Enter & View Report: Chelston Park Care Home, Wellington

Hospital Discharge: Recommendations

• The team noted that the setting up of a formal agreement relating to Hospital discharge and the home, involving a tick list of actions that the hospital need to take prior to discharge may help reduce some of the issues experienced.
• Develop a form called 'All about me' which accompanies any resident being admitted to hospital. This contains details of the person such as, their likes and dislikes, their wishes and their preferences. (see appendix 2)

Staff - Good Practice

• Staff were observed to keep a presence in or near communal areas at times when Residents were present in these areas.
• Staff given authority to carry forward good suggestions and challenge existing Practices. Using staff skills and knowledge to help the service develop.
• Involving students and volunteers in addition to usual staffing .
• 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.

Staff - Recommendations

• The E+V team would recommend that training be offered to all staff in Equality and Diversity Issues. This training is available from SREC (South Racial Equality Council.)

Activities - Good Practice

• Employment of an Activities Co-ordinator.
• A list of regular activities included in the residents guide.
• Arranging fund-raising activities such as car boot sales which contribute to the Residents Fund which can then be used to pay for trips out and additional activities or equipment.
• Staff given time to arrange individual activities for residents.
• 'Residents Guide' refers to staff being encouraged to support residents with life long hobbies which help to ensure that personal interests and skills are maintained.
• Staff seek opportunities for Residents skills and knowledge to be used in a meaningful way such as playing the piano for other residents or helping with gardening.

Control & Choice: Good Practice

• Provision for double rooms provided where possible
• Prospective relatives and residents invited to view the home at any time without the need to give notice.
• Supporting residents to maintain or even regain lost skills.
• Including details about how to complain or comment in the residents information pack.
• 'Residents Information Packs' include contact details of other key services such as Age UK and the Care Quality Commission.
• Holding a church service at the home.

Control & Choice: Recommendations

• As the 'Call System' has the facility to monitor response times we would recommend that regular monitoring is carried out and discussed at staff meetings to aid the continued improvement of response times.
• Information about Advocacy services were 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.

Communication: Good Practice

• 'Friends and Relatives questionnaire conducted quarterly and a recent copy included in the residents pack.
• Residents meetings are planned monthly and 1 to 1 time offered to those who are too frail to attend
• Residents were asked if staff could help them before help was given.

Communication: Recommendations

• Previous Enter and View visits have observed that often the most successful residents meetings have involved speaking to residents and visitors to compile a list of agenda items. This agenda has then been given to residents and visitors in advance of a meeting time. Involvement of kitchen staff and activities staff in meetings is also recommended.
• The team commented that a hearing loop, audible aids and specialist advice may still be able to enhance the communication of some residents and visitors and that the home should seek advice from the Royal National Institute for the Deaf (RNID) about this.

Eating and Nutritional Care: Good Practice

• Meals available for visitors to dine with their friend or relative.
• Snacks and drinks are available all day.
• Residents and visitors can make themselves hot drinks using 'Zip' safety water heaters..
• Several residents commented that the food was always good. And it was observed that fresh vegetables had been used.
• A good choice of either wine or soft drinks was offered to residents.
• Residents were able to take meals in their room if they wished.
• 1940's big band style music was playing quietly during lunch helping to make a social atmosphere.
• Seasonal meals with celebrated themes such as St David's day

Eating and Nutritional Care: Recommendations

• We would recommend staff are made aware of potential problems with chairs and check the anchoring operation of these chairs regularly.
• Review the wording of the statement in the residents guide in the 'Financial Arrangements and Fees' Section relating to residents needing to pay additional costs if residents are disinclined or unable to eat the food provided. This statement was seen to be in conflict with the statement saying dietary needs and choice will be met, and requires revising.

Hydration: Good Practice

• The use of safety water boilers so that able residents and visitors can independently and safely make hot drinks as and when they choose.

Practical Assistance: Good Practice

• Building and maintaining a good relationship with local GP's who visit regularly.
• Staff were observed offering physical support showing dignity and respect.

Privacy in Practice: Good Practice

• Staff were observed asking a residents permission to enter his room.
• Resident's room doors can be locked and valuables can be locked away.
• There were no concerns or comments identified by the team about privacy.

Social inclusion in Practice: Good Practice

• Holding public events such as car boot sales or fireworks displays at the home with profits going to the Residents Fund. This was seen as a good way to provide an activity that brings members of the community to the care homes.
• Organised events such as fireworks displays and barbeques are a good way of involving family and friends of residents.
• Availability of games for children. Many residents are likely to take great pleasure watching their grandchildren at play.
• Making 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 and the cub scouts.
• A Heritage box is obtained from the local library and circulated among residents.
• Giving talks to educate and inform relatives and carers about key subjects such as mental capacity.

Social Inclusion in Practice: Recommendations

• Other visiting services the home may wish to make use of are, Clothes Direct; The old Fashioned Sweet Shop.

For more information

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