Inspection on 23/11/06 for Weston Park Care Home

This inspection was carried out on 23rd November 2006.

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 12/12/07

Weston Park Care Home 20/06/07

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 23rd 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 Weston Park Care Home DS0000068323.V315456.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.V315456.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 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 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.V315456.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: * Within the total number of 90, 51 service users in the category of DE (E) may be accommodated in mulberry and Silk Units at any one time. * No more than 39 service users in the category OP (Old age, not falling within any other category) may be accommodated in Weaver Unit. * Within the total number of 39 in the category of OP, no more than 10 service users requiring intermediate care may be accommodated. * Within the total number 10 service users requiring intermediate care, 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. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance, which may be issued through the Commission for Social Care Inspection. 1st June 2006 2. 3. Date of last inspection Brief Description of the Service: Weston Park Care Home is within easy reach of Macclesfield. 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. The management arrangements remain the same including the same person from Four Seasons being responsible for overseeing the running of the home on behalf of the company. 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. Within that number of beds, 10 are used to provide intermediate care for people leaving hospital under a contract with the local health agencies. Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 5 There are nine day/quiet rooms, eighty nine single bedrooms with en suite facilities, one double bedroom with en-suite facility, ten bathrooms and nine showers. There are enclosed garden areas to the rear of the building. According to the pre inspection questionnaire received before the site visit, the scale of fees range from £390.35 - £545.00 per week. Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection visit took place over 1.5 days. The inspectors visited the home on 23rd November 2006 to do a site visit, and returned on 5th December to speak with the manager. Ms Margaret Barry, an ‘expert by experience’ (see below) visited the home on the 23rd November and stayed approx 2.5 hours. CSCI is trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people whose knowledge about social care services comes directly from using them. Before the site visit the manager was invited to provide information as part of this inspection process. The views of residents, relatives and health and social care professionals were also sought. Their comments are incorporated into this report. During the site visit inspectors spoke with the manager, several staff members, residents and relatives. The expert by experience spoke with several residents in the lounge and dining rooms, spoke with the activity coordinator and had lunch with residents. Five residents’ records were examined as part of the inspection process, in respect of the care they receive. Records of medication, care plans staffing rotas and training were also examined. The home’s policies and procedures and other documents were also checked during the visit. At the time of the last inspection, the home was still owned by Four Seasons Homes No 5 Ltd. The senior manager who was identified as the person responsible in company for the way the home is run (called ‘the responsible individual) was required to send CSCI an improvement plan showing how and by when the organisation intended to meet the large number of requirements made. A meeting took place with the Commission for Social Care Inspection officers and senior managers from the company to discuss in detail the improvements that were required. The company gave assurances of their intention to improve services at Weston Park Care Home. Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? Psychiatric assessments are now done for residents due to be admitted to Silk or Mulberry units. This means that their mental health needs are assessed fully to make sure that staff at the home can meet their needs. In addition a registered mental nurse (RMN) has been recruited to manage Mulberry unit. This appointment will provide residents with the specialist nursing care they need. Recording in the care plans has improved so staff are better informed about residents’ needs. However, there are still improvements to be made to ensure that all residents have current care plans in place which are updated regularly. The home has bought additional equipment, including more hoists, to meet the needs of the residents. More staff have been allocated to work on Silk unit and there are now two qualified nurses working on Mulberry unit during the day. This means that residents should receive the specialised nursing care they require. The way complaints are handled at the home has been improved. A log of all complaints received into the home is now kept so the manager is aware of all issues and can address each individually. The records show that complaints are now dealt with quickly and appropriately. Staff said they feel more supported in their role. Staff and residents said that they feel the manager is approachable. The manager is introducing a quality assurance system into the home to make sure that residents receive a high quality service. Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 8 Staff training has improved. Several staff have attended talks on adult protection, managing challenging behaviour and dementia. 