Inspection on 19/05/05 for Wellington Park Nursing Home

This inspection was carried out on 19th May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wellington Park Nursing Home 10/10/07

Wellington Park Nursing Home 12/06/06

Wellington Park Nursing Home 12/12/05

Wellington Park Nursing Home 10/01/05

Wellington Park Nursing Home 19/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Wellington Park Nursing Home 76 Wellington Road Bush Hill Park Enfield, Middlesex EN1 2PL Lead Inspector Georgia Chimbani Unannounced 19th May 2005 @ 9:45 am 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. Wellington Park Nursing Home Version 1.00 Page 3 SERVICE INFORMATION Name of service Wellington Park Nursing Home Address 76 Wellington Road, Bush Hill Park, Enfield, Middlesex EN1 2PL 020 8360 5977 020 8364 0696 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) Mr Robin Comerford of Goldsborough Healthcare Ltd Ms Jane Hepton N Care Home with Nursing 33 Category(ies) of OP registration, with number of places Conditions of registration Date of last inspection A maximum of 30 service users can receive nursing care. 10 January 2005 Brief Description of the Service: Wellington Park Nursing Home is owned by BUPA Care Services providing both nursing care and personal care. The home is registered for thirty-three older people of which, 30 places are for service users who require nursing care. The home is purpose built and is situated in a residential area, approximately one mile from Enfield Town. All bedrooms have en-suite facilities, telephone point and a remote controlled television. Respite care is provided for people who normally live at home. The home aims to provide high quality nursing care for the older people who live there. Wellington Park Nursing Home Version 1.00 Page 4 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced inspection was four and a half hours in duration. Present was the registered manager, Ms Jane Hepton. The home is registered for thirty-three service users over the age of sixty-five and at the time had six vacancies. As part of the inspection process the inspector was able to speak to approximately seven service users, a visiting relative. Feedback on the quality of care offered by the home was generally very positive. 17 requirements were issued following the last inspection, of these, 10 are met and 7 are restated with significantly shorter timescales. A further 2 requirements were issued bringing the total number of requirements following this inspection to 9. Requirements cover areas relating to service user records, staff training and health and safety checks. What the service does well: What has improved since the last inspection? There is always a member of the nursing or care staff on duty to qualified to administer first aid if required. The pre-admission initial assessment form has been reviewed and is more comprehensive however this must now be implemented. Wellington Park Nursing Home Version 1.00 Page 5 An existing member of staff has been appointed as the Activities Co-ordinator to find ways of meeting service users’ social needs. A service user with mental health needs has received a full assessment of their needs and these have been recorded. The home has devised a form for recording health care visits by professionals such as Chiropodists and Opticians. The statement of purpose has been revised to include information on room numbers and sizes and a signed contract/ statement of terms and conditions is available for all service users living in the home. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wellington Park Nursing Home Version 1.00 Page 6 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 Wellington Park Nursing Home Version 1.00 Page 7 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 and 3 Service users are now able to make informed decisions regarding the accommodation offered in the home and their contractual obligations, based on the information contained in the statement of purpose and the statement of terms and conditions. The home has recognised and reviewed the shortcomings of the current initial assessment tool, however if service users’ social needs are not included then some of their needs will be overlooked. EVIDENCE: The home’s statement of purpose has been revised and it now contains detailed information on the number of bedrooms in the home and rooms sizes. A copy of this document was available on display at the main entrance. A random sample of service user files were examined and they all contained a signed statement of terms and conditions. A comprehensive assessment tool is now available and it is hoped that this document will ensure that the initial assessment of service users before they go into the home covers all aspects relating to their health and welfare. The Wellington Park Nursing Home Version 1.00 Page 8 registered manager informed the inspector that she would seek the opinion of her colleagues regarding the form following which it would be implemented. A copy of this assessment was handed to the inspector at the time of the inspection who noted that it focused on nursing needs and contained little information on social needs such as social interests and hobbies and food preferences. The assessment contains a section on religion and mental health but these must be expanded to ensure that information on whether they practise their religion and if so how they want their religious needs to be met is included. The registered person must ensure that the initial assessment form incorporates information relating to service user’s social needs and that this form is implemented Wellington Park Nursing Home Version 1.00 Page 9 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, 10 and 11 Comprehensive care planning information in the absence of reliable recording casts doubt on