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Inspection on 14/03/06 for Eaton Court

Also see our care home review for Eaton Court for more information

This inspection was carried out on 14th March 2006.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is clean and generally well-maintained, providing residents with a homely place to live. Assessments are undertaken prior to a resident`s admission to ensure the home can meet their needs adequately. Care plans contain clear instructions regarding how individual residents personal and health care needs, are to be addressed Residents and visitors indicate that Eaton Court is a nice place to live within. A number of comments received are as follows; "I would recommended this place, the staff are great the food is good I`m a very good picker" "I`m writing to say how pleased I am with Eaton Court My Mother is extremely well settled with you and well looked after. I particularly like the number of activities organised for the residents. Thank you again for the fantastic job you are doing" "I`ve been living here for a long time now and I`m very happy with everything"

What has improved since the last inspection?

No requirements where made after the last inspection. However the one recommendation made has been address as follows Senior staff members discussed the recommendations of the Royal Pharmaceutical Society with their supplying chemist to ensure pre printed labels are no longer used upon Medication Administration records. In line with good practice guidelines any extra / short-term medication is hand written upon MAR sheets and double signed by suitable trained staff. General improvements continue to be made with regards to the up keep of the building, it was noted that the bathroom upon the first floor is nearing completion of redecoration. The activities co-ordinator and the staff team continue working together to ensure activities offered and arranged within the home are in line with resident`s wishes and desires.

What the care home could do better:

Staff members must follow policies and procedures in place within the home this includes ensuring all risks are minimised and that their desire to care for the residents is not compromised by storing prescribed creams and lotions in appropriately within toilets and bathrooms. In order to demonstrate quality assurance practices the registered owner must undertake monthly monitoring visits and submit a report of his finding to CSCI local office. Staff members must ensure that they sign review reports after they have been typed up upon the computer.