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.V315456.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 Weston Park Care Home DS0000068323.V315456.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Assessment of a resident’s needs is generally done before a resident moves into Weston Park Care Home to make sure that staff can meet their personal, health and social care needs. EVIDENCE: Five residents’ case records were looked at during the site visit. These showed the manager had visited residents before they moved into the home to find out what their needs were. Psychiatric assessments were done as required. However, one resident with a diagnosis of dementia had moved into the general nursing unit. There was nothing to show that a mental health assessment was done before the move. The manager said the assessment had been done but she had not received the paperwork. She said that this resident’s overall nursing needs were because of her physical health. However, it became clear once she moved in that the needed more specialist Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 11 care from the registered mental nurses (RMNs). The manager was in the process of dealing with this. A registered mental nurse has been recruited to manage Mulberry Unit. Intermediate care is provided at the home. There are designated rooms for this purpose as well as a small lounge for residents to use. Residents spoken with were positive about the team involved and said they felt their needs were met. Weston Park Care Home DS0000068323.V315456.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care plans had generally improved but there were some problems with the care provided such as answering of call bells promptly that could put residents at risk of not having their care needs met. EVIDENCE: The care plans have improved since the last inspection. Most of the residents had a care plan in place that was based on their needs. However, for some residents there were still gaps in recording that could mean that staff may not be aware of their health, personal and social care needs. Mixed comments were received from residents and relatives on whether residents’ health personal and social care needs are met by staff at the home. Some residents said ‘staff are good and kind’. Another said ‘congratulations to Weston Park for their welcoming and gentle and caring attitude’. One relative was happy that his father had put on weight recently and was well cared for. Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 13 However others comments were received as follows: ‘staff do not always listen to what I say and are not always available when I need them’. One healthcare professional commented that ‘it was not always easy to find staff when visiting and that there are sometimes language problems with staff’. On Weaver Unit a ‘draw’ sheet was placed on a resident’s bed. When asked the resident did not know why it had been placed there. This is not considered good practice as it could lead to the development of pressure sores. All of the residents spoken with on Weaver unit said that call bells are not answered quickly enough. One resident when asked about response times to call bells commented ‘we don’t mention that’, another resident said ‘it can take up to half an hour to have a call bell answered’ . A third resident said ‘sometimes it can be up to one hour before staff answer the call bell’ One visitor said that sometimes it can take a long time to answer the buzzer and she felt it was not acceptable as residents have to wait for the toilet. On Weaver unit residents were seen calling out for attention. After approximately 10 minutes a nurse came in and said to one of the residents that she would be back as she was attending to another resident at that time. On Mulberry unit a qualified nurse was seen giving an update on the residents’ condition to care staff at 1120hrs. This took place in the lounge/dining room where residents were sitting. Information relating to specific residents should not be discussed in communal areas. The inspector saw one resident in the lounge repeatedly try to stand up and it was only after four attempts that a carer went over to help him. Several records were seen lying in the residents’ lounge/dining room when there were no staff members present. This is not good practice as someone unauthorised to see the records could look at the information or residents may decide to move them and potentially lose them. A carer was seen sitting at a table in the lounge area filling a fluid balance chart at 1130am. At the same time another resident’s fluid balance chart was seen to be still blank. If staff are filling in charts for residents who have had breakfast and drinks some time afterwards, the charts may not be accurate and so residents’ health could be put at risk. The healthcare needs of residents should be monitored more closely. For example, for one resident who was admitted in early October, the daily records identified problems with eating and drinking, however there was no record that she had been weighed since she moved into the home. After the site visit a social told the inspector she had done a review on the care of a resident. During the review she found that the resident had lost a large Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 14 amount of weight over a considerable period of time and nothing had been done to address this until the review of their needs had been done. The amount of equipment available for residents to use has improved since the last inspection. There is a hoist specifically for use on Silk unit. Several other hoists were seen around the home. There appeared to be enough pressure relieving mattresses available for residents. The storage of some medicines needs to be improved as several creams were found in residents’ rooms. These had no name labels to identify who the creams belonged to. Medicines are generally managed satisfactorily although there were some discrepancies on the medicine administration record (MAR) sheets relating to staff signatures. Staff need to be careful to ensure that medicines are signed for appropriately. The amount of variable doses given to residents also needs to be recorded. Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 &15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The lack of activities and poor practice in relation to assisting people to eat means that residents are at risk of their needs not being met. EVIDENCE: There was little evidence of meaningful activities taking place in the home on the day of the site visit. A church service had been organised on one of the units in the afternoon. The expert by experience discussed the activity programme at length with the activity organiser. There was evidence that the organiser is trying to meet the needs of the residents. However she only has 26 hours per week to do activities with all of the residents in the home. This is not sufficient to ensure that residents are kept occupied and active. The manager confirmed that an advertisement has been placed to recruit another activity organiser. Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 16 The library visits monthly bringing 70-100 books from Macclesfield Library. Large print books are available and talking books with news, jokes and local news for people who are partially sighted. Occasionally outside entertainers visit the home. The vicar visits monthly. The home allows £80/month for activities. Out of this a £20-£30 donation is made for the singing group. Christmas Hamper, Spring Fair and Summer Fete all bring in money which is used for activities. Many of the residents on Weaver Unit were seen sitting in their rooms for most of the day. Although members of staff said this was the residents’ choice, there was nothing happening in the lounge areas to encourage residents to leave their rooms. One lady at lunch said she does some cross-stitch whilst another lady said that there was ‘nothing much to do’. Trips out for a few of the residents have been organised. For example: two ladies had attended a member of staff’s wedding followed by lunch out and the afternoon shopping. One lady was taken to see her sister’s new house and a man who had been a farmer was taken to watch some lambing in the hills locally. Four ladies said they would like to do some Christmas shopping. There was little evidence to suggest that the majority of residents are kept stimulated and active. Visitors said they are made welcome into the home. However one GP and one relative said that there are sometimes difficulties in getting an answer to phone calls especially at weekends. Residents said that choice is promoted, that they are able to choose what to wear, when to get up and go to bed and what they want to eat. A comment back on a CSCI survey form said ‘it would be helpful for staff and visitors if meal times – especially mid day one - could be on time thus giving staff time to help their relative/friend eat as necessary. Another said ‘the food is not always hot enough’. The unit manager was seen given out tea in the morning – no biscuits or snacks available. Staff confirmed that biscuits are not offered mid morning. One resident told the inspector that she was hungry; she had been given tea and porridge at breakfast, there was no toast offered and no mid morning snack. Comment cards also indicated that there is a lack of staff available at mealtimes to help residents. The expert by experience had lunch with some of the residents on Weaver unit. New menus have been introduced on a four week cycle where there is Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 17 nothing repeated in the four weeks. This means residents are provided with varied meals. The dining room and tables did not appear to be homely or inviting as there were no tablecloths on the tables and the napkins were cut into quarters. Throughout the meal one lady was asking loudly about her husband and refused to eat anything. The expert by experience did not see any recording of the amount people ate during the lunchtime period. Three ladies were seen eating their meals away from the main dining tables. One lady was eating from a bed table piled high with books. This does not lend itself to a pleasant environment for eating. At 1245pm the inspector saw a resident sitting at the dining table with her food in front of her. She needed help but as one carer was already helping another resident, the other resident’s food would have been cold before she received any help to eat. After the site visit a social worker said that a concern had been raised about lack of help at mealtimes and not monitoring a resident’s food intake which led to them losing weight. She confirmed that since the issues were raised with the manager, she has taken action and the resident has gained some weight since the review. Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 18 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 good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously so residents can be confident that they are listened to, and they are protected from injury or harm. EVIDENCE: The way complaints are handled at the home has been improved. A log of all complaints received into the home is now kept so the manager is aware of all issues and can address each one individually. The records show that complaints are now dealt with quickly and appropriately. Several members of staff have attended adult protection training since the last inspection. Staff spoken with knew the action to take should an allegation or incident occur. Appropriate action has been taken by the manager regarding incidents that have occurred since the last inspection. Weston Park Care Home DS0000068323.V315456.