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Enter & View Report: Chelston Park Care Home, Wellington

The Somerset LINk Enter & View Team visited Chelston Gardens Residential Home in Wellington on 23 June 2011. You can download the full report of their visit here.


What happened next? >> Download the Enter & View Recommendations & Actions Record here.

 

The following summarises the good practice observed at the home and the Enter & View Team's recommendations.

Hospital Discharge: Recommendations

  • It is recommended that discussions with Musgrove Park Hospital  Discharge Planning Team continue.

Staff – Good Practice

  • Use of Bank Staff rather than agency to maintain continuity to residents
  • Staff were observed to treat residents with respect and one staff commented that they enjoyed working at the home.  
  •  Staff using gentle distraction to calmly helping residents to reduce feelings of anxiety that are often related to dementia.
  • Staff sought resident’s knowledge to help with gardening activity.
  •  ‘Investors in People Award’ obtained.
  • An internal phone line to an answering machine is provided for staff. This is checked daily by the Manager or Quality Development Manager and provides another way for staff to raise concerns, ideas, whistle blow or ask for support.
  • All staff are trained in the following subjects by an in-house nurse trainer:
    Care code of conduct; Confidentiality; The Rights of Residents; Health and Safety; Food Hygiene and Safety; Personal Care Tasks; Care Assistants Responsibilities; Infection Control; Nurse Call System; Fire Procedures; Manual Handling; First Aid; Abuse Awareness; Dementia care.

Staff – Recommendations

  • The E+V team would recommend that training be offered to all staff in Equality and Diversity Issues. 

Activities Good practice

  • The team observed a gardening activity. The staff member leading the activity was seen to engage residents as much as they wanted or were able in a focused and meaningful task. 
  • A long list of regular activities was included in the residents guide and include; art, craft, massage, aromatherapy music and armchair exercise to name but a few.
  • Trips out arranged to a local stroke club.
  • Visits from pets are encouraged.
  • Home provides a DIY club to encourage and support residents to maintain life long hobbies and skills which helps to ensure that personal interests are maintained
  • Tactile wall hanging which had been made by residents was displayed and observed to be  touched by residents.

Control and Choice:  Good Practice

  • Residents were encouraged to do as much for themselves as they were able. This includes getting dressed and feeding oneself.
  • One resident was being supported to do up shirt buttons and choose a pair of shoes. Staff appeared to value this time helping him to make decisions and were unhurried.
  • Visitors spoken to confirmed that they were welcome and encouraged to support residents with there needs.
  • Details about how to complain were included in the residents pack and it was observed that there was a care aware helpline available to staff and visitors.
  • One room had been decorated like a pub and bar games such as table skittles were provided. This was seen to be a social environment and of much value to those who can no longer get out and about.
  • Pictures or personal effects that had meaning to residents personalised the entrance to their rooms helping them to recognise it.
  • A picture of a toilet was placed on toilet doors helping residents to recognise it.
  • Unsafe areas such as utility cupboards were locked which meant that residents who lack the capacity for danger were able to wonder about the home.
  • Home provided a hairdressing salon that also opens at set times as a shop providing toiletries and other useful items.

Control and Choice: Recommendations

  • Information about ‘Advocacy’ services was available but it was thought this could be included in the residents pack along with information about The Somerset LINk and other local services in leaflet format where possible.
  • It is recommended that advice be sought about colour schemes and different areas be painted in different colours when the home is next redecorated.
  • The manager informed us that the bathrooms were plain and they were looking at doing something to brighten them up. The team noted that at a previous visit to Grovelands Care Home (Somerset Care) that, red fishing nets had been hung from bathroom ceiling containing seaside objects which provided a stimulating focal point. Toilets could also have a red seat making them stand out more to those with Alzheimer’s disease. The E+V team recommend that these good practice examples are considered as part of any re-decoration.   

