CARE HOMES FOR OLDER PEOPLE
Priory Park Nursing Home Priory Crescent Penwortham Preston Lancashire PR1 0AL Lead Inspector
Vivienne Morris Unannounced Inspection 14th November 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 Priory Park Nursing Home DS0000025580.V311806.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. Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Priory Park Nursing Home Address Priory Crescent Penwortham Preston Lancashire PR1 0AL 01772 742248 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) Southern Cross Care Homes Limited Mrs Christine Mary Mellor Care Home 45 Category(ies) of Dementia (30), Mental disorder, excluding registration, with number learning disability or dementia (1), Old age, not of places falling within any other category (34) Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Within the overall total of 45 a maximum of 34 service users requiring either nursing or personal care who fall into the category of OP - Old age, not falling within any other category. Within the overall total of 45 a maximum of 30 service users requiring either nursing or personal care who fall into the category of DE ( Dementia) Within the overall total of 45 a maximum of one service user requiring either nursing or personal care who falls in the category MD - Mental Disorder, excluding learning disability or dementia. 10th November 2005 2. 3. Date of last inspection Brief Description of the Service: Priory Park is a three story, purpose built home, which is registered to care for service users with a variety of needs. The home is located in a quiet residential area of Penwortham, close to local shops, Churches and public transport and is a short car journey into the centre of Preston. Although some shared rooms are available at Priory Park, these are used for single occupancy. Although en-suite facilities are not provided at Priory Park, toilets and bathrooms are located at convenient intervals throughout the building. All areas of the home are easily accessible to service users by the use of a passenger lift and ramps to the outside of the building. A variety of communal areas are available at the home and separate dining areas are provided. Service users cared for on the Dementia Care unit, have safe, easy access around the unit and into the garden area. The service users’ guide, which contains relevant information about the service, including the most recent inspection report, is given to people who are thinking about living at the home, so that they are able to make an informed choice about where to live. The scale of charges as at 14th November 2006 ranged from £460.00 to £475.00. Additional charges were being incurred for hairdressing, newspapers/magazines, toiletries and private chiropody. Residential clients were responsible for providing their own incontinence aids. Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. An unannounced site visit, which formed part of the key inspection process, was conducted over one day in November 2006. During the course of the site visit to the service, discussions took place with those living at the home, as well as relatives and staff. Relevant records and documentation were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas were seen. Comment cards were received from eighteen people involved with the service and their feedback is reflected throughout this report. The information provided by the home on the pre-inspection questionnaire has also been taken into consideration when writing this report. The total key inspection process focused on the outcomes for people living at the home. Comments from people living at the home included, “I enjoy living here. The staff are all lovely, very kind and caring” and “the staff are always there to help me when I need. I just have to ring my buzzer”. One relative said, “the staff are all very friendly” and another said, “I am made to feel very welcome when I visit my relative and Im always asked if I would like a cup of tea”. The Commission for Social Care Inspection had not received any complaints about this service since the last inspection. However, an allegation of abuse was being investigated by the home at the time of the site visit. What the service does well:
The information gathered before admission about each person thinking about moving into the home was detailed, providing staff with a clear picture of individual needs, so that the home was able to determine how they could meet the assessed needs of people. The care plans were found to be well-written documents, providing staff with clear guidance as to how individual needs are to be met, including supporting people to maintain their privacy and dignity. Service users or relatives were involved in this process so that they were able to have some input into the care planned. The plans of care had been reviewed as often as required, but at least on a monthly basis, so that any changes in circumstances were recorded. One service user said, “I enjoy living here. The staff are all lovely, very kind and caring”. A wide range of risk assessments were in place at the home to ensure that systems were put in place to protect the health and safety of anyone on the premises. A lot of external professionals were involved in the care of people
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 6 living at the home to ensure that their health care needs were being sufficiently met. Medications were well managed and the home had arranged for service users to receive advice and treatment from a variety of external professionals to ensure that people’s health care needs were being appropriately met. The service offers a wide range of activities, both indoors and within the community, so that people are entertained, should they wish to join in. Those less able to participate receive 1:1 input from the activities co-ordinator, ensuring that some form of stimulation is provided. However, no one is pressurised to join in, showing that people have a choice and are able to have some control over their lives. Relatives spoken to were happy about how visitors were received into the home and they informed the inspector that the staff were all very friendly, kind and caring. Sufficient information was provided to people about the use of the local advocacy services to act on their behalf, should they so require. Service users were provided with nutritious, well-balanced meals so that their dietary intake was adequate and those requiring support with eating their meals were assisted in a discreet manner, whilst others were encouraged to eat independently. The home