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24 & 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although the environment is generally well maintained some areas of the home were not very clean and poor staff practices in relation to infection control could leave residents at risk. EVIDENCE: The general maintenance of the building appears satisfactory. New carpets have been purchased for Silk Unit since the last inspection. New flooring has been provided for the kitchen. The manager has done an audit on the home and identified several mattresses and bedding that require replacement. Several pillows have been replaced and more are due for replacement shortly. While touring the building the inspector noted that a heavily stained mattress that required replacement was placed on an empty bed in a double room. The bed had not been made and so would be unsightly for the resident or any Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 20 visitors using that room. Some poor quality pillows were also noted but the manager said she is in the process of replacing all of the pillows. . Residents’ rooms were personalised in the main. Some of the bedding was marked and stained and required replacement. One resident said ‘my bed has not been made for two weeks – since I came into the home’. A number of the bathrooms and shower areas were seen during the site visit. There is no screen/curtain around the shower and so residents may feel exposed when taking a shower. Socks and tights were stored in three baskets in the linen store. These did not have name labels to identify who owned them. The cleanliness of the home needs to be improved, in particular Silk unit . Bedrooms had not been cleaned by the afternoon, dirty laundry was left in the room from the morning, and there were bits on beds and carpets. Some cups on Mulberry unit were marked and stained. Although the manager said these were staff cups, care should be taken to ensure that they are kept clean. The temperature of the fridge in the kitchenettes was not kept and so it is difficult to ascertain whether any food stored there was at a correct temperature. Several infection control issues noted for example: incontinent pads were stored on top of the sluice machines, an overlay mattress on floor. There was no soap in the holder or paper towels in the sluice room. Weston Park Care Home DS0000068323.V315456.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. 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 have been improvements in the staffing on Mulberry and Silk units, there were not enough staff working on Weaver Unit to meet the needs of the residents. EVIDENCE: Some residents were complimentary about the staff and comments such as ‘the staff are kind and good’ were made. One resident said she felt staff did not take things seriously and laughed at her. Another lady said ‘she objects to people not talking to me properly’. A comment from a social worker indicated that at times language could be a problem. Three of the comment cards received back indicated that there are not always not enough staff on duty at all times to meet the needs of the residents. However, since the last inspection the number of staff on Silk unit has increased by one in a morning. Members of staff spoken with said that they felt this was beneficial and they could now meet the needs of all of the residents on that unit. Some members of staff were seen standing around in the lounge areas and did not appear to be interacting well with the residents. Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 22 On Mulberry unit a registered mental nurse has been recruited to take charge of the unit. The skill mix of staff has been changed and two qualified nursing staff are now on duty every morning which means that the healthcare needs of the residents should be met. Weaver unit did not have enough staff on duty on the day of the site visit. The manager said this was due to the fact that a resident admitted for intermediate care had to attend a planned hospital appointment. Additional staff had not been brought in to cover this temporary shortfall. Several of the residents on Weaver unit were still in bed at 11am. Staff appeared rushed and were not able to attend to residents’ needs promptly. Three personnel files were looked at during the site visit. These contained most of the information required to ensure that staff were suitable to work in a caring capacity. Criminal Record Bureau checks had been requested and these are returned to the company’s head office. Staff at head office then inform the manager whether the person is suitable to work. However there is no written record kept on the personnel file at the home of when it was returned and when the decision was made that the staff member was suitable to work with vulnerable adults. One member of staff started work in early November but the manager did not get confirmation from head office that the POVAfirst check had been received until eight days later. This is not good practice. The amount of training available to staff has improved since the last inspection. Members of staff spoken with said that there are plenty of training opportunities for them. There was evidence that staff are taking part in various training courses. However, some of the staff had not attended up to date training on moving and handling. Weston Park Care Home DS0000068323.V315456.