Inspection on 07/06/05 for Monmouth Court Nursing Home

This inspection was carried out on 7th June 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

Monmouth Court Nursing Home 19/06/07

Monmouth Court Nursing Home 10/01/06

Monmouth Court Nursing Home 27/10/04

Monmouth Court Nursing Home 02/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Monmouth Court Nursing Home Monmouth Close Off Montgomery Road Ipswich IP2 8RS Lead Inspector Jane Higham Announced 7/8 June 2005 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 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. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Monmouth Court Nursing Home Address Monmouth Close Off Montgomery Road Ipswich Suffolk IP2 8RS 01473 685594 01473 680785 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Lorna Rose Mrs Claudette Yvonne Lyons Care Home 120 Category(ies) of OP Old Age (120) registration, with number TI Terminally Ill (120) of places PD Physical Disability (3) Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Physically disabled - aged from 50 years. General medical; Terminal Chromically Sick; Palliative Care - 3 patients Cilgerren House Date of last inspection 27/28 October 2004 Brief Description of the Service: Monmouth Court was built in 1993 and purchased by BUPA Care Homes in 1998. The home is siuated next to a pleasant park in the residential Maidenhall area of Ipswich, about two miles from the town centre. It is on a local bus route to and from Ipswich town centre and near a local parade of shops. There is ample parking to the front of the building. Monmouth Court is a modern purpose built care home and consists of four houses (Raglan House, Powys House, Cilgarren House and Harlech House), each accommodating up to 30 residents. Since the previous inspection Harlech House has been brought back into use after a period of being leased to the Ipswich PCT for the purposes of intermediate care. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Announced Inspection of Monmouth Court, a 120 bedded nursing home for older people and for people suffering from a terminal illness. The home is owned and administered by BUPA and sited within a residential area of Ipswich. This was the first inspection in the inspection year 2005/2006. The inspection took place on the 7 and 8 June 2006 over a total period of 12 hours. On the day of the inspection, the Registered Manager was unfortunately on sick leave but the inspection was facilitated by the Acting Manager, Ms. Grada Jones and the Operations Manager, Ms. Lorna Rose. Information contained within this report has been gathered from the pre-inspection questionnaire, discussions with the Acting Manager, Operations Manager, staff, residents and visitors to the home. Additionally, prior to the inspection taking place the home was provided with comment cards for distribution to both residents and relatives. Five resident and ten relative comment cards were returned and information contained within these cards has been incorporated into this report. Additionally as part of the inspection, eight resident care plans were examined as were risk and moving and handling assessments. Staffing rotas and required policies and procedures were also reviewed as part of the inspection process. What the service does well: What has improved since the last inspection? Since the previous inspection, the home has ensured that all resident rooms are now provided with carpeting. This has enhanced the attractiveness of these rooms and created a more homely and comfortable personal environment. Risk assessments in relation to the storage of mobile hoists in communal Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 6 bathrooms have now been completed and are on display and accessible to staff members. All houses have now been provided with fit-for purpose cabinets to ensure that confidential information with regard to residents is stored securely. 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. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 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 standard(s) 3 and 4 It was not clear in all cases whether a pre-admission assessment had been carried our prior to prospective residents transferring to the service. It is imperative to evidence the quality and content of pre-admission assessments in order to ensure that the needs of any resident admitted to the home will be met. Residents can be assured however that care practices are based on specialist and clinical guidance where required. EVIDENCE: As part of the inspection process the admission documentation relating to eight recently admitted residents was examined. Whilst in all cases there was evidence to confirm that individual resident’s needs had been assessed and documented on the day of their admission, only in two cases was evidence available to show that a pre-admission assessment of need had been carried out either by a named assessor, as in the case of all placements accessed via the local authority or by a senior member of the home’s nursing staff in the case of residents who are privately placed. The home was however able to evidence that it provides staff with the necessary nursing expertise to ensure that the individual needs of residents continue to be met. Additionally the home was further able to evidence that specialist services such as speech and Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 9 language therapy and physiotherapy are accessed where there are concerns around a particular resident. On the day of the inspection, a therapist from the “Stroke Club” was holding a physical activity session for residents from any of the four houses who may derive benefit from this form of exercise. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 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 standard(s) 7,8 and 10 Residents accommodated at the home can expect to be provided with a detailed plan of care which ensures that their individual needs are met. Residents can also expect that their health needs will be monitored and addressed and that they will be treated with respect. EVIDENCE: The care plans of eight residents were examined as part of the inspection process. In all cases these were found to be comprehensive and gave a clear breakdown of the individual needs of each resident and highlighted the interventions required to meet those needs. Each care plan covered a minimum of ten areas of assessed need ranging from “Maintaining a Safe Environment” to “Communication”. All care plans contained assessments in relation to moving and handling, pressure areas and nutrition. Importantly each care plan contained an outline of each resident’s daily preferences which helped to ensure that care provided was resident led. Evidence was available on each of the care plans to confirm that they were reviewed on a regular basis and were up to date. Two areas were identified in discussions with residents where a particular need had not been included in their care plan. One resident was concerned that he/she experienced pain when moving the right leg and that on occasions staff forgot that this was the case when Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 11 assisting with personal care tasks and mobility. The