was tastefully furnished and pleasantly decorated to a high standard and the premises, both internally and externally were well maintained providing those living at Priory Park with a safe, clean, comfortable and homely environment. Robust recruitment procedures and financial arrangements were in place at the home, which demonstrated that those living at Priory Park were adequately protected. A detailed induction programme is provided for new members of staff on the commencement of employment, which involves the completion of a detailed workbook. New staff are assigned a mentor to guide them through the induction process. The registered manager holds relevant qualifications, has a lot of experience and is appropriately trained to manage the care home. Residents, relatives and staff thought highly of her and they all felt supported by the management of the home. The health, safety and welfare of residents were protected by the policies, procedures and practices of the home to ensure that any hazards, which could pose a potential risk, were minimised or eliminated. Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 7 A variety of sources showed that residents were given the same opportunities, despite their differing needs and that everyone living at the home was treated with the same respect. What has improved since the last inspection? What they could do better:
Although the plans of care were well written documents more consideration needs to be given to the social care needs of people living at the home and how they can be supported to maintain their leisure interests and hobbies. Any instructions on the risk assessments need to be followed in day-to-day practice so that people are adequately protected from harm. Although the inspector noted that people were supported to maintain their leisure interests and hobbies, where possible, the care plans did not provide staff with clear guidance as to how this could be achieved. At the time of the site visit some items of kitchen equipment needed repairing or replacing to ensure that the catering staff had enough equipment to allow them to do their jobs sufficiently. The kitchen flooring and under the units needed cleaning so that good standards of hygiene were maintained. The policies and procedures in relation to safeguarding adults needed to be reviewed and updated in accordance with the Department of Health guidance ‘no secrets’, so people knew that if any allegations were received which
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 8 suggested that a criminal offence had been committed then the police would be involved. At the time of the inspection there was a slight unpleasant smell in some areas of the home, which did not demonstrate that adequate odour control measures were in place. The home should be able to demonstrate compliance with the Water Supply (Water Fittings) Regulations 1999 to show that appropriate checks have been conducted on the water system. The home needed to progress towards achieving a minimum ratio of 50 of care staff with a National Vocational Qualification to ensure that sufficient numbers of care staff are adequately trained to do their job. The registered manager should extend the monitoring of the quality of service provided by getting the views of other external professionals who are involved in the care of people living at the home. 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. Priory Park Nursing Home DS0000025580.V311806.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 Priory Park Nursing Home DS0000025580.V311806.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 and 3. Standard 6 did not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People wishing to move into the home are given up to date information about the service and the preadmission process is thorough enough to ensure that the home is confident that individual needs can be adequately met. EVIDENCE: Although standard 1 is not a key standard, it was assessed on this occasion as one recommendation was made at the last inspection. However, the inspector found that this had been addressed and therefore the standard was now fully met. The inspector saw that the statement of purpose and the service user’s guide had been reviewed to provide those interested with up to date information about the home. The service users’ guide was also available on audiocassette for anyone who could not see well enough to read the information provided. The statement of purpose showed that those using the service were treated equally and were provided with the same opportunities. The service users’ guide was freely available throughout the home and copies were left in bedrooms, so that people were able to look at the information supplied whenever they wished. Each service users’ bedroom contained a
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 11 welcome message and a photograph of their key worker so that they knew who was responsible for their care. At the time of the site visit there were 41 people living at Priory Park. The care of three of these people was ‘tracked’ whilst the inspector was at the home. The care records showed that detailed information had been obtained prior to admission in order to determine the needs of each person, so that the home was certain that the staff team could meet the individual needs of people. The service user or their relative had signed the preadmission information, showing that they had been involved in this process. Policies and procedures were in place at the home, so that staff were provided with guidance about the admission process. A separate assessment was undertaken for those with dementia care needs and for those with impaired understanding the care records included a list of words that were understood by them, which was considered to be very good practice. Staff had also received specific training in relation to dementia care to ensure that they were aware of the needs of people suffering from dementia. The assessed needs of those admitted to the home were consistently recorded within the care plan therefore staff were provided with detailed information as to how service users’ needs were to be met. Staff spoken to knew about the needs of people and how to access the care plans, policies and procedures, which showed that they were able to obtain relevant information if they needed it. Priory Park Nursing Home DS0000025580.V311806.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have some input into the care they receive and the care planning process provides staff with sufficient guidance to ensure that residents’ needs are fully met and that their privacy and dignity is consistently maintained. The management of medications is satisfactory. EVIDENCE: The care of three people living at the home was ‘tracked’ during the course of the site visit, so that the inspector could establish if adequate care was being provided. The plans of care were found to be extremely detailed and very well written documents providing staff with clear instructions of how the needs of people were to be met. A very informative social history had been obtained to determine what those living at the home enjoyed doing and to find out something about their past lives so that staff could relate to them more effectively. The three care records examined demonstrated that service users or their representatives had been involved in the care planning process showing that
