Inspection on 28/09/07 for Preston Park Nursing & Residential Home

This inspection was carried out on 28th September 2007.

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

Other inspections for this house

Preston Park Nursing &... 11/11/09

Preston Park Nursing &... 29/06/06

Preston Park Nursing &... 09/11/05

Preston Park Nursing &... 09/06/05

Preston Park Nursing &... 18/01/05

Preston Park Nursing &... 27/07/04

Preston Park Nursing &... 09/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Preston Park Nursing & Residential Home Preston Road Yeovil Somerset BA20 2EF Lead Inspector Justine Button Unannounced Inspection 24th 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 Preston Park Nursing & Residential Home DS0000003281.V349084.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. Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Preston Park Nursing & Residential Home Address Preston Road Yeovil Somerset BA20 2EF 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) 01935 474023 01935 431727 Somerset Care Limited Ms Janice Anne Passmore Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Elderly persons of either sex, not less than 60 years, who require general nursing care. Up to 9 places for personal care. Registered for a maximum of 30 `nursing` clients. Date of last inspection Brief Description of the Service: Preston Park House is a ham stone listed building with a two-storey extension and an attached bungalow. Behind the home are attractive private gardens. Preston Park is situated near the centre of Yeovil, with local amenities of a pub, post office and shops within walking distance. The home offers general nursing care for up to 30 people and personal care for up to 33 people in total. The home provides day care for personal care for up to 6 people per day. The Day Care service does not need to be registered. Accommodation is in single rooms with double rooms available should couples move in to the home and wish to share. Somerset Care Limited, operate the home. Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out the inspection over 8 hours on one day. The Registered Manager provided the Commission with the required preinspection information about the home and surveys were sent to service users, relatives and visiting professionals. This information has been included in the relevant areas of the report. On the day of the inspection 29 people were living in the home. An additional person was in hospital receiving treatment. The current fee rates are: £532 for nursing care. Free Nursing Care payments are charged in addition to the nursing fees. This is detailed in the home’s Statement of Purpose. The inspector spent time during the visit observing care and daily life at Preston Park, toured the building and spoke to staff, service users, relatives and a visiting professional. A range of records was inspected and the care of a selection of individuals examined in detail. Throughout the visit the atmosphere in the home was calm and relaxed. Staff interactions with service users were respectful, clear and appropriate. The activities organiser was available and spent some time during the afternoon engaging service users in social activities and conversation. Feedback received during the visit and through the surveys was positive about the home, including comments such as “staff respect my decisions and let me choose what I want” and ‘they care for me well’. The Registered Manager, Ms Passmore, was available throughout the inspection and was given feedback at the end of the day. The inspector would like to thank the service users and staff for their welcome and assistance during the inspection. What the service does well: Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 6 The home provides detailed information about the home that is made available before a person chooses to move into Preston Park Care plans contain sufficient details for staff to provide the care needed and all are regularly reviewed. Medication is well managed and minimises risks to service users. Bedrooms are pleasant and personalised and the dementia care floor has been refurbished to reflect the needs of people living there. Service users benefit from a committed staff team who provide a good standard of care in relaxed and friendly surroundings. Staff are provided with a range of training and exceed the standard for numbers of NVQ qualified staff. Meals are wholesome and provided in homely and unhurried surroundings. The home is well managed and organised. A service user comment received stated ‘I am looked after well’. What has improved since the last inspection? At the last inspection one requirement was made with regard to the medication. This requirement has been met. The service carries out a Seeking Your Views audit/survey twice a year. The home responds to any comments made and keep the outcomes and responses to any queries in the foyer of the Home for all to access. They also have an open door management style and hold residents and relatives meetings. As a result of these systems the management team and staff have have varied the menues; altered the mealtimes; improved showering facilities and enhanced the garden space for all to access. Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 7 What they could do better: Feedback was given to the manager at the end of the inspection. Service users would benefit from the further development of the care plans that better reflect a person-centred approach to care. Some areas may also need review to take account of the Mental Capacity Act 2005; this would include decisions about resuscitation and end of life care. The involvement of service users or their representatives in the care planning and review process could be widened. The home need to consider widening the range of snacks for those people on specialist diets or for those who have swallowing difficulties and cannot eat biscuits and cakes. Staffing levels were also raised as an issue via the feedback from people living at the home. The duty rota’s were seen. These did not show any shortfalls in the minimum staffing levels required however staffing levels were not compared to the dependency needs of the people living at the home by the inspector. The management need to ensure that the staffing levels are such that all needs are met. Accidents are audited, however, the audit does not include times that the accident occurred. This would be useful to ensure that any patterns in falls or incidents are identified and remedial action taken. A number of people had charts in the room on which staff documents the care given. These had been completed inconsistently despite appropriate care and support being provided by staff. Charts should be used to monitor and influence the care being provided. If the charts are not being completed consistently by staff it is difficult to understand how this process is completed. This was discussed with the manager at the end of the inspection who agreed to review the usage of charts and to ensure that those in place were completed accurately. Please contact the provider for advice of actions taken in response to this Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 8 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. Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 9 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 Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 10 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, 3, 4, 5. Standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families are provided with sufficient information to make a choice about moving into the home. All service users are appropriately assessed before moving in to ensure that they home can meet their needs. Service users benefit from living in a service, which meets their individual needs. EVIDENCE: Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 11 The home has a comprehensive written Statement of Purpose and Service User Guide. Both these documents are written in the corporate style but have been adjusted to reflect the particular service at Preston Park. Both have recently been updated and provide all the relevant information. The home encourages people to visit the home before making any decision and move in on a trial basis of 4 weeks. Feedback from people living at the home confirmed that they had received enough information prior to moving to the service. All service users are assessed prior to moving into the home to ensure that their needs can be met. This information was seen on the files examined during the inspection. The home is an older style building which has sufficient equipment and employs adequate numbers of appropriately trained staff to provide the service detailed in the Statement of Purpose. Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 12 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. Care plans are sufficiently detailed to provided staff with the necessary information to deliver the care and support needed. Service users would benefit from the further development of the care plans to reflect a person-centred approach. Service users can be assured that their healthcare needs will be met through visiting professional input and regular monitoring by staff. Medication procedures and storage are well managed. Staff provide care and support that is respectful and sensitive to the needs of the individual. Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 13 EVIDENCE: 4 care plans were examined in detail and compared with the care observed during the inspection. Each of the plans seen had a range of assessments and all the plan had been reviewed the care plans. All files contained information about reviews held with relevant professionals. All service users had nutrition assessments and all records examined showed that services users had either gained weight or remained stable. Supplements are provided where required and recorded on the Medication Administration Record. All service users had pressure risk assessments and appropriate plans. These plans included the detail of which type of hoist, sling and air mattress ito be used, where indicated. The home currently supports a number of people who are frail and as such nursed in bed. The inspector visited these people at intervals throughout the inspection. All people seen had a regular change of position and were help by staff to have regular fluids. A number of people had charts in the room on which staff documents the care given. These had been completed inconsistently despite appropriate care and support being provided by staff. Charts should be used to monitor and influence the care being provided. If the charts are not being completed consistently by staff it is difficult to understand how this process is completed. This was discussed with the manager at the end of the inspection who agreed to review the usage of charts and to ensure that those in place were completed accurately. All people observed in both the communal areas of the home and those nursed in bed appeared to be clean comfortable and well kempt. Oral hygiene had been completed as toothbrushes and toothpaste had recently been used. The plans contained some details with regard to the individuals likes and dislikes. They would benefit, however, from continued development to more accurately reflect the uniqueness of the individuals, for example life histories were not seen in all the plans viewed. Generally plans contained sufficient detail to enable staff to provide an appropriate level of care. Staff spoken to understood the needs of the service user group and the care observed was consistent with the care plans seen. In two of the plans seen relatives had given signed consent for the use of bed rails for individuals living at the home. This document should be reviewed to Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 14 take account of the new legislation, the Mental Capacity Act 2005, to ensure that the individual’s wishes are accounted for and sought wherever possible. The files examined confirmed that relevant healthcare professionals were involved with service users. People living at the home confirmed that they have regular access to healthcare professionals including GP when required. The medication records were sampled and the storage arrangements were inspected. These were in line with good practise guidelines. The clinical room was clean and tidy and administration and returned medication records and storage temperature records were well maintained and reflected best practice. Some blood bottles were found to be out of date. This was raised as an issue with the manager who immediately removed them from use. Creams seen in rooms had been dated on opening and the administration was recorded. Prescribed nutritional supplements were also recorded when given. None of the service users currently manage their own medication. All staff seen and heard were respectful and spoke appropriately to service users. Help was provided promptly and discreetly in a kindly manner. The feedback received from people living at the home confirmed that they received the care they need and all comments received during the visit were complimentary about the staff attitudes. The outcome from the survey completed by the home states that 95 of people living at the home felt that they were treated well. 91 of people felt that the home met their needs. People at the home stated that the home respects decisions, communicates well and meets personal care needs whilst maintaining dignity. Preston Park Nursing & Residential Home DS0000003281.V349084.