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Inspection on 22/05/08 for Deer Park Nursing Home

Also see our care home review for Deer Park Nursing Home for more information

This inspection was carried out on 22nd May 2008.

CSCI found this care home to be providing an Adequate service.

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

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

What the care home does well

What has improved since the last inspection?

Potential new people are now assessed in more detail to ensure that the home know their needs and can plan for their care. Plans of care are now in place for all individuals who live at Deer Park. They contain good basic information about the individuals` needs and how staff are to meet these needs. One of the biggest improvements has been the introduction of activities on a regular basis. The home have employed an Occupational Therapist for two days per week. She has made a big difference in a short space of time. People were observed being engaged in activities and people were talking about things they have been doing. One person commented `` I didn`t think I could draw, but I have joined the art class and am really proud of the things I have done so far.`` Another person said `It`s really nice to have things to do and look forward to.`` The Occupational therapist is trying to do a social assessment on all individuals, to find out what they are interested in so she can gear activities around their interests. She has also tried to do some one to one work with individuals who do not like joining groups and/or prefer to spend time in their own room. The home are now looking to employ an activities co coordinator who can work with the OT to ensure that activities are available each day. This would help to ensure that individuals` social needs are well met. The home have recruited more staff and rotas and discussions with staff and people who live at the home evidence that staffing levels have improved over recent weeks. One support worker said `` it is much better now we have more staff on duty, we can give people more time and attention.`` Having consistent good staffing ratios is key to providing quality care and support. Records of maintenance and health and safety checks are now being recorded, which helps to maintain a safe environment for staff and people who live at Deer Park.

