Inspection on 03/10/06 for Newpark

This inspection was carried out on 3rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newpark 16/07/08

Newpark 31/07/07

Newpark 16/11/05

Newpark 18/04/05

Newpark 21/09/04

Newpark 13/08/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Newpark 3 Park Road Southborough Tunbridge Wells Kent TN4 0NN Lead Inspector Lynnette Gajjar Key Unannounced Inspection 3rd October 2006 09:20 Newpark DS0000041066.V308753.R01.S.doc Version 5.2 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 Newpark DS0000041066.V308753.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 Adults 18-65. 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. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newpark Address 3 Park Road Southborough Tunbridge Wells Kent TN4 0NN 01892 537717 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) gem.newpark@tiscali.coi.uk Chistlehurst Care Ltd Miss Gemma Lucy Wanstall Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2005 Brief Description of the Service: Newpark is a residential care home for 10 service users who have a learning disability. Newpark is a large semi detached house in a residential area with accommodation over three floors. It has ten single rooms, none of which have en-suite facilities. Two rooms are located in a ground floor flatlet adjoining the main building where service users occupying these live more independently. There is a telephone point fitted in two bedrooms and all rooms are fitted with a television point. The home does not have a shaft lift and all the bedrooms in the main house are located on the first and second floors. The nearest shops and other amenities such as church, pub and post office are within walking distance. There is easy access to public transport. The town of Tunbridge Wells is approximately three miles away where there are all the facilities of a large town including a main line railway station. There are gardens to the front and rear of the property, which can be used by service users. There is car parking space to the front of the house. The home’s current scale of fees range from £512.00 to £717.92 per week. The last inspection report can be located in the entrance hall next to the visitors signing in book. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the key unannounced inspection, for the year running from April 1st 2006 to March 31st 2007. The visit lasted from 09:20am until 15.20pm. New Park has 9 people in residence who have lived together for a number of years and is running with one vacancy in the more independent living flatlet. The visit was spent talking with four service users who were at the home. Due to the planned activities other residents had left for the day and were attending various day service activities. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct conversation, observation and physical responses with those living in the home followed by discussion with staff and manager, evidencing records and care plans held at the home. A tour of the house was undertaken. A number of CSCI “comment cards” (completed questionnaires) were received from 8 relatives/visitors and 1x care manager. The report also uses information provided by the manager through a detailed questionnaire. “Whenever we visit our son we are always made welcome. He is very happy at Newpark, clean and tidy. As we tend to arrive just before lunch there is always on aroma of the home cooked food. We are happy with the care our son receives” “This is an excellent home and have caring staff. (Name of service user) very happy here.” “My cousin (name of service user) has always been very happy at Newpark” What the service does well: Newpark provides a welcoming, bright, spacious home in a residential area with shops and other amenities such as church, pub and post office within walking distance The ladies and gentlemen living here feel well supported and encouraged by staff to be involved in all aspects of their daily lives to the best of their ability. Being encouraged to take part in the local community, follow personal interests through a varied social and leisurely lifestyle at a pace suitable to them Those living here through the positive interaction with staff and manager feel genuinely liked and respected. The ladies and gentlemen presented as being relaxed and comfortable with staff indicating they feel safe and secure at the home. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 6 There continues to have good relationships with other professionals and regular contact with the G.P to ensure up to date assessments, health care, guidelines and equipment is assessed and made available to promote a safe and supportive lifestyle. The ladies and gentlemen benefit from having a committed and stable staff team, promoting an open and relaxed support. What has improved since the last inspection? What they could do better: Safer access to the rear garden would be achieved through the assessment and advice from an occupational therapist regarding grab railing to stepped and slopping patio areas, highlighting edging to steps and patio and the levelling of uneven paths/ patio for those with limited and restricted mobility. Those living here would benefit from staff having clear guidelines and information regarding when to administer PRN medication, safe and separate Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 7 storage of internal and external medication and safe disposal of medication that has expired its use by dates. Staff can develop further the daily records and diaries by ensuring accurate details of the support and care given, opportunities for choices, how the person has felt, been involved etc, to reflect the guidelines and assessed plan of care. Care plans and records would be easier to track and follow by removing old and out of date information. Those living here and staff would benefit from undertaking additional training in specialist areas related to the conditions and care needs of their clients such as Epilepsy, Person Centred Care Planning, visual/hearing impairment, skin conditions and arthritis etc. Bathrooms and shower rooms are in need of more thorough deep cleaning to promote good infection control of these communal facilities. Those living here expressed how they would find the home more homely, and comfortable through the ongoing redecoration and maintenance/repairs being completed and upgrading of furnishings. 