Care Home: Chelston Park Nursing Home

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What the care home does well Overall the homes were very clean, warm and well presented. As the inspection was shortly before Christmas rooms had been decorated with tasteful decorations and there was a festive atmosphere. People were satisfied with the care they received both in Chelston Gardens and Chelston Park. Of Chelston Gardens one relative wrote "This is a place where X is calm and cared for so that there is nearly always a ready smile." Another relative wrote, "The care at this home is excellent. The staff are very kind and caring. Families are kept up to date with the residents treatment and consulted when appropriate." There was also praise for Chelston Park. The staff were praised for their hard work and kindness. People wrote, "Care staff are always polite and very prompt when help is needed." The Expert by Experience wrote in her report "Speaking to several residents they all described the staff as kind and understanding, and always having time to listen to any concerns they might have or simply just to stop for a chat. These comments were in accord with what I saw. I was also told that visitors are always made welcome and they, too, were happy that any concerns could be raised and would be listened to sympathetically." All comment cards stated that staff are always or usually available when people need them and that they listen to people and act on what they say. Rotas indicated a stable work force with attention to appropriate numbers of trained staff. The majority of people who returned cards said that they always received the medical support they needed. A minority said that they usually did. It was clear from what people said and from records in the home that a range of health professionals visited when needed for routine and urgent reasons. There are activities available for those who want to take part. People in Chelston Gardens are offered art and music therapy sessions. There are trips out offered to all people who are well enough to make them. One person spoke of the care taken to ensure she could access transport and outings. People in Chelston Gardens and Chelston Park are offered a weekly programme of events although people vary in the amount they participate in according to preference and capacity. What has improved since the last inspection? The home has considered its admissions procedures and is working with the Somerset Partnership to agree protocols ensuring the continued support of mental health professionals. Training in the home is seeking to ensure that all staff working Chelston Gardens have sufficient skills and experience. Staff have undergone training in care planning and dementia care. There is a training plan for the 2009 designed to further develop staff skills. There has been action taken to monitor and record peoples` food intake and weights. Further developments in practice are planned. The programme of activities and events continue to develop as staff gain confidence in working with people on individual activities. The staffing at the home is sufficient. The appointment of a deputy manager has been effective and contributes to the continuity of care in Chelston Gardens. The service has improved the system for the handling of medication such that people now receive all their medicines safely. What the care home could do better: Overall this was a positive inspection with no requirements. Chelston Gardens has plans to further develop person centred care planning and to continue to develop best practice in dementia care over the coming months.Whilst the communal environment in both homes was very well maintained attention should be paid to details in some peoples rooms. This would include cleaning hairbrushes regularly, removing dead flowers and old disposable razors. The menu of the day should be clearly displayed, as the master menu is difficult for people to see clearly. All people should have access to a call bell at all times. CARE HOMES FOR OLDER PEOPLE Chelston Park Nursing Home West Buckland Road Wellington Somerset TA21 9PH Lead Inspector Shelagh Laver Unannounced Inspection 10th December 2008 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 Chelston Park Nursing Home DS0000003249.V373493.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. Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chelston Park Nursing Home Address West Buckland Road Wellington Somerset TA21 9PH 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) 01823 667066 01823 653163 info@chelstonpark.co.uk Chelston Park Nursing & Residential Home Limited Mr Derek Lott Mrs Joanne Girdler Care Home 86 Category(ies) of Dementia (50), Old age, not falling within any registration, with number other category (36) of places Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) 2. Dementia (Code DE) maximum of 50 persons The maximum number of service users who can be accommodated is 86. 