Communication: Good Practice

  • Staff interacting with residents and talking about topics which interested them encouraging them to partake in conversation.
  • Staff are encouraged to eat meals with the residents. The E+V team noted that meals are an important social occasion and a good opportunity to chat.
  • Relatives and visitors receive an information pack that was seen to contain essential information such as menus social facilities and activities.
  • A notice was observed inviting visitors to join the ‘Friends of Chelston Gardens’ This is a group who help to influence the service providing suggestions on how to improve the quality of the service and raising funds for activities.
  •  A satisfaction survey is conducted quarterly and addresses many areas of service provision. It is sent to; social worker, doctors, other care professionals, visitors and residents.
  • Translation services were sought and notices written in Finnish for Finnish resident.
  • During a gardening activity it was observed how a resident was assisting a member of staff by giving him the name of the transplanted plants this was felt to be a good example of communication in practice helping to retain the knowledge of residents in a meaningful activity.

Communication: Recommendations

  • It is important to ensure all staff are aware of the need to including residents in communications about them, even if there capacity to understand and partake is limited. It is recommended that the manager address this with the entire staff team.

Eating and Nutritional Care: Good Practice

  • Anxious resident was supported to look at the menu and focus on choosing a meal which calmed their anxiety.
  • Snacks and drinks available all day.
  • It is anticipated that residents will experience weight loss due to the nature of their illness. This is monitored on a regular basis.
  • Support to cover with a serviette was given to those who needed it. And eating with fingers was not discouraged. It is important that any level of independence be maintained for as long as possible.
  • Residents were given the choice of where to eat and some residents took luncheon in their rooms.
  • Choices of meals were provided.
  • Visitors were welcome to stay and eat and give support to their relative.

Eating and Nutritional Care: Recommendations

  • It is recommended that the staffing of dining areas are closely monitored to ensure support is given where needed and that this is discussed regularly in supervision and staff meetings and that changes to the meal time support arrangements such as staggered meal times are implemented as necessary.  
  • It is recommended that rather than re-heating meals that smaller portions are given to residents who would benefit from them. These include those residents who are less likely to have the attention span to eat a meal and those needing to be fed ensuring that two small portions are given where needed.
  • It is recommended that staff are supervised to be vigilant in observing the support needs of residents who are being helped by visitors. Visitors also need to be aware that they need to tell staff when they are leaving.

Hydration: Good Practice.

  • During lunch staff were seen to be actively encouraging residents to drink.
  • Choices of two cordials were offered with lunch.
  • The Manager informed that a jug of water was placed in all bedrooms.

Hydration: Recommendations

  • The E+V team observed that water should also be made available with meals and that staff should ask or research what individual choices of drinks would be preferred.

Pain Management in Practice: Good practice

  • Staff were observed to spend time trying to find out if an anxious resident was in pain

Pain Management in Practice: Recommendations

  • The E+V team accept that there maybe times when nursing assistance cannot be offered immediately. However, if there is likely to be a wait for nursing assistance, such as a wound dressing, then care staff should be directed to support the resident until assistance can be provided.

Personal Hygiene: Good practice 

  • Alcohol Hand Gel was found to be in reception and a visitor was observed to be using it.
  • There is an in house hairdressers and a price list was on display
  • Manicures were noted as an activity in the resident’s pack

Practical Assistance: Good Practice

  • Staff were observed offering physical support showing dignity and respect.
  • The Service provides a helpline Called ‘Care Aware Helpline’ and details are in the residents packs.
  • Resident information pack included contact details of other key services such as Age UK, Somerset Direct and the Care Quality Commission.

Privacy in Practice: Good Practice

  • Staff were observed asking a residents permission to enter his room.
  • It was noted that doors could be locked and we were informed that valuables could be locked away.
  • There were many seating areas in which residents can receive visitors or talk to staff.

Social inclusion in Practice: Good Practice

  • Trips out to the local stroke club are arranged.
  • Use of the Stroke club minibus is utilised for trips out.
  • Events are organised such as a visit from the local motorcycle club and barbeques Notices advertising these were observed.
  • The service makes use of visiting services such as the Donkey Sanctuary and a visiting pet service.
  • Local organisations are encouraged to participate in the home’s activities such as a pantomime, the local choral society, the majorettes, the cub scouts and children from the local school.

For more information

For more information read the full report or contact Jonathan Yelland on jonathon.yelland@helpandcare.org.uk.

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