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. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The ladies and gentlemen living here and their representatives have access to the information needed in making a decision as to whether the home can best meet their needs. EVIDENCE: There have been no changes to the home’s statement of purpose since the last inspection, and this was assessed as satisfactory at that time. However the service users guide has been translated into written word and the ‘Widget’ Symbol system. One service user has a fair understanding of this system but for others it is difficult to judge if they understand this. Alternative formats such as audio cassette/CD, video/DVD, more personal photographic and pictorial object referencing was discussed, and that they would better identify with. The manager stated she would explore this further with those living here. The home is currently running with one vacancy in the semi-independent flatlet. A prospective service user had been assessed for this. The manager detailed a thorough assessment process, visits by the service user and family, leading to staying to tea and over night trial visits. However another preferred placement became available nearer to their family and the service user decided not to move in. Other service users had been involved with the visits and were ‘quite excited’ about their possible new friend moving in. There are currently no new assessments taking place. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 10 Service users have contracts in place as outlined in the standard. Wording about the allocation of rooms should be reviewed to be clearer as to why ‘I may need to change rooms’, this is ambiguous and open to misinterpretation. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Care plans, risk assessments and guidelines continue to develop to offer information to ensure consistent support by staff in meeting the individual health and social care needs. Better tracking and recording of support and care given would reduce the risk of missed information and evidence of care provided. EVIDENCE: Through discussion with the manager and assessing two current care plans and direct observation, it is clear that those living here are given full support and encouragement to maintain personal contact with health and social care professionals, to maintain good standards of health and social care. However the files are in need of clearing to remove old and out of date information that leads to duplication, potential risk of missed reviews and access to the latest information. Through the introduction of a review-tracking sheet at the front of each section this will aid monitoring, reviewing documentation and appointments. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 12 Guidelines and risk assessments continue to develop to help staff to access information that is most important and to maintain individual and collective goals safely. One care plan needs reviewing, as it did not refer to the service user’s hearing loss in their risk assessments and support strategies. This has a large impact on their support and care needs through discussion with the manager. Photographic, pictorial and object referencing in care plans would aid communication and better understanding and involvement by the ladies and gentlemen living here. Daily write ups seen showed the individuals going to day services, watching TV and cleaning their rooms on their key day. This does not reflect the actual care and support given. A more detailed summary of the care and support given and reciprocated would give a clear picture of personal choices; dignity and support needed giving a full triangulation of care. Yearly care management reviews have been undertaken. The home does not act as appointee for service users’ monies. This is done via family members or local authority financial services. Service users access the home’s petty cash for personal spending; this is collated and invoiced to their appointee monthly for reimbursement. Independent formal audits are not undertaken of personal monies. Interaction between the residents and staff continues to be good, showing genuine respect, friendship and appropriate familiarity with each other. Records seen were stored securely. