Inspection on 16/06/08 for Charlton Park Care Centre

This inspection was carried out on 16th June 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Charlton Park Care Centre 14/12/09

Charlton Park Care Centre 15/12/08

Charlton Park Care Centre 19/12/07

Charlton Park Care Centre 11/06/07

Charlton Park Care Centre 27/02/07

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Charlton Park Care Centre Park Farm, Off Cemetery Lane Charlton London SE7 8DZ Lead Inspector Maria Kinson Key Unannounced Inspection 16th June 2008 11:20 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Charlton Park Care Centre Address Park Farm, Off Cemetery Lane Charlton London SE7 8DZ Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8316 4400 020 8316 4422 charlton.park@fshc.co.uk Four Seasons (No 7) Limited Dr Akintunde Adesiyam Amusa Akintilo Care Home 66 Category(ies) of Dementia (34), Old age, not falling within any registration, with number other category (32) of places Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 32) 2. Dementia - Code DE (maximum number of places: 34) The maximum number of service users who can be accomodated is: 66 19th December 2007 Date of last inspection Brief Description of the Service: This home is located in Charlton, within walking distance of local bus routes and Charlton village. The home consists of a 31-bedded unit for older people that require nursing care on the ground floor and a 35-bedded unit for older people with dementia that require nursing care on the first floor. All of the bedrooms are single occupancy with a private toilet and hand washbasin. Laundry and kitchen facilities are provided on site. There is a garden at the rear of the property and 17 parking bays in the area in front of the home. The fees charged by the home range from £579.24 - £629.24 per week. This does not include additional charges such as chiropody and hairdressing. This information was supplied to the commission on 07.07.08. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection that we have carried out in this home this year. On 12/04/08 we completed a random inspection. We found that some of the concerns that we had identified during the previous inspection had not been addressed and the home was not taking adequate action to promote people’s health, safety and wellbeing. We issued a statutory enforcement notice. The report that was completed following the random inspection in April 2008 can be obtained on request. This inspection was carried out over two days and involved two inspectors. We assessed all of the key standards and assessed compliance with the enforcement notice. On 16/06/08 we spent five and a half hours in the home examining staff recruitment, money, health and safety and fire safety records. We visited all of the communal areas on both floors and sampled six bedrooms. We assessed the management of medicines on each floor and spoke with two relatives. On 22/06/08 we spent five hours in the home. We spoke with four residents, two relatives and five members of staff. We examined three sets of care records on each floor and observed staff supporting people to eat and drink and move around the home. Prior to the inspection we sent comment cards to some of the people that use, visit or work in the home to obtain their views about the service. We received five comment cards back, two from relatives, two from staff and one from a health care professional. Some of the feedback that we received about the service is included in this report. At the time of the inspection there were a number of vacant beds on both units. What the service does well: Staff carried out an assessment before people moved into the home to determine what support they required. Residents had access to community health care services. Relatives were able to visit their family members when they wanted and were able to play an active role in their family members care if they wished. People could choose where and how they spent their time and staff encouraged people to make decisions for themselves where possible. Complaints and concerns were recorded and were investigated promptly. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 6 The home was clean, tidy, and well maintained. Staffing levels were satisfactory. Staff received regular training updates and told us that senior staff were supportive and helpful. The home kept good records about peoples money and valuables. Regular checks were carried out to ensure that staff were following procedures and to improve the quality of care provided in the home. What has improved since the last inspection? What they could do better: Records did not always show what action staff were taking to minimise the risk of residents developing pressure sores. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 7 Medicines were not managed safely. We noted a variety of concerns on almost all of the charts that we checked. Staff were administering some ‘non prescription’ medicines that were not on the agreed list. The home did not obtain all of the required records or undertake adequate checks when appointing new staff. This could compromise people’s health and safety. Activities had improved but some residents did not appear to have the same level of support. People did not have an opportunity to visit places of interest in the local community. Although the home was clean and tidy there were some unpleasant odours in parts of the home. Some people would find it difficult to summon help because they did not have access to a call bell. Some health and safety checks were not carried out whilst the maintenance person was absent. 