their care plans to whatever degree they are able. Some service users are able to sign the care plans, and relatives sign others, where the service user is unable to do so. Records show that the plans are reviewed on a monthly basis and there is information in records to show that an Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 11 independent advocate is involved in supporting those service users who are unable to be involved in decision making-processes. The registered manger and staff demonstrated a clear understanding of the Mental Capacity Act (2007) and described how this helps people with decision-making in areas such as end of life wishes and personal finances. There are clear behaviour management guidelines in place where appropriate; and specialist guidance from support services, such as Speech and Language and Occupational Therapy, is also in place. Individual risk assessments cover needs such as the use of bed rails, choking and having keys to lockable doors. Service users were observed choosing their daily routines such as, meal times, activities and who they wished to socialise with. Some service users were able to talk about making their own choices about what they want to do; one person said that they sometimes ‘leave it up to the staff to choose when I can’t be bothered, they know what I like and get it right’. Staff demonstrated that they have a very good understanding of service users needs when supporting them to make choices by using various forms of communication, such as gestures and pictures. They also demonstrated through discussion and practice that they considered equality and diversity issues on a daily basis. For example, they made sure that service users who chose to spend time on their own were helped to do so; that all the service users were offered the same opportunities for activity and social interaction, regardless of their needs, and helped them individually to join in; and they made sure that one service user is supported to maintain their cultural needs relating to diet. Pre inspection information shows that there are policies in place for privacy, dignity, choice, and care planning/review processes. This information also shows that staff receive training in how to promote choice and equality. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users enjoy a wide range of activities, and can choose what they want to do with their time. They also benefit from being able to choose from a variety of home cooked, freshly prepared foods. EVIDENCE: For those service users who do not use the day centre, there is a programme of activities for them to choose from, which includes outings from the home. Questionnaires completed by service users prior to the visit indicate that they can choose what they want to do during the day, evening and weekends. During the visit service users said that they go out to local shops and cafes, and one person said that they ‘go to the seaside’. During the visit some service users were going horse riding, which is an activity the registered manager said has been introduced since the previous inspection. Other service users were joining in with puzzles, games and reading; and staff gave individual help for Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 13 people to join in with group activities. One service user who is partially sighted is visited by a ‘befriender’ from a local charity and receives taped books and newspapers to listen to. Although service users can choose from a range of activities, the options for them to be involved in developing their own weekly programme were discussed with the registered manager, who said she would discuss this with the activity co-ordinator (see St’s 6-10 also regarding making choices). Pre inspection information shows that there are policies in place for contact with family and friends, and records show that there is good communication with them. One service user said that their sister visits, and another said that their friend comes to see them. Since the previous inspection the service provider has made a car available for service users, in addition to the mini bus that they already have. During the visit the cook was seen preparing fresh foods, and baking. Service users said or indicated that they enjoyed their lunchtime meal, which was well presented. One person said that the cook ‘excelled herself today, the food is delightful’. Service users using the day centre were seen making sandwiches for lunch, and service users in the respite area had the same choices of food as those in the residential service. Those staying in the respite service also have facilities to make snacks and light meals of their choice. A recent service user survey carried out by the home has led to changes in the options available on the menus, and the registered manager said that they now use picture formats to help service users make their choices. Pre inspection information shows that there are policies in place for food safety, nutrition and hygiene. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having access to a range of local heath care services; and detailed care plans ensure that all of their health care needs are met. EVIDENCE: Each service user has a person centred health action plan, which sets out how they prefer their healthcare to be provided. Records show that they all receive annual health screening from their GP, and they continue to receive hearing checks every three years. Records also show that a chiropodist visits service users regularly, and some service users have support from specialist therapies such as Speech and Language, Occupational Therapy and Consultant Psychiatry. Contact sheets kept in individual files record all health related appointments and they direct the reader to more detailed notes of the visits. Dental health handbooks continue to be maintained for each service user, which shows regular input from dentists and hygienists. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 15 Pre inspection information shows that there are policies in place for pressure area care, first aid, continence and medication administration. Care plans demonstrate that policies are put into practice, and they cover needs such as pressure area care, use of moving and handling equipment and preventing dehydration. Staff described how they are developing a care plan with one service user, who chooses not to undergo any medical tests advised by the GP. They were able to describe how choices are presented to the person, and how information is conveyed in a manner that the person understands. Medication records were fully completed on the day of the visit, and medication was stored appropriately. There are no written protocols in place for the consistent administration of medication that is used only when necessary, although the registered manager said that she authorises all use of this type of medication. Staff confirmed that they were aware of this protocol. Written protocols were discussed with the registered manager, who said that she would discuss this further with the prescribing doctors. Records show that staff have received training in medication administration procedures. