Care Home: Newtown House

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What the care home does well The home makes sure that all prospective service users have the information they need before deciding to move in. The staff team are caring and committed and clearly know their roles and responsibilities in caring for people.Good healthcare arrangements are made available, with for example district nurses, chiropodists visiting the home regularly and medication procedures are well maintained and help to keep people safe. The quality of food is good and service users likes and dislikes are taken into account. They can choose from a number of options on the menu what they would like to eat. All staff receive good training and this helps people to know they will be well looked after regardless of their various needs. The home is clean and generally well looked after and provides a comfortable and homely place for service users to live in. What has improved since the last inspection? The manager now ensures that all prospective service users have a care management care plan in place before a service user is admitted into the home. This ensures that a care plan can be prepared prior to the person moving in, so as their needs are clearly identified. Some areas of the home have been refurbished including four bedrooms repainted, the dining room floor replaced and new dining room furniture purchased. This benefits the people living there. Policies and procedures have all been reviewed and staff have been made aware of them, to ensure people living in the home can expect a good standard of care. Staff achieving a care qualification has improved and the home now have over 50% of the staff team qualified. This makes sure service users are looked after by people who have the knowledge and skills to do so. What the care home could do better: When an assessment visit is made to a person who is thinking of coming into care by the home manager, the information should be recorded on the home`s assessment records. The service users would benefit from increased and varied activities and to include some outings for service users who cannot go out of the home independently. All activities should be fully recorded, whenever an event has taken place. The dining arrangements should include further ideas to give service users more choice around their meals such as what they would like to eat on their plates.All staff references should be located within their personal files. CARE HOMES FOR OLDER PEOPLE Newtown House Newtown House Stanhope Bishop Auckland Co Durham DL13 2PG Lead Inspector Eileen Hulse Unannounced Inspection 10:00 9 & 15th July 2008 th 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 Newtown House DS0000031205.V368441.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. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newtown House Address Newtown House Stanhope Bishop Auckland Co Durham DL13 2PG 01388 528234 01388 527483 joan.debues@durham.gov.uk www.durham.gov.uk Durham County Council 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) Mrs Joan de-Bues Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2006 Brief Description of the Service: Newtown House is registered to provide care for 28 older people and is owned and managed by Durham County Council. The home cannot provide nursing care. The building was once a hotel and has pleasant gardens overlooking the River Wear. It is close to the village centre of Stanhope with its shops, pubs and there are bus services to neighbouring towns and villages. The building has two storeys with a lift and chairlift to the first-floor. There are 24 single bedrooms and two doubles for those who wish to share. The ground floor has a number of lounges including a smoking area and a dining room. The weekly minimum fees are £432:32 and additional charges are made for personal items such as hairdressing and toiletries. Newtown House DS0000031205.V368441.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 2 star. This means that people who use this service experience good quality outcomes. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 22nd June 2006 • The annual review of the service that was carried out on 10th January 2008 • How the service dealt with any complaints & concerns since the last visit • Any changes to how the home is run • The provider’s view of how well they care for people • The views of people who use the service, their relatives and staff. The Visit: An un-announced visit was made to the service on 9th July 2008 and completed on 15th July 2008. During the visit we: • Observed staff practice and talked with people who use the service, relatives, staff and the Manager • looked at information about the people who use the service & how well their needs are met • looked at other records which must be kept • checked that staff had the knowledge, skills & training to meet the needs of the people they care for • looked around the parts of the building to make sure it was clean, safe & comfortable • checked if any improvements had recently been made. We told the Manager what we found. What the service does well: The home makes sure that all prospective service users have the information they need before deciding to move in. The staff team are caring and committed and clearly know their roles and responsibilities in caring for people. