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Inspection on 05/06/09 for Parkview Nursing Home

Also see our care home review for Parkview Nursing Home for more information

This is the latest available inspection report for this service, carried out on 5th June 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Despite being a fairly large home this service provides comfortable and homely accommodation for the people who live there. The new extension has enhanced the facilities that are offered; all of the new bedrooms have en-suite facilities including showers for people who have limited mobility. It has also provided additional communal areas in the form of sitting rooms and dining rooms.The home is always very clean and smells fresh. We consider that the home is providing excellent outcomes for the people who live there. A comprehensive admission procedure helps to make sure that the home will meet the needs of anyone who is thinking about moving in and that the risk of unsuitable placements is avoided. Relatives, we spoke with, were able to tell us how the staff had helped them with what they felt had been a very difficult time. There is a varied activities programme in place and a dedicated activities organiser arranges both group sessions and individual ones for those who do not wish to join in. There are also trips out of the home. People tell us that they are free to choose how they spend their days and that times for getting up and going to bed are flexible. Generally they enjoy the meals that are served, there is always a choice and any special diets can be catered for. Everyone has an individual care plan which sets out how they prefer to be supported and they have been encouraged to participate in compiling these. Medication procedures ensure that they receive their medication as it has been prescribed. Documentation that the home is required to keep as evidence of its commitment to the health and safety of those who use the service is all in order and equipment is well maintained and serviced regularly.

What has improved since the last inspection?

The requirements that were made at the last inspection have been met, there had been concerns about the standard of the food that was served in the home. A new chef has now been employed and generally people agreed that the meals were better. Special attention is also paid to peoples nutritional status. Anyone with a poor appetite would be encouraged to eat and the calorie intake of their meals would be boosted. Smoothies have also been introduced to help those who are not eating well. The home is working with the local hospice to improve the quality of of care to those who are nearing the end of their lives and advanced directives which detail peoples wishes are being incorporated into the care planning process.

What the care home could do better:

