Inspection on 14/09/07 for King`s Park Nursing Home

This inspection was carried out on 14th September 2007.

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

King`s Park Nursing Home 06/10/06

King`s Park Nursing Home 10/11/05

King`s Park Nursing Home 17/05/05

King`s Park Nursing Home 04/12/04

King`s Park Nursing Home 26/05/04

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

CARE HOMES FOR OLDER PEOPLE King`s Park Nursing Home King`s Road Ashton-under-Lyne Tameside OL6 8EZ Lead Inspector Joseph Kenny Unannounced Inspection 14 September 2007 09:30 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 King`s Park Nursing Home DS0000025439.V342467.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. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service King`s Park Nursing Home Address King`s Road Ashton-under-Lyne Tameside OL6 8EZ 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) 0161 343 4733 0161 343 4943 www.schealthcare.co.uk Southern Cross Healthcare Services Ltd ** Post Vacant *** Care Home 44 Category(ies) of Dementia (44), Dementia - over 65 years of age registration, with number (44) of places King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No service user under the age of 55 years to be admitted to the establishment. Over 24 hours - 2 Registered nurses The Person in Charge shall be supernumerary to the stated staffing levels and shall be a first level registered mental nurse. 6th October 2006 Date of last inspection Brief Description of the Service: Kings Park is a Care Home with Nursing that provides specialist dementia care for up to 44 service users. Kings Park is owned by Southern Cross Healthcare, which is a private limited company. Fees for accommodation and care at the home range from £465.35 to £583 per week. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. Registered nurses with both mental health and general nurse qualifications are on duty throughout the 24 hours. The home is a purpose built, two-storey building. Accommodation is provided in 36 single rooms, four of which have en-suite facilities. Four double rooms are provided for service users who wish to share. There are several lounge and dining areas on each floor. Hallways are wide ensuring that service users have plenty of room to mobilise. A keypad system ensures that potentially hazardous areas to service users are restricted. The home is situated in the Hurst Cross area of Ashton under Lyne. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out as an unannounced key inspection on 14 September 2007. The inspection started at 09:30 and finished at 17:40 hours. Two regulation inspectors conducted the inspection. The inspection looked at requirements and recommendations made at the last inspection, social and nursing care programmes, examination of records required to be held, a tour of the building and discussions with people living in the home. The opportunity was also taken to meet people visiting the home at the time of the inspection. A self assessment form referred to as the Annual Quality Assurance Assessment (AQAA) had been completed by the home and received by the Commission prior to the inspection. The records of six people being supported by the home were examined in relation to information gathered at the time of their admission, care planning and review procedures. Records relating to staff, staff training, medication records, complaints, staff rotas and health and safety records were examined. Comment cards were left at the home to be distributed to people living at the home to gain their views about the service they received. This survey was conducted at the time of a postal strike. The Commission received three completed comment cards. The home does not have a registered manager at present and temporary management cover has been put in place whilst the position of registered manager is resolved. What the service does well: Discussions were held with people living in the home, staff and visitors. A number of people commented they were happy with the support and care provided. The files examined did hold information about the assessment of the needs of people living at the home. People are provided with a contract relating to the care they receive. Visitors were made to feel welcome and commented that staff kept them informed on matters relating to personal and health care. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 6 The organisation had a clear record of the training programmes provided to each member of staff covering a range of mandatory and specialist training in topics such as abuse awareness, medication and pressure care. Staff confirmed that meetings and supervision sessions were provided on a regular basis. Policies and procedures are developed as corporate documents used within all Southern Cross health care homes. What has improved since the last inspection? What they could do better: The home’s Statement of Purpose and Service User Guide should be regularly reviewed to reflect changes in management and staffing arrangements for the home. The home must take action to appoint a manager in day-to-day charge of the home who is registered with the Commission for Social Care inspection. Programmes of social care and activities for people should be reflected in their records and on information boards around the home to evidence social care needs are being met. Care plans must be regularly monitored and reviewed to ensure information is current and support plans need to have enough detail to inform staff how to provide care. Daily records must be monitored and evidence the support offered to individuals. All care plans and risk assessments should be dated and signed by the person completing the documents. Procedures relating to informing the Commission of events affecting the wellbeing of people required reviewing to ensure information was forwarded within 24 hours of the incident. The home must regularly monitor, assess and address issues relating to the premises. A number of areas for development are identified in the premises section of this report. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 7 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. King`s Park Nursing Home DS0000025439.V342467.R01.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 King`s Park Nursing Home DS0000025439.V342467.R01.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): 1, 2 and 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place to assess people’s needs prior to admission to determine if the home can meet their needs. Information in the Statement of Purpose and Service Users Guide needs to be reviewed to ensure people receive sufficient information regarding the terms and conditions of their placement. EVIDENCE: The home uses a standard document to assist in assessing people’s needs prior to admission. Separate assessment forms are in place for short stay assessment, pre-admission assessment and dementia assessment. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 10 On the day of the inspection there were 30 people accommodated, one person was in hospital and one person being cared for was assessed as requiring personal care only. Information in the home’s Statement of Purpose and Service Users Guide required reviewing to ensure people had information on the funding arrangements for their care. Any amendments made to the funding of care must be appended to or amended on contracts and/or the statements of the terms and conditions of the placement. The contract for one private paying person had not been amended to reflect an increase in charges. The content of the statement of terms and condition of placement should be drawn up in line with Standard 2, National Minimum Standards for Older People. Information in each document also required reviewing in relation to the current management and staffing structure and training/qualifications of staff. A section of the Service User Guide required reviewing as the finance section stated it offered a pooled facility for residents. This was not correct as the home offers an online accounting service. People who are privately funded are provided with a contract and copies were seen on the day. Information is received from the placing authority initially and the manager or senior staff member will visit the person referred to complete the home’s assessment forms. This information is then used to develop programmes of support and care for the person referred. The home encourages people to visit the home prior to admission; this can take the form of a day visit, stay for a weekend, have a meal and meet staff and other people living in the home. A relative completing a comment card stated that she had received information about the home and had taken the opportunity to visit the home. Information specific to six people was case tracked to assess how information provide on admission was used to develop and deliver care appropriate to meeting assessed needs. The files of two people admitted in 2005 did not have pre-admission assessment details, however, the others had the homes preadmission assessment and care manager’s assessment. King`s Park Nursing Home DS0000025439.V342467.R01.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 adequate. This judgement has been made using available evidence including a visit to this service. Care plans identified health and personal care needs of people. Some practices did not respect people dignity. Medication records and audits of medication protected people. EVIDENCE: Care plans are drawn up to identify physical, emotional and social care needs of people. The home uses a standard corporate pre-admission assessment and dementia assessment. It was recommended that the assessment include a section to assess specific religious or cultural needs as the current form only had a small box to document these needs. This information is necessary to ensure that issues around diversity and equality are identified and responded to by the home in a more person centred approach. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 12 The files of six people were examined, looking at assessed needs and how the person’s needs were being met and recorded. It was encouraging to note that the home had identified the need to develop a more person centred approach to assessment of needs and was in the process of developing plans in a person centred way to ensure the support offered reflected the person’s preferences. Where someone was unable to contribute to this process, relatives were consulted on their behalf. A member of staff supporting a person at mealtime was seen to stand beside the person, this was brought to the attention of senior staff as it failed to respect the person’s dignity. Following admission, plans are reviewed within six weeks by the placing social worker and are then reviewed using the home’s internal review procedures. The manager in charge at the time of the inspection stated he had identified shortfalls in the care planning process and requested each unit manager to review all care plans. To assist in monitoring this process the manager intended to provide care-planning training. Each person being cared for had a named nurse and a key worker assigned to support them. Discussions were held with relatives, and there were varying comments relating to how they perceived the care provided to their relative. Some relatives said they were satisfied with the care provided whilst others commented on the need to ensure the care provided met the person’s preferences. Files contained information about the person, including a photograph, personal profile, contact details for family and health professionals. Plans were developed in sections to assess pressure care, risk assessment, dependency level, moving and handling, nutritional assessment, and continence assessment. The plan also included a social care assessment. Plans contained several body mappings, however it was reported that many were out of date. Such information should be maintained up to date to ensure information is current. Care plans required developing to ensure information was clear and detailed. Sections recorded “ensure staff are aware of identified need” and “needs assistance with feeding”, “assist with