3rd July 2008 Date of last inspection Brief Description of the Service: Chelston Park is a large house that was adapted and extended to become a care home in 1986. The home offers general nursing care for older people. In November 2007 a major variation to the home was made. A 50 bed separate building known as Chelston Gardens has been built to provide care for people with dementia. The home has been designed and finished to a high standard. There are now two registered managers, Jo Girdler is manager of Chelston Park and also currently acting as overall care manager at the home. She is an experienced nurse and home manager. Derek Lott RMN is manager of Chelston Gardens. He has extensive knowledge and qualifications inn clinical nursing, palliative care and person centred dementia care. The new build is spacious and comfortable and sits in large landscaped grounds. There are excellent views of the Blackdown Hills and Wellington Monument from some rooms. Fees are currently; Chelston Park - £522 to £850 Chelston Gardens - £552 - £795 Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. The focus of this inspection visit was to inspect relevant standards under the Commission’s ‘Inspecting for Better Lives’ framework. This focuses on the outcomes for service users and measures the quality of the service under the four general headings. These are –excellent, good, adequate and poor. Chelston Park and Chelston Gardens are registered as one service. Chelston Park is a well established nursing home for 36 people. Chelston Gardens was registered in November 2007 to provide nursing care for 50 people with dementia. Prior to this key unannounced visit we (Commision for Social Care Inspection) had received regular communications from the home that indicated that areas of concern identified at the Key inspection of 3rd July 2008 were being addressed. A random inspection visit to the home in November 2008 and discussion with Jo Girdler further gave further information relating to training and monitoring of care. For this Key Inspection three inspectors were accompanied by an expert by experience. The inspectors included a pharmacy inspector and an inspector with extensive experience of dementia care. The Expert by Experience visited Chelston Park and spent time talking to people who lived there and staff. The expert observed lunch and made observations of some parts of the buildings. Comment cards were sent to the home and 18 were returned. Some had been completed by people who live in the home. Some had been completed by relatives on behalf of the person living in the home. The inspectors made a tour of the home speaking to people who lived there and observing care practice. Care and staff records were reviewed. An Annual Assurance Assessment was sent to the us when requested in June 2008. The provision is registered as one service however in many respects Chelston Park and Chelston Gardens operate independently. There are two managers and two staff groups. The homes share the kitchen and laundry services. Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 6 On the day of the inspection there were 29 people living in Chelston Park and 35 in Chelston Gardens. What the service does well: Overall the homes were very clean, warm and well presented. As the inspection was shortly before Christmas rooms had been decorated with tasteful decorations and there was a festive atmosphere. People were satisfied with the care they received both in Chelston Gardens and Chelston Park. Of Chelston Gardens one relative wrote “This is a place where X is calm and cared for so that there is nearly always a ready smile.” Another relative wrote, “The care at this home is excellent. The staff are very kind and caring. Families are kept up to date with the residents treatment and consulted when appropriate.” There was also praise for Chelston Park. The staff were praised for their hard work and kindness. People wrote, “Care staff are always polite and very prompt when help is needed.” The Expert by Experience wrote in her report “Speaking to several residents they all described the staff as kind and understanding, and always having time to listen to any concerns they might have or simply just to stop for a chat. These comments were in accord with what I saw. I was also told that visitors are always made welcome and they, too, were happy that any concerns could be raised and would be listened to sympathetically.” All comment cards stated that staff are always or usually available when people need them and that they listen to people and act on what they say. Rotas indicated a stable work force with attention to appropriate numbers of trained staff. The majority of people who returned cards said that they always received the medical support they needed. A minority said that they usually did. It was clear from what people said and from records in the home that a range of health professionals visited when needed for routine and urgent reasons. There are activities available for those who want to take part. People in Chelston Gardens are offered art and music therapy sessions. There are trips out offered to all people who are well enough to make them. One person spoke of the care taken to ensure she could access transport and outings. Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 7 People in Chelston Gardens and Chelston Park are offered a weekly programme of events although people vary in the amount they participate in according to preference and capacity. What has improved since the last inspection? What they could do better: Overall this was a positive inspection with no requirements. Chelston Gardens has plans to further develop person centred care planning and to continue to develop best practice in dementia care over the coming months. Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 8 Whilst the communal environment in both homes was very well maintained attention should be paid to details in some peoples rooms. This would include cleaning hairbrushes regularly, removing dead flowers and old disposable razors. The menu of the day should be clearly displayed, as the master menu is difficult for people to see clearly. All people should have access to a call bell at all times. 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. Chelston Park Nursing Home DS0000003249.V373493.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 Chelston Park Nursing Home DS0000003249.V373493.