Inspection on 25/05/05 for Thurlston House

This inspection was carried out on 25th May 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

Thurlston House 07/11/06

Thurlston House 10/11/05

Thurlston House 16/11/04

Thurlston House 02/06/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Thurlston House Victoria Hill Road Fleet Hampshire GU13 8LG Lead Inspector Rodney Martin Unannounced 25th May 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. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Thurlston House Address Victoria Hill Road Fleet Hampshire GU13 8LG 01252 628520 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) Hampshire County Council Alice Lai-Kuen Cheang CRH 49 Category(ies) of OP Old age - 49 registration, with number DE Dementia - 15 of places Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Up to 49 male and female service users in the OP category may be accommodated at the home. Up to 15 male and female service users in the DE (E) category may be accommodated at the home. Date of last inspection 16th November 2005 Brief Description of the Service: Thurlston House is a large residential care home, managed by Hampshire County Council, which was first officially opened on 26 March 1974. The home is over two floors with all the bedrooms on the ground and first floor. There is a large garden. Thurlston House is situated within a mile of Fleet town centre. Thurlston House is able to offer care for up to forty-nine older persons, in the category OP and up to fifteen service users in the category, DE [E], for those suffering from dementia. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place between 9.45am and 4.30pm. The unit manager was available to assist the inspector in the inspection process, along with two assistant unit managers. The inspector was able to tour the building as well as speak to the staff members on duty as well as a number of residents and a surveyor from a private company, who was measuring up the kitchen for the provision of a fly screen. The inspector had a meal at lunchtime. Residents were appreciative of the care they received and although there had been complaints, these had been dealt with satisfactorily. On the day of the visit the home was accommodating forty-two residents, which included three clients on a short stay. Thurlston House has thirteen males and twenty-nine female residents. Since the last inspection the unit manager’s application for registration as the registered manager was approved. Residents are supported and encouraged in all aspects of individual health care and personal needs. What the service does well: What has improved since the last inspection? Since the last inspection, dated 16 November 2004, the provider was required to action seven matters with two recommendations that would improve the service. Two matters were met regarding keeping relevant daily information on the residents’ contact sheets and maintaining monthly reviews of the care plans; plus the home had taken steps to ensure sufficient staff are employed to meet the needs of residents. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 6 Many aspects of the physical environment has improved, following the refurbishment programme. The dining room is tastefully decorated and furnished. The care plan assessment process has been revised and encompasses more of the resident’s needs and wishes. There has been an increase in staffing hours, since the last inspection, when the home was falling quite short of the number required to meet residents’ needs. Since the last inspection two assistant unit managers have been recruited, achieving a full compliment of management team. The four assistant unit managers have been assigned to a wing each in order to improve communication and support the keyworkers that work on each wing. 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. Thurlston House H54 S34233 Thurlston House V229000 250505.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 Thurlston House H54 S34233 Thurlston House V229000 250505.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) 3,4,5 and 6 The home has a system in place to identify service users’ needs, however, the mental health needs of residents are not identified. EVIDENCE: On the day of the inspection the home was accommodating forty-two residents, which included three clients on a short stay admission, another short stay was booked from 28 May to 11 June 2005. It was noted that clients enjoy coming back to Thurlston House as a number have had multiple short stays within the home. The inspector was given access to residents’ files. All prospective service users have a care manager and as such various assessments are completed prior to admission. There was evidence that newly admitted service users had various assessments completed, including a manual handling risk assessment, as well as the care plan. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 9 The inspector spent some time discussing with the management team the admission of residents in the dementia category [DE(E)]. The unit manager wrote to a consultant psychiatrist on 10 September 2004, submitting sixteen names of residents whom the home suspected as having an age related mental health problem, including dementia and requesting a psychogeriatrician assessment. The home received a reply on 15 September 2004. In the letter the consultant wrote, “I have always felt that Thurlston House has been quite tolerant and I highly praise the care given there”. However, it was reported that the assessments have still not taken place because the question of payment has not been resolved. This is having serious implications for the home’s registration, as the sixteen residents are still being accommodated in Thurlston House. Thurlston House is only registered to accommodate up to fifteen residents with dementia and until this has been resolved should not be in a position to admit clients with a known diagnosis of dementia. All prospective service users are visited by a staff member and have the opportunity to spend some time in the home, prior to admission. Before a permanent placement is agreed, prospective service users are admitted on a trial basis to confirm that the initial assessments made are such that the home can meet their needs. As noted above, a number of residents have had previous short respite stays in the home, prior to making a decision to want to live permanently in Thurlston House. Unplanned admissions are avoided where possible. Thurlston House has undergone building alterations to convert one wing [Kennet also known as red wing] over to providing five intermediate beds and five respite beds. On the day of the inspection, the home had seven vacancies, with most of the empty beds being on red wing. The service has not been fully developed yet for providing intermediate care within the unit. Prospective service users can come for a short respite stay, if there is a vacancy. Short stay service users are assessed in the same way as permanent service users. The inspector spoke to a number of residents, both privately and also in the various lounges and dining room. The consensus of opinion was summed up by one resident who stated that they “find the staff very helpful and they have no problems or complaints”. Thurlston House H54 S34233 Thurlston House V229000 250505.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, 9 and 10 The arrangement for planning care ensures that residents’ physical needs are met. However, care plans do not currently contain adequate information for staff, regarding the mental health needs of residents. Working practices within the home ensure the promotion of privacy and independence for residents. EVIDENCE: A working file is kept in the staff handover room, with a file for each wing. The file contains the service users’ contact sheet, a manual handling risk assessment, which identified the risks and an action plan, the individual personal plan on each service user, the care plan outcome sheet and a visual pictorial chart for manual handling, depicting the service user’s capabilities. Since the last inspection the daily contact sheets for each resident have been regularly maintained, with relevant information written. The four assistant unit managers have each been allocated to one of the four wings of the building. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 11 Since the last inspection the home has updated and revised the care plan format, which includes an assessment of activities for daily living, an assessment matrix, manual handling assessment, various risk assessments and the care needs required during the morning, afternoon and night shifts. The care plans have also been reviewed on a monthly basis. From discussions with residents, staff and an inspection of the relevant files, there was evidence to demonstrate that the home is meeting service users needs. However, the home has not yet expanded the care plan to include all aspects of the care needs of those residents who have dementia. This was again discussed with the management team. The home is also reviewing and updating the main resident’s file, which previously was an individual indexed modular file containing the service user’s details held on the Social Services computer, an admission check list, reviews held on the resident, various correspondence, previous contact sheets and medicine administration sheets, financial details, a care plan agreement form from Social Services, a signed copy of the terms and conditions of residency and a photograph of the resident. The file also contained a pen picture assessment on the resident. The home operates a Nomad system. Medication is kept securely in the staff handover room and on a day-to-day basis is dispensed from a drugs trolley, which is kept in the dining room. For those residents who are accommodated upstairs, the night time medication is kept in the medical room. This was found to be secure, clean and tidy. A sample of the blister packs was found to be satisfactory. It was reported that all service users are on some form of medication. The drug administration sheets were found to be satisfactorily completed. Lockable storage is available in the service user’s room. Two albums of service users’ photographs are kept on the drugs trolley to aid in the administration of medication. Thurlston House has a medical room, which is used by the visiting chiropodist. For minor consultations, service users can see their GP in the medical room, but generally they are seen in their individual bedroom. Records indicate that residents’ health needs are met within the home. The inspector observed an assistant unit manager take post round to residents, unopened. It was also noted that residents were treated with respect and that their dignity was maintained, especially regarding personal matters . Thurlston House H54 S34233 Thurlston House V229000 250505.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 and 15 Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: The home has a regular programme of activities, which are listed and displayed on a notice board. A care assistant produces a quarterly newsletter, which contains colour photographs of recent events and lists residents’ forthcoming birthdays, staff and resident news et cetera. The home has regular bingo sessions and music and movement. Various shows have been organised. On 5 June a person is bringing various rabbits for residents to handle. Residents were observed to have freedom of movement within the home. The minutes of a residents’ meeting, held on 1 February, was on display, when eighteen residents attended. One resident told the inspector that the home had tried various activities but there had been a lack of interest shown. However, the inspector spoke with a new assistant unit manager who was an activities co-ordinator in their previous job and is planning to introduce a variety of age related activities, including those involving reminiscence. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 13 A visitors’ notice in foyer stated, “visitors welcome at all reasonable times, in accordance with Hampshire County Council no smoking policy. We thank you for not smoking during your visit within the establishment”. Residents confirmed that they could see visitors in the privacy of their room, if they wanted to or in the communal areas of the home. Thurlston House has a five-week menu and the meals were varied and well balanced. The meals tend to be mainly traditional although curry is provided as an alternative to chicken supreme, once in five weeks. The home has daily laminated menu sheets. Several residents said that, because of changes with vegetables et cetera, the menus did not always correspond to food arriving on their plate and would prefer to have the blackboard back, for the cook to write up the day’s meals. This was discussed with the management team. It was agreed that this would be taken forward. Breakfast is served from 8.30am to 9.15am. Lunch is served at 12.30pm. Although there is a main meal provided, salad is always available as an alternative. On the day of the inspection residents had honey roast ham with potato, cauliflower and peas, with jelly and blancmange for dessert. Residents, spoken to, confirmed that the quality and quantity of food provided is very good. Tea is served at 5pm. Fresh cakes are baked each day. Thurlston House H54 S34233 Thurlston House V229000 250505.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, 17 and 18 The home has a satisfactory complaints procedure, which residents feel able to use and an adult protection procedure to safeguard residents from abuse. EVIDENCE: The home has a detailed and relevant complaints procedure. Residents, spoken to, were aware of whom to complain to, should they have a need to. One resident told the inspector that they had an issue over medication, which was resolved. Thurlston House has a complaints’ book. There were twelve complaints recorded, since the last inspection. These were all in-house issues, relating to food and domestic matters. They had been resolved. One resident had voted at the general election on 5 May. The inspector spoke to a number of residents, who were not interested in exercising their right to vote. Thurlston House has the corporate Hampshire County Council and adult protection procedure, which includes a whistle blowing policy. Staff receive training in preventing and dealing with suspected abuse. There have been no incidents of abuse recorded in the home. Thurlston House H54 S34233 Thurlston House V229000 250505.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, 20, 21, 23, 24 and 25 Residents live in a clean, safe and pleasant environment, where they have individualised their bedrooms, to suit their needs. The outstanding alterations to the building, would further enhance living in the home. EVIDENCE: The home’s entrance has a welcoming appearance, which has benefited from the refurbishment programme. A smart plaque was on display detailing the name of the duty manager. The inspector was able to tour the building. However, there are still some outstanding issues, noted in previous inspection reports, with the building. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 16 The lighting on Lodden [yellow] wing is poor with the corridors dark as there is no natural sunlight that is in stark contrast to the corridor opposite [red wing] which has been refurbished, redecorated and ceiling lights installed. The side wall lights are not very bright which compounds the problem in the evening when it is dark outside. A staff member told the inspector that with the home accommodating residents with dementia, accommodated on red wing opposite, the poor light and colour scheme is not conducive for clients with dementia, as they need rooms to have good light and brighter colours. Four residents, on yellow wing, have poor eyesight. A further two residents on yellow wing had poor eyesight but following cataract operations has improved. It was noted that rooms 17 to 21 are also dark, due to a proliferation of trees. The inspector spoke to one resident in their room, and although it was a sunny day the room was dark. The resident told the inspector that the sun doesn’t shine in the room until around 4pm. However, in the winter the room is very dark and needs the light on all day. The accident book showed that several residents had fallen, on yellow wing. This had resulted in a visit to casualty. The inspector spoke to two staff members that work specifically on yellow wing. They both commented how dingy the corridor and that the wing is not particularly a nice area to work in. This wing has not been painted for some time and is in need of redecoration, as well as the provision of more suitable lighting and remedial action taken to create more light, by pruning the encroaching trees. The inspector met a surveyor from a private company, who specialise in fly screen and bird exclusion. He was measuring for the provision of a fly screen in the kitchen. There is still an outstanding requirement regarding the bathrooms on green and blue wing, upstairs. They have a glass skylight, which cannot be opened. On