resident reported that this could at times cause discomfort. The relevant resident care plan did not highlight the need for care staff to exercise caution in relation to the residents leg pain when administering personal care etc. Equally one resident was seen to be using an oxygen cylinder in their room but there was no mention in the care plan about the management of this piece of apparatus and no risk assessment was apparent. One comment card received from a relative stated in their opinion staff did not always adhere to the individual needs set out in the care plan. Resident’s records confirmed that they are enabled to access community health facilities such as GP and outpatient hospital services and one resident reported that they had attended an outpatient appointment the previous day. All bedrooms within the home are for single occupancy only and therefore offer maximum privacy. Good systems are in place to ensure that residents wear their own clothing at all times. All medical examinations, including visits from GPs are carried out in the privacy of residents rooms and on the day of the inspection, staff were observed to knock on resident’s doors before entering their rooms. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 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 standard(s) 12,13,14 and 15 Residents accommodated at the home can expect to be provided with a varied range of activities by dedicated Activities Co-ordinators and can receive visitors whom they wish to see at any time convenient to themselves. The home continues to provide a high standard of meals. Certain issues in relation to resident’s choice about when and how often they use toilet facilities must be addressed. EVIDENCE: The home is to be commended on the level of activity which is provides to residents. Each of the four houses has its own Activities Co-ordinator who provides meaningful activity to residents on a day to day basis. On the day of the inspection it was noted that on residents had gathered in Harlech House to participate in a physical activity session led by a representative from the “Stroke Club”. One resident spoken to reported that they had enjoyed this session very much, particularly because the session leader gives residents more confidence in relation to their mobility. On the second day of the inspection, it was noted that one of the Activities Co-ordinators was carrying out a reminiscence quiz with residents accommodated on Raglan House. This was a lively session and appeared to be enjoyed by all who participated. The home produces a monthly activities report which evidences what activities have been provided on each house, who has participated and whether it was received well. Evidence was available to suggest that residents are also Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 13 encouraged on an individual basis to continue to enjoy hobbies and pastime. One resident, who had previously been a local artist, reported that they continued to paint in their own room and a large painting by this resident was displayed in the reception area. The home has a policy of open visiting and on the day of the inspection several relatives and friends were visiting residents. One resident was enjoying having lunch with her daughter. Whilst residents are encouraged to make choices around aspects of daily living, it was noted by the inspector that during the reminiscence quiz session, a carer was moving residents away from the activity group in their wheelchairs in order for them to use the lavatory before lunch, without asking whether this was what they wanted to do. Additionally staff were not ensuring that everyone was included in the session and some residents were positioned in their wheelchairs with their backs to others. During the two day duration of the inspection, residents were observed enjoying a leisurely breakfast and mid-day meal. Each house has a Hostess whose responsibility it is to ensure that residents enjoy their lunch. The home provides a varied and nutritious menu of meals which are served directly from a hot trolley delivered from the main kitchen. All staff on the house work together to ensure that residents are served at the same time and that assistance is given where appropriate. In addition to the main menu choices, alternatives such as salads and omelettes are available. It was noted that jugs of fruit squash are provided on the dining table and residents are able to have an alcoholic drink with their lunch if desired. On both days of the inspection, residents reported that they had enjoyed their lunch and that the standard of food was consistently good. Residents were enabled to eat their meals at their own pace in a congenial and pleasant atmosphere. Whilst feedback gained from residents on the day of the inspection in relation to the quality of meal provision was very positive, feedback from relatives and residents via feedback cards was very varied. Comments ranged from “Excellent” to “variable quality”. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 14 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 standard(s) 16 Residents accommodated at the home can expect to be provided with all required information to enable them to raise complaints and /or concerns with the service provider or the regulatory authority. Residents can rest assured that complaints will be appropriately investigated and actioned. EVIDENCE: The homes complaints procedure was on display in various locations around the building available to all residents, staff and visitors. The home was able to evidence that any complaints received are logged with a clear audit trail identifying outcomes. A monthly audit of all complaints is carried out and any themes or concerns identified. At the time of the inspection, the CSCI had received two complaints in relation to the service. Both complaints were referred to the management of the home for investigation and at the time of writing one has been appropriately addressed. The CSCI awaits the outcome of the second. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 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 standard(s) 19-26 Residents can expect to be provided with a high standard of both private and communal accommodation which is appropriate to their needs and abilities. EVIDENCE: The home consists of four separate houses each with thirty bedrooms. Additionally there is a main administration block with a reception area and office accommodation. On the day of the inspection an environmental tour was carried out which covered all four houses. Each house has a large centrally sited lounge which also incorporates a dining area and a conservatory. All lounge areas seen were furnished to a good standard and attractively decorated. Conservatories provided a very light and sunny area for residents who wanted to read or simply relax. All thirty bedrooms on each house are for single occupancy and all those seen were attractively furnished and in many cases had been made to look very personal by the occupant and their families. It was very positive to note that since the previous inspection an additional ten bedrooms had been provided with Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 16 attractive carpeting. Bedrooms