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): 1 2 3 5 Quality in this outcome area is good. The home aims to supply people with all information required to enable them to make a choice about coming to the home. The home undertakes an assessment to ensure peoples’ needs can be met by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Colour brochures of the home are available and there is an Internet web site that can be accessed by members of the public. The information pack contains copies of the current menu and activities programme. Whenever possible an assessment visit is made by one of the managers. Occasionally a person from out of county may be admitted based on information from the referring authority. The home is currently working on an Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 11 agreement or memorandum of understanding regarding out of county admissions to Chelston Gardens to ensure continued support is available. People coming to Chelston Parks or Gardens will also be assessed independently to determine whether they need nursing care and whether the home can meet their needs. Most people who returned a comment card said that they had received a contract. Contractual information includes cost of room and extra payments required for newspapers, hairdressing chiropody and phone calls. Four admissions have been made since the last inspection. Files contained clear assessments by home management and supporting documents from other health care professionals. If a person’s needs change in Chelston Park indicating that they may need care for dementia they are assessed in the same way as a new entrant to the home. Most people who returned comment cards said that they had received enough information. “The tour was comprehensive and questions were answered frankly.” Another person wrote, “When I viewed the home nothing was too much trouble.” Chelston Park Nursing Home DS0000003249.V373493.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 11 Quality in this outcome area is good. There is a care planning system in place that sets out peoples needs and is still developing in some areas. Peoples’ health needs are met by the service. People are treated with respect and their privacy is maintained. There is a system of medication administration. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection requirements were made relating to care planning particularly in Chelston Gardens. Training has been received and staff continue to “work through” the care plans updating and developing them. It was agreed at the inspection that person centred care planning was still a work in progress with staff recently attending a course run by Dementia Care Matters on how to give and record personalised care. Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 13 There was evidence that people and their relatives are involved in care planning. One relative wrote, “We have been involved in care plan writing and although the staff are very busy they will take time to listen.” In Chelston Gardens two people had pressure damage. One person with pressure damage was seen to be on an air mattress. A ‘turn chart’ indicated regular change of position. For another person there were clear records of wound management. People were observed to have fluids available and to be assisted to drink when required. There was a clear care plan for one person identified as needing regular help to eat because of depression. There was clear guidance to staff regarding the action they should be taking. There was evidence of involvement of the person’s doctor and a referral to the dietician. At this inspection the records of weights and Must scores were seen to be fully maintained. There were manual handling assessments in place that identify the type of hoist and size of sling. At Chelston Park care plans were clear and showed involvement of the person receiving care. People told us that the doctor always came when needed. One person told us that transport for her appointment at the eye clinic had been organised. There was evidence that health issues were acted upon swiftly. Records showed requests for tests and appropriate treatment amendments. One person said that they liked to be kept informed test outcomes and to be given some idea of when tests might be back. Records show a range of health professionals visit the home including doctors and community nurses, chiropodists, physiotherapists, the community psychiatric nursing service and the palliative care team. One person said that it would be good to be offered more showers in line with what they would expect at home. There were no people with pressure damage however care records for one person showed risk assessments and there were pressure relief mattresses in place. The person had an individual wheelchair and cushion. There was a clear care plan for a person receiving palliative care including a plan for pain control that complied with best practice. Relatives wrote about the health care received in comment cards. “When my mother had a chest infection, staff acted promptly and the doctor attended.” A relative in Chelston gardens wrote, “Great care has been taken in both emergencies and in more routine events. Drug prescription regimes are changed as condition dictates.” There were some individual comments that have been referred to the home for attention. Some people have been in Chelston Park for a long time. Care plans had been up-dated to reflect changes in needs and care. Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 14 We found that there are clear records for the administration of medicines prescribed with variable doses and that it is possible to easily see the actual dose administered. We also found that for those people prescribed medicines to be administered “when required” that there is clear guidance available for staff to make the decision of whether to administer or not. We found that for some people that agreements were in place to administer their medicines covertly. Whilst these demonstrated that others had been consulted about the need to administer medicines in this way the date of the discussion had not been recorded. Throughout the inspection we observed staff treating people with respect and observing their privacy. Chelston Park Nursing Home DS0000003249.V373493.