Care Home: Warwick Park Nursing Home

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What the care home does well The home has an experienced and competent staff team, who provide good standards of care, and who treat the residents with respect and affection. The home has good links with other health professionals, and is quick to request advice or referrals as indicated. There is a very good range of activities from Mondays to Fridays, and plenty of opportunity for residents to go out to places of interest, or for walks or shopping. The food is suitably varied, and provides good nutrition. It is home cooked, well prepared, and well presented. The provider maintains a good staffing ratio, enabling care to be given properly. Mandatory staff training is kept up to date, and additional staff training courses are made available. There are currently 75% of care staff with NVQ levels 2 or 3 in health and social care, which is excellent. What has improved since the last inspection? The pre-admission assessment forms have been improved to enable the manager, or nurse assessing, to include more details. Two bathrooms have been structurally altered, providing more space. These bathrooms have been fitted with assisted bathing/shower facilities. The kitchen assistant hours have been increased, enabling the cooks to spend more attention on home cooking. Staff training has been further developed, and includes training in the Mental Capacity Act 2005, and the implications in this when for caring for older people. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Warwick Park Nursing Home 55 Warwick Park Tunbridge Wells Kent TN2 5EJ Lead Inspector Mrs Susan Hall Unannounced Inspection 27th August 2008 08:45 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 Warwick Park Nursing Home DS0000026212.V369373.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. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warwick Park Nursing Home Address 55 Warwick Park Tunbridge Wells Kent TN2 5EJ 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) 01892 541434 01892 549991 Up-Beat Enterprises Limited Miss Karen Lesley Pratt Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2006 Brief Description of the Service: Warwick Park Nursing Home is situated in a pleasant residential area of Tunbridge Wells, close to the town centre and the well-known “Pantiles” shopping area. It is owned by Up-Beat Enterprises Ltd., who have two other care homes. The premises are a large detached house, set in its own grounds. It has been adapted to provide accommodation for older people who require nursing and residential care. The accommodation consists of fifteen single, and six shared rooms; however two of the shared rooms are mostly used for single use. Accommodation is provided on three floors, and access is obtained via a passenger lift. Three bedrooms are only accessible via a short flight of stairs, and there is a stair lift for these. There is a large, very well maintained garden to the rear of the building and limited parking to the front. There is additional street parking nearby. The fees currently range from £498.00 to £750.00 per week, and are set according to the individually assessed needs of residents, and the room available. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home is assessed as having a rating of “good”, 2 stars. This was a key inspection, which takes into account all information obtained since the previous inspection, as well as the visit on the day. The visit was carried out by one inspector, and lasted for seven hours. We (i.e. CSCI) received eleven completed survey forms from health professionals, staff and residents. Some residents had asked their relatives to assist them in completing the forms. These contained very positive comments, particularly about the staff, the activities and the food. Comments included: “The staff are always caring and always gentle when looking after my mother” (from a relative); “ Residents are made very welcome and at home. It is a warm friendly home for residents and staff” (from a staff member); and “The staff provide for the residents’ health needs in an excellent and professional manner. They are very attentive and affectionate. The care is professional, competent and with a personal touch” (from a health professional). During the inspection visit, we chatted with five residents, one relative, and six staff members, as well as the manager, who was available throughout the day. Residents said that the “staff are marvellous”, “the food is excellent”, and “there is always something to do”. The home provides an excellent range of activities and outings. There are many photographs and art and craft items on display, showing the range of activities available. The provider has improved some of the bathroom facilities during the past year, and has dealt with a large unexpected roof repair, and boiler repairs. Some of the bedrooms have been redecorated, and some areas have been recarpeted. The premises are a large old building, and it is now in need of further internal decoration, more new carpets, and some ongoing repairs and new furniture. The rear garden is beautifully maintained, and is a pleasant area for residents to sit in good weather. CSCI received one complaint about the home since the last inspection. The provider was asked to carry out an investigation, and the complaint was thoroughly investigated, and very well handled. There have been no referrals to the Social Services Safeguarding Adults team. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home is generally let down by it’s run down appearance in many areas. The entrance area does not provide a good first impression; the home is very cluttered due to a lack of storage space; décor in communal areas is “tired”; and there are carpets and furniture which need replacing. The kitchen units and worktops are now old and damaged and need to be replaced. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 7 Some documentation needs amending to keep it up to date. For example, the complaints procedure needs to include timescales; the staff application forms should request a full employment history; and there are currently no property lists in residents’ care plans. 