CARE HOMES FOR OLDER PEOPLE Deer Park Nursing Home Rydon Road Holsworthy North Devon EX22 6HZ Lead Inspector Jo Walsh Unannounced Inspection 09:30 22 AND 29TH May 2008 nd 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 Deer Park Nursing Home DS0000026711.V365077.R01.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. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Deer Park Nursing Home Address Rydon Road Holsworthy North Devon EX22 6HZ 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) 01409 254444 01409 254448 deerpark@rydonroad.fsbusiness.co.uk Mr Andrew Gordon Orchard Mrs Ruth Hatcher Care Home 56 Category(ies) of Old age, not falling within any other category registration, with number (56), Physical disability (56) of places Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for 56 - Adult/Elderly General Nursing Care Registered for 3 Elderly Residents Date of last inspection 13th November 2007 Brief Description of the Service: Deer Park Nursing Home is a purpose built care home situated on the edge of Holsworthy, a market town in North Devon. The home is privately owned; the Registered Manager is a qualified nurse and oversees the day-to-day management of the service. The service is currently registered to provide care for 56 people. People who use the service are provided with care that is overseen by qualified nurses. There is also access to other health services and people are escorted to attend hospital appointments when necessary. Additional health service personnel that visit the home include, the chiropodist, dentist, speech and language therapist and an audiologist. Care staff undertake activities with people at the home in the afternoons. There are regular bus trips and visiting entertainment from time to time. The minibus is also used for hospital appointments and transporting people using the day care facility. Visitors are welcome into the home at any time. Meals are cooked on site and a doctor visits the home weekly. There is a ‘ trolley - shop’ and a hairdresser comes to the home twice a week. Although the home is large, it does have a homely and comfortable atmosphere. Fees vary and range from £ 481 to £ 550. Extra costs are charged. These include: Hairdresser £4-£18, Chiropody £7 per visit, Toiletries- At cost, Newspapers and Magazines- At cost with no delivery charge. The Statement of Purpose, Service User Guide and recent inspection reports can be found in the entrance hall to the home or from the Registered manager. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 5 Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. A random inspection was carried out on the 22/03/08. The reason for this inspection was to check the home was complying with legal notices issued in respect of plans of care. We found that the home had made improvements in assessments of individuals and in the plans of care. The report for this random inspection is not made public but can made available upon request to CSCI. One area of concern highlighted during the random inspection was the low staffing levels. The Commission have received several complaints in respect of this, and as a result we asked the home to produce an improvement plan to look at how they intended to improve this and meet other requirements. The Commission met with the registered manager and provider to discuss their improvement plan and we are satisfied that action is being taken to address requirements and particularly low staffing levels. This key inspection was completed over two days and lasted approximately 10 hours. During this time 8 people who live at the home were spoken to about their experiences of living at Deer Park. Care practice was observed particularly over a lunchtime period. All staff during one shift were also spoken to, including kitchen staff. A total of 14 staff were asked for their views about how the home is run and about care practices within the home. Prior to this inspection taking place surveys were sent to people who live at the home and to a sample of staff. Their views are included in this report. Time was also spent looking at some of the key documents including assessments, plans of care, risk assessments, medication records, complaint information, staff files, training and records of monies held on behalf of people who live at the home. The registered manager was available throughout the inspection and assisted in ensuring that key documents were made available for inspection. Prior to the inspection the home completed an Annual Quality Assurance Assessment (AQAA), which gives us information about how the home maintains a safe environment, what training has been completed and tells us how they are reviewing their services to improve the care and support provided. This information helps to inform the inspection process. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? Potential new people are now assessed in more detail to ensure that the home know their needs and can plan for their care. Plans of care are now in place for all individuals who live at Deer Park. They contain good basic information about the individuals’ needs and how staff are to meet these needs. One of the biggest improvements has been the introduction of activities on a regular basis. The home have employed an Occupational Therapist for two Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 8 days per week. She has made a big difference in a short space of time. People were observed being engaged in activities and people were talking about things they have been doing. One person commented ‘’ I didn’t think I could draw, but I have joined the art class and am really proud of the things I have done so far.’’ Another person said ‘It’s really nice to have things to do and look forward to.’’ The Occupational therapist is trying to do a social assessment on all individuals, to find out what they are interested in so she can gear activities around their interests. She has also tried to do some one to one work with individuals who do not like joining groups and/or prefer to spend time in their own room. The home are now looking to employ an activities co coordinator who can work with the OT to ensure that activities are available each day. This would help to ensure that individuals’ social needs are well met. The home have recruited more staff and rotas and discussions with staff and people who live at the home evidence that staffing levels have improved over recent weeks. One support worker said ‘’ it is much better now we have more staff on duty, we can give people more time and attention.’’ Having consistent good staffing ratios is key to providing quality care and support. Records of maintenance and health and safety checks are now being recorded, which helps to maintain a safe environment for staff and people who live at Deer Park. What they could do better: Plans of care could be further enhanced by including more detail about individuals preferred routines and social histories and interests. Work has begun on this with the occupational therapist and this will greatly assist the planning of care in a more person centred way. The records of induction training should be dated so it is clear when this training has taken place. The registered manager needs to ensure that staff have opportunities via meetings, supervision and quality assurance surveys, to have their views listened to. Most of the staff spoken to and those who returned surveys said that they had become ‘’demoralised’’ during the previous six months as they had been extremely short staffed and were having to cover additional shifts with fewer staff per shift. One person said ‘’ the care for our residents was definitely compromised, and I do not want to go back to that situation again, it’s not fair on us and not fair on the residents.’’ Most staff commented that the staffing levels had increased over the previous few weeks and several said Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 9 they believed that this was because the management knew they were going to be inspected. 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. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 10 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 Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential new people benefit from a reasonable admission and assessment process, which ensures that the home can meet their needs. EVIDENCE: The assessment information for the three newest people to the home was looked at and discussed with the nursing staff. The registered manager or one of the nurses normally completes assessments. Assessments seen were more detailed than the ones we saw at the last key inspection. Some staff spoken to said that they found the assessment information useful and that usually when a new person was admitted they were given brief overview of their needs during handovers. One staff member did say that if they were off for a few days they were not always given verbal information and so time was needed to look at the assessment and care plan. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 12 One person who was new to the home was asked about whether they had been involved with the assessment prior to them coming to the home. They could not remember but said their family had discussed their needs with the Matron. Staff spoken to appeared to have a good understanding of the needs and wishes of the newer people to the home. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 13 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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals’ personal, social and health care needs are usually well met. EVIDENCE: A sample of five plans of care were looked at and discussed with the nurse team on duty. Plans are now in place for all individuals within a few days of them being at the home. When they first arrive an initial assessment and plan is put in place and this is then expanded to look at individual areas of need and how these needs are to be met. Plans are being reviewed monthly and contain risk assessments including those areas that have previously been identified during inspections, such as use of bed rails and recliner chairs, as these can be seen as a form of restraint. Health care needs are identified within the plans of care and records show what health care input has been actioned. People spoken to and those who returned surveys said that their personal and health care needs were being Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 14 met. One person commented ‘’now there is more staff we don’t have to wait so long if we call for help.’’ This was confirmed by most of the staff we spoke to. Previously staff have raised concerns about the levels of staff being very low and their concerns about trying to meet even basic care needs in a timely fashion. One support worker said ‘’ it is much better now we have more staff on duty, we can give people more time and attention.’’ Having consistent good staffing ratios is key to providing quality care and support and this has been discussed at length with the registered manager and the registered provider. The medication storage and records were seen and discussed with one of the nurses on duty. Good systems are in place for safe storage, recoding, administration and disposal of medications. One blister pack of medications did not follow the sequence of how they should be dispensed, but the right number of tablets had been administered. The nurse said this was due to the fact that the medication had come after their usual pharmacy run as it was an additional medication. There was some confusion as to which day of the blister pack they should start the medication, but records show that the right number and amount of this medication was administered. It was agreed in future they would mark the day of commencement on the blister pack. During the inspection staff were observed to treat people with respect and the atmosphere of the home appeared much calmer than on the previous inspection. People spoken to said that staff were respectful and good humour was observed between staff and people who live at the home. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 15 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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made to ensure that individuals’ social needs are being met EVIDENCE: One of the biggest improvements has been the introduction of activities on a regular basis. The home have employed an Occupational Therapist for two days per week. She has made a big difference in a short space of time. People were observed being engaged in activities and people were talking about things they have been doing. One person commented ‘’ I didn’t think I could draw, but I have joined the art class and am really proud of the things I have done so far.’’ Another person said ‘It’s really nice to have things to do and look forward to.’’ The Occupational therapist is trying to do a social assessment on all individuals, to find out what they are interested in so she can gear activities around their interests. She has also tried to do some one to one work with individuals who do not like joining groups and/or prefer to spend time in their own room. The home are now looking to employ an activities co coordinator who can work with the OT to ensure that activities are available each day. This would help to ensure that individuals’ social needs are well met. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 16 The OT said that she has been doing some dementia assessments to enable her to gear activities around individuals’ capabilities, needs and wishes. It was clear that this has been put into practice with individuals who previously have been sat for long periods with no real engagement, now being encouraged to do puzzles, take part in gentle exercises and art groups. One person showed off their art work and others said that they looked forward to activities and getting together to do things. One person had started knitting and this had become a group activity and several people were enjoying and discussing. One visiting friend said she had been made welcome and people who live at the home confirmed that visitors are welcomed at any time. One person said that they had their own phone to stay in contact with friends, and confirmed that post was brought to them unopened. The main meal of the day is served at lunchtime and was observed to be a relaxed and unhurried meal. Staff were available to assist those who needed support to eat their meals and this was done in a respectful manner. The home provides a good choice and range of meals. Comments from people who live at the home included • The food is always good • We have plenty of choice • My favourite is roasts, we normally have them twice a week. The kitchen staff confirmed that they can cater for special dietary requirements and they have a list of individuals’ likes and dislikes. They use fresh ingredients and offer a balanced diet. People who need support to eat their meals are given this support in a kind and respectful way. The registered manager said that they are looking to improve the décor of the dinning room as part of their ongoing programme of redecoration and refurbishment of the building. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 17 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of the people who live at Deer Park and the families and friends are listened to and are usually fully acted upon. EVIDENCE: A complaint from a family who have had contact with CSCI over concerns about care in the home was discussed with the registered manager. The complaint had been investigated and a response had been written to the family. We are satisfied that the complaint has been looked at and that staff training and supervision will be implemented to ensure that staff are aware of the need to provide care in a timely fashion. The Commission have received several complaints in respect of low staffing levels and this triggered a random inspection being carried out in MARCH 2008. Staffing levels were below what should be expected to fully meet the needs of people safely and in a timely fashion, however this appears to have been addressed. The registered manager has recruited more staff and can use staff from the attached domiciliary care agency if they are short staffed in an emergency. Staff are aware that should they feel that the needs of the people who live at the home is being compromised by low staffing levels again, they can make their concerns known to CSCI. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 18 Staff spoken to confirmed they have training on the protection of vulnerable people and when asked understood what might constitute abuse and what actions should be taken if abuse is suspected. Ensuring staff are trained in this is a way of keeping people safe. We looked at staff files and were satisfied that appropriate checks were being completed to ensure that people who work in the home are suitable to work with vulnerable adults. Good systems are in place to ensure that individuals’ finances are protected. The administration staff keep good records and there is a clear audit trail for individuals monies. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 19 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Deer Park provides people with a clean, homely safe and hygienic environment. EVIDENCE: Deer Park Nursing Home is a purpose built care home situated on the edge of Holsworthy, a market town in North Devon. It is a purpose built care home arranged over two floors. There is a spacious lobby / entrance hallway which is furnished to provide a pleasant and comfortable seating area for visitors and people living at the home. There are several lounge areas and a conservatory area, which has level access to the garden. Grounds were seen to be well maintained and enjoyed by people sitting outside during the fine weather. The home employs a maintenance man three days a week and use outside contractors for specialist services, such as maintaining the hoist, bath, lift, electrics, emergency lighting and the call bell system. Maintenance records for Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 20 these are detailed in information we ask the home to provide on an annual basis (Annual quality assurance assessment). Since the last inspection the registered manager has ensured that monthly records are kept on maintenance and safety checks such as the hot water. Staff also keep records of bath temperatures when they run a bath to ensure that the water is the right temperature and not a risk to people. The laundry floor is has been improved to ensure that all parts are washable and seals in the sink have been replaced. These were identified during the last key inspection as possible risks to infection control and have been dealt with within the timescales set. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff group are experienced, sufficiently trained and supported to ensure the needs of the people who live at the home are well met most of the time. EVIDENCE: Following complaints and the completion of a random inspection in March 2008 we have highlighted the need for staffing levels to be increased, so that the home could ensure all needs could be met safely. This appears to have been addressed. All care staff and nurses on duty during this inspection were spoken to and all said that staffing levels had increased over recent weeks. (See section on health and personal care) Most staff say that they are now at sufficient number per shift to ensure individuals get their care and support needs met. Several staff voiced concerns that this may not continue, and they lack confidence in management to ensure that staffing levels remain or increase. This was discussed with the registered manager and it was agreed that more team meetings are needed to keep staff informed and allow them to build confidence in the management team that their views are being listened to. Staff spoken to said that they have opportunities for training and they had covered most of the health and safety courses. There is now a clear system in place that alerts the registered manager that this key training needs to be updated. The home also now have a training coordinator who covers all three Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 22 homes owned by the provider. The trainer is available one day per fortnight to Deer Park and has set up a series of training/talks on various topics that staff are encouraged to attend and includes some specialist areas such as dementia care, palliative care. Four staff files were looked at and all had relevant checks and references in place prior to the person starting work at the home. This ensures that only people who are suitable to work with vulnerable people are employed. One file did not contain the individuals complete work history and the registered manager was reminded that this is something they should always obtain. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 23 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): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health safety and welfare of people who live at the home is now better protected but management need to ensure that staff have confidence in them and that their views are listened to. EVIDENCE: Since the last inspection the registered manager is now spending all her time at Deer Park. Previously she had been trying to provide management support to another home owned by the same provider. Some staff commented that since the registered manager has been around more things have started to improve. The registered manager herself said it had been difficult trying to support two homes and says she is now able to concentrate on making Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 24 improvements at Deer Park to ensure that they provide quality care and support consistently. Most of the staff spoken to and those who returned surveys said that they had become ‘’demoralised’’ during the previous six months as they had been extremely short staffed and were having to cover additional shifts with fewer staff per shift. One person said ‘’ the care for our residents was definitely compromised, and I do not want to go back to that situation again, it’s not fair on us and not fair on the residents.’’ Most staff commented that the staffing levels had increased over the previous few weeks and several said they believed that this was because the management knew they were going to be inspected. Staff appear to have lost confidence in the management of the home and it was suggested that the outcome of the inspection be shared with the staff team and that they be given an opportunity to say honestly how they feel, without recrimination. Some staff were very reluctant to talk openly about the management of the home, for fear of reprisal. This was discussed with the registered manager who said that she had always had an open door policy and was surprised by this. The registered manager needs to ensure that staff have opportunities via meetings, supervision and quality assurance surveys, to have their views listened to. We checked the records and actual monies held for three people and found the system to be robust, with a good audit trail. This means that individuals’ finances are safeguarded. Information provide by the home prior to the inspection shows that they have up to date policies and procedures in place for all safe working practices, staff have training in these areas to ensure both they and the people they support are safe. The registered manager said they have an up to date fire risk assessment and have recently been awarded a green light (good) by environmental health for their premises in terms of health and hygiene. Improvements have been made by the management team to ensure maintenance checks are recorded and a safe environment is maintained. They Health and Safety executive have confirmed they will not be taking any further action in respect of the incident where someone was scalded in a hot bath, and are satisfied safety measures are in place to prevent this happening again. Staff inductions caver all areas of health and safety but should be dated as to when this training is given. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 25 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 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 Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP38 Regulation 26 Requirement Where the registered provider is an individual but not in day to day charge of the care home, he shall visit the care home in accordance with the regulation. The visit should include talking to people who live there and to a sample of staff The registered manager and provider must ensure that systems are in place to ensure that staff can be confident that their views are listened to, including regular supervision. Timescale for action 30/08/08 2. OP38 21 30/08/08 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 OP7 Good Practice Recommendations The Registered manager should ensure terminology in assessments and care plans cannot be misleading or misinterpreted and clearly explains what care is needed. DS0000026711.V365077.R01.S.doc Version 5.2 Page 27 Deer Park Nursing Home 2. OP12 The Registered manager should ensure all persons are treated equally and are not ignored when they do not demand attention from staff or are quiet. 3. OP21 The Provider should consider ways of providing privacy for the toilets situated by the lounge. 4. OP7 Plans of care should contain more detail about individuals’ social history, their preferred routines, and where possible should be shared and developed with the individual and/or their family. 5. OP26 The home should use the Department of Health guide ‘Essential Steps’ to assess your current infection control management 6 OP38 Induction processes should be dated so it is clear when this has taken place. Deer Park Nursing Home DS0000026711.V365077.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Deer Park Nursing Home DS0000026711.V365077.R01.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. 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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