Inspection on 12/12/07 for Weston Park Care Home

This inspection was carried out on 12th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Weston Park Care Home 20/06/07

Weston Park Care Home 23/11/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Weston Park Care Home Weston Park Moss Lane Macclesfield Cheshire SK11 7XE Lead Inspector Helena Dennett Unannounced Inspection 12 December 2007 10:00 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 Weston Park Care Home DS0000068323.V355542.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. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Weston Park Care Home Address Weston Park Moss Lane Macclesfield Cheshire SK11 7XE 01625 613280 01625 502914 weston.park@fshc.co.uk 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) Lunan House Limited vacant post Care Home 90 Category(ies) of Dementia - over 65 years of age (51), Old age, registration, with number not falling within any other category (39), of places Physical disability (2) Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 90 service users to include: * Up to 51 service users in the category of DE(E) who may be accommodated in Mulberry and Silk Units only * Up to 39 service users in the category OP may be accommodated in Weaver Unit * Within the total of 39 in the category of OP, no more than 10 service users requiring intermediate care may be accommodated * Within the total of 39 no more than two service users between the ages of 55 years and 65 years in the category of PD may be accommodated in Weaver Unit 31st October 2007 Date of last inspection Brief Description of the Service: Weston Park Care Home is close to Macclesfield town centre, in Cheshire. The ownership of the home was transferred in July 2006 from Four Seasons Homes No 5 Ltd to Lunan House Limited, also a subsidiary company of Four Seasons Healthcare. Weston Park Care Home is a three-storey building with accommodation for residents on the ground and first floors. The second floor houses the laundry, offices and staff facilities. A two-storey annexe was opened in 1997 and is connected to the main building by an internal corridor. The annexe (Silk Unit) and the ground floor (Mulberry Unit) of the home provide care and support up to 51 older people with dementia. The first floor (Weaver Unit) provides nursing and support for up to 39 older people. There are nine day/quiet rooms, eighty-nine single bedrooms with en suite facilities, one twin bedroom with en-suite facility, ten bathrooms and nine showers. There are enclosed garden areas to the rear of the building. According to information received before the site visit, the scale of fees range from £402.37 to £580 per week. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. After the last major inspection of the home, the senior management of the company were asked to provide an improvement plan to demonstrate how the company intended to make improvements to meet the requirements made during that visit. Short, focussed inspection visits were carried out to monitor progress; however there continued to be concerns around the administration of medicines and the quality of the care being provided to people in the home. As a result two statutory requirement notices were issued, one in relation to medication and the competency of staff, the second making requirements to improve care plans, health care provision and the privacy and dignity of residents. Two further short inspections were carried out after that and staff were found to have complied with most of the requirements of the notices. This visit, which is part of the major key unannounced inspection, took place on 12 and 14 December 2007. Helena Dennett, Paul Ramsden and Anthony Cliffe, Regulatory Inspectors, visited the home on 12 December and looked at the care provided to residents. Elaine Bray, pharmacist inspector, visited on 14 December 2007 and looked at the medicines. The visit was just one part of the inspection. Staff at the home were not informed of the date the visit was to take place, but a few weeks before the visit the manager was asked to complete a questionnaire to provide us with some information about the service. The manager was also asked to distribute CSCI questionnaires to residents, relatives and health and social care professionals, such as nurses and social workers, to help us find out what they think of the home. During the visit we spoke with the acting manager, staff, residents and visitors. We toured the premises and looked at various records in relation to the running of the home. What the service does well: Residents spoken with were positive about the staff and the care provided at the home. The following comments were made on survey forms returned before the site visit: ‘Care is excellent and to a high standard. Commitment to residents welfare is evident’ -The environment of the home is pleasant, staff are friendly and approachable’ Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 6 Staff visit people either in their own home or in hospital before they move into the home so that an assessment of a person’s health and social care needs is carried out to make sure that everyone is aware of the needs of the person before they move in. There are good links with the Primary Care Trust nurses and good relationships exist so staff can get more specialised input as necessary. There is a good complaints procedure available in the home so residents can be confident their complaints will be listened to and acted on accordingly. The