whether a consistent level of care is offered to service users. Service users do not have the assurance that the respect that they are currently accorded in the home will continue in the event of their death, as their wishes are not recorded. EVIDENCE: A sample of four service user care plans was seen. Each service user had individual care plans based on needs identified in their assessments. These were all being reviewed on a monthly basis. Each case note record also included a moving and handling risk assessment in an aim to prevent falls. All files had been reviewed monthly and contained a photograph of the service user. A file of a service user with mental health needs contained a detailed assessment of their needs and how these would be met. Turning charts were seen for three service users and they were completed appropriately however there was no indication on the turning chart as to the required frequency of the turns. An examination of a service users care records Wellington Park Nursing Home Version 1.00 Page 10 showed that this information was not available there either. The nursing staff informed the inspector that the frequency of turns should be recorded on the service user file and on the turning chart. They responded that when a new turning sheet is started some staff might have omitted to record the turning frequency. A restated requirement is made requiring the registered person to ensure that the frequency of service user turns is clearly and consistently recorded. Records examined contained records of visits by GPs to service users. The registered manager showed the inspector a form that had been recently implemented to ensure that visits from professionals such as opticians and dentists were recorded. Service users interviewed confirmed that staff treated them with respect and maintained their privacy. The inspector observed that staff addressed service users with respect and service users responded positively. At the previous inspection the registered person was required to ensure that the wishes of service users in the event of their death are recorded. Four care plans were examined and only one contained information on service user’s wishes in the event of their death therefore this requirement is restated. Wellington Park Nursing Home Version 1.00 Page 11 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) 12 and 15 A named member of staff to facilitate activities ensures that service user’s social needs are given priority. There is great satisfaction with the range and quality of food offered to service users in the home. EVIDENCE: At the previous inspection, it was required that an activities co-ordinator is recruited. At this inspection the registered manager advised that a member of staff who had been working in the home for many years had taken over this responsibility. The day before the inspection some service users had gone out for a pub lunch. This was confirmed in discussions with some service users and staff. The home has service users with a range of needs and abilities but at present their social needs are catered for adequately. A service user confined to their room as a result of a leg ulcer stated they were not lonely or isolated as they enjoyed reading in the privacy of their room. The inspector was able to observe service users eating their lunch. The lunchtime meal was well presented and looked appetising and feedback from service users was very positive. One service user described the food as “excellent.” The atmosphere in the dinning area was relaxed and service users needing assistance with eating were assisted in a sensitive manner. Wellington Park Nursing Home Version 1.00 Page 12 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) 16 Service users have confidence that their concerns will be listened to and dealt with appropriately. EVIDENCE: The home has a satisfactory complaints policy. There have been four complaints in the past year, three were substantiated, and one was not. Interviews with service users confirmed that while they had no particular complaints they were confident that they would be able to address these to the relevant members of staff. One service user described to the inspector issues that they were not happy with relating to their care. These were immediately referred to the registered manager who advised she would look into the issues straight away. Wellington Park Nursing Home Version 1.00 Page 13 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, 24 and 26 The home provides a safe and comfortable living environment for service users but the security and privacy of their possessions must be ensured through additional refurbishments. EVIDENCE: The home is purpose built and the accommodation is located across four storeys. The dining and main lounge area are on the lower ground floor. The reception area and offices are on the ground floor as well as some of the bedrooms. There are further bedrooms on the first and second floors. There is a conservatory and a small paved garden area at the rear of the home for service users who wish to sit outside. During a tour of the home the inspector noted that it is well maintained, comfortable and there were no offensive odours detected. Bedrooms are brightly decorated however not all of them have lockable storage spaces and this is required. Wellington Park Nursing Home Version 1.00 Page 14 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) 29 and 30 There are no concerns about recruitment practises in the home. There has been some progress in staff training, however, to ensure staff effectiveness in performing their duties, training must be arranged in outstanding areas. EVIDENCE: At the time of the inspection interviews were being held for prospective members of staff. The inspector was satisfied that the registered manager was aware of the requirements