Inspection on 23/11/06 for Ashgrove House

This inspection was carried out on 23rd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ashgrove House 02/02/06

Ashgrove House 11/10/05

Ashgrove House 10/03/05

Ashgrove House 02/12/04

Ashgrove House 19/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Ashgrove House 63 Station Road Purton Wiltshire SN5 4AJ Lead Inspector Steve Cousins Key Unannounced Inspection 09:30 23 – 24th November 2006 rd 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 Ashgrove House DS0000015886.V307923.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. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashgrove House Address 63 Station Road Purton Wiltshire SN5 4AJ 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) 01793 771449 01793 772286 Mr Keith Paul Trowbridge Mrs Mary ColletteTrowbridge Mrs Kim Mark Care Home 34 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (34), of places Physical disability (10), Terminally ill (3), Terminally ill over 65 years of age (3) Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. No more than 10 persons with a physical disability between the ages of 30 and 64 years may be accommodated at any one time No more than 3 service users with a terminal illness over the age of 30 years may be accommodated at any one time No more than 5 service users with dementia aged 65 and over may be accommodated at any one time The maximum number of service users who may be accommodated in the home at any one time is 34 No more than 3 persons may be in receipt of day care at any one time The staffing levels agreed with Wiltshire Health Authority and set out in the Notice of Staffing dated 11 January 2000 must be met at all times 2nd February 2006 Date of last inspection Brief Description of the Service: Ashgrove House provides nursing care and accommodation for up to 34 people who are mostly over the age of 65. This includes up to five older people with dementia. The home is also registered to care for some younger adults and is registered to take up to ten with physical disability. The current range of fees is £560 to £730 per week, although this may be higher should a person have complex needs. The service is privately owned and is situated in the large village of Purton, which offers a range of local amenities. The town of Swindon is only a few miles away. Ashgrove House is an old property, which has been substantially extended since becoming a nursing home. Accommodation for residents is provided on two floors and there is a lift between these. There are 22 single bedrooms and six that are shared. All offer some en-suite facilities. Suitable adaptations and equipment are available for less mobile people. Because the home provides nursing care, qualified nurses are on duty at all times supported by carers. Ashgrove House also employs staff for other key tasks, such as catering, cleaning, laundry, maintenance, and administration. The home’s manager is Mrs. Kim Mark and the proprietor is Mr. Keith Trowbridge. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the 23rd and 24th of November 2006 in order to inspect all of the key minimum standards relating to care homes for elderly people. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the home and takes into account the views and experiences of people using the service. The findings from this inspection are based on a tour of the premises, speaking to residents, relatives, managers and staff, and visiting frail residents. A number of records were inspected, including care plans, medication records and staff records. Comment cards were received from residents’ relatives and representatives and the home’s GP following the inspection and the findings are incorporated in this report. The findings of the visit were discussed with Mrs Mark, the manager, at the end of the second day of the inspection. What the service does well: What has improved since the last inspection? There has been an improvement in how nurses administer medications and practice is now safer. Recruitment procedures are better and all required information is now obtained before a new staff member starts work. There have been improvements to the environment; the dining room has been re-decorated, as have some bedrooms and a corridor on the top floor. Toilets and bathrooms have been fitted with suitable locks and the call bell system has been repaired. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 6 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. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 7 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 Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4. This service does not offer intermediate care. The quality in this outcome area is excellent. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: Records reviewed contained pre admission assessment forms that had been completed by registered nurses. Some contained other supporting documents such as assessments from care managers and hospital discharge summaries. The information is used to aid completion of individual care plans and information had been supplied by relatives where required. The staff currently supports a group of residents with very diverse physical, mental and social needs. On the evidence of this inspection the home is very good at meeting the needs of the residents and is well managed, with staff who are well trained and who have appropriate skills and experience. The home is suitably equipped for frail elderly people and is accessible for those in wheelchairs. Residents have the opportunity to ‘test drive’ the home, either as day care clients or during ‘respite’ stays. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The residents’ health and personal care needs are seen as a priority and every effort is made to meet those needs. The procedures for dealing with medicines protect the residents and they are treated respectfully and their right to privacy is upheld. The quality in this outcome area is excellent. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: The inspector reviewed the care of six residents, four males and two females between the ages of 58 and 88. They had varying physical, social and mental health needs. Some were new to the home and others had been at Ashgrove House for a number of years. One was unable to verbally communicate and was fully dependent on staff support. The care plans of the six residents were reviewed and were found to be of a good standard. Care plans appeared to be a reflection of assessed needs and were regularly reviewed. Tissue viability, nutritional and manual handling assessments were undertaken and care plans were in place where appropriate. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 10 The inspector visited the residents and found that interventions were in place to meet their assessed needs, such as pressure relief equipment, continence aids, and manual handling equipment. The residents’ appeared to be having their personal hygiene needs met and those who were able to communicate indicated great satisfaction with the care given. Those who were assessed as being nutritionally at risk were regularly weighed. A physiotherapist is employed and residents’ records indicated that they had access to other healthcare professionals, such as their General Practitioner (GP), speech and language therapists, nutritional team and tissue viability nurse. A GP visits the home weekly. The inspectors observations and the residents care records indicated that staff take prompt action when residents have an acute health care need and residents reported being able to see a GP when they needed to. A comment card received from the GP recorded his satisfaction with the overall care provided within the home, describing it as “Outstanding, well run, very caring staff, a high standard of nursing care (A view shared by visiting hospital consultants)”. He also indicated that residents’ medication was appropriately managed and that communication with the home was satisfactory. The arrangements regarding administration of medication were reviewed and found to be generally satisfactory. Registered nurses are responsible for the administration of medicines in the home. Medications were stored safely and records of receipts, administration and disposals maintained. Indirect observation confirmed that medication was being safely administered. Due to their complex needs, there were no residents who self-administer their medication. Some ‘Post It’ notes were attached to Medication Administration Record (MAR) sheets with instructions regarding administration; the ‘General Notes’ section of the MAR sheet should be used for this purpose. There was evidence to suggest that residents’ privacy and dignity was respected. Personal care was given behind closed doors and staff knocked on doors before entering a room. Residents who required help were dressed in clothes that maintained their dignity and that, where possible, they had chosen. Residents and relatives were complimentary about the home and their comments included “Ashgrove is recognised locally as ‘the best’” and “a warm, friendly, caring atmosphere at all times”. Staff were described as “friendly, polite and helpful” and “they are very good”. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 A variety of social activity is provided and residents are able to maintain contact with family and friends. Residents are encouraged to live their own lifestyle as far as possible with the support of the staff if necessary. Nutritious, balanced meals are available, which the residents enjoy. The quality in this outcome area is good. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: The home employs an activities coordinator and ensures opportunities are provided to enable residents to pursue their hobbies and interest. A range of in house and external activities are provided, which were either held in groups or with individual residents. Transport is also available, which enables access to the local community. Where required, plans for social integration were evident in residents care plans. One resident’s records indicated that the staff had made efforts to support him gain access to social resources in the local community. Information supplied by the manager, which remains confidential, suggests that the home recognises equality and diversity issues and supports residents to maintain their own lifestyle as much as possible. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 12 Relatives comment cards received all indicated that they were able to visit in private and were welcomed at any time. They also felt that they were kept informed of important matters concerning the resident. Visitors were in evidence throughout the three days of the inspection and several residents confirmed that they were able to keep in contact with friends and relatives. A payphone is also available at the home for residents’ use and a number have also installed a private telephone in their bedroom. As far as possible, residents were being supported to exercise choice and control. Examples were evident in residents’ comments such as “I’m able to get up when I want, within reason” and “I have all I need”. A staff member said, “We try our best to support the residents choice”. Records indicated that staff supported residents to maintain social interaction outside of the home. Residents are able to bring in personal items and furniture if required. There is a choice of the main meal of the day. Residents spoken to comment favourably on the quality of meals provided and the menu appeared nutritious and balanced. Discussion with the cook confirmed that residents’ likes and dislikes are known and recorded and any special diets are catered for. The inspector observed part of the lunchtime meal. Residents who required assistance with their meals were provided with support from staff in a discreet and sensitive manner. Residents are able to eat in the dining room, in the lounge or in their own rooms if they want to. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 A complaints procedure is available and residents feel they are able to complain if they wish. No complaints have been received to enable a judgement to be made on how they are handled. As far as possible, residents are protected from abuse and staff have are aware of correct reporting procedures. The quality in this outcome area is good. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: The home has a complaint procedure, which is on view in both entrance lobbies. A complaint record is kept. No complaints had been received since December 2005. Residents spoken to who could offer an opinion said that they would approach one of the staff or the manager if they needed to complain, but none had needed to do so. Of the three comment cards received from relatives, all said that they have not had to make a complaint. One of the comment cards indicated that the person completing it was unaware of the homes complaint procedure. A recent allegation of suspected abuse had been dealt with promptly and appropriately by the home. Subsequently staff had received training in Protection of Vulnerable Adults (POVA) issues, which the manager felt had raised their awareness. Review of training records indicated that staff had received training about abuse awareness Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 14 A review of staff employment documentation indicated that procedures for the protection of residents had been carried and Criminal Record Checks (CRB) and POVA checks had been obtained. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21 and 26 The home is well maintained and provides a clean, comfortable, well-equipped and safe environment for residents. The quality in this outcome area is good. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: The overall environment has improved since the previous inspection. Rooms on the top floor of the home have been decorated and new en-suite facilities added along with a modern shower room. The dining room has also been decorated. The call bell system now works efficiently. A maintenance person is employed and there is a maintenance programme in place, which ensures minor repairs are quickly responded to. The manager reported that new corridor carpets were being provided in some ground floor corridors. There is one large communal sitting room in the centre of the home, which is attached to the dining room, but no additional communal space. Furniture Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 16 provided was comfortable and homely. There is a small accessible patio area to the side of the home. Bedrooms have en-suite toilets and either washing or bathing/showering facilities. Further toilets and bathrooms are situated close to communal and bedroom areas. Bathrooms and toilets had locks fitted to ensure residents dignity and privacy is respected when using them. One bathroom on the first floor would benefit from redecoration. The home was clean and free from unpleasant odours. One resident said, “The cleaners do a very good job”. There had been an improvement in infection control measures since the previous inspection; hand gel was available in all parts of the building, along with gloves and aprons. There is one bedpan sterilising unit on the ground floor of the home and thought should be given to installing another on the first floor. The laundry is situated on the first floor well away from any food preparation areas. In addition there is a small laundry area on the ground floor, which is used for infected laundry to reduce the risk of cross infection. The laundry staff have received infection control training. The kitchen was clean and tidy and food safety measures were in place. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. The numbers and skill mix of staff meets the residents’ needs. Staff are well trained and competent. The residents are protected by the homes recruitment practice. The quality in this outcome area is good. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: The inspectors observations, allied to the comments of the residents indicated that there were enough care staff on duty in the home. Residents’ comments indicated that they were generally satisfied with the numbers of care staff in the home, one saying, “There are usually plenty about” and another “I just ring and they come”. The inspector noted that call bells were answered promptly over the two days of the inspection. All of the relatives who returned comment cards answered ’yes’ to the question: ‘In your opinion are there always sufficient numbers of staff on duty?’ The care staff spoken to thought that staffing levels were enough to meet the residents’ needs, however the loss of some experienced care assistants recently had affected the skill mix on occasions. A review of the care staff duty rota’s confirmed that the home either worked to, or exceeded the home’s minimum staffing notice. The efficiency of the laundry, domestic, catering and maintenance services would indicate that the number of support staff is appropriate. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 18 Training is provided by an external training company and supplemented by in – house training by the manager. The inspector met with the training manager. Training is available for nursing, care and support staff. A training plan is in place based on an assessment of needs and individual records are kept. These indicated that training was appropriate and sufficient. New staff undertake induction training that meets Skills For Care standards. There is a commitment to providing NVQ training for care assistants and the training manager reported that there were fourteen care assistants with, or working towards, an NVQ, with a further eight due to start in December 2006. The recruitment records of four recently recruited staff members were reviewed. Criminal Records Bureau checks had been obtained or applied for and references and POVA checks had been obtained prior to the person starting employment in all cases. Other documentation required was in place. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. The home is very well managed in the best interests of the residents. Quality assurance systems are in place and the health safety and welfare of the residents and staff are promoted and protected. The quality in this outcome area is excellent. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: Mrs Kim Mark is a registered nurse with previous experience in care home management and is the homes registered manager. Residents and staff were very complimentary about the manager and her proactive style of management; one saying, “She is quick to tackle problems” and another “she leads by example, it’s well organised here”. Mrs Mark is currently completing the Registered Managers Award. Staff were able to confirm that monthly staff meetings took place and that they were able to ‘have their say’ and the home achieved Investors In People status in January 2006. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 20 There are several systems for auditing quality in the home. Residents and relatives meetings are held every three months and recorded. Meetings have been held to discuss the meals and a monthly audit of care plans and residents’ care has been introduced. An annual satisfaction questionnaire is sent out, but this had not happened at the time of this inspection. The arrangements for handling service users money were checked and found to be satisfactory and secure, however it is recommended that two signatures are obtained for any withdrawals made, and that monthly audits are recorded and signed Mrs Mark stated that she had overall responsibility for the management of health and safety. Accidents are correctly recorded and the manager currently carries out a monthly audit of accidents and records any action taken. Staff training covered mandatory health and safety topics and comprehensive general risk assessments are in place. Moving and handling equipment is available around the home. Hazardous substances are safely stored and staff are trained in there handling. Food hygiene procedures were in place and an Environmental Health Officer commented after a food hygiene inspection in February 2006 “—continues to maintain high standards of good hygiene and safety practice”. Fire safety checks are undertaken and recorded but the home does not currently have a visitor’s register and the need for this was discussed. Records indicate that all essential equipment and services are being regularly maintained. Hot water temperatures are controlled and checked and radiators are covered where required. Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 4 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 4 Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13 (2) Requirement The registered person is required to ensure that additional directions for the administration of medicines are directly entered onto medication administration records. The registered person is required to keep a record of all visitors to the care home, including the names of the visitors. Timescale for action 24/11/06 2 OP38 17(2) Schedule 4 (17) 01/01/07 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 OP19 OP26 Good Practice Recommendations It is recommended that the first floor bathroom be redecorated to enhance the environment for residents. It is recommended that thought be given to installing another bedpan sterilising unit on the first floor of the home. With regard to residents’ money, it is recommended that two signatures be obtained for any withdrawals made; and that monthly audits are recorded. OP34 Ashgrove House DS0000015886.V307923.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 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. 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