home is well maintained, clean and tidy and free from any unpleasant odours so people live in pleasant, comfortable surroundings. There is a good quality assurance system in place, which means that managers should be able to identify problems as they arise and deal with them quickly and effectively. All essential equipment is maintained regularly to make sure that it is safe for people to use. What has improved since the last inspection? Care planning has improved since the last inspection; however further improvements are needed to make sure that they are kept current and reflect the actual needs of the person so all their needs will be met appropriately. Record keeping has improved, so the health care needs of residents are monitored and action is taken when necessary. Specialised equipment is provided for people at risk of developing pressure sores and there is good evidence that staff are monitoring peoples wounds closely so ensuring that the best care is provided. The provision of activities has improved since the last inspection. Residents spoken with confirmed that activities are provided and entertainers visit. Members of staff also said they thought the amount and type of activities provided was good. The dignity of people living in the home is now maintained. Staff no longer discuss residents needs in the lounge area and records are kept more securely in the offices so confidentiality is maintained. All staff have had moving and handling training, which means residents should not be placed at risk through poor practice. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 7 Communication systems in the home have improved and the acting manager or senior staff notify the appropriate authorities in the event of any serious incident occurring so that appropriate action can be taken to ensure the health and safety of people living in the home. What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have their needs assessed before they move into the home so they can be confident that staff at the home can provide the care and facilities they need. EVIDENCE: Information about the home is contained in a statement of purpose and service user guide both of which are available for anyone who is considering moving in to Weston Park Care Home. They contain information on the facilities in the home, the staff and fees that are charged. A contract is issued to everyone when they move to the home. The owners of the company agreed after consultation with social services to stop admissions to the home for a period, so that changes could be made to the care provided to ensure that everyone’s needs could be met. Recently after consultation with social services and the primary care trust (PCT) it was Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 10 agreed that the acting manager of the home could start admitting people to the home, up to a maximum of two people per week. The notes of one person who had recently moved in were looked at. A qualified nurse visited the person before they came into the home to assess their needs. A full pre admission document was completed. This provided staff with the information they needed to make sure that they had the right equipment etc available when the person moved to the home. Intermediate care is no longer provided at Weston Park Care Home, so standard 6 does not apply. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although people living at the home receive adequate health and personal care, which is based on their individual needs, there were some problems with reviewing care plans, which could leave people at risk of their needs not being fully met. Residents’ dignity is maintained at all times. EVIDENCE: Due to concerns about poor care planning practice, some poor nursing care practice and serious concerns regarding medication, we issued two statutory enforcement notices since the last key inspection, requiring the provider to make sure that people’s needs are met and that they are not placed at risk. Inspections were carried out after the notices were issued to check that the required improvements were being made. These inspections identified an improvement in the care provided and the management of medicines, although some aspects of record keeping needed further improvement to make sure that people’s needs are met. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 12 The records of six people were looked at during this inspection visit. Each record contained some risk assessments, care plans, daily records and records of GP and other health care professionals’ visits. Care planning practices have improved since the last key inspection and some improvements were seen since the last short inspection but there are still some issues that need to be dealt with. The care plans for people living on Weaver Unit were found to be comprehensive and factual and were written in the main to address individual needs. Good daily records were kept on the health and well being of the person. Risk assessments are completed, and residents’ weight was monitored and recorded regularly. One person’s nursing needs had changed, but the care plan had not been updated to reflect the changes so there could be a risk that the person’s needs might not be met. This was discussed with the acting manager who agreed to address this issue with the staff. One care plan for a person living on Silk unit was looked at. This contained all the necessary information required to ensure that the people’s needs are met. Two people’s