Inspection on 29/10/08 for Allerton Park

This inspection was carried out on 29th October 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Allerton Park 30/04/08

Allerton Park 01/05/07

Allerton Park 09/05/06

Allerton Park 01/12/05

Allerton Park 31/08/05

Allerton Park 04/05/05

Allerton Park 14/12/04

Allerton Park 04/10/04

Allerton Park 22/06/04

Allerton Park 01/10/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Allerton Park 39-41 Oaks Lane Allerton Bradford BD15 7RT     The quality rating for this care home is:   one star adequate 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: Liz Cuddington     Date: 2 9 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 28 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Allerton Park 39-41 Oaks Lane Allerton Bradford BD15 7RT 01274496321 01274782841 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Ruth Kaluba Lumbwe Type of registration: Number of places registered: Park Homes (UK) Ltd care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The total of places for dementia care must not exceed 26 Date of last inspection Brief description of the care home Allerton Park is part of Park Homes UK Limited, a registered company with several care homes in the area. Allerton Park provides nursing and personal care for a maximum of fifty people. The building has been divided in order to provide two different types of care in designated areas. The William Forster suite is a 26-bedded nursing unit for people who have dementia and need nursing care and the Joseph Cartwright suite is a 24-bedded residential unit for people who need support with personal care only. Each unit provides mainly single room accommodation. All but two bedrooms are equipped with an en-suite toilet. Each unit provides shared lounges and dining rooms. There is ramped access to the main door and a passenger lift ensures easy access to both Care Homes for Older People Page 4 of 28 Over 65 26 24 6 0 Brief description of the care home floors. The home is situated three miles from Bradford city centre and can be accessed by public transport. Parking is provided within the grounds. Care Homes for Older People Page 5 of 28 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: one star adequate 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: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Allerton Park. The visit to the home was carried out Care Homes for Older People Page 6 of 28 over one day by one inspector. The last key inspection was in October 2007. The methods used to gather information included conversations with the people living at the home, their relatives and the staff, as well as looking at care plans and examining other records. We received the homes self-assessment questionnaire before the inspection visit. This gave us a lot of useful information about the home and helped us plan the visit. The fees charged are variable and depend upon the level of the individuals care and support needs. We would like to thank the people who live at the home, their relatives and the staff, for their welcome and hospitality and for taking the time to talk and share their views during the visit. What the care home does well: What has improved since the last inspection? All the requirements we made at the last key inspection have been met. The staff who administer medication now make sure that the systems they follow are safe. Staff are kept up to date with peoples changing needs. Wherever possible, the people who live at Allerton Park and their relatives are involved in developing and revieing their care plans. The staff recruitment procedures have been reviewed, to make sure they are as Care Homes for Older People Page 8 of 28 thorough as possible. What they could do better: 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 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 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they are admitted to the home, to make sure their needs can be met. Evidence: People said that they were given enough information about the home before deciding to move in, and they had also received a contract. Where possible the home encourages people and their families to visit and talk to the people who already live at the home, their relatives and the staff. The home invites them to come and spend time there, share a meal and maybe take part in the days activities. This means that the homes staff can get to know the persons needs and the individual has the information he or she needs to make a decision. The care plans included pre-admission assessments completed by the home. Before Care Homes for Older People Page 11 of 28 Evidence: moving into Allerton Park, peoples needs are assessed to make sure that the home is able to meet their needs. This assessment forms the basis for the individual plan of care and support. Care Homes for Older People Page 12 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare needs are generally being met. People are protected by the medication administration systems. Staff treat people with respect, care and consideration at all times. Evidence: People receive the medical and healthcare support they need and any concerns about peoples health are followed up. Everyone we spoke to said the care and support provided at Allerton Park is of a good standard. People said they are very satisfied with the care offered. They felt that the staff know what they are doing and understand peoples needs. One person said that the staff come very quickly when they are called and are always happy to help. Our observations confirmed that the staff understand peoples care needs. However, Care Homes for Older People Page 13 of 28 Evidence: we saw one instance when the staff had not attended to an important part of one persons care needs. This meant that the persons dignity had not been maintained. A number of ladies were not wearing stockings and one lady was wearing bed socks when fully dressed. Two people were wearing trousers that were several inches shorter than they should be. This means that peoples appearance and dignity is not being maintained as well as it should be. If these are peoples preferences then the information needs to be recorded in their care plans. Three care plans were looked at, to make sure that peoples health and personal care needs are being met in the way each person prefers. The plans cover each area of the individuals care needs. They all contain enough information to guide staff in how to care for and support each person. The home is planning to streamline the plans to make them easier to use and include a life history section. There are risk assessments for areas of identified risk. These include assessments for the use of bed rails, falls management and nutrition. One persons weight had reduced significantly during the previous five months. This meant that the person is now very underweight. There was evidence of follow up action on one occasion during this time, when the dietician visited. But the person continued to lose weight. It is vital that all