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service. The ladies and gentlemen living here are given encouragement and support to make choices about a range of local social and recreational interests at a pace suitable to them. The menus and food provided offers the quality, nutritional value and healthy fresh products. Affording them the right to exercise choice and control over their diet. EVIDENCE: The ladies and gentlemen living here are able and encouraged to follow hobbies and interests of their choosing and the staff know individual personal preferences. Discussion with service users and looking at photographs reflect that a steady, though flexible routine occurs on a day - to -day basis and individuals feeling safe with this. Daily records do not support this. Routine is important for those living here. Other opportunities include; leisure outings such as the local pub as a particular favourite, having ‘lunch out’ particularly birthdays, bowling and Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 14 walks to the park. Other occasional opportunities include trips to theatre, shows; daytrips to the coast were discussed and photographed shared. Others prefer watching personal videos, TV, listening to music, puzzles and board games. Evening activities are limited, as many prefer to relax at home watching their favourite soap operas and programmes. No service users currently attend religious services. All service users have at least two planned activity days at places of education or work experience such as Pepenbury, Riverside, local social services day centre, Hadlow college pottery and community based day services, to include archery and bike riding. Personal preferences of getting up and going to bed were observed. Holidays have been taken this year, choosing to go away together in two groups of four. Discussion showed they chose Butlin’s as they like loud music and lively entertainment on offer. One service user, due to personal needs and assessment, has had more local outings. Contact with families and relatives are promoted on an individual basis, through visits to their home and short stays, telephone calls and letters. The menu offers a varied and wholesome variety of meals, with ample fresh fruit and vegetables. These are tailored to the specific that those living here like and dislike. Direct observation showed mealtimes to be at a pace comfortable to the individuals. The ladies and gentlemen are supported to be involved in write shopping lists, and be involved in the preparation and cooking of foods to the best of their ability but requiring full staff supervision and completion of the task. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health, social and personal care needs of those living here are well supported with regular contact with specialists and external professionals. Those living here are treated with genuine respect and dignity by care staff. EVIDENCE: Staff are clearly aware as to the type and nature of the support required for individual’s personal and intimate care needs. Every effort is made to maintain privacy and dignity when people are being supported with bathing, washing and dressing. Direct observation during the site visit showed personal preferences and wishes being followed. Generally good practice in relation to medication administration was observed. MAR Sheets are clearly signed with no gaps but these require clear PRN guidelines of administration to be introduced. Safer storage of internal and external medication must be reviewed, with closer monitoring of medication expiry dates and appropriate disposal of un-used medication. The staff team have been working closely with the learning disability team and Clinical Psychologist for assessment of a person living at the home who may Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 16 have developed Dementia. Good strategies have been implemented and reassessment is due soon. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Systems are in place to enable those living and those visiting the home to raise concerns or complaints with staff and people they trust, but alternative photographic/pictorial or audio formats would enhance this further. Protection from abuse has been promoted through staff training and understanding of the support and actions they may need to take. EVIDENCE: The home has a clear complaint procedure in written format that is on display in the hallway and Widget System for those living here. Due to the nature of the service and those living here, using this system is limited and alternative photographic/pictorial or audio formats should be explored with them. It is evident for the majority, that they would be heavily reliant on a relative/ advocate/staff to identify concerns and raise them on their behalf. Of the eight comment cards received from friends and relatives four stated they were unaware of the home’s compliant procedure. The home’s records indicate they have not had any formal complaints. Staff who have been spoken with evidenced a good understanding of how to protect and prevent abuse, including reporting under local procedures. A number of staff have completed training in this area since the last inspection or are due to attend next month. There are no current Adult Protection alerts regarding this home. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The ladies and gentlemen live in a generally clean, comfortable and homely environment, which would be enhanced further by the completion of decoration and refurbishment at the home and re-assessment of the garden area to make safer access and meet the assessed needs of those with restricted mobility. EVIDENCE: The responsible individual continues to fund improvements to the home with the new laundry room and conservatory. It is acknowledged that the responsible individual continues to be committed to ensuring that the home is very well furnished and maintained and is replacing furnishings slowly. Although service user did comment on something’s taking all long time, like getting the new TV and redecoration. Sofas had been replaced in the semi independent flat. The ladies and gentlemen have the use of a lounge that is comfortably furnished and has a TV, video, DVD and music centre. Two wall light fittings have been replaced leaving exposed plaster and holes in the wall, with another Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 19 still to be done. The manager was unable to confirm when this will