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. The summary of this inspection report can be made available in other formats on request. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff carried out a care needs assessment before people moved into the home. EVIDENCE: Before people moved into the home a senior member of staff carried out an assessment to find out what level of support the person required. Staff recorded their findings on an assessment form and this document was kept in the residents file for staff to refer to when preparing a care plan for the person. Copies of pre- admission assessments were seen in all of the files that we viewed. The assessment form included information about the person’s physical, and emotional needs, medication and health issues. Staff also obtained information about people’s social background and interests. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 10 Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care planning was becoming more person centred and work was in progress to monitor and improve record keeping practices. Access to community health care services was satisfactory and the home was starting to identify specialist link nurses. The management of medicines was poor. This could compromise people’s health and safety. EVIDENCE: We examined five sets of care records, three for people that had wounds or pressure sores, one for a person with challenging behaviour and one for a person that was at risk of becoming malnourished. Most of the records that we examined provided adequate information for staff about the support that people required and included specific information about peoples likes and dislikes. One person was able to confirm that staff were providing all of the Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 12 support that was recorded in their plan and we noted that staff were following the care plan, for some of the other people that we observed. Care records showed that staff identified concerns about people’s nutritional needs and were taking action to increase peoples food and fluid intake. Wound care records had improved overall but some record keeping issues were noted on Epsom. For example one person had developed a grade two pressure sore. The photograph of the wound showed that the surrounding skin was very red and inflamed but there was no evidence that staff had noted any changes in the persons skin integrity prior to the person developing a sore. There was a care plan to show what staff were doing to assist the wound to heal. See requirement 1. One person was assessed to be at high risk of developing pressure sores but did not have a care plan to show what action staff were taking to reduce the risk of developing a sore. Although there was no plan in place we were able to establish that staff were taking appropriate action. Staff told us that the resident was now going back to bed for a rest after lunch, the person was nursed on an air mattress and was sitting on a pressure relieving cushion and staff were monitoring and trying to increase the persons food and fluid intake. See requirement 2. The acting manager had identified some concerns about record keeping practices and was taking action to address this issue. A manager from another home was working with the acting manager and staff to resolve this issue. Staff completed pain assessment charts for some residents. A separate tool was used to identify when people with dementia or people that had difficulty communicating were in pain. This work will benefit residents. We received written feedback from one health care professional that visits the home. The person said there had been “issues with some staff in the past” but the current team of staff usually had the right skills and experience to meet people’s health care needs. Relatives that we spoke with said staff were able to meet their relative’s needs and always informed them about significant issues such as accidents and hospital visits. One person said, “Queries were now dealt with straight away”. The GP visits the home regularly and people were referred to other health care professionals if necessary. The home was in the process of identifying continence; palliative care and wound care link nurses. These members of staff will be a source of advice for the other staff that work in the home and will liaise with specialist nurses in the community. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 13 We looked at six medication charts. We noted various concerns about the management of medicines on both units. One medicine was out of stock so was not given for nine days on Goodwood. Some action was taken by staff to address this issue but we do not know at what stage staff contacted the GP, as the fax sheet was not dated. On the second chart there were two tablets missing at the end of the blister pack for one medicine. Staff said the previous months supply ran out early and they were advised by the pharmacist to use some from the new stock. This was difficult to evidence, as it was not recorded on the chart or in the care records. There were no errors on the third chart that we examined on Goodwood. On Epsom there was at least one error on all of the three charts that we examined. On one chart there was no record of receipt for one medicine, on the second chart six doses of one medicine were not accounted for and on the third chart four medicines were incorrect when the supply remaining was checked against the amount dispensed and administered. See requirement 3. Two unlabelled medicines were found in the cupboard on Epsom. Staff told us that they were received in the home on 11/06/08 and the daily care records supported this. We