CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE
Winston House 68 - 69 The Promenade Southport Merseyside PR9 0JB Lead Inspector
Mrs Margaret Van Schaick Unannounced Inspection 21st November 2005 09:00 X10029.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 Winston House DS0000017265.V271903.R01.S.doc Version 5.0 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 and Care Homes for Adults 18 – 65*. 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. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Winston House Address 68 - 69 The Promenade Southport Merseyside PR9 0JB 01704 532188 01704 530112 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) www.craegmoor.co.uk Parkcare Homes (No. 2) Limited Mrs Valerie Kay Care Home 64 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (34) of places Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Variation agreed for 1 named resident under pensionable age Service users to include up to 30 OP and up to 34 PD The service should employ a suitably qualified and experienced manager who is registered with the CSCI 31/3/2005 Date of last inspection Brief Description of the Service: Winston House is a large detached building, which was originally built in the late 1800’s and was converted into a nursing home in the 1940’s. The home is situated across from the marine lake on the promenade area of Southport, which is within easy access of the amenities of this seaside town. The care home offers nursing care for 34 younger adults with physical disability and 30 older persons with general nursing needs. The home is divided into 3 units over four floors with the older persons unit on the top floor and the two younger adult facilities on the basement, ground and first floors. There is ramp access to the front of the home and the two lifts access all four floors. A nurse call system is in place and suitably adapted bathrooms are situated throughout the home. Park Care Homes Ltd own Winston House and it is managed by Mrs Valerie Kay Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over three days and lasted 17 hours. This was the first unannounced inspection carried out this year as part of the regulatory requirement for care homes to be inspected at least twice a year. As part of the inspection process most of the home was viewed. Care records and other nursing home records were inspected also. Discussion took place with the Manager, Registered Nurses, Administrator and one to one interviews with three of the care staff. Several residents were also spoken with. Four of the residents were interviewed on a one to one basis and their views of the home and the care provided obtained. Satisfaction cards were left for residents and relatives to complete. Comments received about the service from residents and relatives were complimentary and positive. What the service does well:
All of the residents spoken with in the home were complimentary about the staff. Residents stated that staff are always kind, hard working, and supportive. “Staff are lovely, all of them are very nice”, stated one resident. Another resident stated, “staff are kind, Val (Manager) always listens to me”. Comments from the residents about the care received included “I have been on respite care here on two occasions and been well looked after that’s why I am here to stay permanently” and another resident stated “I have been resident here for some years, I like it here and my care and medical needs are looked after.” Care plans are comprehensive and evidence regular reviews of care. New documentation is being implemented at present, which will ensure care records are more organised and user friendly. The home offers daily bus outings for the residents and areas visited include local areas of interest and local markets, which ensures residents are kept in regular contact with their local communities. Residents interviewed are very settled in the home and enjoy a unique ‘community’ type atmosphere. One or two of the residents have been able to bring their ‘family’ pet into the home and other residents have made them welcome.
Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection?