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. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 (standard 6 does not apply in this home). Quality in this outcome area is good. The home provides sufficient information to enable residents to make an informed choice about moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a very detailed statement of purpose and service users’ guide. These have been amalgamated into one rather lengthy document, which contains comprehensive information. However, there is no information included about the qualifications and experience of the registered provider and manager, and the manager said that she would amend this immediately. The service users’ guide includes details about practical issues such as visiting, bringing in own items of furniture, pets in the home, meal times and menus, and arrangements for activities, and meeting religious needs. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 10 Residents and relatives are invited to view the home and meet staff members. The manager carries out most of the pre-admission assessments herself, and ensures that details are obtained about items such as moving and handling, to ensure that the room available is suitable for the person concerned and the equipment they need. Some pre-admission assessments are carried out by the administrator, who is nurse trained. The manager may also take a carer with her – especially those training for NVQ 3, as this enables them to understand the admission process more fully as part of their training, and enables the resident to meet some staff prior to admission. Three pre-admission assessments were viewed, and these provide detailed information about all aspects of daily living. The forms have been revised during the past year, and now enable the manager to add in more data at the time of the assessment. All residents, or their appointed representative, are provided with a contract which includes the terms and conditions of residency. However, it was noted that there are no terms included for the home to give notice, if this should be necessary. The manager said that she would ensure that a clause is added to this effect, including timescales for giving notice. All admissions are for a trial period, and a review is carried out at the end of this time to check that the placement is suitable. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 Quality in this outcome area is good. The residents receive skilled care and nursing attention from the nursing and care staff. Care plans confirm that their health needs are being met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans are presented in individual folders, which are indexed for easy access of information. Admission details and assessments are carried out well, and include risk assessments, moving and handling assessment, falls risk assessment, skin care, and a nutritional assessment. Care plans are reviewed every month, and amended as needed. All aspects of care needs are discussed with the resident and/or next of kin as appropriate. Blood pressure and weight are monitored on a monthly basis. There are good details for assessments such as moving and handling, clearly specifying if a hoist is to be used, the type of hoist and sling, and if two care Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 12 staff are needed. The care plans follow all aspects of daily living, and are set up according to the needs identified in the initial assessments. Health care needs are clearly identified, and there is good evidence for input from other health professionals such as GPs, dietician, speech and language therapist, hospice nurses and psycho-geriatrician. Wound care is well managed, with clear directions for the dressing to be applied, and a record written for each dressing change. Consent is obtained for taking photographs for wounds, and also for head and shoulders photos for medication charts. Daily reports are written by the care staff who are giving the actual care, and the nurse on duty adds in other nursing information. These records are suitably detailed and informative, including information about the resident’s mood, skin care, eating and drinking, and if they have taken part in any activities. Medication is administered via a nomad cassette system. This is a suitable system for this home, as there is very limited storage space. The clinical room is very small, and was cluttered with unnecessary items. There is insufficient room for the medication trolley to be stored in here, and it is kept chained and padlocked to a wall on the ground or first floor when not in use. The manager orders all medication, and carries out monthly audits, including a monthly check for controlled drugs. A number of drugs which are Schedule 3 or 4 drugs (and therefore do not have to be treated as controlled drugs) are stored in the controlled drugs (CD) cupboard for additional safety, and numbers for auditing purposes are recorded in a notebook. This is good practice. There is a new and larger CD cupboard which meets specifications. The drugs fridge and room temperatures are recorded daily and are satisfactory. The storage cupboards were mostly in good order, but very full due to a recent delivery. One item of liquid medication had been opened and not dated on opening, but the practice is usually to date all liquid medications on opening. Some external medications were stored next to internal, and the manager said she would address this. Medication Administration Records (MAR charts) were all viewed and are well completed. However handwritten entries had not been signed, and these must be signed by two appropriate staff members. There are proper procedures in place for disposing of unused medication. Staff ensure that residents’ privacy is preserved when they are giving personal care. Shared rooms have satisfactory screening in place to provide privacy. Staff were seen to treat residents with affection and with respect. There is a relaxed and homely atmosphere, which residents appreciate. A number of staff have attended training at the hospice in managing end of life care, and the home promotes the wishes of residents who prefer to stay in their own room when dying and do not want hospital treatment. Relatives and Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 13 friends are enabled to stay according to the wishes of the resident concerned. The care plans include some indication that discussions are held with each resident and/or representative in respect of their wishes about whether or not to resuscitate them in the event of an emergency. However, the documentation does not clearly show how the Mental Capacity Act has been applied; and if decisions are being made on behalf of residents who have impaired mental capacity, it is important that the documentation reflects how decisions have been reached, and includes names, dates and signatures of the people who have made the decision. There is a recommendation to clarify this documentation. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Quality in this outcome area is excellent. The home provides an excellent range of activities and opportunities for going out. Food is well managed in the home, and provides a good variety to meet nutritional needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides an excellent variety of activities and entertainment. The activities assistant is employed five days per week, and keeps up an ongoing supply of stimulating activities throughout the day. She stated that these are decided on a day-to-day basis, according to what residents feel like on the day. Other staff spoke highly of her ability to find activities which relate to different residents, depending on if they are happy to join in with group activities, or prefer one to one time. Activities include items such as scrabble and word games, exercises to music, ball games such as indoor golf and basketball, bingo, arts and crafts, painting and drawing, musical events etc. There is an abundance of evidence throughout the home of arts and crafts, with many displays on different Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 15 subjects. Outings are arranged on a regular basis to places such as Leeds Castle, country farms, and other places of interest; and residents are taken out for walks, or shopping in the nearby Pantiles area of Tunbridge Wells. The home has a beautifully maintained rear garden, and residents enjoy sitting outside in good weather. There is easy access to the garden via the lift, which extends into the basement, and has a doorway into the garden. The home has a residents’ fund, and this is used to purchase additional items such as a gazebo for outside. The home held a fete and a sponsored walk in the summer, which boosted this fund, and enables the residents to discuss other items they would like to purchase to enhance the home. Visitors are always welcomed into the home, offered drinks, and actively invited to stay for meals. There is a small conservatory area, which is used for relatives and residents to meet in together. Residents are enabled to bring in their own items to personalise their rooms, and some rooms have their own furniture items as well as pictures, ornaments etc. There is no formal list maintained for residents’ own items, and it is recommended that a property list is completed for residents on admission. Residents spoke highly of the food, which is home cooked, and well prepared and presented. Menus are discussed between the cook and the manager, and residents can suggest new ideas. There is a four weekly menu plan, and this is altered to include seasonal changes. The home provides one main meal at lunchtimes, but there is always a good variety of alternatives available. There is a hot dish, and soup or sandwiches at tea times, as well as a choice of desserts and home made cakes. Snacks and fresh fruit are available at any time. Residents can have a cooked breakfast if they wish, and some like to take advantage of this once/twice per week for variety. The home has a cook and a kitchen assistant on duty from 8am to 6pm every day, ensuring that individual preferences can be met. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Residents are confident that they can share any concerns, and that appropriate action will be taken. Residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure in the service users’ guide, and also on display in the front entrance hall. This does not include timescales for a response to complainants, and therefore needs to be amended. The manager stated that she would ensure that this is done. Complaints are logged in hardback notebook by the nurse on duty, and the manager then deals with the issues raised. There were three complaints during the past year, and the records show that these were very well handled, properly investigated, and with suitable feedback to the people concerned. Details of letters etc. are stored separately, so as to maintain confidentiality. Residents are confident that their views are listened to, and are able to share concerns. The manager has an open door policy, and speaks to most residents individually each day, so they can easily voice any issues. Staff are trained in the recognition and prevention of adult abuse, and training records confirmed that this training had been updated during 2008. The home Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 17 has policies and procedures in place for whistle blowing, and the policies and procedures file is easily available. The home has a copy of the Kent and Medway Safeguarding Adults Procedures on file, and the manager is familiar with these procedures. Staff recruitment procedures are well managed, with all required checks carried out. Warwick Park Nursing Home DS0000026212.V369373.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): 19-22 & 24-26 Quality in this outcome area is adequate. The home provides a homely and comfortable environment. However, there is a need to upgrade décor, carpeting, and furniture in many areas; and to provide additional storage space to reduce clutter. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was viewed in all areas, including many of the bedrooms. It is a large detached building set in a very desirable area of Tunbridge Wells. The front garden and entrance area are not particularly welcoming, and could be improved. The home is disappointing in the initial impression it gives when walking into the building. Many areas look tired, and are in need of repainting and redecorating to show the home off to advantage. There is an abundance of art Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 19 and craft work on display. The communal lounge, dining room and conservatory are not well presented, and as these are areas where residents mostly sit, it would be beneficial if more attention is paid to them. These rooms and the corridors are cluttered with unnecessary items; there is no space for hoist storage or storage of the medication trolley; and old furniture needs replacing. The dining room carpet is shabby and stained and needs replacing. Carpeting on the first and second floor landings and back stairs is rucked and could soon become dangerous. This also needs replacing. There are requirements to review the lack of storage space, to replace carpeting as identified, to review and replace furniture as needed, and to provide a programme of routine maintenance for redecoration. The provider has dealt with an unexpected roof repair during the past year, and this has contributed to a delay in undertaking other improvements. The kitchen is fitted with suitable cooking equipment. There are fly screens at the windows. The flooring is in good order, but the kitchen units are old and damaged and need to be replaced for good management of cleaning and infection control. This was highlighted by the last visit from the Environmental Health Officer. Two of the bathrooms have been refitted after structural alterations to make these rooms bigger, and the bathroom and shower facilities are now much improved. There are a sufficient number of bathrooms and disabled toilets. It is unfortunate that the main toilet for use on the ground floor is situated by the front door. Better décor in the front hall may detract from this a little. There are no en-suite toilet facilities. Each room is fitted with a washbasin, but many of the cupboards below these are damaged and tatty and need to be repaired or replaced. The rear garden is very well maintained, and is a pleasant area for residents. The home has sufficient hoisting facilities, and assisted baths. There are grab rails, raised toilet seats, pressure-relieving mattresses and some nursing beds. The manager said that the provider has purchased some new beds, and must continue to ensure that suitable nursing beds are available. Some bedrooms have been redecorated during the past year. All radiators have been fitted with mesh covers for safety. Some rooms have been fitted with additional wall heaters, as the rooms still feel cold even when the radiators are fully on. The laundry and sluice floors have been repaired in response to previous recommendations. Hand washing facilities are adequately provided, except that the staff toilet is exceptionally small, and the bin for paper towels is inadequate. The laundry room is situated in the basement, and includes one commercial sized washing machine and one tumble dryer. This room was seen to be well organised. There is a separate drying/ironing room, which also has a Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 20 backwash sink, and is used for hairdressing. The tiles at the back of this sink need replacing. The home usually has sufficient numbers of cleaning staff, but numbers had been down for two days due to sickness. The home was still generally clean throughout. There were two rooms where there was some odour, but this was localised and was being dealt with. The home is not easy to keep clean, as the current décor does not provide a good basis for easy cleaning. Warwick Park Nursing Home DS0000026212.V369373.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): 27-30 Quality in this outcome area is good. Residents benefit from being cared for by a competent and well trained staff team, who are enthusiastic about providing good standards of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels consist of at least one trained nurse on duty at all times. However, there are sometimes two nurses on duty, and the manager is also a trained nurse and is available for advice if needed. The home has 5-6 care staff on duty in the mornings; 3-4 care staff on duty in the afternoons/evenings, and 1 carer working a “twilight” shift during the busy times of 6-10pm. These numbers of staff reflect that a high priority is given to ensuring that the needs of residents with high dependency levels can be met. The home also employs an activities assistant from Mondays to Fridays; a cook and a kitchen assistant each day; and dedicated cleaning, laundry and maintenance staff. It was evident that staff have a good rapport with each other, and interact well with residents and visitors. Staff said that they help each other in different roles in times of crisis or sickness. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 22 The home enables care staff to carry out NVQ training, and 75 have now achieved NVQ levels 2 or 3, which is an excellent percentage. Residents said that the staff are “wonderful”, “marvellous”, and “always there for them”. Recruitment practices are generally well managed, with POVA First and Criminal Record Bureau (CRB) checks carried out; two to three written references, (which are checked verbally as well); proof of ID; an interview record, and health record. However, the application form does not request a full employment history (with gaps explored), and there is a requirement to amend this. Each staff member has a job description and a contract. The home uses a detailed induction programme, which is tailored to fit the specific job for each staff member. After the initial first day of induction, staff commence mandatory training until each subject is completed. The training matrix confirmed that mandatory training is kept up to date – e.g. moving and handling, basic food hygiene, infection control and health and safety. There is also plenty of opportunity for staff to develop their skills and knowledge with relevant training courses, such as diabetes, Parkinson’s, strokes, nutrition, and continence care. Nursing staff, as well as care staff, are able to attend these courses and also other nursing updates such as medication training, stoma care, and use of syringe driver. Three of the nurses can carry out venepuncture, which is an asset in the home. Warwick Park Nursing Home DS0000026212.V369373.