could not be certain what dosage or how many unlabelled tablets were received, as this information was not recorded. Staff administered one medicine that was not on the agreed homely remedy list. See requirement 4. Room numbers were written on some medication boxes. This practice is unsafe as residents could receive another person’s medication if they move rooms. This issue was identified during previous inspections on 27/02/07 and 22/04/08. See requirement 5. Failure to ensure that medicines are properly managed could result in enforcement action. Some staff had attended ‘reality’ training. This provides an insight into resident’s experiences and helped staff to understand how it felt to be left alone for periods or to receive support without an explanation about what was happening. Although staff seemed more responsive overall there were still some members of staff who did not utilize opportunities for communicating with residents and would benefit from this training. See recommendation 1. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provision of activities had improved but there was some variation in the support that people received. Relatives said they could visit at anytime and were kept informed about important issues. Work had been undertaken to improve the dining experience and to ensure that resident’s nutritional needs were met. EVIDENCE: The home employs a full-time activities co-ordinator. The activities coordinator was on leave and a temporary person was covering the post. Records of activities had improved slightly but some entries were not dated and some of the records for the people that lived on Epsom had not been completed for some months. Residents told us that in recent weeks they had played dominos, scrabble, draughts, and watched films. The records on Goodwood showed that some people had refused to take part in activities but some of the other residents joined exercise, gardening and baking groups, had hand massages and played Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 15 word search games. One resident said they liked to spend a lot of their time in the garden and said activity staff were “brilliant”. On the day of the inspection, there was musical entertainment on Goodwood and some of the residents from Epsom joined the session. A number of residents watched a film in the lounge after lunch. Some new initiatives had been introduced on Epsom. Two therapy dolls had been purchased and were proving popular with residents. Staff were setting up ‘rummage’ boxes, which will contain a variety of different items for residents to handle and discuss with staff. A supply of magazines and books were provided in the lounges. The home has its own mini bus but there was no evidence in the activity records or during discussions with residents that any outings were taking place. See recommendation 2. Relatives said they were able to visit at anytime and were always made to feel welcome. There were regular residents and relatives meetings. Relatives were encouraged to raise concerns and to provide feedback about progress with issues they had raised in the past. The care records advised staff to encourage people to make choices. Some residents chose to spend their time in their bedroom, other people said they liked to sit in the lounge or move about the home to see what was going on. Staff tried to ensure that people sat with their friends at mealtimes. Work had taken place to make the dining rooms look more welcoming. Tables were nicely laid out with fanned napkins, tablecloths, condiments and a small vase of flowers. We observed lunch on Epsom. Although there was some delay in supplying pureed diets to the units, due to a problem with the blender the arrangements for serving the meal were much more orderly. People received prompt assistance to eat and support to cut their food up if necessary. One person expressed concerns about the presentation of pureed food. The person said that sometimes, different foods such as meat and vegetables were served separately on the plate and sometimes all the food was mixed together, which in their view made the meal look “uneatable”. The manager was aware of this issue and agreed to discuss the presentation of pureed food with the Chef. Staff and relatives told us that recent staffing issues in the kitchen had led to some difficulties with “portion control” and with the supply of certain diets such as pureed food. This was not evident on the day of the inspection but was discussed with the acting manager. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People knew how to make a complaint and said their concerns were taken seriously. The home worked in partnership with other agencies to ensure that allegations of abuse were investigated and vulnerable people were protected. EVIDENCE: The complaints procedure was displayed in the main reception area and there was a summary of the procedure in the ‘Service User Guide’. Some of the rooms that we visited did not have a Service User Guide or welcome pack. See recommendation 3. The acting manager had found it difficult to establish exactly how many complaints the home had received prior to his appointment in January 2008, as some of the paperwork was not in the complaints file. We examined the complaints log for the period May to June 2008. The home had received five complaints in this period. The acting manager advised people that he had received their complaint and told them when he thought he would be able to let them know about the outcome of his investigation. Most of the concerns raised were about staff attitude and performance. There was a delay in investigating one complaint but the