CARE HOMES FOR OLDER PEOPLE Eaton Court 128 - 130 Grove Road Wallasey Wirral CH45 OJF Lead Inspector Karen Barry Unannounced Inspection 14th March 2006 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 Eaton Court DS0000018883.V281446.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. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eaton Court Address 128 - 130 Grove Road Wallasey Wirral CH45 OJF 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) 0151 639 1093 Shadowsource Limited Janet Ann Wyn Jones Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 5th January 2006 Brief Description of the Service: Eaton Court is located in a residential area of Wirral, which is close to local shops and Liscard town centre. The local bus station provides access to other parts of the Wirral and Liverpool. The home is a large three-storey detached building that is set in its own grounds with a well-maintained garden to the rear. Accommodation is situated on three floors in both single and double rooms, six of which have en-suite facilities. Communal space within the home consists of two lounges and a large conservatory that is used as the dining area. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The staff in the home had not been told that the inspection would be taking place prior to the inspector’s arrival. The inspection took place over a period of 6 hours. The inspector examined various records relating to the care and management provided within the home, undertook a tour of the building with the deputy manager and spent time discussion experience of life within the home with a number of residents and staff members. General observations of working practices where discussed with the manager and her staff throughout the inspection. The inspector would like to thank all the residents and staff for their cooperation throughout the day. What the service does well: The home is clean and generally well-maintained, providing residents with a homely place to live. Assessments are undertaken prior to a resident’s admission to ensure the home can meet their needs adequately. Care plans contain clear instructions regarding how individual residents personal and health care needs, are to be addressed Residents and visitors indicate that Eaton Court is a nice place to live within. A number of comments received are as follows; “I would recommended this place, the staff are great the food is good I’m a very good picker” “I’m writing to say how pleased I am with Eaton Court My Mother is extremely well settled with you and well looked after. I particularly like the number of activities organised for the residents. Thank you again for the fantastic job you are doing” “I’ve been living here for a long time now and I’m very happy with everything” Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 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 Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 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. There is evidence to demonstrate that residents are assessed before moving into the home to ensure their needs can be met. EVIDENCE: The inspector was informed that arrangements where underway for a new resident to be admitted to the home the next day. Pre assessment documentation was examined which demonstrated how the deputy manager had visited the lady in hospital in order to gather relevant information regarding her present situation and identified physical and social needs. Later in the day the inspector observed the deputy making arrangements with the named social worker to ensure other essential information was agreed and received, whilst the manager gave and gathered further information from the ladies niece who had called to view the room that had been allocated. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 9 The visitor told the inspector that she had received excellent reports about the home and that when she previously visited to gather written and verbal information about services offered she had been impressed by her general feelings about the home and its staff team. Eaton Court DS0000018883.V281446.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): 7,8,9,10 & 11 Care plans provide details of individual needs. Care is provided sensitively ensuring resident’s are treated with respect and their rights to privacy are maintained. Procedures followed for managing medication within the home ensures residents receive their prescribed medication correctly. However more care is required in ensuring that prescribed creams and lotions are stored securely. EVIDENCE: Three care plans where examined, documentation seen indicated that the health and social care needs of residents were being met. Staff members on duty expressed their concerns for one of the residents who had recently become unwell. Discussions and records confirmed that professional advice and treatment was regular sought to ensure her changing needs continue to be monitored, recorded and met in an appropriate manner. The inspector also observed the manager discussing the present situation over the phone with a family member and noted that appropriate levels of reassurance and support where given alongside the factual information he was requesting. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 11 Another resident talked to the inspector about a visit he had received from his GP earlier in the day. “My eyes had been a bit sore lately, the staff suggested I seen the doctor and he’s told me I’ve got conjunctivitis, Jan is going to arrange for the chemist to deliver my prescription later today so I’m sure they soon feel better”. A number of monthly review reports had not been signed after being typed up on the computer. And on a couple of occasion’s alterations to care plans had note been dated. These matters where brought to the attention of the manager and the deputy during the inspection and found to have been minor oversights as other supporting evidence was found within daily records. Repeat prescriptions are ordered from GP surgeries on a monthly basis via the use of Medication Administration Records (MAR) that have been received from the supplying chemist with the previous months supply of medication. A random selection of medication held within the home was checked against the appropriate residents record sheet all those checked where found to be correct. It was noted that when a MAR sheet had been handwritten, for example, when a resident had been prescribed a short course of antibiotics etc these entries had been double signed in accordance with the recommendations of the Royal Pharmaceutical Society. Quantities of all medicines brought into and removed from the home appeared to be recorded correctly. During a tour of the home a number of prescribed creams and lotions where found within the downstairs toilets and bathrooms. The manager requested staff member went in to these areas and asked them to identify what could be wrong. It was noted that staff did immediately identify that they where putting other residents at risk by leaving these creams in these areas and therefore they removed them and placed them in more appropriate storage facilities within the individuals bedrooms. All residents spoken with confirmed that staff treat them with privacy and respect, and stated that they are always referred to by their preferred names. Sadly two residents have passed away since the previous inspection, which took place in early January. The manager discussed the various levels of support, care and attention that was provided for both the residents and their families in dealing with these often difficult times. Discussions relating to the implementation of polices and procedures regarding the care of dying and dealing with expected and unexpected deaths confirmed that staff members themselves are also provided with various levels of support and assistance to ensure the wishes of the resident and their families are followed. Eaton Court DS0000018883.V281446.