be completed or redecorated. The kitchen has been refurbished as part of the ongoing maintenance schedule for the home. There is a large cooker; microwave, dishwasher, fridge, freezer and all were clean and tidy. Flooring has been replaced. The laundry sited off the new conservatory. There is a sink/drainer, commercial washing machine and a drier (further sluicing washing machine is available but with restricted accesses as located in the basement). There is a separate hand washbasin. There was no lockable storage space identified here for COSHH items. Individual specialist equipment in a mechanical bath seat and high raised chairs are available and assessed on individual need. Even though service users wear hearing aides the home does not have a loop system installed in communal or private accommodation. A flashing fire alarm system has been fitted to one service users bedroom. Further advice should be sought for accessing the garden. Particularly grab railing on steps leading out to the garden, painting of edges of steps, patio, grab rail to the concrete slop off the patio to grassed areas, making this valuable leisure resource safe for access by the tenants with restricted mobility. There are areas that still require attentions, such as furnishing the conservatory, refitting semi-independent flat kitchen, replacing flooring in bathrooms to promote good infection control but these have been recognised through the regulation 26 visits too and stated to be in hand. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service A staff team that receives core training and on-going support in meeting individual needs of those living at Newpark. The ladies and gentlemen living here would benefit from a full review of staffing hours and allocation to meet residential forum guidance to improve the individual’s whole quality of life. EVIDENCE: Those living here continue to benefit from having a stable staff team, who have been in post for a number of years. Giving them familiarity and consistent support. The home currently has 8 care staff (many of whom are part-time). The manager is in the process of recruiting a new staff member and existing staff is covering shifts un-allocated. It was noted that a shift remained uncovered for the weekend. Staff records seen were from previous owners but appropriate recruitment checks and procedures were done. Induction programmes are followed and signed by staff. During the weekday there is 2 staff on at peak times and 1 staff member on duty during the day when 2 service users are at home. This can be restrictive to those remaining a home and spontaneity of activities and 1:1 time such as attending medical appointments or hairdressing, as the fellow peer would have to join them. The residential forum guidance on care staffing for those with a learning disability shows that for 2 medium dependency and 7 low dependency care Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 21 needs and deducting time spent out of the home in day care and supervised by other staff = 292.15 direct care hours and 383.44 rostered hours through 10.36 full-time care staff are recommended (not including the manager or handy person). The homes current care staff rostered hours are stated by the manager to be 182 per week, through 8 Part-time care staff and additional shifts There is regular core training provided for staff, with updates being booked and attended on a rolling programme. The home currently has one staff NVQ 2 trained, a further two care staff are due to start. Supervisions have improved with an average of 5 per year. The manager continues to have two days per week where she is supernumerary on the rota and fulfils her management duties. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The ladies and gentlemen living here have their personal preferences, support and care needs encouraged through the registered managers open leadership, and the promotion of a welcoming home. EVIDENCE: The manager is with NVQ level 4 and continues to update her training through short courses. The home has built an extra visitors and laundry room. The fire officer has visited and deemed the work to be satisfactory to fire regulations. The washing machine with the sluicing facility remains in the basement. Items under COSHH are not stored securely in the laundry room. Other work identified in the previous visit has been addressed. Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 23 The ladies and gentlemen through the interaction observed appeared very comfortable and well supported by the manager. Newly appointed service manager undertakes regulation 26 visits monthly supports the manager. Monitoring health and safety in the home is to good standard, equipment serviced as required to maintain a safe home and facilities. The pre inspection questionnaire lists maintenance and associated records. Risk assessments are completed for individual’s activities but could be expanded upon. The registered manager evidenced a good understanding of accident/incident recording and reporting under regulation 37 to the Commission, with a monitoring /auditing tool will assist the manager with observing for patterns and triggers. Staff training records showed ongoing training in health and safety, food hygiene, moving and handling, care of the back, fire awareness. The manager monitors this and staff informed when refresher training is required. A full insurance certificate was on display and current. Newpark DS0000041066.V308753.R01.