benefited from low sited windows which provided residents with clear views over the garden areas. Whilst none of the bedrooms have the advantage of ensuite facilities each house is provided with four communal bathrooms equipped with both assisted bathing and showers. It was evident from inspection that specialist equipment including hoists were provided to assist people with mobility problems. One room seen had a door leading out onto the garden where the resident’s spouse had provided potted plants and a parasol and enjoyed sitting out in the garden together. Attractive garden areas were provided for the use of residents which included covered walkways. On the day of the inspection, all areas of the home were maintained to a good standard of cleanliness and hygiene. Several maintenance issues which required attention were identified. * Chipped areas on vanity units in bedrooms, exposing bare chipboard were identified. This exposes a porous surface which attracts bacteria. An audit has been carried out of all vanity units and an order has been placed for their repair where necessary. * Section of wallpaper has come away from wall in the lounge – Harlech House * Bedside light broken – Room 10 – Harlech House * Unpleasant odour identified in Room 10 – Powys House Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 Residents accommodated at the home can expect an appropriate level of staffing to ensure that their assessed needs are met and that they are provided with an adequate level of social activity. It was highlighted that residents may not always be cared for by a consistent staffing group. EVIDENCE: On the day of the inspection, the home was able to evidence that it provides an adequate level of staff to meet the individual care needs of residents. During the morning period, each house is staffed by two registered nurses and care assistants. This level decreases in the afternoon and evening period when two registered nurses and two care assistants are in attendance. During the night period each house is staffed by three members of staff, one of whom is a registered nurse. In addition to staff providing direct care to residents, each house also employs a hostess, whose responsibility it is to facilitate meals and refreshments and an activities organiser. As part of the inspection, a selection of staff personnel files were examined. These evidenced that the home has a robust recruitment procedure which includes the obtaining of two written references and clearance by the Criminal Records Bureau before any prospective member of staff commences duties. Feedback from residents was very positive in relation to the quality of staffing. One resident remarked that “ staff are lovely and nothing is too much trouble for them”. Comment cards received by both residents and relatives included feedback such as “staff treat residents with considerable care and attention”. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 18 However, comments made by residents at the time of the inspection and feedback contained in resident and relative feedback cards indicated that both parties were concerned at what they perceive to be a high staff turnover. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 37 and 38 Residents accommodated at the home can expect to live in a safe environment which is well maintained. Residents and their families will have the opportunity on a regular basis to provide feedback to the owning organisation as to the quality of services provided. EVIDENCE: The home was able to evidence that fire alarms were tested on a weekly basis and all tests recorded on the appropriate logs. The home was also able to evidence that the yearly testing of portable electrical appliances was carried out. A very organised approach was adopted to the maintenance of safety equipment. Moving and handling assessments and fall risk assessments were completed for all residents accommodated at the home. However, it was noted that due to the fact that a partially sighted resident was worried about not being able to access the call bell, care staff had tied this around her wrist. This presented a health and safety hazard and an alternative method of ensuring that the call bell is readily available to the resident must be provided. Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 20 The home produces a newsletter, a copy of which was seen at the inspection. This newsletter is for the interest of residents, relatives and friends and keeps people informed about developments and events within the home. A “Relatives Evening” was held in February of this year which as well as being a social evening provided an opportunity for people to raise any concerns they may have. The home was able to evidence that a yearly satisfaction questionnaire is provided to all residents and feedback is collated at an organisation level. Records required by regulation were referred to throughout the inspection and found to be detailed and available. Feedback cards contained very positive comments on the way in which the home is run and comments in one feedback card stated that “the home is extremely well run” Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x x x 3 2 Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 22 yes Are there any outstanding requirements from the last inspection? 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 3 Regulation 14(1) Requirement The Registered Persons must ensure that accommodation is not provided to any service user unless the needs of the prospective resdient have been assessed by a suitably qualified or suitably trained person. A copy of the assessment must be provided to the home. The Registered Person must ensure that staff must confirm with each resident that all individual care needs are included in the plan of care. The plan must also include the use of specialist equipment. The Registered Persons must ensure that residents are enabled to make decisions and choices in relation to when and how often they use lavatory facilities. The Registered Persons must ensure that areas and items requiring repair (as set out within the main body of this report) are attended to. The Registered Person must ensure that the chord of the resident call sysytem is appropriately located within Timescale for action Immediate 2. 7 15(1) Immediate 3. 14 12(2) Immediate 4. 19 23(2)(a)& (b) 01.09.05 5. 38 13(4)c Immediate Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 23 6. 38 (13(4)c 7. 26 16(2)(k) reach of resdients in a safe manner which does not consitutue a health and safety risk. The Registered Persons must ensure that a risk assessment is carried out in relation to any resident who requires the use of an oxegyn cylinder in their own room. The Registered Persons must ensure that the unpleasant odour as identified in the resident room indicated in the main body of this report is eliminated. Immediate Immediate 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 None Good Practice Recommendations Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ 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 Monmouth Court Nursing Home I54 - I04 S24449 Monmouth Court V220221 050706 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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