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good policies and procedures, and a knowledgeable staff team protect service users. EVIDENCE: Records show that there have been no complaints made about the service since the previous inspection; and also that no Safeguarding Adults referrals have been made. A copy of the complaints policy is kept in service users files and it is available in symbol format. There are also policies in place for whistle blowing and safeguarding adults. Questionnaires completed by service users prior to the visit indicate that they know who to speak to if they are not happy with anything, and that staff listen and act on what they have to say. During the visit, service users said that they would talk to any of the staff if they had a complaint; one person specifically said that they would speak to the registered manager. They also said that they felt safe living at the home, and they trusted staff. Staff demonstrated a detailed knowledge of how to recognise and respond to Safeguarding Adult issues. They were clear about reporting procedures and protecting service users. Staff said that they have received training in the protection of vulnerable adults, and records confirmed this. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable and safe environment, which meets their needs and wishes. EVIDENCE: Questionnaires from service users, received prior to the visit indicate that they think the home is kept fresh and clean. During the visit, both the residential and respite accommodation was well maintained and nicely decorated. The garden areas were also well maintained and accessible to service users. Staff said that some service users like to help with the gardening and feed the resident goat. Bedrooms were personalised and comfortable, and service users said that they helped to choose the décor. A service user staying in the respite accommodation has the use of a TV and games consul for their room. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 18 Communal areas were nicely furnished and there was ample space for those service users who use wheelchairs to mobilise. Pre inspection information shows that the home has had very good feedback from environmental health services; and the registered manager and deputy manager now attend an infection control group, which is run by the local health services. Records show that all staff have received training in infection control procedures. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 19 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, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported and protected by a safely recruited and well trained staff team. EVIDENCE: Recruitment records contain information such as references, criminal record bureau checks and proof of identity. Work rotas show that there is a consistent team, with enough staff on duty to meet the needs of service users. Other staff records show that they undertake a good induction process and they have training in subjects such as medication administration, diabetes awareness, behaviour management, infection control and moving and handling. The registered manager said that 20 out of the 22 staff members now hold a nationally recognised care qualification at various levels, and some staff have applied for training at higher levels. Staff confirmed that they receive a good induction and training package, and also spoke about training in first aid, fire safety and basic food hygiene. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 20 Staff said that they receive regular supervision sessions and records confirmed this. They said that supervision is very useful and they can talk about any aspect of their work and personal development. The service has recently been assessed and has been successful in maintaining the Investors in People Award for the next three years. Service users said that they like the staff, and one person said ‘they are wonderful ladies and gentlemen’; another said ‘they do a grand job’. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 21 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, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, in the best interests of the service users. Their health, safety and welfare needs are protected by good policies and practices, and a comprehensive quality assurance process. EVIDENCE: The registered manager is qualified as a nurse with many years experience in the care profession. She also holds a nationally recognised care qualification at Level 4, and the Registered Managers Award. Staff said that the registered manager is supportive and has a flexible management style; they said that they feel comfortable to air their views and feel that their views are listened to. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 22 Comprehensive policies are in place for issues such as quality assurance equal opportunities, fire safety, health and safety and record keeping. Quality assurance activity includes regular surveys to gain the views of service users, relatives, staff and other professional about the service provided. The results of surveys are kept and used to inform service improvements such as was mentioned in Standards 11-17 regarding menus. The Local Authority carry out regular monitoring visits to make sure that service users are provided with a good quality service; and records show that audits are also carried out for staff training, staff skills, national minimum standards and medication. There are minutes of regular service user meetings, which demonstrate that service users are asked for their views about the service and how they would like to improve things. The registered manager said that she is planning to encourage service users to join staff training sessions so that they can be a part of helping staff to develop their skills. On the day of the visit a contracted electrician was testing the portable electrical equipment within the home for safety. Cupboards containing substances that are hazardous to health were locked; and records show that hoists and specialist baths have been recently serviced. All service users have an individual fire evacuation procedure to meet their specific needs. Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 4 X 3 X X 3 X Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 24 N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations It is recommended that care plans contain more information about social and leisure needs; so that service users know they will be supported to do the things they want to do. It is suggested that daily notes include more information about how the care plans have been followed, so that service user’s progress can be reviewed more easily. It is recommended that service users have the opportunity to develop their own weekly activity programme; so that they know what they are going to be doing each day, and they have more control over the use of their time. 2 3 YA6 YA14 Capricorn Cottage DS0000069535.V341216.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 - 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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