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. Service users benefit from a flexible routine and social opportunities both in and outside of the home. Visitors are welcomed into the home and service users are supported to maintain contact with the local community. The opportunities for choice and control have increased and systems are being developed to support this further. Meals provided are wholesome and reflect the preferences and needs of service users. EVIDENCE: During the inspection people spoken to stated that there were always things to do if you wanted to take part. The activities organiser had obvious enthusiasm Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 16 for his role. During the morning of the inspection a number of people were supported by staff to play bingo. This appeared to be enjoyed by those who chose to participate. Staff respected the decision of those people who did not want to play. The activities for the week were on display in the foyer. This included the homes shop on a Monday morning, quizzes, and a trip to the fleet air arm, darts, board games, cookery, arts and crafts, hairdressing and a trip to the local shops. The atmosphere was calm and friendly throughout the home and visitors spoken to felt welcomed. Feedback from one person stated that the home is ‘welcoming to visitors’. The mealtime experience was good. All dining areas were clean and pleasant set with tablecloths and small flower vases. Menus were displayed. People spoken to stated that the food was always of an excellent standard. People during the inspection stated that there was always a choice of meal available. People living at the home told the inspector “food is excellent. There is always plenty of it and it is always hot. Staff ask you in the morning what you would like but if you change your mind it does not matter as they will always get you what you want” Choices of drinks were available and jugs of water were available in all bedrooms. Lunchtime was relaxed and unhurried and those who needed it were helped discreetly. Biscuits were available and homemade cake is offered in the afternoon. The cook had a good knowledge of service user preferences and was able to offer the soft and vegetarian diets needed and fresh fruit. Consideration should be given to providing snacks that are suited to people needing a soft diet who cannot manage biscuits. The kitchen was clean and all required records were completed. The home has a set menu that is altered to reflect the preferences of the service user group, who the cook stated enjoyed traditional home cooking. The home runs a “keyworker” system and all those spoken to during the inspection were ware who their keyworker was. One person at the home described how “her keyworker” had recently supported her on a shopping trip to town to buy some new clothes. People spoken to stated that their preferences were met by staff as much as possible. One person described that she rang the bell in the morning when she wanted to get up, this was usually after her morning cup of tea. Staff supported her in the evening, as they know that she liked to go to bed in time to watch “the soaps”. Preston Park Nursing & Residential Home DS0000003281.V349084.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. Service users and relatives can be assured that complaints are acted upon Robust systems are in place to ensure that service users are protected from the risk of abuse. EVIDENCE: The home has clear policies for whistle blowing (staff disclosures), safeguarding and complaints. The complaints procedure is detailed in the Statement of Purpose, Service User Guide and displayed in the entrance to the home. CSCI have not received any complaints regarding the home since the last inspection. The home’s complaints file was examined and no recent complaints have been received by the home. The recruitment procedure is robust and staff do not start work until a POVA 1st check/Enhanced CRB check is received – staff files were seen to confirm this. Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 18 Feedback from people living at the home confirmed that they knew how to make a complaint. All stated that they would feel comfortable to discuss any issues or problems they had. The staff training records were examined and Protection of Vulnerable Adults training is given at induction. The manager confirmed in the AQAA and during the inspection that communication is considered an important issue in the home and this is reinforced in regular training sessions and staff meetings. Preston Park Nursing & Residential Home DS0000003281.V349084.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, 20, 22, 23, 24, 25, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean and comfortable well-maintained environment for service users. Some areas are accessed by stairs/stair lift and service users need to be assessed as able to negotiate these safely in order to be accommodated in these rooms. The home is an older style building and consideration may need to be given in the future to extensively redesigning the layout in order to be fit for the future. EVIDENCE: The home is well maintained, warm and comfortable. Communal facilities are well attractively furnished. The main lounge is well used and can feel cramped when service users congregate there. Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 20 Bedrooms can be personalised and were seen to be clean and comfortable. Windows are restricted above ground floor level. Hot surfaces in bedrooms are covered. There are assisted bathing facilities and these had been serviced. The passenger lifts between floors had been serviced. Equipment is available for care provision such as adjustable beds and pressure relieving equipment. Hoists are available for manual handling and these had been serviced. The home is well adapted for the client group. Infection control is well managed and there are good hand washing facilities for staff. The home has appropriate waste control management in place. The laundry processes were reported to be satisfactory and there is a dedicated laundry person to manage the process. The building is an older style and despite on going refurbishment and decoration the layout may not be suitable for future needs. Personal expectations are now for larger bedrooms with en-suite facilities. These are not provided at Preston Park. Despite this the home provides an informal comfortable home. Preston Park Nursing & Residential Home DS0000003281.V349084.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): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are appropriate to the numbers of current service users. These have not been compared to dependency levels. The perception of people living at the home and family/ friends is that there are sometimes not adequate numbers of staff particularly in the evenings and at weekends. The training opportunities available to staff are good. The home follows appropriate staff recruitment procedures. EVIDENCE: A number of comments from people living at the home, friends and family during the inspection stated that there were sometimes inadequate numbers of staff on duty to meet the needs of the needs of the people at the home. The staff duty rota’s were reviewed during the inspection. These showed that there are adequate numbers of people on duty. The home has have 7 care assistants and 1 trained staff on duty for am and pm shifts, although this did drop to 6 care assistants at times. There are 1 trained nurse and 2 care assistants on duty each night. This is exclusive of the Deputy and Manager as additional Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 22 support. Ppeople living at the home stated that they sometimes had to wait for staff assistance. The perception of people living at the home was that staff were very busy. Comments included “the staff are lovely but they are very busy. We could do with more staff at the weekends” Staff stated that they felt that the dependency needs of the people living at the home had increased. It is recommended therefore that the management review the numbers of staff in relation to the dependency levels at the home. The home currently employs 21 care staff members. Eleven of these have an NVQ level 2 or above. An additional 3 staff are working towards this award. The staff training records showed that the majority of staff have completed all mandatory training, including moving and handling, food handling, fire and health and safety. New staff complete a full induction which is in line with best practise guidelines. The home has a system of regular staff meetings. Minutes of these meetings were seen during the inspection. Three staff recruitment files were examined. These contained all appropriate information as required in Schedule 2 of the Care Homes Regulations 2001. Enhanced CRB checks and POVA checks were in place. Preston Park Nursing & Residential Home DS0000003281.V349084.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, 32, 35, 36, 37, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well organised and the manager is competent and pro-active in her management style. Staff are supported and supervised to carry out their work. Service users can be assured of a safe environment and that systems are in place to rectify problems. EVIDENCE: Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 24 The homes Manager is supported by an experienced Deputy Manager and an Administrator. The management style of the home is appreciated by staff and people living at the home. All stated that the manager was approachable and had an open door policy. The company, Somerset Care Limited; undertake quality assurance assessment of the home, surveys had been made to assess service user satisfaction. All records seen were stored appropriately and safely. Financial records seen were satisfactory and clear about the amounts paid to the home. All new service users are encouraged to have an appointed Enduring Power of Attorney in place. Servicing and maintenance records were sampled these included: Fire records: weekly fire alarm tests had been made and recorded. Routine inspections had been made for the alarm and the emergency light. Fire instruction records demonstrated that staff receive regular instruction in this area. Assisted baths and hoists are serviced regularly .The home has a generator for back up, this is serviced annually. The home has waste removal contractual arrangements, which include the removal of pharmaceutical waste. The passenger lifts servicing was also confirmed. The manager currently audits any accidents that have occurred at the home. The audit does not include times that the accident occurred. This would be useful to ensure that any patterns in falls or incidents are identified and remedial action taken Preston Park Nursing & Residential Home DS0000003281.V349084.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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 3 3 Preston Park Nursing & Residential Home DS0000003281.V349084.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. Standard Regulation Requirement Timescale for action 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 Care plans should be reviewed where decisions are made to take account of the Mental Capacity Act 2005. Staff should consider ensuring the care plans are person centred in all areas. The registered manager should audit the use of fluid balance charts and ensure staff responsible, complete and total them to determine individual residents hydration. It is recommended that consideration should be given to widening the range of snacks for those people on specialist diets or for those who have swallowing difficulties and cannot eat biscuits and cakes. It is recommended that when the manager audits the accidents that this include times that the accident occurred. This would be useful to ensure that any patterns in falls or incidents are identified and remedial action taken DS0000003281.V349084.R01.S.doc Version 5.2 Page 27 2. 3. OP8 OP15 4. OP38 Preston Park Nursing & Residential Home Preston Park Nursing & Residential Home DS0000003281.V349084.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Preston Park Nursing & Residential Home DS0000003281.V349084.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. 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!