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, 14 and 15. Residents are supported to make choices regarding their lifestyles and have opportunities to pursue a variety of suitable social activities. A good choice of meals served within pleasing surroundings assist’s residents to receive a wholesome balanced diet. EVIDENCE: The activities co-ordinator and the care staff continue to arrange a variety of in-house activities and outings on a regular basis. Records & discussions with residents and staff indicate that the recent St David’s day celebrations was a great success and that one resident in particular has been very touch by the simple gesture of providing the residents with daffodils. Arrangements are well underway to replicate this type of celebration on Friday this of this week as it is St Patrick’s day. The inspector was told that residents had been asked about changes to the menu in order to offer a traditional Irish dish of stew followed by a small glass of Guinness. Other events planned for later this year are as follows Easter Sunday ………….‘Easter bonnet parade.’ This will include resident and staff working together to design and decorate bonnets. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 13 31st May ………….‘Hawaiian party’ Craft afternoons are arranged to enable staff and residents to make various decorations such as palm trees and grass skirts. Posters are also being designed to invite the families and friends of residents and staff to this event. Its envisaged that prizes will be awarded at both events for the best bonnet and the best Hawaiian dress. Other daily and weekly activities provided within the home include Board games Bingo Sing along’s Manicures Quizzes Armchair exercises Crossword puzzles Walks within the local community One resident who spoke with the inspector confirmed that he is very happy living at the home, “the staff are great they do anything for you, the only problem is there aren’t many men living here” This resident told the inspector that he used to work in the salt mines and that he had enjoyed swimming and that he believed this form of exercise is what has helped him stay so healthy he stated he hasn’t been able to do this now for some time and advised the inspector “to make the most of everyday, as none of us will last forever” Comments regarding activities received at the home from visitors include the following; “I visit the home about 4 times a week and whenever I am there I see things being done to stimulate the residents”. “I’ve seen a number activities being organised for the resident, they are varied and provide plenty of interest & stimulation for the residents” Menus are varied to provide a wholesome balance diet, residents favourite dishes and special diets can easily be catered for. Staff encourage residents to eat together within the dining room as this can provide a great deal of social interaction however they respect residents rights to chose not to and will serve meals within residents own rooms if required. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 14 Sufficient supplies of fresh food was seen within the kitchen and staff members confirmed that these are regular replenished to take into account the requirements of the menu’s and extras are always available. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 15 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 & 18 Staff members appear to have sufficient knowledge of polices and procedures regarding protecting residents from abuse and responding appropriately to any concerns raised. EVIDENCE: Residents and their families are encouraged to raise issues and concerns directly with the staff team as quickly as possible in order to prevent any misunderstandings developing. The services of local advocates are advertised within the main hallway to ensure everyone has an opportunity to ensure their voice is heard. Also on display within the hallway is a copy of the homes complaints procedure and a variety of letters and cards that have been received from past and present residents. Residents appear to have confidence in the management teams approach in taking on board any issues or concerns raised and that the appropriate actions will be taken. Staff members have received training in adult protection during the induction process and as part of their NVQ training. This is updated by in-house training regularly. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 16 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): 19,20,21,22,23,24,25,& 26 Eaton house offers a comfortable, clean and tidy environment for residents to live in, with fixtures and fittings of a good domestic standard. Bedrooms are bright and individualised. EVIDENCE: Eaton House has two lounges and a large conservatory, which is used as the homes dining room. All communal areas were found to be free from any hazards and clutter. There are sufficient toilets and bathrooms available throughout the home to meet the needs of the residents. Specialist equipment to aid independence and safety for residents and staff was seen to be available within the home. One bathroom upon the first floor is presently out of use as it is being refitted its expected that this work will be completed shortly. Bedrooms are available on all three levels of the property. Rooms are allocated dependent upon the needs and choice of the individual resident. The fees charged reflect the differences in room allocation made. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 17 19 rooms are designed for single occupancy, 6 of these offer en-suite facilities and the further 7 rooms offer twin beds for those who may wish to share. The home was found to be clean and tidy. Decoration, repairs and replacement of fixtures and fittings is undertaken on an ongoing basis. The manager keeps records relating to inspections of the premise she undertakes herself, which highlight when any work is required, these are rechecked on a regular basis by the manager and her deputies to ensure necessary work is reported and undertaken in a satisfactory manner. The home has a well-maintained garden that the resident’s stated they enjoy sitting and walking in during the summer months. The inspector and the manager discussed how a number of armchairs within the first lounge have become worn and agreement was reached that these need to be repaired or replaced. Various forms of specialist equipment were evident within the home to aid resident’s health, safety and wellbeing. These included various hand / grab rails and turntables which aid mobility and transfers in accordance with safer handling polices and procedures. One resident is dependent upon piped oxygen various cylinders are kept close to the lady within the lounge and then later in the evening within her bedroom it is recommended that suitable signs are displayed to demonstrate to show where oxygen is stored as staff, visitors and fire personal need to be aware of the implications this may have upon the environment. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 18 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 & 30 Procedures followed for the selection and recruitment of staff are robust and provide suitable safeguards to protect residents living in the home. Staff are encouraged to undertake suitable training programmes to equip them in undertaking their duties to good effect. EVIDENCE: The core group of staff have worked at the home for a number of years, which provides continuity of care for the residents. One member of staff has left the home recently and arrangements are underway to find a suitable replacement. The inspector observed the deputy manager preparing for a meeting with a prospective employee and noted that arrangements had been made for the person to call to the home to discuss the requirements prior to an application form being submitted. This ensured the person considering applying was fully aware of what the position would entail. The management insists that all care staff at Eaton Court pursue National Vocational Qualification (NVQ) to at least level 2 to ensure residents consistently receive appropriate levels of support, care and attention from staff members who have a deep rooted understanding of their needs, experiences and aspirations. The staff spoken with said they had good opportunities to attend training courses relevant to their jobs and records seen confirmed that supervision is undertaken to aid individual’s professional and personal development within the team. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 19 3 staff files where examined these contained evidence of two references and the necessary CRB checks having been obtained before the staff member commenced duties. Certificates relating to training and qualifications undertaken prior and since employment where also kept within these files. Staff receive regular supervision and yearly appraisals in order to reflect upon their roles and responsibilities within the home. Records seen confirmed that the management team use these session to help staff members identify development and training opportunities as well as recording when good practise by the individual has been noted etc. Discussion between the manager, deputy and the inspector highlighted how dealing with poor job performances is a necessary part of their job. Records examined confirmed that when such issues had arisen steps had been taken my the management team to support staff in improving the situation as far as possible before deciding that expectations could not be met. Rotas examined confirm that residents needs are met by the skills and numbers of staff employed within the home. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 20 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): 31,32,33,35 37 & 38 An experienced manager oversees the running of the home and leads the staff team in meeting the needs and expectations of the residents and their families in her care. money held on behalf of residents is handled appropriately. EVIDENCE: The registered manager is due to complete the Registered Managers award within the next few months. She has a number of year’s experience within caring service and appears very committed to leading her staff team in a manner that ensures the home is run to meet it’s stated aims and objectives effectively. Although the manager produces regular reports highlighting issues, concerns and events that have occurred within the home, it was noted that the owner himself has not undertaken regular monthly monitoring visits in accordance Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 21 with regulation 26 of the care Home Regulations. Such visit should be recorded and a copy of the report should be submitted to CSCI local office. Although most residents over see their own financial affairs with the assistance of their families if necessary, the home does make arrangements to hold small amounts of resident’s personal allowances in order for them to have access to funds as and when they require. Monies held belonging to 2 residents was checked and these where found to be correct with appropriate records and receipts being kept. The home has a large number of policies and procedures in place to safeguard both the residents and staff a random selection of these where examined during the inspection and appeared satisfactory. Accident books were seen and appear to be well maintained and the inspector was able to confirm that the home submits significant information to the commission as and when necessary via the use of Regulation 37 forms. These forms highlight when a resident has encountered any serious injury, illness or if there has been an event occurring in the home, which could affect the safety of the residents. A random selection of service records and certificates examined relating to the safety of the building and equipment where found to be well recorded and valid. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 22 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 3 3 3 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 3 3 2 X 3 3 3 3 Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 23 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 Requirement Timescale for action 30/04/06 2 OP9OP22 13 (4a) 3 OP33 26 The registered person must ensure that prescribed creams and lotions are held & stored safely within individuals residents rooms and not in toilets and bathroom areas where they could pose a risk to residents health and well being. The registered person must 30/04/06 ensure warning signs are in place to highlight when Oxygen is stored and used by residents within their bedrooms. In accordance with guidance from Royal Pharmaceutical Society 8.1 The register person must 30/06/06 undertake regular visits to the home and record his findings with regards to the conduct of the home and forward a copy to CSCI Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 24 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 20 Good Practice Recommendations The registered person should repair or replace the armchairs within the first lounge that are becoming worn upon the armrests. Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Liverpool Local Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Eaton Court DS0000018883.V281446.R01.S.doc Version 5.1 Page 26 - 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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