Inspection on 29/12/05 for Brownhill House

This inspection was carried out on 29th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brownhill House 17/04/09

Brownhill House 23/12/08

Brownhill House 11/12/07

Brownhill House 21/02/07

Brownhill House 12/04/05

Brownhill House 21/09/04

Brownhill House 28/06/04

Brownhill House 04/02/04

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

CARE HOMES FOR OLDER PEOPLE Brownhill House Lower Brownhill Road Maybush Southampton Hampshire SO16 9LA Lead Inspector Jan Everitt Unannounced Inspection 29th December 2005 09:30 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 Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 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. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brownhill House Address Lower Brownhill Road Maybush Southampton Hampshire SO16 9LA 023 8077 1808 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) Southampton City Council Patricia Elizabeth Dixon Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (14), Physical disability (25), Physical disability of places over 65 years of age (25) Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Orthopaedic intermediate care may only be provided to a maximum of 16 service users and may only take place in the orthopaedic care unit. A maximum of 9 people may be in receipt of general rehabilitation care on Beech One unit only. When rehabilitation care is being provided on Beech One to less than 6 service users one dedicated member of staff must be available at all times. When there are between 6 and 9 service users accommodated in this unit, two dedicated staff members must be available at all times during the waking day. 12th April 2005 Date of last inspection Brief Description of the Service: Brownhill House, built originally as a private residence in the late 1900s, now operates as an older persons resource centre under the management of Southampton City Council. It is located in a suburb in the west of Southampton. The home makes provision for three separate services. Currently the home can accommodate fourteen service users in the old age category of over 65 years. Three beds are allocated for long-term residential care with a further eleven for respite care. A new purpose built wing to the home has been opened and accommodates sixteen service users admitted directly from the orthopaedic wards at the General Hospital for a period of rehabilitation and discharge planning following orthopaedic surgery. This service is classified as intermediate care. The anticipated length of stay in this unit is six weeks, following which, most service users return to their own homes. The general rehabilitation unit is situated on the first floor of the house and can accommodate nine service users who have been assessed as needing some assessment and rehabilitation. The service users who are admitted to this unit are both from home and hospital and have been assessed as needing a period of supervision and rehabilitation before going back into the community. The anticipated length of stay in this unit is six weeks. At the time of the inspection only six of these beds were operational. All accommodation in the home is single occupancy with sixteen rooms having ensuite facilities. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of Brownhill House took place over a period of five hours on the 29th December 2005. The registered manager assisted the inspector throughout the process. The inspection focused on the requirements made from the previous inspection and the key standards that remained to be assessed in this inspection year 2005/6. The inspector discussed the requirements from the last inspection that had not been complied with fully and this will be addressed in the main body of the report. Thirteen standards were assessed, nine of which were core standards. Of the thirteen standards assessed nine met the national minimum standards and four were identified as having minor shortfalls. The inspector toured the building and spoke to most of the service users in residence at the time and some of the staff. The home was still decorated for the festive season and the residents reported to have had a ‘wonderful time’. A sample of records and documentation were also inspected. The atmosphere in the home was happy and that of a team that work together well. The agency staff on duty at the time was familiar with the home and reported to really enjoy being allocated to this service. The ethos and overall care and services delivered in the home were good and staff displayed a caring attitude to the service users. At the time of the inspection the home was accommodating thirty-six service users, three of which were long stay and eight service users were accommodated for a short stay/respite care. These service users are accommodated in a separate area of the home. What the service does well: Brownhill House provides a variety of intermediate and long-term care for people over 65 years of age. The service users gave positive feedback as to the standards of the rehabilitation and care they receive whilst in residence. Staff moral was good and staffing levels adequate at the time of the inspection. Staff were observed to interact well with the service users and taking time to sit and talk to them on an individual basis. The orthopaedic rehabilitation unit is managed by a coordinator and also accommodates a multidisciplinary team managed by health. The presence of this team enables service users to undertake rehabilitation programmes and Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 6 comprehensive discharge planning. During the Christmas break the service users reported that they continued with their exercise programmes that were displayed on the walls for group work. A coordinator and a separate staff group manage the general rehabilitation unit. The two intermediate services offer a rehabilitation programme of approximately six weeks to enable service users to reach their full potential of