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 &38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well managed but there were some health and safety issues that need to be addressed to ensure that residents and staff are not placed at risk. EVIDENCE: There is no registered manager in post at the home. With agreement from CSCI, an experienced manager who has worked for the company for some time is managing the home for a period of time – no less than six months. This meant that the company would have time to recruit the right person for the manager’s post at Weston Park. There have been several improvements made since the temporary manager has come into post. Staff, residents, relatives and visiting professionals have Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 24 been very positive about her input. One resident said that ‘the manager Julie is good and listens and treats you as an individual’. The manager was in the process of introducing a quality assurance system into the home. Some audits have been done with plans to do more. More supernumerary time needs to be allocated to the unit managers to ensure that the home is run in the most efficient and effective way. This time should be identified on the weekly rota. There was evidence that the manager was attempting to address problems as they arose. For example minutes from a staff meeting highlighted that staff had been told to make sure that fluid balance charts were filled in correctly. A senior manager from the company visits Weston Park Care Home monthly, speaks to residents, and checks a sample of records. A report of her findings is given to the manager and a copy sent to CSCI. There is an adequate system in place for the management of residents’ monies. This has not changed since the last inspection. A sample of maintenance records were looked at. These were found to be satisfactory. The records indicated that moving and handling training is outstanding for some members of staff. The manager confirmed that additional moving and handling training has been organised and staff have been sent a letter to remind them to attend. Weston Park Care Home DS0000068323.V315456.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 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 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 3 2 x x 3 X 3 X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X 2 2 Weston Park Care Home DS0000068323.V315456.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 OP8 Regulation 12(1)(a) Timescale for action The registered person must 23/12/06 ensure that call bells are answered promptly to ensure that residents’ health and welfare is maintained. The registered person must 23/12/06 ensure that the fluid intake of residents is recorded accurately. (Previous timescale 12/06/06 not met.) The registered person must 30/12/06 ensure that residents who are at risk of weight loss are weighed regularly. This must be monitored by staff at the home and appropriate action including referral to the GP and dietician must taken as soon as possible. The registered person must 31/01/07 ensure that suitable activities are provided for residents to take part in on all units so that residents are kept stimulated and active. The registered person must 30/12/06 ensure that all areas of the home are cleaned regularly. Requirement 2 OP8 12 3 OP8 12(1)(a) 4 OP12 16(2)(n) 7 OP26 23(d) Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 27 8 OP26 16(2)(e) 9 OP26 13(3) 10 OP27 18(1)(a) 11 OP27 19 Schedule 2 12 13 OP30 OP38 8(1) 18(1)(c) The registered person must make sure that residents’ bedding is changed regularly and any sheets, pillowcases, duvets etc that are marked or stained are changed without delay. (Previous timescale 01/07/06 not met.) The registered person must make sure that items are not stored inappropriately in the sluice and that soap and paper towels are provided to minimise the risk of cross infection. The registered person must ensure that there are enough staff on duty on Weaver unit to meet the needs of the residents, should a member of staff have to accompany a resident on a visit outside of the home. The registered person must ensure that a CRB disclosure or POVAfirst check is obtained before a member of staff commences employment at the home. (Previous timescale01/07/06 not met.) The registered person must recruit a manager to be put forward for registration. The registered person must make sure that all staff receive annual updates on moving and handling techniques. 23/12/06 23/12/06 23/12/06 05/12/06 31/03/07 30/01/07 Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 28 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 7 Refer to Standard OP3 OP8 OP9 OP11 OP15 OP15 OP15 Good Practice Recommendations The registered person should make sure that any assessment documents associated with the admission of a resident are kept on file at the home. The registered person should ensure that draw sheets are not placed on residents beds unless it is assessed as a clinical need and agreed with the residents. The registered person should ensure that creams are stored appropriately. The registered person should ensure that information pertaining to specific residents is not discussed in a public area. The registered person should ensure that residents eat in pleasing surroundings. The registered person should make sure that hot and cold drinks and snacks are available at all times and offered regularly. The registered person should ensure that the temperature of the fridges in the kitchenette areas is taken twice daily and this is recorded, if these fridges are used to store food or drink for residents. The registered person should keep a record of the date the CRB check was returned and the outcome of the check. The unit managers should be allocated supernumerary time to undertake the management aspects of their role. This time should be identified on the weekly rota. Staff should make sure that records pertaining to residents are not left unattended in communal areas. 8 9 10 OP29 OP31 OP37 Weston Park Care Home DS0000068323.V315456.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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.V315456.R01.S.doc Version 5.2 Page 30 - 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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