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 good. The home is run by a competent and experienced manager, so that residents benefit from a smoothly run home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is a level one nurse with many years of experience in caring for older people. She has been in post as the manager for over five years. She has completed the Registered Managers’ Award (RMA) this year, which has complemented her previous management training, and her degree (BSc Hon) in nursing studies. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 24 She works alongside other staff and leads the way in promoting good standards of care. Staff work well together, and take part in formal and informal staff meetings. Formal meetings are held approximately twice per year, but the manager will often sit and have coffee/lunch with other staff, and is present at handovers, so that she is aware of any new pressures or concerns in the home. This provides good ongoing communication within the home. Residents meet with the activities organiser and discuss items such as changes to the menu, where to go on outings, different activities to try, and new items to purchase from the residents’ fund. Relatives are invited to join in with these meetings, or with activities, if they are present in the home. The home sends out surveys to residents and relatives (usually yearly), and these ask pertinent questions about different aspects of life in the home such as the cleanliness of the home, the attitude and willingness of staff, and the variety of activities. The results of these surveys are amalgamated, and appropriate action is taken to address ideas or concerns raised. The home does not act as appointee for any residents, but may hold small amounts of pocket money for some residents. These are stored safely and individually, and an individual account is maintained for each person. All receipts are retained. Formal staff supervision is given on a one to one basis approximately every two months. As the manager is often present on the floor, there is frequent informal supervision as well. The manager is careful to maintain confidentiality of these documents. Records are generally well maintained, and policies and procedures are reviewed and amended yearly. Maintenance records show that servicing is carried out according to requirements. Some servicing records were viewed. Fire logs show that fire alarms are tested weekly, and there are sufficient numbers of staff fire drills. A revised fire risk assessment was completed in 2007. All bedroom doors are fitted with “dorguard” fixtures, so that they can be left open if residents prefer this. Accident forms are satisfactorily completed, but are not being stored in accordance with Data Protection legislation. The manager stated that she would address this. There was no formal auditing process in place for auditing accidents/incidents, but the manager had just started to carry this out, and is putting a formal procedure in place. Warwick Park Nursing Home DS0000026212.V369373.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 2 3 2 X 2 3 3 STAFFING Standard No Score 27 4 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 26 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. 1 Standard OP9 Regulation 13 (2) Requirement Timescale for action 30/09/08 2 OP16 22 3 OP19 23 (2) (b,c,d,l) Handwritten entries on Medication Administration Records (MAR charts) must be signed by two appropriate staff members (i.e. nursing staff and experienced care staff). The complaints procedure must 30/09/08 include information about the timescales in which complainants will receive a response to their complaints. To provide an action plan to 31/10/08 CSCI by the given date for the following items: • To review the lack of storage space in the home and provide a plan to address this; To remove unnecessary clutter from the corridors and communal areas; To implement a programme for routine redecoration of the premises, including communal areas and corridors; To audit the old furniture in each room, and provide Version 5.2 • • • Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Page 27 • • • • • a programme for replacing this as needed; To replace the kitchen units and repair broken wall tiles in the kitchen; To replace wall tiles behind the back wash sink; To audit the state of wash basin cupboards in individual bedrooms, and repair or replace these as indicated; To replace carpeting on the first and second floor landings and back stairs; To replace the carpet in the dining room. The action plan should include proposed dates for this work to be carried out. 4 OP29 19 & Schedule 2 To ensure that the application form is amended, so that all applicants are asked to provide a full employment history i.e. from the time of leaving full time education; and with any gaps explored. 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP2 OP8 Good Practice Recommendations To ensure that contracts include the terms of notice which may be given by the home, including timescales. For documentation to show evidence of compliance with the Mental Capacity Act 2005, when decisions are made about resuscitation. Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 28 3 OP14 To complete a property list in respect of residents’ individual items of furniture/personal possessions, on admission to the home. To ensure that accident forms are stored in compliance with the Data Protection Act. 4 OP38 Warwick Park Nursing Home DS0000026212.V369373.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Warwick Park Nursing Home DS0000026212.V369373.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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