independence. The outcomes from the rehabilitation and orthopaedic rehabilitation programmes for those in intermediate care have been proved to be good and lead to service users being able to return to independence and in most cases to their own homes. The PCT pharmacist visits the home weekly and has a programme for educating the service users to enable them to confidently self medicate when they are discharged. She also monitors and reviews medication regimens and consults with the GP if necessary for reviews. The long stay service users are accommodated in their own area of the home and have been in residence for many years and would not wish to be moved elsewhere. The activities programme provided is varied and service users reported to have enjoyed the festive activities. The local authority provides adequate training for the staff to enable them to meet the needs of the service users. The services provided in this home are unique within the area and therefore is viewed as a much-valued service for the elderly population of Southampton. The environment in general is pleasant and well decorated. The home has a comprehensive service user feedback system and all service users who leave the home following rehabilitation are requested to complete an evaluation form. For the long stay/respite care service users an anonymous survey is distributed to them annually. The results of this survey is analysed and documented and were viewed by the inspector to be very positive. What has improved since the last inspection? The medication policy is now in place and available in the home. The automatic fire door closures have been installed in the orthopaedic rehabilitation unit. The garden area has been tidied but the completion of landscaping is to be undertaken in the spring. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 7 Cleaning materials are now maintained in a locked environment and not left unattended when not in use. 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. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 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 Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1. Prospective service users are supplied with the information they need to make a decision whether to be admitted to the home. EVIDENCE: The Statement of Purpose reflects the services that are available at Brownhill House and contains all relevant information. The Statement of Purpose is to be reviewed to reflect the recently changed conditions of registration with regards to the number of beds available for rehabilitation. Service users spoken with in the intermediate care area reported that they were aware that they were at the home for a period of rehabilitation and that they would be discharged as soon as they had been assessed as safe in their own home. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 10 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): 8&9 Service users health care needs and rehabilitation needs are fully met. Service users, where appropriate, are responsible for their own medications, and those service users who do not self-medicate are protected by the homes policy and procedure for the management of medicines. EVIDENCE: The home is serviced by a GP practice that will visit the home when the home requests a visit. The multidisciplinary team, which consists of a physiotherapist, occupational therapist and a nurse attend the home every day to agree rehabilitation programmes and monitor improvements and plan discharge. By the nature of the service that is mostly short stay, services users prefer to use community practitioners for dentistry, ophthalmic and podiatry. These services are available to the long stay residents. Service users in the general rehabilitation and those in long stay and respite are encouraged to mobilise around the home freely, which the inspector observed to be happening. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 11 The medication policy is now in place. The inspector spoke with the visiting Primary Care Trust pharmacist who was attending the home at the time of the inspection to assess and give instruction to a number of service users who were self-medicating. Assessments of their capabilities and understanding of their medication takes place before they are able to be completely be independent of direction. She reports that at the time of the inspection, most of the service users in the orthopaedic unit were self-medicating as these residents are discharged home as quickly as possible. There are various methods of administration of medication. The medication is stored appropriately and records maintained. The home has the support of the visiting pharmacists who will check prescription charts and discuss medication with the service user and if necessary request the GP to review the prescribed medication. The care co-ordinators dispense medication and there was evidence of appropriate training in their records. The registered manager undertakes a monthly audit of the MAR sheets to ensure correct recording. The inspector viewed the charts and they were recorded appropriately. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 12 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 Service users find that the home life matches their expectations and preferences and meets their social, recreational, cultural and religious needs. Those service users in the intermediate care services find that services meet their expectations of their needs. EVIDENCE: The inspection took place following the Christmas period and the home was decorated and dressed for the festive season. The service users spoken with reported to have had a ‘wonderful Christmas’ and that there was ‘plenty to eat drink and be merry about’. Some of the service users in the intermediate care area said they had gone home for the day but most of them had chosen to remain in the home. The manager reported that the home had received visits from various outside groups to sing carols etc. and that lots of games and activities had taken place. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 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): 18 Service users are protected from abuse. EVIDENCE: The home has the local interagency adult protection policy in place and a procedure of how to deal with witnessed or alleged abuse. A whistle blowing policy is in place should staff wish to report any incidences. There have been no reported incidences of abuse. All staff have received training in this subject. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 14 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, 21 & 22 Service users live in a safe, well-maintained environment in general but there are areas of the home that need attention. Service users have sufficient lavatories and bathing facilities. The home has sufficient adaptations and equipment to maximise their independence. EVIDENCE: The automatic fire closure doors have been fitted in the orthopaedic rehabilitation areas since the last inspection and the manager reports this has been an advantage to the service users not having to open and close heavy fire doors whilst trying to manage walking aids. The garden area has been tidied but the manager reports that it is to be landscaped and completed in the spring to comply with the requirement from the previous report. At the time of the inspection none of the service users Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 15 were inclined to use the garden or patio area. The kitchen had recently undergone some running repairs though the manager was not satisfied with the standard of work. This was discussed with the works manager from the local authority who agreed to oversee further work on the decoration of this area. The laundry was visited. The machines are fit for purpose but the cleanliness and décor of this room was poor. Behind the washing machines, which are not accessible for cleaning, there was a build-up of dust and dirt behind them. The general appearance of this room was that it was in need of cleaning thoroughly. The home was clean and homely in all other areas. The bathrooms were visited. The first floor bathroom on the orthopaedic wing, although large and well equipped, has no toilet fitted in this room, the consequence of this is that if a service user wishes to go to toilet once undressed, they have to be transported back to their own room via the lounge area on this floor. In such a situation this would compromise their privacy and dignity. The bathroom/toilet next to the office on the general rehabilitation wing can only be used as a toilet, and then if a service user is using a frame, the room is not large enough to close the door and accommodate the frame at the same time. This has been discussed with the responsible individual. This bathroom must be converted into a toilet room only to enable service users to be able to close the door. Without this bath, which was never used, the number of assisted baths/showers available would be sufficient for the stated ratio of one to eight service users. The manager reported that there are plans to create more communal areas for the general rehabilitation residents by using the existing office as a lounge/dining area, which will then be situated further down the corridor. The home has a shaft lift to the first floor, handrails around the home and ramps situated appropriately at doorways to the outside. The home has one hoist that was not in use at the time of the inspection and was being stored under the stairwell, along with unused mattresses and a Christmas tree. The inspector noted that this had a tendency to be a dumping ground for rubbish and storage area for equipment. This was discussed with the care co-ordinator and it was agreed that this area must not be used as a storage place for any inflammable materials. Requirements and recommendations will be made from the standards assessed in this section. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 16 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): 28 & 29 Service users are cared for by employees who have received training and supervision. Service users are not consistently protected by the local authority’s recruitment practices. EVIDENCE: The manager produced a training matrix that evidenced that twenty of the thirty-three in her care team have achieved NVQ level 2 and 3 training and that a number of the care coordinators are undertaking NVQ level 4 in care. The matrix also evidenced that appropriate training is being undertaken by the staff and that all mandatory training is provided. A sample of recruitment files was viewed. In the past it has been the practice of the local authority homes that the human resource (HR) department coordinate the employment procedure and that all records are maintained in the HR department. This practice is gradually changing and the homes will now provide evidence that all the required checks as stated on Schedule 2 of the Care Home Regulations, have been undertaken and that the registered manager and RI are satisfied that these have been vetted and received. The inspector viewed two personnel files for two recently employed people. One of these files contained a copy of a CRB check that had been taken up by an agency and had been accepted by the local authority, the reason being given that is was less than a year old. This was discussed with the manager, that Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 17 CRB checks are not transferable in the care industry. There is no stated or legal requirement that states the frequency of CRB checks. The manager indicated that all local authority homes were in the process of processing all CRB checks for all employees. Although the personnel files held some information there was no structured system for the inspector to be satisfied all the relevant information has been received and vetted and that the registered manager was fulfilling her duty to ensure this was in place. A requirement will be made around these findings. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 18 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): 33, 36 & 38 The home is run in the best interests of the service users. Staff are appropriately supervised. The health, safety and welfare of the service users and staff are promoted and protected, however, fire alarm tests are not consistently recorded. EVIDENCE: The home has a quality assurance system in place and audits are undertaken by both the manager and the local authority representative, who returns a copy of the monthly visits she undertakes, to the CSCI which gives account of various quality issues and standards which are reported on within this document. The manager undertakes a service user survey. The results of this are analysed and the inspector viewed the resulting report that indicated a high Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 19 degree of satisfaction with the services provided in this home. Owing to the volume of admissions and discharges in the orthopaedic rehabilitation unit, the service users are requested to complete an evaluation of their stay in the unit on their discharge and these are handed back to the manager at that time. The results of these are not analysed as the other survey, but the manager reads them and identifies any areas for improvement but in the main the service users receiving this service are very satisfied. Indeed, the inspector spoke to all of the service users in this unit and they reported an excellent service, they understood their rehabilitation programme and that they were in the unit for a limited time only and to ensure they were safe and capable of managing within their home environment. The general rehabilitation unit was accommodating six service users at the time of the inspection. All were able to mobilise around the unit freely with the aid of walking equipment. These service users were spoken to and they reported that for various reasons they had not been managing at home or their carer was not managing their care and they had been admitted to be assessed and undertake a rehabilitation programme to enable them to return home. The carer on duty reported to the inspector that she enjoyed her job and gained a great deal of job satisfaction seeing the service users improving and returning home. The inspector observed that she treated the service users with great respect. She was observed to be encouraging independence when talking through movements with a gentleman who was having difficulty in initiating mobilisation. The policies and procedures are corporate for all local authority homes and copies are maintained in the home to guide staff in their practices. The supervision of staff was discussed with the manager. She reported that the home has this in place and staff are supervised by designated senior coordinators who are key workers to a number of staff, and this includes housekeeping and catering staff, and as well as bi-monthly supervision a section meeting takes place monthly. The registered manager supervises her care co-ordinators. The professionals, who work in the orthopaedic rehabilitation unit, and who are employed by the Trust, are supervised by their own line managers within the Trust. The fire logbook was viewed. The inspector observed that the fire alarm system was not consistently recorded as being tested weekly. The care coordinator reported that they are tested weekly but there lacked evidence that this took place and a requirement will be made. The inspector viewed the hot water testing records. This evidenced that the home is testing, on a random basis, hot water taps around the home to ensure they are safe for use. Thermostats are fitted to all taps emitting hot water. The accident book was viewed and accidents are reported fully and regulations 37, the reporting of incidences to the CSCI, are received appropriately. Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 20 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 3 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X 2 3 X X X X STAFFING Standard No Score 27 X 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X 3 X 2 Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP19 Regulation 16(2)(j) Requirement The laundry room floors, walls and surfaces must be cleaned and maintained to an acceptable standard. The bathroom on the first floor general rehabilitation unit must be adapted to enable service users to use the toilet whilst accommodating any walking aids and be able to close the door when in use. An action plan of timescales for this to be complied with must be submitted to the CSCI within the stated timescales given. The registered manager is required to obtain all the necessary and stated checks for all new employees. The fire alarm must be tested at recommended intervals and records of this taking place must be recorded in the fire logbook. This was a requirement from the previous inspection report with a timescale of 31.5.05. . Timescale for action 28/02/06 2. OP21 23(2)(f) 12(4)(a) 31/03/06 3. OP29 19(1)(b) 31/03/06 4. OP38 23(4)(e) 14/02/06 Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 22 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 OP19 Good Practice Recommendations It is strongly recommended that the area under the stairwell should not be used for a storage area for equipment and unwanted items that may contain inflammable materials, which would present a fire risk and would compromise the safety of the home. It is strongly recommended that the bathroom on the first floor on the orthopaedic rehabilitation wing have a toilet fitted in this bathroom to prevent service users having to be taken back to their rooms if they wish to use the toilet before a bath. 2. OP21 Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. Extracts may not be used or reproduced without the express permission of CSCI Brownhill House DS0000039229.V276664.R01.S.doc Version 5.1 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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