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 13 they had been given the opportunity to have some input in the care planned for them. A wide range of risk assessments had been conducted, which were found to be detailed and showed what systems had been put in place to reduce the possibility of injury. The service users plans of care did not show how service users were supported to maintain their leisure interests and hobbies, whilst living at the home, if they so wished. The records of one service user showed the necessity for the development of a care plan in relation to nutrition, as advised by the risk assessment. However, there was no such care plan in place so that this person’s dietary intake could be accurately monitored. The management of medications was found to be satisfactory in all areas ensuring that the people living at the home were protected from drug errors or drug misuse. The inspector observed staff speaking with service users in a respectful manner and saw them knocking on bedroom doors before entering to ensure that their privacy and dignity was protected. One relative stated, “ The staff are all marvellous. They work very well as a team”. A written policy was in place and available to staff, which demonstrated that those living at the home were supported to maintain their privacy and dignity at all times. Induction records showed that staff had been instructed to treat service users with respect at all times. One service user said, “the staff get the doctor if I need him when I am not well” and those spoken to confirmed that if a doctor needed to carry out an examination, then this would be conducted within the privacy of the service user’s own bedroom. Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 14 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 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Social, cultural and recreational activities meet residents’ expectations and those living in the home receive a healthy, varied diet according to their preferences. EVIDENCE: The home employed a person to be responsible for the organisation of and the provision of activities. The pre-inspection questionnaire showed that a variety of activities were provided, both within the home and in the community so that people were provided with some form of stimulation and entertainment, if they wished to participate. Posters were displayed around the home informing people of various events and activities, which were planned and relatives were also welcome to join in. Information about the provision of activities within the home was included within the statement of purpose and service uses guide. Service users spoken to told the inspector that they enjoyed the activities provided and that they felt there was plenty going on. Records were kept of what activities people joined in with and if they were enjoyed, which showed that those who were less able to participate were given the same opportunities as others by the provision of 1:1 activities and by kind encouragement from staff.
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 15 The statement of Purpose included an explanation of the six principals of care, including rights and choices, showing that those living at the home were able to make decisions and informed choices. One service user confirmed that religious ministers visited the home regularly to conduct services and the statement of purpose supported this information. The inspector saw that plans of care had been written in relation to individual religious beliefs, showing how people could be supported in meeting their spiritual needs. However, the plans of care should be further developed so that guidance is provided as to how people can be supported to maintain their leisure interests and hobbies if they so wished. A visiting policy was in place at the home and information relating to visiting was also included in the statement of purpose and service user guide to ensure that all interested parties were aware of the visiting arrangements of the home. Relatives were seen to be visiting service users in private and two visitors spoken to felt that they were welcome to the home at any time and that a friendly environment was provided for both service users and staff. The comment cards received supported this information. Comments from one person living at the home included, “I enjoy living here. The staff are all lovely, very kind and caring”, and another told the inspector, “the staff are always there to help me when I need. I just have to ring my buzzer”. One relative said, “the staff are all very friendly” and another said, “I am made to feel very welcome when I visit my relative and Im always asked if I would like a cup of tea”. The inspector noted that personal possessions adorned individual rooms, where appropriate to create a homely environment and audits of service users’ belongings had been conducted on admission to protect the safety of individual’s personal possessions. One person living at the home was using an advocate to help them in making decisions and this was clearly identified in the service user’s care records. Information was provided in the statement of purpose and service users’ guide in relation to advocacy services. Leaflets were also readily available within the home; so that people were able to contact the local advocacy service themselves if they so wished. The bedroom doors on the dementia care unit were in the process of being designed to resemble individualized house doors to assist people in recognizing their own bedrooms. The manager informed the inspector that a lot of work was being done in relation to helping people living at the home to be familiar with their surroundings and to recognize their own space and belongings.