records on Mulberry unit were also looked at. In one person’s records there were twenty separate care plans in place, some of which contained the same information and so could be confusing for staff. One care plan identified the need to use sedatives as required but when to use them was not clear and the review did not identify whether the use of the sedative was effective. Another care plan identified that a crash mat should be used but when the resident’s room was visited there was no crash mat available. A specialised bed was in place that should prevent the person falling out of bed but the care plan had not been updated to reflect this change. The other person’s records identified that they had challenging behaviour; however the care plan went on to describe normal behaviours rather than challenging behaviour. One intervention stated ‘to apply a therapeutic relationship.’ It is not clear what this means. Some of the care plans use medical language, which means the resident or their relative might not understand the meaning. Residents spoken with were positive about the care provided in the home. They said that the staff were ‘very good’ and looked after them well. The following comments were made on survey forms received back before the site visit: ‘The residents always look clean and smart’ Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 13 ‘There is always a good level of care provided, with patience and excellent understanding’ One healthcare professional visiting the home was positive about the care provided. She said she thought the care had improved recently and that the staff were aware of the individual’s needs. Several people on Weaver unit were seen being nursed on specialised mattresses in bed so reducing the risk of pressure sores. Staff were seen to promote the dignity of people living in the home. Bedroom and bathroom doors were closed before personal care was carried out and staff were seen to knock on residents doors before entering. A CSCI pharmacist inspected the medicines on Mulberry Unit as there had been ongoing concerns about the management of medicines in the home. Residents’ medicines were managed in a monitored dose system where possible. Whilst some were managed satisfactorily, some were not always managed properly. The records for seven residents showed that there were instances where it appeared that medicines had either been given incorrectly or it was not possible to be sure that they had been given properly. It was difficult to ascertain whether everyone had been given their medicines as prescribed as there were unexplained gaps where the persons record had not been signed to say the medicine had been given in twelve residents medicine administration record (MAR) sheets. A waste disposal contractor collects medicines that are no longer needed. There is a list of these medicines but it does not show when the medicines are removed from the premises. The dose of some residents’ medicines, such as painkillers, can vary according to their needs. There is now a protocol in place to describe how to give these medicines. Many of them do not describe in detail when and how to give the medicines. All medicines that are not given as a regular dose each day are not included. There is a list of staff that can give medicines. It is not dated to show it is a current record. There is a system to audit the management of medicines. When problems are identified it does not identify those staff that may need further help. Some items were audited by asking staff on the unit rather than finding hard evidence. It also audited the return of medicines to pharmacy, which is not appropriate in a home providing nursing care. Weston Park Care Home DS0000068323.V355542.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home are able to choose what they eat and there is a range of recreational activities so that people are provided with stimulation. EVIDENCE: A full time activity co-ordinator is employed to work at the home. She produces a weekly activity sheet, which provides information for residents on the activities going on in the home. Residents were positive about the range of activities. The following comments were made during the site visit: ‘There is plenty of entertainment downstairs which I don’t have to pay any extra for.’ ‘There is a very good activity lady who does plenty of things for us. There is entertainment, music and regular church services’ ‘There is plenty going on in the home to keep us busy’ Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 15 The following comment was received back on a survey form before the site visit to the question ‘how do you think the care home can improve’: ‘Perhaps more appropriate regular activities (such as the musical entertainment for residents who can’t take part in handicrafts’ The following comment was made to the question ‘what do you feel the care home does well: ‘Residents are kept entertained at fairly regular intervals and they evidently enjoy this’ Visitors confirmed that they could come and go as they please. Visitors said they are made feel welcome by staff at the home and this was seen during the inspection. Staff appear to have a good rapport with visitors and residents. Residents confirmed that they could choose when they get up and go to bed and whether to take part in any activity going on in the home. Some residents were positive about the meals and confirmed they had a choice. However one resident said that his food was usually cold when it is served. Although the dining rooms on Weaver unit had improved in appearance more could be done to make them warm and inviting and so encourage residents to eat at the dining tables. Hot trolleys are used to serve the meals from. On Mulberry unit during breakfast time, toast was served on the tables early. This meant that any person getting up later would have cold toast. On Weaver unit two members of staff were serving the food and delivering it to residents’ rooms. Although the trolley was plugged in to keep food warm, some of the containers were placed on the tables and so the food would have not have been hot by the time some of the residents received their lunch. This needs to be addressed. Members of staff were seen assisting residents to eat in a sensitive and dignified way. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although residents can be confident that any complaints made will be taken seriously and acted on, the high number of adult protection referrals could mean that residents could be placed at risk by poor practices. EVIDENCE: There is a satisfactory complaints procedure for the home. It is displayed in reception and included in the service user guide. Residents said they would know who to complain to if they had any concerns. Five complaints have been made to the manager of the home in the last twelve months. All of these complaints have been upheld. There has been a large number of referrals made under safeguarding adults procedures since the last key inspection. Several of these related to altercations between residents on Mulberry unit and some unexplained bruising. A review of moving and handling practices was carried out by the deputy manager and he confirmed since then the number of unexplained bruises on residents has reduced. Discussion took place at previous inspections about the need to ensure that residents on Mulberry unit have appropriate supervision and are kept occupied as much as possible to prevent altercations occurring. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 17 None of the care staff working on Mulberry unit have done training on challenging behaviour. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Weston Park Nursing Home is well maintained so residents to live in safe and comfortable surroundings. EVIDENCE: Weston Park Nursing Home provides a good standard of accommodation throughout. There is limited garden space for the residents to use. On a survey form received back before the inspection visit, one relative expressed concern that a proposed extension to the ‘Silk’ unit would result in the loss of a large portion of the garden. All accommodation for residents is on two floors and was found to be satisfactory. Where necessary, adaptations had been made to meet the needs Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 19 of residents who had a physical disability. These included grab rails along corridors and in bathrooms and toilets, raised toilet seats, specialist baths/showers, wheelchairs and hoists. Specialist pressure relieving mattresses were available. Discussion took place with the manager regarding the need to improve the signage on Mulberry unit so that residents would be able to recognise their own rooms. Bathrooms and toilets have been painted a different colour but also require some form of signage so that residents can easily identify them. The manager confirmed plans were in place to improve the environment on Mulberry unit. Residents’ rooms looked comfortable and they contained many personal items such as photographs and ornaments; some residents had brought in small items of furniture. The home was clean and tidy and free from any offensive odours. The laundry was found to be clean and well organised. Residents spoken with were happy with the laundry service. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there were enough staff working to meet the needs of the residents, the lack of training on challenging behaviour could mean residents’ needs are not always met appropriately. Good recruitment procedures means residents can be confident that staff are suitable to work in the care industry. EVIDENCE: There were enough staff working on all of the units to meet the needs of the residents on the day of the site visit. The following comment was made on comment cards received back before the site visit: ‘Today (2/12/07) it took the carers 20 minutes to come even after I pressed the bell. This was around 1.30pm when some of them have their lunch and others haven’t arrived yet to do their shift. Even so when you have to go you have to go! I still fell that lunch hour period should be covered by at least two carers. ‘ Although staff on Mulberry unit confirmed that they felt there were enough staff working on the unit to meet the needs of the residents, they stated that Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 21 at times it is quite difficult as a lot of the residents are mobile, are at risk of falls and have to be checked every fifteen minutes. A sample of recruitment files was looked at during the site visit. These contained most of the necessary checks required to ensure that the person was suitable to work in the care home. For one person, although there was evidence that a Criminal Record Bureau (CRB) disclosure had been requested some time ago there was no record of its return. The member of staff confirmed she had received a copy and agreed to bring it into the home. Members of staff spoken with said they felt supported in their training. Four members of staff have undertaken training on dementia care mapping so they can assess that the most appropriate care is provided to residents. The acting manager keeps a training chart to identify the training individual members of staff have completed. According to the chart five staff completed dementia care training in November 2006; however as stated previously training on challenging behaviour has not been provided for any member of staff. This should be addressed. 