toileting needs”. There were no details as to the level of assistance required. This comment also relates to the daily records maintained by staff, some stated “safety maintained”, “hygiene needs met”. A particular plan of support for one person nursed in bed related to pressure care turning programmes. The plan required monitoring to ensure the plan was being complied with. The plan was signed on a regular basis and at King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 13 regular intervals for some days and other dates indicated limited intervention. Such programmes of support must be sustained and regularly maintained by staff. Care plans were not updated in areas relating to monitoring of weights and wound care. Wound care plans had not been reviewed in relation to the type of dressing, how often it should be renewed and length of the wound and did not reflect the current care plan. A specific instruction to staff when moving and handling one person was recorded in a monthly review report but had not been transferred to the current care plan. Plans are formally reviewed on an annual basis and at three month and six month intervals. Monthly evaluations are completed for each identified need. Care plans did contain information about the person’s general practitioner and other health professionals. Medication procedures were assessed on ground and first floor. This included audits of medication held as controlled drugs, audit of liquid medication and visual checks on the monitored dosage system against the medication administration records. A number of people are prescribed thickener used to thicken drinks where there is a swallowing impairment. The administration of thickeners was randomly maintained on medication administration records and the fluid input record did not state that drinks had been thickened. Therefore there was not an accurate record of thickened drinks given. In order to ensure that care needs are being met a record must be maintained of use of thickener in all liquids. Staff are advised to ensure thickeners are administered from prescribed containers. This comment related to use of one tin for three people used in one of the satellite kitchens. A list of staff signatures could not be found to accompany the medication records. Staff signing the medication administration records should sign using both initials. One opened bottle of liquid medication should only had 20 mls liquid remaining; there was clearly more that 20mls left. The dispensing label stated 2, 5mls twice a day but the record had been altered to 1, 5ml twice a day. There was no evidence supporting this change in dispensing. The tablet count for Warfarin for one person was incorrect in that 21 Warfarin tablets had not been carried forward, and where 4 mg should have been given the records indicate only 3 mg given. The above issues require attention to King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 14 ensure medication is being given as prescribed, and the accurate records are being maintained. Procedures were in place to record medication received by the home. Prescriptions are received by the home, checked, photocopied and then sent to pharmacy for dispensing. A record is kept of medication disposed of, however, the record should record the date when the medication is picked up for disposal. Controlled drugs are held securely and were found to be in order on the day. King`s Park Nursing Home DS0000025439.V342467.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 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans need to evidence the social needs of people are assessed and met. People should be consulted about their preferences for meals. EVIDENCE: The home was preparing to introduce the meal and menu plan system referred to as Nutmeg diet. This consists of a system to provide a nutritional, balanced menu plan based on individual dietary needs. The menu plan on display did not reflect the meal provided on the day of the inspection. One lady stated she had a nice breakfast. There is a need to ensure menu and meal arrangements evidence consultation with individual on their personal preferences. On inspection of one of the satellite kitchens, cooked meat in the fridge was not properly covered and did not have a date of opening label. This was requested to be destroyed. The microwave and dumb waiter required thorough cleaning. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 16 There is a need to ensure care plans reflect the social and leisure interests of people. Plans should record how people chose to spend their day and how staff support them to engage in social and leisure activities. The home has a designated activities organiser. The senior in charge stated that all social and leisure programmes were being reviewed to ensure people’s social and leisure interests were being met. However people using the comment cards and from discussion on the day stated there was little evidence of activities in the home. The activity board on the first did not record activities available to people. The activity coordinator was on site and was seen talking to residents. One person using the comment cards stated her relative liked visiting local shops and going on trips out and stated, “it is rare that this is done”. People spoke about a garden fund, which they contributed to with little evidence of improvement in the garden. During inspection of the grounds, the designated garden area showed little evidence of work being carried out and the area did not appear pleasant or safe to access. King`s Park Nursing Home DS0000025439.V342467.