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 good. People are able to choose how they spend their days. There is a programme of activities available for those who chose them. People are offered wholesome and appealing meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In Chelston Gardens people were able to choose how to spend their day. Some people were seen in their rooms some came to the communal areas. Some people had newspapers available. The activities co-ordinator was seen making a nativity scene with people and on other days had made Christmas cards. There are boxes of interesting items for people to look at (rummage boxes). There are individual records of peoples’ activities in their files. These include “chats “ and a trip to have fish and trips. There are also records showing when a person has been offered a trip out and has refused it. On the day of inspection at Chelston Gardens there were some carol singers and at Chelston Park 13 people were going out for lunch at the local golf club. Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 16 People found Chelston Park to be friendly. One person said, “ I have more friends in here than I did outside.” People talked about the trips out and quizzes. One person wrote of the “provision made for me to go out in my wheelchair.” This person enjoyed the trips especially to the garden centres for lunch. People are able to spend their days quietly at Chelston Park. One person receiving care at the end of life was seen resting peacefully. Across the service people are encouraged to go out with family and friends according to needs. There was evidence that people are encouraged to remain independent whenever possible. Throughout the inspection staff were observed making drinks for people and offering snacks that included biscuits and dried fruit. There were some good staff interactions observed as staff assisted people to eat and drink. There was one staff member who needs to be reminded to sit down and talk to people when assisting them. There is a 4-week menu that offers a choice of meals. On the day of the inspection it was chicken or beef casserole with potatoes or rice and vegetables. Soft diets are from the kitchen in individual dishes. Cream is available to add to desserts to enhance the calorific value at the point of service when needed. People at Chelston Park spoke about the food. One person said, “ There is plenty of food. I am putting on weight. There is so much choice.” One person said that he had made a special request for haddock for breakfast and this had arrived that morning. The Expert by Experience observed lunch at Chelston Park and wrote in the report “Speaking to a number of residents who had opted not to go out, there was general appreciation of the quality and choice of food provided. I noticed that mid-morning as well as tea and coffee, biscuits, cake, yogurt and fruit were offered. Lunch, which included three choices, was served from a heated servery in the dining room. It all looked very appetising, including the pureed food, which can so often look a mess but was offered in clearly distinguishable portions. Most people were able to feed themselves but help was freely available for those who couldn’t.” Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 17 18 Quality in this outcome area is good. Policies and procedures are in place to protect people from abuse. People felt confident that any concerns would be listened to and acted on. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are policies and procedures in place to protect people from abuse that are based on the local safeguarding protocols. The global training records show that people have been trained in the protection of people from abuse. Comment cards indicated that if people were concerned about anything they would know who to talk to. There is a formal complaints procedure that is clear and freely available to relatives and people in the home. At Chelston Gardens there have been no complaints since the last inspection. At Chelston Park people told us that they knew who to talk to if they were worried. One person said, “I would always just talk to Jo. It will be sorted out.” At both homes there are entry procedures, risk assessments and guidance for staff practice that designed to protect people. Chelston Park Nursing Home DS0000003249.V373493.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 20 21 22 23 24 25 26 Quality in this outcome area is good. People live in an environment that is clean and well maintained. The homes are designed and adapted to meet peoples’ needs in comfortable and pleasant surroundings. There are procedures in place to minimise infection in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who returned comment cards said that the service was always or usually clean. On the day of the inspection both Chelston Park and Gardens were clean, warm and attractive. Chelston Park is has a traditional country house atmosphere and outlook. The renovations are almost completed and the home is looking clean and attractive. There are some very smart new shower rooms and en-suites and warm clean bathrooms that have Arjo assisted baths. The lovely views from Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 19 most windows were mentioned at this inspection. The maintenance man was working in one room personalising the space with mirrors and pictures as requested by the person coming to that room. The Expert by Experience observed the environment in Chelston Park and wrote “The first thing I noticed on entering the building was how