CARE HOMES FOR OLDER PEOPLE
Preston Park Nursing & Residential Home Preston Road Yeovil Somerset BA20 2EF Lead Inspector
Justine Button Key Unannounced Inspection 29th June 2006 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.V302160.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.V302160.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.V302160.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 9th November 2005 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.V302160.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 in line with the CSCI framework ‘Inspecting for Better Lives 2’. This unannounced key inspection was conducted over one day by CSCI Regulation Inspector Justine Button. The inspector was able to meet with the majority of service users and staff. Service users were positive about the care they received. Staff stated that they felt well supported. The registered manager was not available at the inspection. The inspector liaised with the deputy manager throughout the day and the area manager at the end of the inspection. A tour of the premises was carried out where all communal areas and the majority of bedrooms were seen. Records were examined relating to service users, staff, medicines and health and safety. The inspectors would like to thank service users and staff for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well:
Preston Park provides a comfortable environment for older people who have nursing needs. Service users are cared for by appropriately trained registered nurses and care staff. The home provides 24 hour nursing care. The numbers of staff on duty are appropriate to meet the needs of service users. Service users and staff benefit from an effective and stable management team who promote an open and inclusive style of management. Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 6 The home ensures that prospective service users are provided with the information they need to enable them to make an informed choice about moving to the home. No service user moves to the home unless their needs have been fully assessed. This is to ensure that the home can meet an individual’s needs and aspirations. During the inspection the inspectors observed staff interactions with service users. Staff were heard communicating with service users in a kind and respectful manner. Service users appeared comfortable in their surroundings. Comments from people during the inspection included “staff are excellent” and I could not ask for a nicer place to live” Service users benefit from a wholesome and varied diet. The inspector was able to observe service users enjoying lunch. Choices were offered. Meals, including special/soft diets were attractively presented and portions were generous. Service users enjoyed lunch in a relaxed an unhurried manner. Staff sat with service users and offered assistance where required. This was carried out in an unhurried and respectful manner. Service users spoken with stated that they liked the food. The home ensures that service users have access to appropriate/specialised healthcare professionals. The home was extremely clean and tidy on the day of the inspection. The gardens were well kept and used by the majority of people living at the home on the day of the inspection when the weather was warm. There was plenty of seating areas in shaded parts of the grounds. A recent survey of people living at the home had been conducted. This information had been used to influence the care and support offered at the home. What has improved since the last inspection?
At the last inspection two requirements and three recommendations were made. These related to the monitoring and administration of insulin to diabetic’s, bed rail management, staff recruitment procedures and on going maintenance and health and safety. Since the last inspection these areas have been addressed to a satisfactory standard.
Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 7 A new shower room and improvements to the toilet facilities on the ground floor have been completed since the last inspection. These facilities have been upgraded to a high standard. New carpets in some of the communal areas have been replaced. What they could do better:
Whilst some improvements were noted with regard to records relating to service user care plans, further requirements have been raised at this inspection. Wound care plans seen did not contain sufficient detail relating to the size/progress of the wound. The home should consider the use of photo’s/tracings to properly track the progress of a wound. Wound care plans had not always been raised where there was an assessed need. The care plans need to be more specific to ensure that clear guidance is given to the care staff with regard to the care and support needs of individuals. Staff need to ensure that they offer care and support in all aspects of personal hygiene. During the inspection the inspector visited some of the bedrooms and bathrooms. It was observed in some case that the toothbrush was dry and the top of the toothpaste was hard. This leads the inspector to believe that people had not been supported to clean their teeth or dentures. The weather on the day of the inspection was warm and humid. Staff need to consider the availability of drinks. Tea and coffee are served at all meals and in the mornings and afternoons. It was however observed that some people did not have access to fluids outside of the “official” drink rounds. This is particularly relevant in the warm summer months. One incident had been recorded by staff for one individual. It could not be confirmed what action had been taken in response to this incident. The deputy manager agreed to investigate this concern at the end of the inspection. Medication records were viewed during the inspection. These were generally in good order however one individual living at the home had received ten Paracetamol in a twenty four hour period. The maximum safe limit is eight in any twenty four hour period. The systems for recording medication prescribed ‘as required’ need to be reviewed. It was observed on the day of the inspection that a number of people spent significant periods of time sitting in wheelchairs. Wheelchairs do not provide good postural support and should not be used for long terms seating. Consideration should be given to ensuring that people living at the home are offered the opportunity to sit in seating which is more appropriate.
Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 8 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. Preston Park Nursing & Residential Home DS0000003281.V302160.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.V302160.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5. Standard six is not applicable. The quality for this outcome group is good. Prospective service users have the information they need to make an informed choice about moving to the home. The home takes appropriate steps to ensure that an individual’s assessed needs can be met by the home. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide. Copies are made available to service users, prospective service users and their representatives. These documents are also displayed in the reception area of the home and include a copy of the home’s last CSCI inspection report.
Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 11 The registered manager provided the CSCI with pre-inspection information that stated that the home’s current fees are £600 per week. Fees are determined upon the assessed needs of an individual. Any ‘Free Nursing Care’ element awarded is incorporated into the fees and is not refunded to the service user. Extra charges are met by service users for newspapers, hairdressing, trips/outings, personal toiletries/items and special requirements. Contracts for service users were examined, funding arrangements were clear; the Registered Nurse Care Contribution (RNCC) was documented. The sample contained evidence of social service spot purchase of a place, self-funding contract and a block-contracted place being taken up. The manager or her deputy visit a prospective service user and carry out an assessment to ensure that the assessed needs and aspirations of the individual can be met by the home. Documented evidence of pre-admission assessments was seen in the care records examined. Assessments from other professionals were also seen in care records. Prospective service users and/or their representatives are invited to visit the home prior to making a decision. Service users move to the home initially on a 4 week trial period. This is to ensure that all parties are happy with the placement. The most recent service user confirmed this. Preston Park Nursing & Residential Home DS0000003281.V302160.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. The quality in this outcome group is adequate. The home’s procedures for documenting individuals assessed needs require improvement. The home ensures that service users have access to appropriate healthcare professionals. Service users are treated with respect. The home’s procedures for the management & administration of medication are generally good though further improvements are needed. EVIDENCE: Five service users were case tracked at this inspection. This involved meeting with the service users, examining care and related records and viewing their bedrooms.
Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 13 Care plans contained up to date assessments, which included moving and handling, reducing the risk of pressure sores & falls. Social histories were documented, as were the preferences of service users. Records are maintained relating to the preferences of service users following death. Staff need to avoid ambiguous statements in the care plans. Statements seen included “ensure adequate fluids or turn regularly”. The plans of care need to be specific e.g. how much fluid or how frequently the person needs support to change position. The registered nurses need to ensure that the use of medical terminology is avoided. Both of these measures will ensure that clear guidance is given to care staff. Wound care plans need to be developed. For individuals who have wounds the plans did not clearly demonstrate the progress of the wound and therefore if a different treatment should be considered. The use of tracings, photographs and measurements should be considered. During the inspection the inspector visited some of the bedrooms and bathrooms. It was observed in some case that the toothbrush was dry and the top of the toothpaste was hard. This leads the inspector to believe that people had not been supported to clean their teeth or dentures. Service users who were able to express a view were very positive about the care they received. Staff interactions with service users were noted to be very warm, professional and respectful. Interventions were observed to be ‘unhurried’. Staff were heard explaining interventions to service users before carrying out. Service users appeared relaxed and comfortable throughout the day. The home’s procedures for the management and administration of medication were examined at this inspection. The home uses the monitored dosage system (MDS) with pre-printed medication administration records (MAR). The registered nurse on duty administers medicines. Medicines were found to be securely stored. MAR charts were generally good but for one individual hand transcribed entries had not been confirmed with two signatures. For one individual regular Paracetamol (four times a day IE eight tablets, the maximum dose) is required for pain relief. This individual had woken in the night in pain and staff had brought forward the early morning dose. This had been recorded on the back of the MAR sheet as required, however this had not been made clear on the regular prescription. The regular prescription had
Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 14 therefore continued. Thus the individual had been given ten tablets in a twenty four hour period. The system for recording such incidents needs to be reviewed to ensure that this error does not reoccur. It was observed on the day of the inspection that a number of people spent significant periods of time sitting in wheelchairs. Wheelchairs do not provide good postural support and should not be used for long terms seating. Consideration should be given to ensuring that people living at the home are offered the opportunity to sit in seating which is more appropriate. Preston Park Nursing & Residential Home DS0000003281.V302160.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. The quality in this outcome group is good. Service users are given the opportunity to exercise choice and control over their lives. The home provides service users with a wholesome and varied diet. EVIDENCE: As previously mentioned in this report, the home takes appropriate steps to ensure that wherever possible, the preferences of service users are identified in the individual’s plan of care. Relatives & friends are encouraged to provide information relating to their loved one’s social history, previous hobbies/interests, preferences, likes and dislikes. There are regular resident and relatives meetings. The last meeting was held on the 5th May 2005. Minutes of this meeting were seen. A number of minor issues only were raised at the meeting and staff agreed to “look into” these concerns.
Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 16 Those service users able to express a view informed the inspectors that their wishes were respected and that they could choose what time to get up or go to bed. Service users can choose where and how to spend their day. Any restrictions would be identified in risk assessments. Due to mobility difficulties, not all service users can move freely around the home. Throughout the day the inspectors observed regular staff presence in each of the lounges. As previously mentioned, staff interacted with service users in a kind and respectful manner. The home offers service users a range of social opportunities. Trips out are organised and there is an activities programme produced weekly and available to all service users. Activities on offer include board games, bingo, library service and cookery sessions. The home welcomes visitors at any reasonable time in accordance with the wishes/preferences of the service user. All meals are prepared and cooked on the premises. Copies of a two week menu were made available to the inspector. The menu appeared wholesome and varied. The main meal is served at lunch time with a lighter cooked meal at tea time. Alternatives/choices are offered. This was evident at the time of the inspection. The inspectors were informed that milky drinks and snacks were offered in the evening. Special diets are catered for. The inspectors observed soft diets being served to those with an assessed need. These were seen to be attractively presented. Sweets were available for those requiring a diabetic diet. Staff were observed assisting service users in a manner that was relaxed, unhurried and respectful. Service users able to express a view were positive regarding the meals available and stated that there was always plenty to eat. The weather on the day of the inspection was warm and humid. Staff need to consider the availability of drinks. Tea and coffee are served at all meals and in the mornings and afternoons. It was however observed that some people did not have access to fluids outside of the “official” drink rounds. This is particularly relevant in the warm summer months. Preston Park Nursing & Residential Home DS0000003281.V302160.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. The quality for this outcome group is good. The home has a complaints procedure which is made available to service users. People living at the service are protected from abuse with the homes policies and procedures and practice. EVIDENCE: The home has adult protection and Whistle blowing policies. Staff are made aware of the home’s whistle blowing policy and information on ‘elder abuse’. These documents are also displayed in the main reception area of the home. The home follows robust recruitment procedures. The home has a complaints policy and procedure. All complaints are investigated and a record is kept. No complaints have been received since the last inspection. Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. The quality for this outcome group is good. 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. EVIDENCE: The home is well maintained, warm and comfortable. Communal facilities are well attractively furnished. The main lounge is well used. A number of the communal areas have had new carpets laid.
Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 19 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. Since the last inspection the toilet facilities in one area of the ground floor have been update and an accessible shower room installed. 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. Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. The quality in this outcome group is good. Staffing levels and skill mix are appropriate to the numbers and needs of current service users. The home follows appropriate staff recruitment procedures. EVIDENCE: Staffing levels are currently adequate to meet the numbers and assessed needs of the service users at the home. The deputy manager informed the inspectors that staffing levels would be increased to reflect any increase in service user numbers or any increase in assessed needs. Copies of a four week staffing rota were made available to the inspector. Staff spoken with during the inspection did not raise any concerns about staffing levels. The home also employs kitchen staff, domestics, laundry staff and a maintenance person. Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 21 The registered manager provided the inspectors with information indicating that of the are staff employed, 6 had achieved a minimum of an NVQ level 2 in care. This gives an overall percentage of 32 . Four staff were currently undertaking this award and an additional 5 staff about to start. Two 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 also in place. The recruitment file for one individual was discussed at the end of the inspection. The deputy agreed to discuss this individuals work history, as the information on the application form did not comply with prior knowledge. Newly appointed staff follow a TOPPS induction programme. This covers the initial induction programme and on-going training for staff. Staff spoken with during the inspection were positive about the training opportunities available to them. Staff also indicated that they had received appropriate training to enable them to meet service users’ assessed needs. Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37 & 38. The quality in this outcome group is good. The home is well managed in an open management style. The home is run with the service users best interests safeguarded by policy, practice and procedures. Attention to the health and safety of service users and staff is of a good standard. EVIDENCE: The home’s Manager is supported by an experienced Deputy Manager and an Administrator. Staff and service users appreciate the management style of the home.
Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 23 The company, Somerset care Limited; undertake quality assurance assessment of the home, survey had been made to assess service user satisfaction. All records seen were stored appropriately and safely. Servicing and maintenance records were sampled these included: Fire records: weekly fire alarm teats had been made and recorded. Routine inspections had been made for the alarm and the emergency light on 13.10.05. Fire instruction records demonstrated training in February 2006. The Environmental Health Officer had visited on 28.2.06 Assisted baths and hoists were serviced in November 2005. The Landlords Gas Safety Certificate was dated 02.06. The home has a generator for back up, this is serviced annually. The home has waste removal contractual arrangements, which now include the removal of pharmaceutical waste. Preston Park Nursing & Residential Home DS0000003281.V302160.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 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 2 8 2 9 2 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 3 X X 3 3 3 Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement It is required that a system is in place to ensure that ‘as required’ medication (PRN) is documented clearly to ensure that medication is given within prescribed safe limits. Timescale for action 30/07/06 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 OP15 OP8 OP7 Good Practice Recommendations It is recommended that the provision of fluids is reviewed to ensure that people living at the home have access to drinks at any reasonable time. It is recommended that suitable seating is available and the time people sit in wheelchairs, which do not provide good postural support, is limited. It is recommended that service users plans are reviewed to ensure They give clear guidance to the care staff on the individual needs of the people living at the home. That the progress of any wounds is documented clearly. Consideration should be given to the use of
DS0000003281.V302160.R01.S.doc Version 5.2 Page 26 Preston Park Nursing & Residential Home 4. OP8 measurements, tracings and photographs. It is recommended that staff ensure that oral hygiene is offered to all people living at the home at least twice daily. Preston Park Nursing & Residential Home DS0000003281.V302160.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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