Inspection on 21/06/05 for Stratford Court

This inspection was carried out on 21st 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

Stratford Court 12/03/09

Stratford Court 21/02/07

Stratford Court 12/12/05

Stratford Court 02/02/05

Stratford Court 10/06/04

Stratford Court 18/12/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Stratford Court Stratford Road Salisbury Wiltshire SP1 3JH Lead Inspector Sally Walker Unannounced 21 & 23rd June 2005 st 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. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stratford Court Address Stratford Road Salisbury Wiltshire SP1 3JH 01722 328855 01722 328494 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) The Orders of St John Care Trust Mrs Caroline Jane Cooper Care Home 48 Category(ies) of DE(E) Dementia - over 65 (14) registration, with number MD(E) Mental Disorder - over 65 (6) of places OP Old Age (48) Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users who may be accommodated at any one time is 48. 2. No more than 14 service users with dementia aged 65 years and over may be accommodated at any one time. 3. No more than 6 service users aged 65 years and over with a mental disorder, excluding learning disability or dementia, may be accommodated at any one time. Date of last inspection 2nd February 2005 Brief Description of the Service: Stratford Court was originally purpose built by the local authority as a care home for up to 48 older people. The home is registered for up to 14 older people with dementia and up to 6 older people with a mental disorder. Three of the beds are offered to older people in the community for periods of respite care. The registered providers are The Orders of St John Care trust and the registered manager is Mrs Caroline Cooper. The accommodation is arranged over two floors, with additional day care facilities located on the lower floor. the home is opposite Victoria Park in Salisbury, close to the city centre. Those residents with dementia and mental disorder live alongside the other residents. The staffing rota provided 5 care staff including a care leader during the morning, 4 care staff during the afternoons and evenings and three waking night staff. The home also employs housekeepers, cooks, kitchen assistants and a handiman. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 9.35am and 5.50pm on 21st June 2005. Six residents, one relative and 2 care leaders were spoken with. Records inspected were: case records, accident log, fire log book, risk assessments, the staffing rota and the medication administration records. A tour of the building was made and come of the bedrooms visited. The inspector gave feedback to the Care Services Manager towards the end of the inspection. Mary Collier, Pharmacist Inspector carried out an inspection of the administration and control of medication on 23rd June 2005 and her comments and requirements are included in this report. What the service does well: What has improved since the last inspection? What they could do better: Staffing levels are not sufficient to allow full completion of the required documentation and administrative tasks. They do not allow regular review and revision of care plans; provide support for residents who want to go out and for sufficient support in each of the different units on both floors. Assessments of residents risk of developing pressure sores needs to be carried out together with nutritional assessments and regular weighing of residents. A policy needs to be in place with regard to male staff working with female residents. The documentation provided for pre-admission assessment does not show the Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 6 source of information or whether some statements of need or skill were witnessed, particularly with those residents who have a diagnosis of dementia and may not necessarily be able to verbalise their needs. 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. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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 Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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 Current recording systems do not support a full assessment for potential residents, particularly those residents who may have a dementia and may not be able to verbalise their current care needs. Great efforts have been made to improve the detail of assessments since receiving a complaint. EVIDENCE: Following a complaint to the home, assessments were in place for the last 3 people admitted to the home. However, the organisation’s assessment form did not necessarily allow the user to carry out a thorough assessment. There was also some confusion as to which documents should be used for this assessment. One document was a combined assessment and care plan. The layout did not allow the compiler to state the source of the information. Given that some people with dementia may not be able to verbalise their current often complex needs, information should be gained from a range of sources, including the assessor’s own observations. The dependency assessment tool only gave a number on a scale of dependency and did not give sufficient information in order to compile a care plan. The day services assessment document was very comprehensive, covering all aspects of need, albeit during the day. This document was more useful than the one provided for residential care. The recommendation that a letter of diagnosis should be obtained prior Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 9 to new residents being admitted was in progress. This document is being required by many of the organisation’s other home with a Category of dementia. One resident showed the inspector their service users guide. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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, 9 & 10 Care plans do not always direct the current care needs of residents. Most of the evidence of staff’s diligence in monitoring residents’ care and following up any concerns was in the daily reports rather than the care plans. Residents were not protected by assessment of their risk of developing pressure sores although the district nurse was involved and equipment in place. Residents’ risk of dehydration in the hot weather was well managed. Current staffing levels do not allow full and accurate recording this may put residents at risk and makes the home vulnerable. The home has satisfactory arrangements for the handling of medication, but the lack of care with cold storage and limited records for external preparations create risks to the residents. EVIDENCE: There is still some work to do in ensuring that care plans are up to date, accurate and direct the care. Mrs Cooper reported that she had set up cluster groups in order to focus staff in keeping the records up to date. The requirement to ensure that significant changes in need identified in the daily report prompted a review and revision of the care plan had not been addressed in full. Revision of the care plans varied and some changes in needs should have prompted an immediate review of the care plan with clear guidance to staff on how that need should be met. Most of the information needed was to be found in the daily report rather than in any proper plan of care. The daily Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 11 report showed good evidence that staff checked new residents medication with their GP, talked to relatives about things they were not sure of and promptly referred concerns to healthcare professionals. There was a good picture of how new residents were supported to settle into the home. Manual handling risk assessments and other assessments of risk had been carried out. Some residents had not been assessed as to any risk of developing pressure sores. The Care Services Manager reported that the organisation was developing a pressure sore risk assessment tool. It was clear that informal risk assessments had been carried out as pressure relieving mattresses, cushions and turning charts were in place for some residents, nutritional supplements were being given and the district nurse was giving advice where indicated. Staff would benefit from training in Tissue Viability. The home had purchased a set of scales where residents could sit and be weighed. Resident’s weights were not necessarily being recorded as residents moved in, nor did residents continue to be regularly weighed as required a the last inspection. Where the district nurse provided nursing treatments and kept their own records, the home was also keeping a record of any interventions, monitoring and progress, as required at the last inspection. However these records did not always give detail of where wounds were. The home was advised that body maps could be used to record wounds as well as other marks noted. Evidence suggests that current staffing levels do not support staff to complete their delegated administrative responsibilities. As a matter of good practice it was noted that the home had obtained the Department of Health guidance to care homes on caring for residents in extreme hot weather. Residents said they had been given extra cold drinks, fans were being used in communal areas and bedrooms and all residents in bedrooms were seen to have jugs of water within their reach. Mrs Cooper reported that they were asking residents if they agreed to personal care from male staff and would note their findings on the care plan. There was no policy on the provision of personal care by staff of another gender. Mrs Cooper was advised to produce an interim policy to protect residents and male staff pending the publishing of a policy from the organisation. Mrs Cooper said she was in the process of asking all residents what arrangements had made or would like to make in the event of their death and this was being recorded in the care plan. Medicines were stored in locked cupboards and trolleys in a locked clinic room. Records of medicines received and returned were maintained. The administration records were completed for all medicines except some creams. Some residents were prescribed two medicines containing paracetamol; the instructions for these should be more clearly marked on the chart. The fridge contained some items requiring cold storage. The fridge temperature had been recorded approximately weekly for many months at a temperature above that safe for the storage of medicines. The inspection took place on a warm day and the temperature read 19c. Some eye drops had not been dated on opening. Staff spoken to were keen to access further training on medication. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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 Residents had their own routines and those who were able followed their own interests. Contact with family and friends was maintained and encouraged. Although the level of activities had improved and a further 20 hours allocated for activities, some residents were not able to go out with staff support as they wished. EVIDENCE: Each resident spoken with had different daily routines; some spoke of getting up early, others having a lie in. Residents said they could have breakfast in their rooms or in the dining room. Residents said they could spend their day where they wished and there was no pressure to join in. A large group of residents made use of the sitting area at the front of the building and one resident explained their responsibility for watering the plant tubs. Resident also used this area to smoke. Residents told the inspector that staff would bring round a trolley with sweets and toiletries to purchase. One relative said they were always made welcome and kept up to date with developments in their relative’s care. They said the staff were very caring, friendly and attentive. They said their relative had put on weight since moving to the home. Residents said they enjoyed the range and quality of the food and that night staff would bring them a drink or make a snack if they were hungry during the night. Formal nutritional assessments need to be carried out with those residents who may be at risk. Where indicated, food and fluid intake needs to be monitored. Staff told the inspector about the recent celebrations Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 13 of one resident’s 100 birthday. A party was held and relative were invited together with the major and the press. Some residents told the inspector about going to a nearby supermarket cafeteria for refreshments. Two residents said they would like to go out more and another said that they did not like to do activities with children, they would prefer staff. Apparently some schoolchildren on a placement were providing some of the activities. Current care staffing levels would not support a high level of activities in the home and the community. Mrs Cooper reported that the home had been given an extra 20 staff hours for the provision of activities. There was no specific activity programme for people with dementia. Although Mrs Cooper said she had attended a seminar of art therapy for people with dementia and spoke about her plans to develop this as part of the activity programme. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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 & 18 The homes complaints procedure was made available to residents and their families. Residents said they felt confident about making comments about the service. The home is familiar with the Vulnerable Adults procedure. EVIDENCE: Residents and a relative said they could make comments or complaints to their keyworker or the manager. They said the manager regularly came to talk to them about the service. One resident showed the inspector their service users guide which contained a copy of the complaints procedure. The home works to the local policy for the Protection of Vulnerable Adults and copies of the booklet entitled “No Secrets in Swindon and Wiltshire” were available in the home. The home was the subject of a vulnerable adults investigation which was not upheld. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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, 25 & 26 The organisation is gradually improving the environment for residents with a five year plan for refurbishment. The home was visibly clean with no smells. Residents’ bedrooms were comfortable and furnished to reflect their personalities. EVIDENCE: Residents’ bedrooms are all single accommodation. Some residents showed their bedrooms and said they were pleased with the accommodation provided. A handyman deals with all minor maintenance and repairs. Environmental risk assessments had been reviewed and updated. The requirement that the cracks in the walls and ceiling of one resident’s bedroom were professionally investigated and works carried out to address the problem had been actioned, although the Commission had not been informed of the outcome. Mr Colin Titcombe, Care Services Manager, reported that the organisation’s property maintenance department had investigated the problem and deemed that the building was structurally safe and the cracks were noted to have been sealed. An action plan for the proposed replacement of one of the central heating boilers had not been received. However, the Care Services Manager reported that the function of this boiler had been investigated, works carried out and no Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 16 problems experienced in the recent cold weather. The recommendation that the old single glazed windows in the bathrooms should be replaced with modern double glazed windows was in progress. The Care Services Manager reported that they would be replaced as part of a 5-year plan for the upgrade of the building. The windows to the front of the building and all the bedrooms had been replaced. Although the toilets and bathrooms were generally clean, some of the undersides of the toilet surrounds and raised seats had brown drips marks suggesting that these supports were only cleaned on the visible surfaces. Mrs Cooper said she would address the matter with the relevant staff. The rest of the building was cleaned to a good standard and no unpleasant smells were detected. The serverys on each of the floors had been fitted with new cupboards, drawers and floor covering and the rooms redecorated. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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 & 30 Current staffing levels are insufficient to enable residents to have a good quality of care without compromising staff’s other delegated responsibilities. Residents had good relationships with staff and felt well supported. The organisation provides few training courses locally with staff having to travel more than an hour if they wish to attend. EVIDENCE: The care staffing rota showed that there was a minimum of 4 care staff and a care leader during the morning and 3 care staff and a care leader during the afternoon and evenings. There were 3 waking night staff. Mrs Cooper reported that she was nearly fully staffed with only 28 hours to fill in the current recruitment. However she reported recent difficulties in covering staff sickness. She had worked a night shift due to staff sickness and inability to get agency staff cover. She was carrying out back to work interviews with staff in order to establish reasons for the high sickness absences. The requirement that the care staff hours must be considered is in progress. The organisation has submitted a proposal which is currently being considered by the Commission. The home has been allocated 27 hours extra hours for housekeeping and 20 hours for activities. All of the residents spoken with and a relative made very positive comments on the staff. They said staff were friendly and that nothing was too much trouble. Staff said that although there was an interesting range of training supplied by the organisation, most of the venues were in the west of the county and would mean an hours journey, with few courses being offered in the Salisbury area despite there being 4 large homes in the area. Many of the staff had experience of care work and had received training in relevant subjects. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 18 Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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) 31, 33, 38 Mrs Cooper has motivated and supported staff since coming to post. She is very clear about how she wants the service to develop. The home is run in the best interests of the residents. EVIDENCE: Staff said that Mrs Cooper was very approachable and very supportive. She was very clear about how the service should be improved and developed. Mrs Cooper talked about her priorities of good care and support for residents and staff support, to develop the activity programme, staff teamwork and record keeping. The requirement that an effective quality assurance system was in place has been addressed. The organisation had attained ISO 9002. The requirement that the environmental, task and procedure risk assessments were reviewed has been actioned. Accidents were being satisfactorily recorded and significant occurrences were notified to the Commission as required by Regulation 37. The fire log book was generally well recorded, but not all staff had received fire instruction for the period January to March 2005. One care leader said that a training session had taken place recently but staff had Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 20 omitted to sign the log. The newest member of staff was not on the list. The emergency lighting had not been checked for over a month and the fire risk assessment was in need of review. Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x 3 2 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x 3 Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 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 OP 7 Regulation 15 Requirement The person registered must ensure that significant changes in need identified in the daily report prompt an immediate review and revision of the care plan with clear guidance to staff on how that need is to be met. (Not actioned in full at 21st June 2005.) The person registered must consider the numbers of care staff provided in relation to the needs of residents at all times and the aims and objectives detailed in the statement of purpose. (The organisation has submitted a proposal to the Commission which is being considered). The person registered must ensure that all residents weights are regularly monitored. (Not actioned in full at 21st June 2005). The person registered must ensure that medicines requiring cold storage are kept between 2 and 8c at all times, this must be monitored and any deviation addressed immediately. The person registered must Timescale for action 21st June 2005 2. OP 27 18(10(a) 21st June 2005 3. OP 8 17 21st June 2005 4. OP 9 13(2) 21st June 2005 5. OP 9 13(2) 23rd June Version 1.30 Page 23 Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc 6. OP 9 13(2) 7. 8. OP 8 OP 8 18(c)(i) 13(4)(c) ensure that all eye drops are dated on opening and discarded after 28 days. The person registered must ensure that the use of all medication is recorded including external preparations. The person registered must ensure that all care staff are trained in Tissue Viability. The person registered must ensure that written assessments are carried out with regard to residents risk of developing pressure sores. 2005 23rd June 2005 1st September 2005 30th September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP 9 OP 19 Good Practice Recommendations Where a resident is prescribed a choice of pain killers, the criteria for their use should be clearly marked on the administration record. The old single glazed windows bathrooms should be replaced by modern double galzed windows. (Not actioned at 21st June 2005. Reported to be included in a 5 year refurbishment plan). The assessment tool used by the day service could be adapted for use in the care home as it is more comprehensive. The assessment should state the source of the information and whether evidence was observed, particularly when potential residents may have a diagnosis of dementia and not necessarily be able to verbalise their needs. 3. OP 3 Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 24 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stratford Court D51_D01_S28322_STRATFORDCOURT_V178725_210605_STAGE4.doc Version 1.30 Page 25 - 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. 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