A major refurbishment of the home has taken place over the past few months to include external walls, new windows, new lift and refurbishment of the other lift, new kitchen equipment, laundry equipment, central heating and boilers upgraded, bedrooms redecorated and many with new carpets, most have new furniture and adjustable beds. 80 of the bathrooms and en-suite facilities have been upgraded/refurbished with new ‘wheel in’ shower areas and hallways redecorated. The fire escape has been refurbished and the entrance has been upgraded to include a new user friendly and secure entrance. New bin sheds have been ordered and a side garden is in the process of being landscaped, which adds further private outdoor space for residents to use. The lounges and sitting areas in the home have also been refurnished and decorated with new carpets fitted also. Residents interviewed are delighted with their upgraded accommodation and comments include “I love my room now and like all of the new furniture” and ‘it’s very nice living here’. Many of the residents have been able to choose the colours when redecorating their rooms. This major refurbishment of the home has provided a higher standard of furnishings and living accommodation and ensures a safer and more comfortable environment for the residents. One of the residents who is a wheelchair user has now been accommodated in a more suitable bedroom with additional space that meets their needs. Senior staff have attended a two-day training course with regard to staff supervision and new documentation relating to this is being implemented. This will ensure that all staff employed at the home has identified supervision sessions on a regular basis with confidential records kept. The Registration Certificate is in date and is now displayed in the ground floor hallway. NVQ training at Level 2 and 3 for care staff is at 80 , which is above the minimum standard of 50 . Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 7 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. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 2 OP 3. OP 6 is not applicable Residents admitted to Winston House have an assessment of their needs prior to admission but some of the assessments carried out need to be more in depth to ensure the home can meet their varying needs. EVIDENCE: Prospective residents to the home have an assessment of their needs carried out prior to admission unless an emergency admission. Some of the assessments on file are also from other health care professionals such as residents coming in for respite. Information is also sought from the relatives of prospective residents where able. Where there is inadequate information during the assessment process the home should not agree admission until full information is made available so that the home can make an informed choice as to whether the home will be able to meet the prospective residents needs or
Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 10 not. This information enables senior staff to ensure all problems and goals are identified and an appropriate care plan is set up to ensure all needs are met. Following assessment, the home should confirm in writing that they are suitable to meet the needs of the prospective resident in respect of his health and welfare. One of the files viewed by the Inspector showed a resident living in the home was ‘out of category’. The resident has been at the home for some years now. This resident needs to be kept under review and reassessed where necessary. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): YA 6,9,16,18,19 and OP7, 8,9 Some of the residents interviewed were informed about their conditions and praised staff for the support provided to enable them to make informed choices. Further training is required to ensure all staff work to the required minimum standards with regard to medication administration. Reviews of inappropriately placed residents needs to take precedence so as to access the appropriate care for their needs. EVIDENCE: Residents interviewed stated they felt that their healthcare and personal needs were being met. Comments included ‘I can get up whenever I wish and all I
Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 12 do is ring for help and someone comes to help me’. ‘I haven’t seen my care plan but I understand my health needs and have told them what I would like to happen’. Residents interviewed stated that they were able to access specialist care on a regular basis and when needed. Care plans and professional visit notes evidence visiting specialist and clinics attended. The care plans viewed during the inspection were not signed by the residents therefore this needs to be addressed. Other residents stated they had specialist equipment in their rooms for their comfort and health needs. These were also viewed during a tour of the building. One resident stated ‘I was able to move to a larger room as I thought my old room was too noisy and smaller than this one’. Medication records are in general set up very well with one Registered Nurse appointed to be responsible for the ordering, receipt and storage of medication, however errors are made which need to be addressed to include missing signatures from the Aberdeen (medicine) sheets and new medication deliveries. Medication is sometimes prescribed following GP visits and when the new medication is received these are sometimes recorded on the Aberdeen’s incorrectly. The home has identified specialist instructions from GP’s, which are recorded in the resident’s medication records with allergies identified also. This is good practice and provides up to date information for the Nurse administering medication. The home has been having problems accessing specialist intervention for one of their residents who is inappropriately placed despite several attempts to do so. The intervention was sporadic and not effective. During the inspection visit the Manager managed to access the specialist who was able to arrange further treatment for the resident concerned. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 7,11,12,13,15,17 and OP15 Some of the younger adults could benefit from using the identified space for development as a rehabilitative unit, which would promote their independence. Some input from educational/training agencies may also help with improved choices about how they wish to spend their time. EVIDENCE: Residents interviewed stated that they were often encouraged by staff to make choices about how they lived their lives and comments from residents included “ I chose to change my room as I wasn’t really happy in the other one” and “I was able to bring my cat with me when I moved in and she is really settling down very well”. Some of the residents interviewed were able to go out
Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 14 independently and enjoy activities in the community to varying degrees. One resident interviewed regularly visits his family and has many outside interests. However there are some residents who would benefit from further education/training and work opportunities, which would enable them to lead a more fulfilling life where practicable. This was discussed with the Manager who is at present trying to access further information with regard to what may be available in the local community. There has also been space allocated in the home for the young disabled adults to use. This space needs to be developed to ensure the younger adults have some form of rehabilitative accommodation that is suited to their needs, which would enable them to have a more active role in the home and local area. Residents interviewed stated, “the activity person has left and not been replaced”. The Manager is at present arranging the activities programme to suit the residents with the homes bus also in use each day to take the residents who wish to on local outings. An activities person has also been identified. Residents interviewed stated they enjoyed the trips as previously discussed in this report. The local clergy visit the home and provide a weekly service. Residents interviewed were generally complimentary about the meals served with comments such as “the lunch menu is lovely”. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 15 Complaints and Protection
The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 22,23 and OP 16,17,18 Residents interviewed stated they were confident about discussing any issues with senior staff and have been able to during their stay. Residents interviewed were aware of how to use the complaints procedure, which enables them to have their concerns raised and resolved to their satisfaction. EVIDENCE: The complaint procedure is displayed in the front hall and residents spoken with understood there was a complaints procedure and who to complain to if they had any concerns. One of the residents interviewed stated, “staff are kind and Val (Manager) always listens to me”. The complaints book was viewed and showed the complaints made, the investigation and the outcomes. Residents interviewed generally stated they had nothing to complain about but if they had they would speak to the senior staff about it. Most of the staff has attended abuse training and many have attended training with regard to the Protection of Vulnerable Adults (POVA). Staff records examined evidence Criminal Record Bureau (CRB) and POVA checks have been made prior to employment. Residents have access to Sefton Advocacy and their contact details are displayed also. The homes administrator has records of residents monies held on their behalf with receipts held also. Financial records kept were viewed and found to be
Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 16 organised and up to date with residents signatures where appropriate. The company also audit the accounts twice a year. Residents are assisted by the home where needed to ensure all monies due to them are accessed. The Sefton Adult Protection Procedure is in place and the Manager is due to attend training with regard to this. A ‘whistle blowing’ policy is in place and staff interviewed was aware of the process. Staff interviewed stated “I feel confident to approach senior staff if I have any concerns”. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 17 Environment
The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 24,26,27,28,29,30 and OP19, 26 Winston House has gone through a major upgrade to include all areas of the home and residents interviewed stated they are happy with the changes and find the home is now brighter, cosier and provides a better service. EVIDENCE: The home has recently undergone a major refurbishment programme as previously discussed in this report and residents interviewed were complimentary about the new furnishings and decoration. Comments from residents included “I like all the new furniture and my room is much brighter”
Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 18 and “I feel as if this is my home and I like it”. Shared facilities including sitting rooms and dining room have been furnished and decorated in a homely and comfortable style. There is a recently landscaped secluded garden area situated at the side of the home, which is in addition to the front patio area. One sitting room has been appointed for smokers. Two rooms have also been allocated for the sole use of young adults, which are to be fitted as a kitchen/sitting/dining room unit to encourage independent use. All public areas of the home for residents use is easily accessed by the residents via ramps and lifts although one small sitting area has to be negotiated by a longer route. Some of the bedrooms have less space than others and therefore each room allocated to residents must be assessed prior to allocation. Outside space is easily accessed also by ambulant residents and wheelchair user residents. Various hoists are in place throughout the home for the use of residents in their rooms or bathrooms with each resident individually assessed for manual handling with updates on a regular basis. Each bed in the home is adjustable and pressure-relieving aids are in use. Many of the bedrooms have been personalised and include favourite items of residents including photographs and ornaments. One of the residents interviewed stated that “my room is really nice and I’ve been able to bring some of my belongings in to make it nicer, it’s my home”. The home is in a clean state despite the ongoing refurbishment and residents interviewed were happy with the cleanliness of the home. There is a sluice facility on each floor and the laundry contains two large washing machines and two tumble driers. Laundry services were organised on the inspection visit. Residents interviewed were happy with this facility. Clinical waste, medication waste and sharps are collected on a regular basis under contract. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 19 Staffing
The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 32,33,35 and OP27, 28,29,30 The home runs an induction programme for all new staff and NVQ qualified training is above the minimum required, this ensures staff are trained to meet the needs of the residents. Due to the complex and varying needs of the residents it is important to maintain sufficient levels of staff, therefore this needs to be kept under review. EVIDENCE: Staffing levels are set at minimum standard with additional staff on duty to cover one resident who has one to one care. Some of the residents interviewed stated the staff are busy and some stated, “Staff are always busy, they seem to have to spend more time with some of the other residents” therefore this needs to be kept under review. The home has a full training programme with training planned over the year to cover mandatory training and additional training where needed including palliative care, diabetes, Huntington’s Disease and managing aggressive behaviour. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 20 Staff files viewed evidence training attended and confirm CRB and POVA checks are in place. An induction programme is commenced at start of employment with evidence of signatures and dates attended. 80 of care staff are trained to NVQ Level 2. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 10,38 and OP33, 35,38 EVIDENCE: Policies and procedures are reviewed on an annual basis and resident’s individual records are held in a secure filing cabinet in a locked office.
Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 22 Residents interviewed stated they liked the staff with comments including “staff are nice and if I’m worried about anything I only need to ask”. Documented evidence is available of Sefton Advocacy visits for the residents where needed. Financial records are kept of all financial transactions with individual records and receipts where necessary. One of the residents has been experiencing problems accessing their personal allowance and was successfully being assisted by the Manager in resolving this issue during the inspection process The home has residents meetings with minutes published and resident’s satisfaction questionnaires are given out each year with responses generally positive. Some of the residents interviewed stated during the refurbishment of the home they were consulted on the choice of room décor. One or two of the residents chose to opt out of having new furniture and wished to keep their original furniture as it belonged to them. Residents interviewed also state they were consulted on a variety of issues including planning trips out, holidays and their individual personal interests. As the home has undergone a major refit with various workmen in the home each day, the Manager has had to liase with the builders regularly to ensure all safe working practice prevents any possibility of injury to the residents. All up to date certificates including emergency lighting, fire alarm maintenance, smoke detectors, electrical equipment testing, boilers, hoists and lifts are in date with certificates evidencing this. Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 23 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 X 2 X 3 2 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 X 32 X 33 2 34 3 35 3 36 X 37 3 38 3 Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 24 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 OP3 Regulation 14 Requirement The Registered Person must ensure a thorough assessment has been carried out prior to admission to ensure the home is able to meet the varying needs of the prospective resident. The Registered Person must ensure there is more evidence to show that the residents are involved in setting up their care plans. (This is a previous requirement). The Registered Person must ensure the home is able to meet all residents’ needs and ensure intervention is accessed at an early stage to ensure appropriate treatment is commenced as soon as possible. The Registered Person must ensure all Registered Nurses responsible for the administration of medication are fully trained in this area. The Registered Person must continue to develop opportunities for the residents to participate in the day to day running of the home and to contribute to the development
DS0000017265.V271903.R01.S.doc Timescale for action 02/01/06 2 YA6 16 06/03/06 3 OP8 12 02/01/06 4 OP9 13 23/01/06 5 YA8 16 06/03/06 Winston House Version 5.0 Page 25 and review of policies, procedures and services. (this is a previous requirement) 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 YA11 Good Practice Recommendations It is recommended that the Registered Person should continue to develop opportunities for social rehabilitation in the home with particular reference to the provision of facilities for domestic training. It is recommended that further educational and training opportunities should be accessed for the younger residents with regard to how they personally develop and become more independent. It is recommended that the identified space of two rooms is developed to provide the rehabilitative accommodation suitable for the younger adults. It is recommended that staffing numbers be kept under review to ensure residents needs are met. It is recommended that staff files are better organised to ensure they are user friendly. 2 YA12 3 4 5 YA24 OP27 OP37 Winston House DS0000017265.V271903.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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