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 16 The inspector examined the four weekly menus and found that a well-balanced diet was offered to ensure that those living at the home received a nutritious dietary intake. Special diets were catered for and the food served appeared appetizing in order to aid nutrition. People were seen being supported with their meals if they needed, whilst independent eating was encouraged where possible. The dining rooms were found to be relaxed areas for people to eat in, with well-presented tables, so that those dining were comfortable and enjoyed having their meals in pleasant surroundings. The inspector noted that there were some items of kitchen equipment out of order at the time of the site visit. The manager said that replacement items were in hand. The kitchen was in need of cleaning, particularly the floor covering, under and behind the kitchen units, to ensure that standards of hygiene were consistently maintained. Service users confirmed that drinks and snacks were always available so that if they wanted a drink or something to eat they just needed to ask. Priory Park Nursing Home DS0000025580.V311806.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints were well managed and any allegations of abuse were dealt with appropriately. EVIDENCE: A detailed, freely available complaints procedure was in place at the home, which had been reviewed since the last inspection and which was included within the service users guide, showing that people were given enough information about making a complaint should they wish to do so. A system was in place at the home so that any complaints received could be recorded and any recurring patterns identified and monitored. However, the home or the Commission for Social Care Inspection had not received any complaints since the last inspection. Residents and their relatives, who were spoken with told the inspector that they knew what to do should they wish to make a complaint about the service. Policies and procedures were in place at the home in relation to safeguarding adults, which had been reviewed and updated in January 2006. The information given to people did not tell them about police involvement if allegations suggested that a criminal act had been committed. Therefore, the policies and procedures of the home needed to be updated in line with the Department of Health guidance no secrets. However, the practices of the
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 18 home demonstrated that correct procedures were followed in the case of allegations of abuse. Staff spoken to confirmed that they had received training in relation to safeguarding adults and the training matrix seen supported this information. Staff were aware of what they should do if they had any concerns about the welfare of anyone in their care to ensure that appropriate action would be taken. Priory Park Nursing Home DS0000025580.V311806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided a safe, well-maintained environment for people to live in, which was homely, clean and tidy. EVIDENCE: The inspector toured the premises during the course of the site visit and found the home to be warm and friendly, providing a relaxed, homely and pleasant environment for people to live in. The pre- inspection questionnaire completed by the home prior to the site visit showed that a lot of bedrooms had been redecorated since the last inspection and evidence was available to show that the bedrooms were decorated on a rolling program so that the home was maintained to a high standard of décor. The building was fit for purpose and was maintained to a good standard of repair so that people were living in a safe environment. However, the home was unable to demonstrate compliance with the water supply regulations 1999 to show that appropriate checks had been undertaken.
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 20 The grounds of the home were well maintained, providing people with pleasant patio areas in which to sit and walk during periods of warm weather. The laundry to department was found to be well organized and detailed infection control policies were in place at the home, which were being followed in day-to-day practice. The fire officer had not visited the home since the last inspection and there were no requirements or recommendations outstanding from the last report. The environmental health officer had visited since the last inspection and had made one recommendation, which had been appropriately addressed. Priory Park Nursing Home DS0000025580.V311806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff working at the home were trained, skilled and in sufficient numbers to fulfil the aims of the home and to meet changing needs of residents. EVIDENCE: At the time of the site visit there were 41 people living at Priory Park Nursing Home. There was a clear duty rota in place demonstrating which staff were on duty at any time of the day or night. The number of staff on duty was being calculated in accordance with the assessed needs of people living at the home. A variety of assessments had been conducted so that any risks in relation to residents’ dependency levels could be identified and systems put in place to reduce the risk factor as much as possible. The records showed that a good skill mix of staff made up the staff team so that residents’ needs were being met. The inspector noted that there was a slight unpleasant smell in some areas of the home, which demonstrated that odour control measures in place were not totally effective. The inspector was informed that the home was currently advertising for someone to cover some additional domestic hours. Residents spoken to felt that their needs were being fully met and that the staff were patient and did not rush them when assisting them with activities of daily living.