clean and fresh it looked, and no doubt this had something to do with the fact that instead of carpets – which can very easily look worn and slightly grubby, however well cared for – all the communal areas had been fitted with wood strip flooring, much easier to maintain. The only disadvantage was that it could be a little noisy, but this was far outweighed by the ease with which it could be kept clean.” Chelston Gardens is a “state of the art” new building where all facilities have been supplied to a high standard. A detailed description of the facilities in the new building can be seen in the report of July 2008. The home continues to look smart and is becoming more personalised with time. Throughout the homes there is plenty of equipment and adaptations to encourage mobility and to facilitate access. There were plenty of gloves and hand washing materials. There is an organised system of waste disposal. Chelston Park Nursing Home DS0000003249.V373493.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 good. The recruitment of staff is undertaken according to policies and procedures that protect people in the home. There is a programme of planned training in place. Staff rotas indicate a stable appropriately qualified work force. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rotas indicated that there are sufficient staff and agency staff are not used. Staff rotas indicated an appropriate numbers of qualified staff on duty. Staff on duty in Chelston Gardens confirmed that there were sufficient staff on duty. Staffing on the different units varied according to dependency and will be increased as new admissions are made. The managers confirmed that they are able to review staffing regularly and make additions if they feel they are needed. One comment card and one person spoken to said that the communal rooms at Chelston Park could be left unattended for long periods. It is recommended that the staffing of these areas is reviewed. Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 21 There are training records that indicate that staff receive training in key areas including manual handling, prevention of abuse, food hygiene and fire. Staff had also received training in October 2008 in nutrition and some were first aiders or had received medication training. There has been an emphasis on developing the specialist skills for staff working at Chelston Gardens. Key staff have attended training in care planning for people with dementia and further training is planned. Staff recruitment records were organised and comprehensive. There was evidence of pre-employment checks and references received prior to the staff member starting work at the home. There is an induction programme in place that is thorough and comprehensive. Chelston Park Nursing Home DS0000003249.V373493.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. The home is well run in the interests of the people who live there. The managers of the home are experienced and well qualified. The managers of the home are pro-active and capable and are committed to continued improvements in the home service. There are health and safety policies and procedures in place designed to protect staff and people who live in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Following the last Key Inspection there were areas of the home practice that needed improvements. There was an immediate response to urgent matters by the managers and this was followed by a detailed plan for improvement. There Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 23 has been very good communication with us that has kept us informed of progress and events at the home. There has been commitment by the owners of the home to ensure that staff are supported with external resources and training. During the inspection in discussions with managers it was agreed that some areas of practice are still being developed and will take time to fully embed. For example the home is committed to the continued improvement of dementia care practice at Chelston Park. Both Chelston Park and Gardens are focussing on further development of person centred care. Some good practice at Chelston Gardens relating to nutrition monitoring will be implemented at Chelston Park. There are opportunities to implement an effective quality assurance monitoring system in the homes. Staff meetings including those for night staff are held and minuted at both Chelston Gardens and Chelston Park. In both homes there are systems in place to ensure health and safety. Fire logs are maintained and records were seen of regular tests of alarms, emergency lighting and fire drills. There are routine checks on hot water temperatures. The home has contracts for all major areas of servicing including hoists and lifts. It is suggested that the managers devise a system that ensures all maintenance records are easily accessible. Chelston Park Nursing Home DS0000003249.V373493.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 x X 3 2 3 3 Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP27 Good Practice Recommendations It is recommended that the staffing arrangements of the communal lounges in Chelston Park be reviewed to ensure that people in the lounges always have access to staff. It is recommended that the menu options for the day be displayed in a clear and easy to understand form. The development of person centred care planning and the promotion of best practice in dementia care should continue as planned. The plans to develop an agreement of operation with the Somerset Partnership should proceed as planned. OP15 OP7 OP8 Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Chelston Park Nursing Home DS0000003249.V373493.R01.S.doc Version 5.2 Page 27 - 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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