a sunny day, as on the day of the inspection, the bathrooms become very warm, even before there is additional heat from running hot water in the bath. Although the bathrooms have an extractor fan, they are not efficient for the room. The inspector spoke to a staff member, in the morning, who complained they were already hot, even before helping the resident to have a bath. The conservatory has been condemned by the County Council but has still not been dismantled and the proposal to provide a new conservatory erected in another part of home. The conservatory is not used and is lying empty. Thurlston House Lodge has a visitors’ room, hairdressing room, two lounges upstairs, a lounge and dining room on the ground floor and a separate lounge and dining room on red wing. There is sufficient communal space within the home but this would be furthered enhanced by residents being able to make use of a conservatory. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 17 There are sufficient bathrooms, toilets and sluice rooms to meet the needs of the residents. Residents have personalised their bedrooms and each one is provided with sufficient furniture. Only single bedrooms are provided. Suitable locks are provided on bedroom, bathroom and toilet doors. The inspector observed several residents had their bedroom door key with them. The home was clean and free from adverse smells, on the day of the inspection. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 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 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 Residents are supported by sufficient staff to ensure that their needs are met. EVIDENCE: Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 19 The manager reported that the home had gone through a rough patch with staffing, as a result of sickness, shortage of staff and down on the number of assistant unit managers. The home had recruited an administrative assistant but they had subsequently left. The home had attempted to recruit three additional care assistants but it was reported that, they had turned the post down. Thurlston House is still short of care staffing hours as well as sixty domestic hours short, which includes kitchen staff. Shortage of staff hours is met within the staff team. A new night carer is due to commence work in July 2005. The home aims to operate with five care assistants, working from 8am to 10pm, with three awake night carers. Since the last inspection, two assistant unit managers have been recruited, achieving a full compliment of four officers. Since the last inspection, much of the time the home had operated with only two assistant unit managers and the manager. This meant that they were working ‘back to back’ and had very little, if any, time to reflect on the service given and forward plan. Now that the home has a full compliment of the management team there is now an opportunity to work out roles within the team and reflect on the service provision to see if improvements can be made. This has already begun with the assistant unit managers each being assigned to a wing. The inspector spent some time viewing the staff duty rota for the week to ensure that there were sufficient staffing hours to meet the needs of the current resident group. The home is working to an agreed formula for calculating the number of staff hours required according to whether residents have high, medium or low needs. Built into the assistant unit manager’s hours is 50 of the time spent on ’the floor’. For the week of the inspection the home needed to provide 776 care hours and according to the duty rota was providing 765 hours [this assumed that half the assistant unit manager’s hours were spent with residents, although often in reality it can be far less]. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 20 Residents were complimentary about the staff that work in Thurlston House. One resident told the inspector that they “find the staff very helpful”. The inspector was able to speak freely to a number of care staff. They enjoy working in Thurlston House and have benefited from the improvements made to the building. Staff have taken on board the need to write up the contact sheets each day and told the inspector that they were now used to completing this task. Although the inspector did not look in depth at staff training [and is not inspected on this occasion] it was reported that only four carers had completed dementia training. It was also noted that one of the assistant unit managers has a background in dementia care, who indicated that more inhouse training in dementia is to be implemented. Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 21 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) these standards were not inspected on this occasion EVIDENCE: Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 x 3 3 2 x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 23 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 7 Regulation 15(1) Requirement The s mental health must be clearly detailed in the care plan to inform staff of the care required. The registered person must ensure the lighting is improved on yellow wing. A flyscreen must be provided in the kitchen. Timescale for action 31 July 2005 31.7.05 31.7.05 2. 3. 25 26 23(2)(c) 16(2)(g) 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 Good Practice Recommendations Thurlston House H54 S34233 Thurlston House V229000 250505.doc Version 1.30 Page 24 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Thurlston House H54 S34233 Thurlston House V229000 250505.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. 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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