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s complaints procedure enabled people to raise concerns about the service they received. Procedures relating to protection ensure staff have the skills and knowledge to provide a safe environment to protect residents from abuse. EVIDENCE: The home has a clear procedure for dealing with complaints and concerns about the service provided. Relatives confirmed they were aware of whom to speak to. A concern for most relatives was that the person in day-to-day charge of the home changed frequently, resulting in uncertainty as to whom to contact or who would address the concern they may have raised. This issue requires addressing through the appointment of a registered manager for the home. One relative commented during the inspection, “not sure who is the manager when you come in to visit”. A register of complaints is maintained in the home. The person in charge was advised to develop procedures to evidence the complainant had been consulted to determine if they were happy with the outcome of the home’s investigation into their concern. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 18 Training records indicated that a significant number of staff had received training in the prevention of abuse, safeguarding adults procedures and whistle blowing. Training is provided through the organisation’s internal training programmes. The person in charge was advised to ensure the training referred to the Local Authority procedure and guidelines. In addition all staff should have access to and be given the opportunity to read Local Authority guidelines. In the period covering the inspection, four incidents were referred to the Safeguarding Team. During discussion with staff they demonstrated a good understanding of the correct procedures to follow in relation to protection procedures. King`s Park Nursing Home DS0000025439.V342467.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 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained and clean. However, improvements were needed to the management of malodours in some areas to provide a homely environment and some areas required repairs to maintain the safety of people. The garden requires attention to offer a safe secure area for people to access. EVIDENCE: The home is set on extensive grounds with parking and garden area to the rear of property. The home is within easy access to transport connections and shops. The home is divided into two units with a designated manager and staff team to support people. Each unit has its own communal dining and lounge areas, bedrooms, toilets and bathrooms. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 20 The home was found to be clean and well maintained. A selection of bedrooms was looked at, and they were seen to be personalised to varying degrees. Some were found to contain evidence of the person’s interests whilst others appeared bland. A high percentage of bedrooms to the side of the building did not have an outward looking view and limited natural lighting due to the mature trees growing down that side of the building. The home should investigate ways of improving the above issues for people living in these rooms. All double bedrooms continue to be used as single bedrooms. A number of bedrooms did present with a lingering malodour and the home is advised to review procedures for managing such odours in rooms. Some rooms did not appear personalised, some required new floor covering, whilst others required assessing in terms of the need for headboards and/or positioning of the bed to ensure access to the call system. Some commodes required replacing. A high percentage of doors to bedrooms did not shut into the frame or swung shut too fast. This presents a risk to people and required attention. Lounges were found to be clean, tidy and had no offensive smells. A small seating area is located on the corridor with a stereo at the end of the corridor outside the other lounge/dinging room. One of the double doors at end of corridors was bolted down and may obstruct safe evacuation if needed. Fire extinguishers are housed in distinctive red boxes, however the key to access the extinguisher was missing on those units inspected. The home is also advised to refrain from using under stairs areas for storage. The back staircase showed sign of damp damage requiring rendering and redecorating. These issues were brought to the attention of the manager. Wardrobes in rooms required fixing to the wall as some presented a risk to people and staff accessing wardrobes. A risk assessment should be conducted on all furniture fittings. Discussions were held with the person in charge regarding style of locks such as mortice locks. It was agreed that this would be replaced with a more appropriate device. Wheelchairs in two particular rooms were very stained and required a thorough cleaning. Wheelchairs did not have both footrests in place. The positioning of some beds in rooms did not allow the person to access the nurse call bell. The call system was randomly tested with a prompt response by staff. As you moved to the first level from the back stairs there was a noticeably strong malodour on the corridor. This required managing through internal domestic programmes. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 21 The garden area required developing to ensure a safe and well-maintained area is provided to people who may wish to access the area. The laundry and kitchen areas were suitably equipped and staffed. Sluices were kept locked when not in use. Staff are advised to ensure appropriate gloves and aprons are located in areas where people are supported with personal care. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 22 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. Recruitment procedures protect people who use the service. Training programmes are in place and ensure staff are competent to meet people’s assessed needs. EVIDENCE: A unit manager is assigned to each floor to oversee delivery of care and support staff. On the day of the inspection the person in charge of managing the home had recently taken up the position assisting the Project Manager, who was not on duty at the time of the visit. The indications were that the person in charge would be put forward for registration as manager of the home. A manager must be appointed and application made for them to be registered with the Commission. The duty rotas indicated appropriate staffing levels were being maintained throughout the week. Information in the homes self-assessment indicated that 60 of care staff had achieved or were working towards NVQ level II or above. A copy of the home’s training programme for all staff was received and recorded mandatory and specialist training received by staff. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 23 Information relating to staff recorded that some staff are working 60 hours per week to cover staff shortfalls. The deployment of staff for long periods required monitoring to ensure staff are able to carry out their duties effectively. Any additional shortfalls are covered by bank staff or use of agency staff. The use of agency staff is monitored and only three agency staff were used in the last month. The person in charge on the day stated the four new members of staff had been recruited subject to successful reference checks. Reference checks are conducted by the organisation’s personnel section and by the homes administrator. This includes regular checks on qualified staff to evidence PIN numbers and CRB checks are in place. In addition the NMC website is regularly checked for nurse suspension or exclusion from the register. The organisation’s personnel section conducts all overseas recruitment. Staff personnel files were examined and contained the required information relating to each person. This included application forms, reference checks, CRB checks, training information and supervision records. Records are also maintained to evidence staff meetings take place. During discussions with staff they confirmed they were regularly supported through training programmes and one to one supervision sessions. The records for people being cared for who may be verbally and physically aggressive did not set out how staff should manage this behaviour should it occur. This identifies a need to develop and support staff in management of challenging behaviour. One relative commented that “staff are very good”, but went on to say they felt the home was “severely short staffed”. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 24 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 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Health and safety arrangements ensure people live in a safe environment and people are people are consulted on their views of the service. EVIDENCE: The home is required to appoint a manager with responsibility for the day-today management of the home. A project manager from within the company is currently in post until a permanent manager is appointed. In addition a further senior member of staff had transferred to the home in the last six days. The post of manager requires addressing in order that people living in the home, relatives and staff can have some continuity and consistency in the management of the home. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 25 Relatives are encouraged to retain responsibility for all financial transactions. Information on management of resident finances is held electronically. The person in charge is advised to periodically audit records and balances of cash held on behalf of people and to monitor amounts of cash held on the premises for insurance purposes. Health and safety records confirmed that maintenance and service arrangements for equipment were in place. Issues relating to health and safety identified in the premises section of this report must be addressed to ensure residents and staff are protected. Documentation relating to maintenance and service checks were examined and found to be in order. This included electric, gas and lift service history. Appropriate Insurance Liability cover was in place. The home had completed its own internal survey of the views of residents and their representatives about the services they received. Monthly monitoring visits are conducted by the home’s operation manager on the conduct of the home. Copies of the report were available for inspection. King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 26 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 3 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X X 2 King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 27 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 OP1 Regulation 4 Requirement The Statement of Purpose and Service users Guide must be reviewed to ensure information was current Information relating to fees and funding, in the statement of terms and condition of placement, must be known to people or their representative. Care plans must set out in detail the action that needs to be taken by staff to ensure all aspects of the health, personal and social care needs of people are being met. The Commission must be informed of significant incidents within 24 hours. Medication procedures must be regularly monitored to ensure people get their prescribed medication. The registered person must ensure that residents are provided with programmes of activity and recreation that meets their preferences and capacities. DS0000025439.V342467.R01.S.doc Timescale for action 09/11/07 2 OP2 5 09/11/07 3 OP7 15 09/11/07 4 5 OP8 OP9 37 13 09/11/07 09/11/07 6 OP12 16 09/11/07 King`s Park Nursing Home Version 5.2 Page 28 7 OP19 23 8 OP27 18 Issues relating to the premises, 09/11/07 identified in the Environment section of this report must be addressed. A manager must be appointed 09/11/07 and application made for them to be registered with the Commission. 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 Refer to Standard OP3 OP8 OP8 Good Practice Recommendations Assessments should include a section to assess specific religious or cultural needs as the current form only had a small box to document what the residents was. The registered person should ensure that care plans include details about the level of assistance and support required by individuals. The registered person should ensure that staff accurately complete charts that are being used to monitor and record residents’ treatment and care. Procedures relating to the disposal of medication must be reviewed to assist in monitoring medication stocks. 4 OP9 King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 King`s Park Nursing Home DS0000025439.V342467.R01.S.doc Version 5.2 Page 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!