relating to new staff such as ensuring that they had enhanced criminal records checks and references before they commenced employment. At the previous inspection a requirement was made requiring the registered person to ensure that staff receive training in moving and handling and infection control. A member of staff at the home is the moving and handling trainer and records showed that twelve staff have received moving and handling training so far. The registered manager advised that another member of staff was due to take over responsibility for infection control with close liaison with the specialist nurse at Chase farm hospital. It is anticipated that this member of staff would take over responsibility for infection control training. This requirement was within the timescales stated at the last inspection and is restated. A nurse is always on duty in the home to provide first aid assistance if required. There was evidence to indicate that care staff are also receiving first Wellington Park Nursing Home Version 1.00 Page 15 aid training for their personal and professional development. An immediate requirement was issued requiring the registered person to ensure that staff receive training in care planning, record keeping and management of pain as this requirement had been restated from the previous two inspections. Wellington Park Nursing Home Version 1.00 Page 16 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) 36 and 38 Current levels of staff support are irregular and therefore inadequate and must be improved as this is likely to affect the standard of care offered to service users. Service users’ health and safety is being compromised by poor health and safety practises. EVIDENCE: Four service user files were examined. There was evidence that staff were receiving supervision but not on a regular basis. Of the four files examined two had received supervision in April while the other two had received supervision in January and were subsequently overdue for their next supervision session. While the inspector acknowledged the progress that had been made to provide staff supervision since the last inspection, there was concern that despite an immediate requirement issued at the last inspection not all staff were benefiting from regular supervision. Wellington Park Nursing Home Version 1.00 Page 17 The home has a maintenance person who carries out regular health and safety checks and organises annual checks by contracted companies. Documentation was seen confirming that the following health and safety checks had been carried out; • Checks on water storage tanks 9/9/04 • Gas safety checks 16/11/04 • Electrical installations 10/01 [valid for five years] • Lift servicing 21/4/04 • Emergency lighting 15/6/04 • Nurse call system 12/11/04 • Hoists 25/6/04 • Fire alarm servicing 15/6/04 The inspector was concerned to note that despite a requirement at the previous inspection fire drills are still not been carried out at the home and records indicated that the last fire drill was carried out in September 2003. Checks on portable appliance testing was last carried out in May 2004 and is now due. Fire extinguishers in the home were inspected on 24/4/04 and are due for servicing. The registered person must ensure that these health and safety checks are carried out without delay. Wellington Park Nursing Home Version 1.00 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 3 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 1 x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 1 x 1 Wellington Park Nursing Home Version 1.00 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14 Requirement Timescale for action 19/8/05 2. 8 12(1)(a) (b) 3. 11 12(2) 4. 24 16(2)(1) The registered persons must ensure that the initial assessment form includes information relating to service user’s social needs before it is implemented. The registered person must 30/6/05 ensure that the frequency of how often turns of service users should take place is clearly documented. [previous timescale of 31/1/05 not met] The registered person must 30/7/05 ensure that each service user has a record of their wishes in the event of their death even if this is just the name of who should be contacted at this time. [previous timescale of 31/3/05 not met] The registered person must 30/7/05 ensure that all the bedrooms have a lockable space provided. [previous timescale of 30/4/05 not met] The registered person must ensure that the following training is provided for staff; Care planning, record keeping Version 1.00 5. 6. 30 18(1)(a) 2/6/05 Immediate requiremen t Page 20 Wellington Park Nursing Home 7. 30 13(3)(5), 18(1)(a) and management of pain. [previous timescales of 15/4/04, 19/7/04 and 10/1/05 not met] The registered person must ensure that all staff receive moving and handling and infection control training. 31/5/05 8. 36 18(2) This requirement is within the timescales set at the last inspection. The registered person is required 9/6/05 to ensure that all staff working in the home receive regular documented supervision at least six times a year. Supervision must cover the aspects outlined under standard 36 of the national minimum standards for older people. [previous timescale of 15/4/05, 19/7/04 and 10/1/05 not met] The registered person must ensure that fire drills take place in the home on a quarterly basis. [previous timescale of 28/1/05 not met] The registered person must ensure that checks are carried out on portable appliances and fire extinguishers. 30/6/05 9. 38 23(4) 10. 38 23(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. Refer to Standard Good Practice Recommendations Wellington Park Nursing Home Version 1.00 Page 21 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 Wellington Park Nursing Home Version 1.00 Page 22 - 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!