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 6 Good healthcare arrangements are made available, with for example district nurses, chiropodists visiting the home regularly and medication procedures are well maintained and help to keep people safe. The quality of food is good and service users likes and dislikes are taken into account. They can choose from a number of options on the menu what they would like to eat. All staff receive good training and this helps people to know they will be well looked after regardless of their various needs. The home is clean and generally well looked after and provides a comfortable and homely place for service users to live in. What has improved since the last inspection? What they could do better: When an assessment visit is made to a person who is thinking of coming into care by the home manager, the information should be recorded on the home’s assessment records. The service users would benefit from increased and varied activities and to include some outings for service users who cannot go out of the home independently. All activities should be fully recorded, whenever an event has taken place. The dining arrangements should include further ideas to give service users more choice around their meals such as what they would like to eat on their plates. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 7 All staff references should be located within their personal files. 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. Newtown House DS0000031205.V368441.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 Newtown House DS0000031205.V368441.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 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While a pre admission assessment from the care manager is included within the care plans for all service users, there is no pre admission assessment completed by the home, following the initial visit to assess the care needs. Therefore, the home has no way of knowing if the care needs can be met. And that people are appropriately admitted. EVIDENCE: Prior to an admission, the home manager will ensure that they receive a personalised care plan from the care manager, which helps to form the basis of the person’s care. Referrals are made to the home from care managers and families and when a referral is made, the home manager will visit the prospective service user to carry out an assessment of need either in hospital or in their own home. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 10 However, a record of this visit is not completed to show the outcome of the assessment and therefore the visit does not help the home to know if they can meet the needs of the prospective service user. Following the visit, a place is offered to the person in writing and a date for admission is arranged that is suitable to both the service user and the home. Prospective service users are invited to visit the home to have a look around and some people decide to spend some time there to meet other service users and to decide if they would like to live there. After six weeks, a review meeting is held between representatives of the home, service user, family and care manager, to discuss if the service user wants to live in the home permanently and to make sure the home can meet all of the care needs. There is plenty of information about the service made available to everyone. Leaflets are located in the entrance and include all the information that service users and their families need. Service users spoken with felt they had good information prior to moving into the home. One service user stated ‘most people have lived in this area most of their lives and people know about the home through visiting or knowing someone who lives there’. There was one completed questionnaire from a relative who stated they had no concerns at all about the service and felt their relative was looked after “really well”. Newtown House DS0000031205.V368441.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users have a plan of care which ensures the care needs of people are met at all times. Furthermore service users have access to all healthcare facilities that promote health and wellbeing and medication procedures are followed by staff, ensuring that medication is always given safely. EVIDENCE: All service users have a plan of care that is followed by staff to meet the care needs. These care plans are organised and although bulky, act as triggers and prompts to monitor, evaluate and act on changes in service users’ needs or circumstances. The range of recording documents contain sufficient information that staff can follow. However in some instances there were no dates, so it is unknown if the records are current and no signatures throughout. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 12 Information that will tell staff how to meet the needs identified, is contained in an array of documents, which staff are familiar with and use effectively. However, the systems and processes for recording the delivery of care to service users look complex and therefore needs to be confidently explained and understood by all staff and new staff, to ensure appropriate care is given. There were some gaps:for exampleOne risk assessment stated that a service user who has a bedroom on the first floor was at risk from falling down the stairs. In April they were given a ground floor bedroom but the risk assessment had not been updated and did not reflect the change of bedroom. Furthermore the review of care record stated no changes and again did not record the change of bedroom. Daily records stated that one service user was out of the door and calling for the police, again this was not noted within the plan of care and gave no instruction to staff on how to deal with a situation like this. One care plan stated that “(name) wears large pads at all times, they are aware they need the toilet but cannot always get there on time”. The care plan gave no instruction to staff on how this issue needs to be addressed and compromises the privacy and dignity of this service user. Weights and other records relating to service users that are regularly checked, are not recorded within the care plan. All recordings are held in one file for everyone. The home continues to use daily records, recorded in a book. Individualised recording pages are used, which are, upon completion, removed and placed in the service user’s care plan. The healthcare arrangements are accessible to all service users regardless of their needs. All service users have their choice of GP following admission into the home and other healthcare professionals are brought into the home when they are required and they include specialist consultants, district nurses, chiropodists, dieticians and dentists. A member of staff escorts service users to attend hospital/doctor appointments if family members are not available. The home has a detailed policy and procedure on the administration of medication and 80 of the care staff have completed an accredited twelveweek medication training course. Medication administration records for individual service users are well maintained, completed and signed. A medication audit confirmed the records and medication were correct. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 13 Service users made the following comments regarding their healthcare needs: ‘I do have a grievance with getting a chiropodist and having to pay £15 to get my feet done’ ‘I can always get somebody to go with me if I have to go to the hospital, but usually my family take me’ Staff give service users good support and they are caring and appear to know service users well. Newtown House DS0000031205.V368441.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides few activities and service users do not go out of the home unless families take them or they can go out independently. This does not give service users choice or promote their right to make decision about their everyday living. Furthermore, service users are offered and receive a varied and nutritious diet which helps to promote the health and well being. EVIDENCE: The home does not employ an activities co-ordinator. Two nominated care staff organise and provide any activities. An organisation called Create comes into the home once every two weeks to give staff ideas for providing various activities and two voluntary workers come into the home to play dominoes with the service users. No outings are organised in the home and service users do not go out individually with staff members, although some service users go out with visiting families to spend some time away from the home. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 15 Service users made the following comments regarding how they fulfil their days: ‘I get up and go to bed when I want to but the days are very long’ . ‘The hairdresser comes in and we get our hairs done, it’s the highlight of my week’. ‘I like it here because I can go out on my own on my scooter’. ‘The one thing lacking in here is something to do’. ‘The only regular entertainment is dominoes on a Friday’. ‘I have never been out since I came here and I miss getting out and about’. ‘We used to have bingo but that’s all stopped now’. There were no activity records available that would describe in detail who had attended the activities, what the outcome of the activity was and who had refused to take part in them. During the visit, lunch was taken with the service users. The menu choice is located on a whiteboard in the hallway so that service users can see what is being offered at mealtimes. A choice of two meals was available and one service user who did not want either of the meals was asked if they would like an alternative. Tables were well set with tablecloths, tablemats, serviettes and condiments however, there were no gravy boats on the tables to enable service users to serve themselves. Cold drinks were offered with the meal and a cold-water machine is located in a corner of the dining room. Help was given to service users in a respectful and dignified way and they were given sufficient time to sit and enjoy their meal without being hurried. Comments about the meals throughout the day included: ‘We are well looked after in here’. ‘Usually the meals are tiptop but today the dinner was cold’. ‘The meals are good, if anything you get too much’. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 16 ‘The food is very good and the girls are brilliant’. ‘The home is very nice it’s more like a hotel’. Newtown House DS0000031205.V368441.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints procedure is available to service users and their relatives, giving them the opportunity to make their views known, confident that they will be listened to and taken seriously. Furthermore, staff awareness of the safeguarding adults procedures ensures that service users are protected from abusive situations. EVIDENCE: The complaints procedure details how to make a complaint about the service and the information is accessible and made available to service users, families and any visitors to the home. Details about making a complaint are written in the Service User Guide and further information is made freely available to people and located in the main entrance of the home. Service users spoken with knew how to make a complaint and who to speak to if they had an issue they were unhappy about or a concern Service users said: ‘I would go and see the manager if I needed to speak to somebody’. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 18 ‘Some of the staff are very good and always asking us if we are alright’. ‘Yes I know how to make a complaint but I don’t suppose I will ever need to complain’. The Commission for Social Care Inspection has received no complaints or safeguarding issues about this service in the last twelve months. All of the staff team, regardless of their roles within the service, have received up to date safeguarding and alerter training from Durham County Council and within their induction training. The safeguarding procedures are in the home and accessible to everyone. Newtown House DS0000031205.V368441.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is a comfortable and homely place to live in and also offers service users a safe environment. EVIDENCE: Newtown House is a detached building standing in its own pleasant and wellmaintained gardens, on the edge of a small housing estate and is attached to a day centre. There is a maintenance worker employed at the home for eighteen hours a week and a maintenance schedule is devised and carried out. All building and equipment checks and repairs are carried out efficiently on a day-to-day basis. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 20 Since the last inspection, some improvements have been made to the home. The dining room flooring has been replaced and during the second visit to the home, new dining furniture was being delivered. Some of the bedrooms have been re-decorated and painting and decorating throughout the building is carried out, as and when it is required. At the time of the visit, the handyman was present in the home and addressing some of the issues identified in the maintenance schedule. Most of the staff team have completed ‘Infection Control’ training. Domestic staff work hard to keep the home to a good standard of cleanliness and free from odours. Newtown House DS0000031205.V368441.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate staffing levels and good levels of training ensure that the needs of the service users are fully and effectively met. While robust recruitment procedures ensure that only suitable people are employed and therefore service users are kept safe. EVIDENCE: There is an effective policy and procedure on staff recruitment. Staff files are organised and detailed and all the files sampled held the required information to assess the person’s suitability to work with vulnerable adults, apart from one staff profile which had no references in it but there was a note attached stating that references had been requested three times. There are good staffing levels, which was confirmed through observation and and the staff rot record. At the time of the visit there were seven care assistants and two senior care staff on duty throughout the day, two domestic staff and two cooks. All of the care staff apart from two, holds an NVQ level 2 qualification in care so the home have achieved the minimum of 50 of the staff team with a care qualification. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 22 Currently ten of the staff has applied to do NVQ level 3 training. The staff-training matrix shows that staff are given regular training and updates and staff risk assessments were also in place and linked to their daily working practices in areas such as:Administration of medication Fire awareness and fire drills Moving and handling Infection control Discussions held with the Manager, senior care staff and care staff during the visit, show that staff have a good understanding of their roles and responsibilities. Staff stated that they are provided with training specific to the needs of the service users and this has allowed the home to have a mix of skills and experience among the staff group. Staff are very positive about the training they receive and in discussions with some of the staff on duty they made the following comments:‘We do a lot of training’. ‘I have worked here for a number of years and have had good training opportunities’. ‘I have had medication training and I going on a four day first aid course in September’. ‘I think the training helps me to do my job better’. Newtown House DS0000031205.V368441.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed by a person who is experienced and qualified and this helps to ensure the service is run in the best interests of the service users, with the risks to the health and safety of service users, visitors and staff minimised. EVIDENCE: The Manager has a lot of years experience in caring work and has managed a number of care homes prior to coming to Newtown House in 2003 as Manager. She is a level two registered nurse and has achieved NVQ levels 3 and 4 in management and has been registered with CSCI as manager of the service. Completion of all the necessary mandatory training and recently completing a dementia awareness course have updated her knowledge and skills. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 24 Questionnaires and a video are used as part of the fire prevention training for all staff employed in the home and records relating to fire safety equipment checks, staff training and staff fire drills were up to date and well maintained. Observation throughout the day showed that staff observe health and safety practice at all times. Staff was seen to use moving and handling equipment correctly for service users requiring staff assistance to move safely. Newtown House DS0000031205.V368441.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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Newtown House DS0000031205.V368441.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 Requirement The manager must complete a record following assessment that has been carried out to ensure all relevant information is recorded Service user risk assessments must be written and kept up to date with the care plan to ensure any risks possible are minimised More varied activities and visits outside of the home must be introduced to ensure service users have fulfilling lifestyles. All staff references must be acquired or chased up for all staff employed within the home. Timescale for action 30/09/08 2. OP7 13 30/09/08 3. OP12 16 30/09/08 4. OP29 19 30/09/08 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 an activities co-ordinator is employed to ensure activities are structured so that staff can carry DS0000031205.V368441.R01.S.doc Version 5.2 Page 27 Newtown House 2. OP15 out other roles. It is recommended that some form of self service be put into place for service users at mealtimes such as the use of gravy boats to enable choice at mealtimes. Newtown House DS0000031205.V368441.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Newtown House DS0000031205.V368441.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. 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