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 22 Staff spoken to felt that there were enough staff allocated to fully meet the needs of residents. There were a total of twenty-two care staff employed by the home, six of whom had achieved a National Vocational Qualification at level 2 or above. The registered manager was aware that although a number of other staff were in the process of completing this award, that she needed to progress towards achieving a minimum ratio of 50 of care staff with a National Vocational Qualification to ensure that sufficient numbers of care staff were adequately trained to do their job. A formal induction process had been adopted by the home, which involved working through a booklet appropriate to their role. This booklet provided some good information to help staff to understand their role and to enable them to perform the duties expected of them. Staff spoken to confirmed that an experienced mentor was allocated to assist new staff through their induction period, which could run over several weeks so that all staff were confident to take on their role before working totally independently. The staff-training matrix was submitted to the Commission for Social Care Inspection prior to the site visit, which showed that a wide range of training was provided for staff so that people working at the home received adequate training to look after the people in their care. All staff completed six mandatory core-training courses to ensure that there was a skilled workforce and that people had the necessary knowledge to meet the needs of the people they were caring for. Three staff files were examined at the time of the inspection. It was found that recruitment procedures were being adequately followed in day-to-day practice and sufficient checks had been undertaken on staff to ensure that those living at the home were adequately protected. Priory Park Nursing Home DS0000025580.V311806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was being well managed by a competent person, having effective systems in place for monitoring the quality of service provided and the health, safety and welfare of people living at the home were adequately protected. EVIDENCE: The manager of Priory Park Nursing Home has been registered with the Commission for Social Care Inspection since the last inspection. She has the required qualifications and experience and is competent to run the home. During the time she has been in post she has worked hard to improve the service and to provide an increased quality of life for residents. There is a strong belief of being open and transparent in all areas of running the home so that people are kept informed of matters involving them. The manager is resident focused and leads and supports the staff team who have been appropriately recruited, so that those living at the home are adequately protected.
Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 24 Comment cards received from service users and their relatives provided very positive feedback about the registered manager. Staff spoken to felt extremely supported by the management of the home and stated that the manager had brought with her a lot of good ideas to improve the service and the outcome for residents, some of which were already being implemented. Surveys had recently been conducted so that the views of residents and their relatives had been obtained about how the service was performing. The information gathered was produced in a graph format to show interested parties the strengths and weaknesses of the service. A variety of meetings had been held and these were recorded as minutes and were sent out to those concerned, so that people were kept informed of any relevant matters. Staff confirmed that minutes of meetings were circulated and they knew where to obtain a copy, showing that relevant information was being provided for people. The registered manager should now further develop monitoring of quality of service provided by seeking the views of other external professionals, who are involved in the care of people at the home. The registered manager had put in place a variety of regular, detailed checks. This enabled her to identify and address any shortfalls within the systems in place at the home and closely monitor the quality of service provided. Systems were in place at the home to ensure that residents’ finances were adequately protected. The company policy does not allow anyone from the home to be appointee for the residents. Therefore relatives were responsible for the management of residents’ money, where residents were unable or did not wish to manage their own affairs. Clear records were kept of any money retained at the home on behalf of service users so that the possibility of mishandling was reduced. Records showed that all systems and equipment within the home were appropriately checked and that any accidents were accurately recorded so that the health, safety and welfare of those living at the home were properly protected. The environment was free from any hazards, which could pose risks to those living at the home. Priory Park Nursing Home DS0000025580.V311806.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 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP15 Regulation 16(2)(g) Requirement The registered person shall having regard to the size of the care home and the number and needs of service users provide sufficient and suitable kitchen equipment. The registered person shall having regard to the size of the care home and the number and needs of service users make suitable arrangements for maintaining satisfactory standards of hygiene in the care home, including the catering facilities. The registered person shall having regard to the size of the care home and the number and needs of service users keep the care home free from offensive odours. (Timescale not met 31.12.05). Timescale for action 31/12/06 2. OP15 16(2)(j) 15/12/06 3. OP27 16(2k) 31/01/07 Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3 4. 5. 6. Refer to Standard OP7 OP7 OP12 OP18 OP26 OP28 Good Practice Recommendations The service users plans of care should incorporate the social care needs and abilities of the individual as well as health care needs. The instructions on the risk assessments should be followed in day – to – day practice. The plans of care should show how people are supported to maintain their leisure interests and hobbies whilst living at the home. The home’s policies and procedures in relation to safeguarding adults should include action to be taken in the case of allegations suggesting a criminal offence. The home should be able to demonstrate compliance with the Water Supply (Water Fittings) Regulations 1999. The home should be working towards achieving a minimum ratio of 50 trained members of care staff (NVQ level 2 or equivalent), excluding managers and registered nurses. Formal feedback from stakeholders in the community should be sought about the quality of services provided and how the home is achieving goals for service users. 7. OP33 Priory Park Nursing Home DS0000025580.V311806.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Priory Park Nursing Home DS0000025580.V311806.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!