25 of care staff have completed a National Vocational Qualification (NVQ) Level 2 or above in care and a further 25 of carers are working towards this qualification. Once completed, this means that at least 50 of carers will have the qualifications, knowledge and skills to meet the needs of the residents as recommended in the National Minimum Standards. There was evidence that staff have done moving and handling training and safeguarding adults training. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The acting manager provides clear leadership so residents can be confident the home is run in their best interests. EVIDENCE: The management of the home has changed since the last key inspection. An acting manager was working on the day of the site visit. She is experienced in management and has worked for Four Seasons Health Care for some time. Staff and residents were positive about the acting manager. Members of staff said they felt the care had improved since the acting manager has come into post. All residents and staff spoken with said that they saw the acting manager around the home during the day and that she was very approachable. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 23 A full time deputy manager who is supernumerary, a unit manager and senior nurses support the acting manager. Regular audits are carried out as well as regular checks on medication, care plans and residents’ weights. The operations manager visits the home weekly to carry out checks and monitor the care provided for the residents. A senior manager carries out monthly visits (unannounced) and produces a report on how the home is running. A relatives’ meeting was planned for the week after the inspection visit. The manager confirmed that a residents’ meeting had not taken place recently. This would provide residents with an opportunity to influence how the home is run. There is a system to manage residents’ money in the home. This is held on computer and records of each transaction are kept. All essential equipment is maintained regularly. Fire checks and fire safety training have been carried out. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 15(2)(b), (c) & (d) Requirement The residents’ care plans must be kept under review, after consultation with them or their representative, revised as necessary and the resident or their representative told of any changes to their care. This means that staff will have detailed guidance on what they must do to meet each resident’s needs in respect of their health and welfare and the resident will be kept aware of any changes to their care. Timescale 15/11/07 not met The administration of medication must be fully and accurately recorded within the medication administration records (MAR) for the individual service user and any non-administration is clearly and fully explained within the MAR. This is to ensure that residents receive their medicines safely as prescribed. (Previous timescales of 22/08/07 and 17/09/07, 28/09/07 and 31/10/07 not met) Timescale for action 15/02/08 2 OP9 13(2) 12/12/07 Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 26 3 OP9 13(2) 4 OP18 18(1)(c) There must be a system to closely monitor the administration and recording of medicines at least once a day to ensure that medicines are given properly to the correct directions and that when errors are found these are correctly documented and staff making errors are identified and given appropriate supervision. This is to make sure that residents are protected from having their medicines incorrectly that may cause significant harm to their health. Timescales 21/09/07 and 31/10/07 not met. Staff working with people suffering from mental health problems must be trained in how to deal with challenging behaviour so the most appropriate care and be given thus reducing the number of incidents happening between residents in the home. 12/12/07 31/03/08 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 Refer to Standard OP7 OP15 Good Practice Recommendations Staff should make sure that care plans are written in plain English so that they are clear to everyone what action should be taken to meet the person’ s needs. The lay out and décor of the dining rooms on Weaver unit should be reviewed to ensure that residents are encouraged to eat their meals in a pleasant and relaxed environment. The way meals are provided to residents should be reviewed to make sure that everyone’s dinner is served at an acceptable temperature. DS0000068323.V355542.R01.S.doc Version 5.2 Page 27 Weston Park Care Home 3 OP27 The manager of the home should review staffing levels during/after lunch time period on Mulberry unit to ensure that there are enough staff on the unit to meet the needs of the residents. Weston Park Care Home DS0000068323.V355542.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Northwest Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Weston Park Care Home DS0000068323.V355542.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. 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