The new extension is extremely well appointed and exceeds the minimum standards. However, this has left some of the rest of the home looking a little tired and worn in comparison. We have been assured that this will be addressed and that the redecoration and refurbishment programme will be continuing in order to raise thestandards throughout the home. The home has also told us that there is an intention to employ an additional activities coordinator so that when bed occupancy increases there will be an opportunity for all residents to participate in activities of their choice.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Parkview Nursing Home 1 - 3 Eversley Road London SE19 3PY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Ford     Date: 0 5 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Parkview Nursing Home 1 - 3 Eversley Road London SE19 3PY 02087715234 02086536493 fyfecarlisle@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Planshore Limited care home 88 Number of places (if applicable): Under 65 Over 65 0 88 88 53 dementia dementia old age, not falling within any other category old age, not falling within any other category Additional conditions: 12 88 0 0 The maximum number of service users who can be accommodated is 65 The registered person may provide the following category of service only: Care home with nursing (CRH - N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 53) Dementia - Code DE (maximum number of places: 12) Date of last inspection Brief description of the care home Parkview is a large home, in Upper Norwood, orginally registered to provide nursing care for up to 65 residents over the age of sixty-five. Recently a new extension has been built which means that the home can now accomodate 88 people. The top floor of the home has been adapted to provide accommodation for people with dementia. Care Homes for Older People Page 4 of 26 Brief description of the care home The home is located in a residential road opposite a large park and there is off street parking to the front. It is near to local amenities and well served by public transport. Accommodation is provided over three floors in a mixture of single and shared rooms some of which have en-suite facilities. There are a variety of communal areas, an atttractive, landscaped, rear garden and a small courtyard garden. At the time of this inspection fees range from £570 - £850 according to the assessed healthcare needs of the resident. Additional charges may be payable for services such as hairdressing and private chiropody and these would be discussed prior to admission. Information regarding fees, the services that are provided and the latest report from The Commission are detailed in The Statement of Purpose and Service User Guide, which are available from the home. Inspection reports are also available from the care Quality Commissions website Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report follows an unannounced visit made to the service as part of our planned inspection activity. When writing the report consideration has also been given to other information that we have received since our last inspection in June 2007. This includes complaints, notifications, the results of questionnaires that we have sent out and conversations we have had with people who use or visit the service. On the day that we visited, the home was preparing for a party to officially open the new extension to the home. We were able to talk with the manager , several staff members and many of the people who live in the home, who were looking forward to the forthcoming celebrations. Care Homes for Older People Page 6 of 26 We looked at various records that the home is required to keep as evidence of their commitment to the health and safety of its residents and staff, we undertook a tour of the premises and we looked at several care plans. The home had also sent us their Annual Quality Assurance Assessment (AQAA) a self assessment which tells us how well the home considers it is meeting its aims and objectives and about their plans for the future. Complaints are all dealt with promptly; the home has had one concern that has been dealt with under local authority safeguarding policies and is now subject to the homes own disciplinary procedures. What the care home does well: What has improved since the last inspection? What they could do better: The new extension is extremely well appointed and exceeds the minimum standards. However, this has left some of the rest of the home looking a little tired and worn in comparison. We have been assured that this will be addressed and that the redecoration and refurbishment programme will be continuing in order to raise the Care Homes for Older People Page 8 of 26 standards throughout the home. The home has also told us that there is an intention to employ an additional activities coordinator so that when bed occupancy increases there will be an opportunity for all residents to participate in activities of their choice. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are fully assessed prior to admission to ensure that the home will suit them and they are able to access information that will help them decide if they will be happy there. Evidence: We looked at a sample of care plans and could see that prior to their admission, people had been assessed to make sure that the home would be suitable and their health care needs, both physical and social, could be met. We also spoke with a relative of a resident who had been recently admitted and they were able to tell us how someone had come to carry out this assessment. A senior nurse explained that they take potential residents a brochure about the home to show them. If they are able to visit to see the home themselves, possibly to stay for lunch, this is arranged otherwise their relatives are encouraged to come and view the Care Homes for Older People Page 11 of 26 Evidence: home. When they return,the nurse who undertook the assessment, talks with other staff to discuss the care and support that will be needed and any potential problems. Information about the pending admission will also be given to the staff in the kitchen, to domestics and to the activities coordinator. All placements are subject to a four week trial period. Information that is produced for residents such as the service user guide can also be made available in large print, audio, Polish Italian and Gujarati. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are treated in a way which maintains their individuality, dignity and respect. Their health care needs are met in a way which suits them and regular reviews ensure that any changes are identified. Medication practices in the home are of a good standard. Evidence: All residents have an individual care plan which sets out the support that they need and we looked at a sample of these during our visit. We saw that all aspects of residents care had been considered and regular reviews ensure that any changes are identified. Other healthcare professionals such as dietitians, physiotherapists, chiropodists and opticians are also involved as necessary. Where possible residents or their relatives have been encouraged to contribute to this process. Individual staff members have been given responsibility for monitoring residents nutritional needs and also for identifying changes which might lead to them getting Care Homes for Older People Page 13 of 26 Evidence: pressure sores. There was evidence to show that any concerns are acted upon and pressure relieving equipment is being used where necessary. For those people who are reluctant to eat smoothies have been introduced to boost their nutritional input. The provision of additional supplements would be discussed with the doctor and given if necessary. One of the nurses is in charge of wound care in the home and has developed an expertise which she shares with other staff. The home is proud of the successes it has had in treating people who have been admitted with quite complex wounds. The home is very keen to embrace new ideas and we saw that doll therapy has been introduced to those residents who have dementia. This is a new initiative which some residents seem to enjoy and the home is monitoring its effectiveness. Residents are all treated as individuals and their personal, religious, and sexual beliefs are respected. The home is a multi cultural society including staff members and they tell us that they are sensitive to race issues. Residents that we spoke with told us that staff always treated them with respect and kindness, that they were kind and caring. One said they cant do enough for you another that they couldnt be better and several told us that they were very happy living in the home and felt safe and cared for. We looked at medication storage and administration procedures and these were all well organised. Regular audits are undertaken. The home is participating in the Gold Standard Framework which helps to provide best quality care for people who are at the end of their lives. One of the nurses is the coordinator for this, liaising with the local hospice. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to choose how they spend their days and consider that the lifestyle in the home is in line with their preferences and expectations. The food that is served to them generally meets their needs. Evidence: The home tells us that staff have been trained in the importance of promoting independence and freedom of choice and residents that we spoke with told us that they are free to choose when they get up or go to bed, the clothes that they wear, their meals and how they sped their days. One lady told us if Im not ready to get up in the morning I just tell them and they come back later on. Their is a full time activities organiser who arranges group activities for those who wish to join in and individual sessions for others. On the day we visited she was taking round drinks for the regular sherry afternoon and dancing with the residents in the dementia unit. Group sessions include gardening, sewing, dominoes and exercise and ball games. There are regular trips out of the home arranged for those who are able to go and a clothes sale had recently been held. A record is kept of the sessions that residents have participated in and there are photographs of various events that they Care Homes for Older People Page 15 of 26 Evidence: have enjoyed. We spoke with some of the ladies in the lounge who told us how much they enjoyed all of the things that are organised for them and how much they were looking forward to going to the party on the following day. Some residents have previously raised concerns and some dissatisfaction wit the food that was served in the home. However, since the last inspection a new chef has been appointed and they agreed that the food was getting better. There is always a choice of meal available and the chef is able to cater for any particular wishes or preferences. The traditional Friday lunchtime meal of fish and chips was served during the inspection and it looked appetising and well presented. Residents all had a drink with their meal and there was help available for anyone who needed it. The chef told us that he was being encouraged to move away from the previous practise of buying in frozen and processed food and buy more fresh produce. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that any complaints that they might have would be taken seriously and addressed promptly. There are procedures in place to ensure that they are protected from abuse. Evidence: The home has a complaints procedure in place and they tell us that they view complaints as a positive means to improve their service. A copy of the procedure is in the service user guide and is displayed on each floor in a large print format. People that we spoke with said that they were sure any issues that they might raise would be dealt with and the manager has an open door policy and is always available to speak with. Staff have all received training in recognising and reporting suspected abuse and they displayed a knowledge of the procedures to be followed should they have any concerns. No new member of staff is employed without clearance from the Criminal Records Bureau to ensure that residents are protected from those who have been judged as being unsuitable to be working with vulnerable adults. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a well maintained home which suits their needs and is being improved so it will exceed that minimum standards Evidence: The property is situated in a quiet residential road opposite a large park. We undertook a tour of the premises. The home has recently been extended to provide a total of eighty eight beds. The new extension exceeds the minimum requirements, the single rooms are large, tastefully decorated and each has en-suite facilities including a shower which can be used for people with limited mobility or who are reliant on a wheelchair. Additional dining rooms and lounges and nurses stations have also been provided. The rear garden has been landscaped with terraced flowerbeds and a sensory garden. In the older part of the home there is a planned programme of redecoration and refurbishment to bring it up to the standard of the extension. We noted that some areas here are looking a little tired now however, this is being addressed. All of the bedrooms are well furnished and comfortable although some are still for shared occupancy. Screens have been provided here to maintain residents privacy. Care Homes for Older People Page 18 of 26 Evidence: Adaptations are in place throughout the home such as handrails,and warning strips and passenger lifts are deliberately slow. All bedroom doors are fitted with automatic closers which operate in the event of a fire to ensure the safety of residents. The top floor which is designated for those people who have dementia is fitted with security pads to maintain the safety of those people who live there. We did consider that more work could be done on this floor in the way of putting up pictures etc that would have some relevance for the people who are there. The manager has agreed to look in to this. The home was clean and fresh and residents and their relatives tell us that this is always so. There are measures in place to help with infection control and one of the nurses has responsibility for ensuring that all staff are regularly trained and updated. The kitchen is about to be extended so that it is able to cope with the increase in residents. We did have some concerns about some of the equipment that was in use although we were told that new equipment had been ordered. Since we visited it has all been replaced. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough, suitably trained, staff in the home to meet the needs of the residents and there are robust recruitment procedures in place to protect them. Evidence: The rota showed that there are always enough suitably trained staff on duty to meet the needs of the residents. People told us that they were kind and caring and we saw that they were respectful toward residents but chatty and cheerful. Staff training is given a high priority in the home and there is a matrix in place showing that all staff are able to access training that helps them understand the problems of the people that they support. There is an in-house trainer who visits once a week and external training is also in place. One nurse is designated as a moving and handling trainer while one specialises in wound care. Another nurse is responsible for infection control making sure that all staff are up to date with current practises. New staff have to undertake an induction programme when they first arrive in the home before they are able to work unsupervised. We spoke to two care staff who were able to tell us all about this and about what they had learnt. Care Homes for Older People Page 20 of 26 Evidence: Those staff members who work on the top floor, supporting residents with dementia, have all attended training to help them understand the problems experienced by these people. The same staff tend to always work on this floor to provide continuity and familiarity. No new member of staff is employed before all of the necessary checks have been carried out to ensure that residents are protected from those who have been judged as being unsuitable to be working with vulnerable adults. We looked at a sample of staff files and could see that all of the required documentation was present. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a person who is fit to be in charge and in the best interests of those who live there. There are effective measures in place to measure their satisfaction wit the service and health and safety procedures ensure their protection. Evidence: The home is currently managed by Mrs Patricia Fyfe, a registered nurse with additional qualifications which include the Registered Managers Award. She has many years experience in working with this client group and considers herself to be approachable and receptive to new ideas. The service is run in the best interests of the people who live there and there are regular residents and relatives meetings for people to contribute their ideas and influence the way that the service is provided. Survey forms are sent out yearly and the result are published in the homes quarterly newsletter. A member of the company visits the home monthly to satisfy themselves that the home is running well and and Care Homes for Older People Page 22 of 26 Evidence: produces a report in line with Regulation 26. There are also regular staff meetings held so that everyone is aware of what is happening in the home. The Annual Quality Assurance Assessment has provided us with information to show that all of the equipment and services in the home are being appropriately maintained and regular audits are undertaken. The home complies with fire safety regulations and inspection visits are undertaken by the environmental health officers. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!