manager wrote to the complainant Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 17 to outline the reasons for this and apologised. The records showed that complaints were thoroughly investigated and the person that raised the concern was advised about the homes findings. Action was taken, where possible, to prevent a reoccurrence. The Commission for Social Care Inspection (CSCI) received one anonymous complaint about the service in April 2008. The provider attempted to investigate the concerns but this was difficult as the information provided was rather vague. Staff were made aware of the complaint and were advised to contact senior staff in the organisation, if they had any concerns. The home had an adult protection procedure and a copy of the local authority safeguarding procedure. Staff said they would report concerns or allegations to the manager or senior staff. Some staff had attended safeguarding training sessions in the home or studied this topic as part of their NVQ course. The acting manager advised the Commission for Social Care Inspection (CSCI) about significant events that occurred in the home such as serious accidents, allegations and deaths. Allegations and concerns were thoroughly investigated and disciplinary action was taken, if appropriate. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean, comfortable and welcoming. Some residents could have difficulty summoning assistance, as the call bell system was not properly maintained. This could compromise people’s health safety and wellbeing. EVIDENCE: The home was maintained to a satisfactory standard overall but some of the internal paintwork was scuffed and chipped and the tiles and flooring around the base of the shower on Epsom were loose. The acting manager said the reception area and dining rooms would be redecorated and the new maintenance person would address all of the outstanding issues once he had completed his induction training. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 19 The acting manager said a separate, secure garden would be created for the people that live on the first floor unit and the patio area at the rear of the home would be extended. Work was still in progress to create the new hairdressing room. Three call bell units were tested on Goodwood and on Epsom. All of the bells were working and the response from staff was good. Several call bell leads were missing on both units. This was also identified during the previous inspection and during routine checks that were carried out in the home. There was no information in the persons care plan to explain why they did not have this equipment. See requirement 6. Residents were able to bring some of their own furniture and belongings into the home if they wanted and could arrange their belongings to suit their needs. Most of the bedrooms that we visited were homely and welcoming. The home was clean and tidy and the corridors looked a little brighter following some recent redecoration work. A leak on the first floor unit had caused water damage in two rooms (27/28) on the ground floor unit. The manager and area manager told us that these rooms would not be used until the damp had dried out and the ceilings and walls were repaired and redecorated. On Epsom there was an unpleasant odour in bedroom 10 and in the toilet in room 35. The air freshener units in the corridors were empty. See recommendation 4. Hand washing facilities were provided and clinical waste was stored in lidded bins. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels were satisfactory. Staff were supported to develop new skills and to keep up to date with current practice. The home did not carry out adequate recruitment checks or ensure that staff without adequate checks were properly supervised. EVIDENCE: The acting manager had decreased the number of staff on each shift, because the home had a number of empty beds. Although there were adequate staff to meet peoples needs, the paperwork had increased for the nursing staff on Epsom, as a number of their colleagues were absent. The area manager agreed to review the staffing levels on Epsom. 42 of care staff had a National Vocational Qualification in Care (NVQ). The number of care staff with a recognised care qualification had decreased slightly since the last inspection. Four staff files were examined, but one record that was discovered to be for a staff member that no longer worked in the home was discounted. All of the remaining files were missing some documents such as one written reference, a nursing and midwifery check or a recent photograph. Two staff were working Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 21 unsupervised without an enhanced criminal record bureau (CRB) disclosure. The area manager arranged for these staff members to be supervised until their CRB disclosure was received and provided written confirmation about the action that he had taken to address this issue. See requirement 7. Two members of staff completed a comment card about the home and we spoke with five members of staff during the inspection. Staff said the training provided in the home was good and senior staff were approachable and helpful. Since the last inspection some staff had attended adult protection, leadership and assertion, fire safety, infection control, death and dying and prevention of pressure sores training sessions. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The acting manager had identified areas for improvement and was determined to raise standards in the home. There were systems in place to monitor and improve the quality of care provided in the home and to safeguard people’s money. Health and safety issues were well managed overall. EVIDENCE: An acting manager was responsible for managing the service during the Registered Manager’s absence. The acting manager had suitable qualifications and experience to mange a care home for older people and showed great enthusiasm for the role. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 23 Staff and relatives said the acting manager was approachable and was “a good listener”. Relatives told us that care practices had improved “since Mr Rowley took charge”, the staff that we spoke with echoed this view stating that team work and the standard of nursing care was getting better. We checked the personal money records for three residents. Adequate procedures were in place to safeguard resident’s money. Individual records were maintained about money given to staff for safekeeping or handed back to the resident. Receipts were kept for purchases made on the resident’s behalf and for payment of services such as chiropody and hairdressing. Fire safety arrangements were satisfactory overall but some records were not reviewed or updated as frequently as the homes procedures indicated. The fire risk assessment review was overdue and the fire alarm had not been tested for the past two weeks. The manager said there had been some recent fire drills during the night but there were no records to show when this occurred and how staff responded. The home should ensure that there are adequate systems in place to continue essential health and safety checks when the maintenance person is on leave or absent. See recommendation 5. We looked at some recent accident and incident forms. There were two different types of form in use. Some of the forms were completed properly but we could not identify which resident some of the forms related to or when some accidents had occurred due to a lack of information. Although systems had been put in place to ensure that unexplained injuries such as bruises and skin tears were investigated, staff did not always use the form that was designed for this purpose. See requirement 8. The manager had developed a tool to analyse accidents that occurred in the home. This will help staff to assess trends and take action, where possible to prevent accidents. This is good practice. We observed staff supporting people to walk and assisting people to transfer from wheelchair to a more comfortable chair in the lounge. All of the transfers that we observed were carried out in a professional and safe manner and residents were told what was happening and were reassured if necessary. The home had recently withdrawn some equipment from use due to safety concerns. Health and safety records were sampled. All of the records seen were up to date and corresponded with the information that was provided by the acting manager in the Annual Quality Assurance Assessment (AQAA) report. Hazardous substances were stored securely. Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X 3 X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X X 2 Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 12 Requirement A plan of care must be developed to show what treatment staff are providing for people with wounds. If residents are assessed to be at risk of developing pressure sores, staff must develop a care plan to show what action they are taking to minimise this risk. Adequate arrangements must be put in place for the safe management of medicines. Specifically the records maintained in the home must enable staff to account for all medicines. Repeated requirement. The previous timescale of 09/06/08 was not met. Staff must only administer medication that is prescribed by a doctor or on the homes agreed homely remedy list. The Manager must ensure that the medication procedure is effective and is followed by staff. This includes ensuring that staff are aware that they must not write room numbers on DS0000068284.V365714.R03.S.doc Timescale for action 26/08/08 2. OP7 12 26/08/08 3. OP9 13 09/09/08 4. OP9 13 09/09/08 5. OP9 13 09/09/08 Charlton Park Care Centre Version 5.2 Page 26 6. OP22 23 7. OP29 19 8. OP38 17 medication packets. Repeated requirement. The previous timescale of 09/06/08 was not met. The Registered Person must 26/08/08 ensure that the people living in the home have access to a call bell to summon help or assistance. The exception to this would be if the care plan indicated the person was not able to use the bell or the provision of such equipment would present a risk to the resident. Repeated requirement. The previous timescale of 09/06/08 was not met. Adequate information and checks 26/08/08 must be obtained and carried out before new staff are permitted to work in the home. Accurate and up-to-date records 26/08/08 must be maintained about accidents and incidents that occur in the home. 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. 3. 4. 5. Refer to Standard OP30 OP12 OP16 OP26 OP38 Good Practice Recommendations All staff should be given the opportunity to attend ‘reality training’. Residents should have an opportunity to attend outings. All residents should receive a copy of the service user guide. Action should be taken to ensure all parts of the home are free from unpleasant odours. Adequate systems should be put in place to ensure that essential health and safety checks are carried out when the maintenance person is on leave or absent. DS0000068284.V365714.R03.S.doc Version 5.2 Page 27 Charlton Park Care Centre Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Charlton Park Care Centre DS0000068284.V365714.R03.S.doc Version 5.2 Page 29 - 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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