<p>The services provided for people with learning disability have changed considerably in the last 20 years with the shift from large long-stay institutions to care in the community. Those clients requiring more intensive assessment and treatment may be accommodated within community-based inpatient units (CBIUs). These are smaller than hospital wards, and are similar in size to many residential homes. However, they are staffed by qualified nurses employed by the NHS, and as inpatient units they are not subject to Care Standards Commission (CSC) regulations. Their menu and food provision is not, therefore, required to meet standards laid down to ensure the quality of service within most residential homes and is not subject to inspection by the CSC.</p>