CARE HOMES FOR OLDER PEOPLE
Parkstone Avenue (1) 1 Parkstone Ave Benfleet Essex SS7 1SP Lead Inspector
Sarah Axam Unannounced Inspection 30th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 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. Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Parkstone Avenue (1) Address 1 Parkstone Ave Benfleet Essex SS7 1SP 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) 01702 558571 01702 558571 Redbridge Community Housing Limited [RCHL] Carroll Bailey Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (1), Physical disability (7) of places Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The registered manager to complete NVQ level 4 in care and management by 2005. The registered manager to complete 2 courses approved in consultation with the CSCI local area office, one relevant to the best practice in the management of staff. The second course to be relevant to reflective care practice within 8 months of registration. Both courses to be identified within two months. 17th June 2005 Date of last inspection Brief Description of the Service: 1 Parkstone Avenue is a single storey purpose built care home in a residential area of Thundersley.Each resident living at the home has a learning or physical disability. Accommodation is provided in two Units. Each Unit has a lounge, dinning area, kitchen and four bedrooms. The home has a medium sized garden that is accessible to wheelchair users. The home is close to shops, parks, libraries and other facilities. A local bus route runs by the home regularly. There is some parking to the side of the home; pathways leading from the home to the local amenities are accessible for wheelchair users. Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 7 hours. A further visit was arranged (6/1/6) to look at recruitment procedures that was not available on the day of Inspection. There was a tour of the building and the deputy Manager and Manager assisted during Inspection. One service user was spoken with during both visits. What the service does well: What has improved since the last inspection? What they could do better:
One outstanding requirement from the last inspection is outstanding due to improvement work needed in the hallways and tiling of one shower room. The manager needs to continue to talk to M.O.A.T. housing to resolve the outstanding maintenance issues. The sensory and new office/visitors room needs to have a deadline on completion and time scales/completion date forwarded to CSCI. The home needs to develop further a ‘service user’ quality assurance monitoring format and for that to be evidenced, monitored and actioned. In general the home needs to make sure all the good practice and work carried out is clearly evidenced in the paperwork they produce. Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 6 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. Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 7 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 Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 EVIDENCE: Intermediate Care is not provided for this home. Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8&9 Care plans are well laid out and contain necessary information Medication is dealt with appropriately EVIDENCE: Care plans highlighted Individual health needs and evidenced that service users were professionally assessed and offered services that catered for their ‘specific’ needs. Appropriate intervention was recorded and guidance given for staff to follow. Care plans in service users folders all had review dates on and yearly reviews for all but 2 of service users had been arranged, the remaining 2 were in the process of being booked. Health Care records were very ‘holistic’ and covered a range of needs depending on the individual. Detailed individualised guides and risk assessments on ‘oral’ hygiene, aids and equipment, nutrition, psychological and physical health are recorded and monitored. Dental, sight tests, chiropody and GP visits were all recorded and appropriate interventions needed are addressed. Service users views on how they like staff to work with them is recorded and kept within the care plans. The home administers and monitors the service users medication. A policy and procedure is in place for the correct receipt, recording, storage and handling, administration and disposal of medications. If able, service users would be supported by the home to administer their own medication, however this is presently not the case at Parkstone Avenue.
Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 10 Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 That service users are consulted with and views recorded. EVIDENCE: The home evidences through Care plans and service users views recorded that personal autonomy and choices are promoted and staff are proactive within this area. During inspection staff interaction with service users was observed to be caring, appropriate and supportive. Staff was seen to be consulting and asking service users permission before going into peoples bedrooms and generally having meaningful interaction with the residents. Service Users rooms were personalised and recently two service users rooms were redecorated and these residents were encouraged to choose their own colour schemes and decoration. Staff presently take overall responsibilities for all service users monies within the home. Whilst on inspection a service user chatted to me about her monies and told me she was very happy for staff to do this. This service user at the time of inspection was given access to her ‘monies’ tin upon her request and showed me where it was kept and why it was locked away. This service user clearly demonstrated that she knew the arrangements for her monies and had the choice to access them if needed. This was also backed up by guidance in her care plan. Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Not inspected on this occasion Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The home generally provides a homely comfortable environment for the service users. The home has good procedures in place for hygiene and infection control within the home. EVIDENCE: In general the home is well-maintained and suited to service users needs. Recently the East Wing has had new carpets in the lounge, curtains and sofas. The Kitchen has also been renewed. In the West Wing a new kitchen has been fitted and there is provision in the next budget to re-new carpets in the lounge as well as the sofas. Two Service users bedrooms have been re-decorated and residents were actively encouraged to take an active lead in choosing colours schemes and materials. Since the last Inspection one shower room has been completely re-tiled and there are plans to re-tile the other shower room. There is a local Handy-person employed to carry out general jobs within the home.
Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 A thorough recruitment process is in place. EVIDENCE: All permanent and ‘relief’ staff files were sampled. The recruitment process in place is of a high standard. Staff files all had CRB and POVA 1st checks completed before staff are given start dates. Two references were present and gaps in employment history were checked. Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 The Organisation has a good Quality Assurance Package in place. EVIDENCE: The organisation has been proactive in having a good quality assurance process is in place. Recording of minutes, regular meetings, addressing issues raised in the different services and an action plan were present. However the home has not yet developed a yearly quality assurance survey that allows individuals within the home to give appraisal of the service, staff and environment provided. Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 16 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X X Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? Yes 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 OP19 23 (2)(b) The registered person must ensure that the premises to be used are of sound construction and kept in a good state of repair externally and internally. This is in relation to the home upgrading hallways and shower room. (Previous timescale of 31st Oct 05 not met) The registered person must develop a quality assurance monitoring survey, which allows service users, families and professionals who use service to give feedback to the home and that the home acts upon this feedback and sends a development plan to CSCI. Regulation Requirement Timescale for action 31/03/06 2 OP33 31/03/06 24 (1)(a)(b) (2) (3) Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 18 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 Refer to Standard OP8 Good Practice Recommendations That the registered person clearly evidences in paperwork health services used by individuals. That dates of visits; follow-ups and actions taken are clearly recorded. That annual check ups for all service users are monitored and arranged. Parkstone Avenue (1) DS0000018102.V280141.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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