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 Adults 18-65 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 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 3 28 2 29 2 30 2 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 X 2 X X 2 3 Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 25 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA30 Regulation 13 (3) Timescale for action The registered person shall make 30/11/06 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. In that: 1) Communal bathroom floors are replaced. 2) Deep cleaning of bathrooms is undertaken regularly. To be completed by timescale date. The registered person shall make 31/10/06 arrangements for the safe handling, storage and disposal of medication received in to the care home: In that: 1) Regular checks are undertaken to ensure that all medication expiry dates are still in date and unused medication disposed off appropriately. 2) All external and internal; medication is stored Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 26 Requirement 2. YA20 13(2) 3. YA24 23(2) separately To be completed by timescale date. The registered person shall ensure that suitable grounds, and safe for use by, service users are provide and appropriately maintained In that: An occupational therapist assesses appropriate grab railing in the garden, flat paving and markings to steps are installed as required enhancing independence of those with restricted mobility and reduce to risk of trips and falls. To be completed by timescale date. The registered person shall ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they perform in that 50 of the care staff hold a NVQ 2. This is ongoing from previous inspections but the evidence show further staff have been supported to commence this training in coming months. To be completed by timescale date. The registered person shall ensure that unnecessary risk to the health or safety of service users is identified and so far as possible eliminated. In that: 1) Cleaning items are removed from cabinets that cannot be locked (new 30/12/06 4. YA32 18 (1) (c) 31/10/06 5. YA42 13(4) (a) 31/10/06 Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 27 laundry rooms). 2) Drinks are not stored with cleaning products. 3) A lock is fitted to the cupboard in the new laundry storing cleaning materials to comply with COSHH regulations. To be completed by timescale date. 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. 6. 7. 8. Refer to Standard YA1 YA5 YA6 YA6 YA6 YA6 YA7 YA7 Good Practice Recommendations It is recommended that the Service users guide explore alternative formats that are understood by the people it is supporting. It is recommended wording in the contract be reviewed to be clearer about when a tenant may move/change rooms. It is recommended that the care plans be made more service user friendly, in that they are in a format the service users can understand. It is strongly recommended care plan files are reviewed to archive old and obsolete information. It is recommended through the introduction of a reviewauditing sheets at the front of each section this will aid monitoring, reviewing of documentation and appointments. It is strongly recommended that daily write up are expanded upon to include evidence of choice, participation and triangulate care assessed to that actually given. It is recommended that independent audits be undertaken of service user finances and expenditure. It is recommended a full policy and procedure is introduce prior to charging for mileage to activities, ensuring clear definitions of what journeys will be charged for and those seen as part of the commissioned care. This should be agreed with all contracting authorities. It is recommended that risk assessments identified be revised to include support issues for those with a hearing impairment. DS0000041066.V308753.R01.S.doc Version 5.2 Page 28 9. YA9 Newpark 10. 11. 12. 13. 14. 15. YA20 YA20 YA22 YA24 YA24 YA24 It is strongly recommended that PRN medication has clearly written guidelines of administration. It is strongly recommended staff responsible for medication is assessed as competent at least annually. It is recommended the complaint procedure be shared with all relatives and visitors. It is strongly recommended that redecoration and refurbishment continue to be undertaken in reasonable timescales. It is very recommended that the semi-independent flat kitchen be monitored and refurbished to the same standard as the rest of the home. It is strongly recommended that an occupational therapist assesses appropriate grab railing in the garden, level paving and markings to steps are installed as required enhancing independence of those with restricted mobility. It is strongly recommended the new conservatory is finished and furnished. It is recommended advice and assessment be sought from visual and hearing specialist in relation to aides and adaptations to aide independence and personal choices. It is strongly recommended that the adapted mechanical bath seat be monitored due to the rusting and corroding of metal components, and appropriate action taken to replace this as required. It is strongly recommended staff received training in specialist areas relevant to the current service users such as hearing and visual impairment, Makaton, Epilepsy etc. It is strongly recommended care staff allocation and numbers are reviewed to residential forum recommendations for current service users dependency It is strongly recommended that action be progressed within agreed timescales to implement requirements identified in CSCI inspection reports. It is strongly recommended the manager obtains the latest amended Care Home Regulations 2006 and be familiar and develop quality review systems. 16. 17. 18. YA28 YA29 YA30 19. 20 21. 22. YA32 YA32 YA39 YA43 Newpark DS0000041066.V308753.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Newpark DS0000041066.V308753.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!