Inspection on 09/06/05 for Preston Park Nursing & Residential Home

This inspection was carried out on 9th June 2005.

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 &... 28/09/07

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

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

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 and Residential Home Preston Road Yeovil Somerset BA20 2EF Lead Inspector Barbara Ludlow Unannounced 9 June 2005 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 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 and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Preston park Nursing and Residential Home Address Preston Road Yeovil Somerset BA20 2EF 01935 474023 01935 431727 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Somerset Care Limited Care Home with Nursing 33 Category(ies) of Old Age - (33) registration, with number of places Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Elderley persons of either sex, not less than 60 years, who require general nursing care 2. Up to 9 places for personal care 3. Registered for a maximum of 30 nursing clients Date of last inspection 18 January 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, a company operating within Somerset, manages the home. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Somerset Care home offers a good level of care and service and is responsive to the feedback made by the inspection process. One inspector undertook this unannounced inspection over a seven and a half hour period. The home’s Deputy Manager was on duty and was available throughout the day to assist with the inspection process. The inspection was well received by service users and staff. The homes administrator gave her time to assist the inspector, records that were seen and examined. A tour of the premises was made and all twenty-six resident service users and two-day care users were seen, nine service users were spoken with during the inspection period. Three visitors were seen and asked for their comments on the home, the experience of visiting a relative / friend and their perception of care and service given. The deputy manager received feedback on behalf of the registered person at the conclusion of the inspection. What the service does well: The home is a pleasant although not purpose built, well adapted and maintained care home. The home has attractive accessible gardens. The home is adequately staffed and offers a good level of training and support to staff. The service users seen were happy with the care and service they receive. The dining room is well used. Twenty-six service users had lunch together; this mealtime was observed to be a pleasant and unhurried occasion. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 6 Record keeping and management of records, was of a good standard. What has improved since the last inspection? What they could do better: The management of dressings and nursing equipment needs to be improved. A number of out of date stock and dressings no longer in use were seen in the store cupboard and treatment room. This must be sorted out. There was sufficient in date stock for the needs and anticipated needs of service users. Oxygen cylinders were not stored securely. It is required that advice is taking from the supplying agent and this must be rectified. The care of service users requiring hoisting in communal areas must be revised to promote the dignity of service users where there is a potential risk when one person undertakes hoist manoeuvres. Risk assessments for unguarded potentially hot surfaces in communal areas must be undertaken. One widely opening first floor window should be risk assessed for security. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 7 There was an unpleasant odour from the sluice; the sluice was clean and tidy. This should be checked to determine the cause. 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 and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,5, NMS 6 does not apply. The home provides a good range of information for prospective service users and visits to view the home can be made to assist those making a choice of care home. Pre admission assessment would be made by the Manager or her deputy to determine that care needs can be met at the home. EVIDENCE: Somerset care provide a Statement of Purpose and a Service User Guide for the home. The home has a brochure. Contracts for three service users were examined, funding arrangements were clear; the Registered Nurse Care Contribution (RNCC) was documented. Preadmission assessments were seen in the care plans; care needs had been assessed prior to admission. The home offers day care services; this enables service users to have experience of the home. Two day care service users attended during the day. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 10 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 standard(s) 7,8,9,10 The care plans were completed to a good standard and held appropriate information for the care of the individual service users. Medication administration processes were satisfactory. The management of stocks, dressings and equipment was poor. Oxygen storage requires review. EVIDENCE: Five care plans were sampled. These demonstrated sufficient personal information detail and good examples of care needs assessment and care planning. Pressure relieving equipment and manual handling equipment were identified. Two people only were identified at this inspection. The management of chronic health conditions such as diabetes was detailed and the condition monitored. There was evidence of input from community health care professionals such as the G.P, specialist tissue viability nurse, chiropodist, dentist and optician. The management of medications was examined. The administration processes were good. The storeroom and treatment room were seen. Controlled drugs were satisfactory. The fridge temperature was seen to be monitored daily. There were dressing stocks building up, these were not examined in detail, it is advised that the stock is checked and only dressings for current service users Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 11 are held. Equipment was identified that was date expired, such as, needles and blood bottles; these should be safely disposed of. There was sufficient in date equipment for safe practice. One box of paracetamol suppositories were seen in with rectal medication for constipation, this is unsafe practice. This was removed at the time of the inspection. Service users were seen to be treated with care, respect and dignity at this inspection. One manual handling manoeuvre was observed that had the potential to compromise a persons dignity, single person hoist manual handling procedures in communal areas should be reviewed. This was not discussed at the time of the inspection. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 12 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 standard(s) Service users have their social needs supported and are able to exercise their choices with daily living and activities. Mealtimes are unhurried and communal dining is encouraged. EVIDENCE: Service users were seen in communal areas and the inspector had opportunity to speak with individuals. Service users confirmed they were satisfied and happy with the care and the service they receive at the home. Visitors were seen; staff were observed to have a friendly and open approach to them and the visitors were made welcome. Feedback from visitors was positive. Day care services are well integrated and service users go out into the community to attend appointments and on excursions. Lunch was observed and the majority ate together. Feedback on the catering service was positive and comment included ‘you can’t fault the food’. The dining room is well presented. Staff were helpful and lunch was an unhurried social occasion. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 13 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 standard(s) 17,18 Service users are protected from abuse at the home by good practice, policies and procedures. EVIDENCE: The home has a complaints procedure, which is well available in the service user information. There have been no complaints made since the last inspection. There are policies, procedures and staff training to promote good practice and the protection of service users from harm. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 14 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 standard(s) 19,20,21,22,23,24,25,26 The environment is not purpose built but has been suitably adapted for purpose. Service users live in well-maintained, clean accommodation and have access to aids and equipment to support their health care needs. EVIDENCE: A tour of the premises was made. There are some changes planned for the environment, these are ‘in hand’. The home was clean, well ventilated and well maintained. Odour was detected in one sluice room that appeared clean and tidy, it was thought that this may has been coming from a drain and should be checked. There was adequate staff hand washing facilities. Gloves and aprons and hand cleansing gel were available. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 15 Risk assessment was examined, none were seen for the uncovered radiators and pipe work in the communal areas (bungalow and first floor corridor), these are recommended. One window on the first floor opened more than 100cm, it is required that a risk assessment for security be undertaken. Individual accommodation was seen to be clean and can be personalised. The inspector was informed that some replacement new furniture is due to be delivered in July. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30. The home was sufficiently staffed on the day of the inspection. There is a skill mixed staff group. Staff are trained to carry out their duties and meet the care needs of the service users. Recruitment practice was good. EVIDENCE: The homes experienced Deputy Manager was on duty and there were six carers on duty in the morning and a trained nurse. There is a qualified and registered nurse on duty at all times. Staff were seen and were spoken with at the inspection. The staff recruitment files were sampled for three new employees. There was a good level of information held and recorded. It is recommended that the interview record is dated and signed. Staff supervision records were seen on file. It was noted that care staff assist with domestic tasks. Agency staff are used to supplement the domestic staff team where there are vacancies. Care staffing has been increased in the morning to meet the assessed needs of the service users. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35,37,38. The home has an open management style that is proactively supported by the homes deputy manager. Financial management, record keeping and maintenance is of a good standard and protects the best interests of service users. EVIDENCE: The home has a new manager whose application for registration is currently being processed by CSCI. There are regular staff and service user meeting, the minutes were seen at this inspection. The homes administrator gave the inspector access to specified records for checking. Staff and service user files were seen to be appropriately and safely stored. Financial management of accounts and small amounts of service users pocket monies were safely managed. No pensions are held. Age concern Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 18 advocates are used where families are unable and are not chosen to or do not wish to assist the service user with their financial affairs. The fire alarm was tested (weekly in house test) at 11.45, during the inspection. Records seen at this inspection included the monthly bed rail checks and six monthly wheelchair checks. Hoists are serviced under contract. Hot water checks are made and where the water is hot, records state in the old system, (in excess of 42 degrees) this was risk assessed. It was noted that CSCI did not have Regulation 37 notices on file where service users had died in hospital; this may have been an oversight during the management changes and is brought attention of the new manager with this inspection report. All relevant Regulation 37 notices had otherwise been received by CSCI. Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 x x x 3 3 3 3 3 Preston Park Nursing and Residential Home D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 20 NO 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 OP 9 Regulation 13(2) Requirement Oxygen storage must be revised. Oxgen must be stored safely. Prescription dressings must be stored for the named individuals in residence / day care only. Potentially hot surfaces in communal areas such as radiators and pipework must be risk assessed to determine whether or not the surfaces require to be guarded. One widely opening first floor corridor window should be risk assessed for security. Timescale for action 30.07.05 2. OP 25 13(4) 30.9.05 3. OP 38 13(4) 30.7.05 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 OP 10 OP 26 OP 29 Good Practice Recommendations Single person hoist manoevoures in communal areas must be reviewed. The malodorous sluice room should be checked for drainage problems. Interview notes should be dated and signed by the person/s undertaking the interview process. D53 - D02 S3281 Preston Park Nursing & Residential Home V227328 09.06.05 Stage2.doc Version 1.30 Page 21 Preston Park Nursing and Residential Home Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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. 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