significant changes that affect peoples health and well-being are rigorously followed up and action taken, in order to help people maintain their optimum health. The new chef showed an excellent understanding of the importance of good nutrition and the impact this has on peoples physical and mental health. If the care and nursing staff work with the chef, as well as with the individuals and their families, it should be possible to develop personal nutritional plans for everyone whose diet puts their health and wellbeing at risk. The people themselves, and their relatives if they wish, are involved in reviewing and updating the care plans. The plans are all reviewed monthly by the staff, to make sure they still reflect the individuals care and support needs. People said that staff are very good and understand their needs. They said staff do what people want, in the way people prefer. People said they are happy with the care they receive. The staff we spoke with during the visit showed a good understanding of peoples needs and preferences. Care Homes for Older People Page 14 of 28 Evidence: During our visit, one relative told us that they were very happy with the care and support offered and had no complaints. The homes management have taken professional advice and put in plans, agreed with all those concerned, that will support someone when they are distressed. The daily records are kept up to date and include information on significant occurrences. Detailed medical records are kept that show, for example, when the GP visited and the outcome, as well as any further healthcare suppport that is needed. The medicines are kept safe and secure and the Medicines Administration Record (MAR) charts are securely stored. For security, the medicine cabinets are locked during the time between giving each person their medication. Most of the medicines are supplied by the pharmacy in a monitored dosage system, but some is kept in the original packaging. The MAR charts, which must show clearly the quantities of medicines received and in stock for each person, were examined. The medicines supplied in the monitored dosage system appeared to be administered and recorded accurately. There were signatures to confirm that staff had administered the medicine. The records of amounts received, administered and in stock of some medicines that were supplied in their original packaging were not always accurate. A brought forward system would make it easier to check all quantities of medicines, to confirm that administration is always accurate. The staff record the dates that packages and bottles of medicines are started. During the visit, all the staff were seen to treat people with respect. The people who commented said that they receive the care they need and are supported to maintain their independence for as long as they are able. Peoples relatives confirmed this. Everyone said the staff generally listen and act on what they say. Care Homes for Older People Page 15 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in a range of activities. People are offered a good choice of meals to make sure their dietary needs and preferences are met. Evidence: The staff provide a range of activities for people to take part in, if they wish. At present the activities include baking, singing, reminiscence sessions, music, playing dominoes, bingo and hand and nail care. On the day of our visit some people were getting the decorations ready for a Halloween party. There is still more development to be done on improving the range of activities and outings that are available for people to enjoy. A Life History in each persons plan will be useful in helping staff to provide meaningful activities for people. Some staff are very good at spending time with people and engaging their attention. Care Homes for Older People Page 16 of 28 Evidence: Other staff tend to be less involved with the individuals and concentrate more on the tasks that need to be done. The home plans to use the expertise of one of the organisations activities coordinators to improve the activities that are available. The staff group need to be involved in this, as a normal part of their daily work. People said they like the meals. The chef is knowledgeable about peoples particular likes and dislikes and makes every effort to give people the foods they will enjoy. People who eat a soft diet are offered their meals in an appetising way and staff were seen to assist people who needed help, in a calm and discreet manner, following the persons own pace. The food looked very appetising and everyone said they enjoyed their meals. One person said The food is lovely. The chef explained how the menus are planned, to include the wishes of the people who live at the home and to meet any special dietary needs. There are always alternatives available if people do not want the choices on the menu. During the winter months the chef said she will make a home made soup each teatime, as well as other freshly made dishes. There are always snacks such as home made cakes, cheese and biscuits and fresh fruit available for people to help themselves to. There are jugs of juice in the lounges. A record is kept of exactly what foods are served each day, as this may vary from the planned menu. People are offered hot and cold drinks throughout the day. The staff approach to people is friendly and respectful and the staff we spoke with showed a good understanding of peoples needs and preferences. Care Homes for Older People Page 17 of 28 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 aware of how to raise a concern or make a complaint if they are dissatisfied with the service. Most staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people at the home are safe. Evidence: Any complaints or concerns are recorded in a complaints file, which is stored securely. The actions taken and the outcomes are recorded. Staff said they know what to do if anyone has concerns. People said they know what to do if they have a concern or complaint. The relatives said the home responds appropriately to any concerns. There was evidence to show that the home makes improvements when a complaint investigation shows that changes are needed. Newly employed staff are made aware of the homes whistle blowing policies and procedures, to be used if they suspect abuse or see examples of poor practice. Most of the care staff have had adult protection training, and further refresher training is planned. All the appropriate policies and procedures are in place to guide staff. Care Homes for Older People Page 18 of 28 Evidence: Since the last inspection one adult protection referral has been made. We saw evidence to confirm that the issues were dealt with thoroughly and rigorous checks are now in place to prevent similar concerns arising. Care Homes for Older People Page 19 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe, comfortable, attractive and reasonably well-maintained environment. Evidence: The home is clean and generally well maintained and everyone we spoke to said the home is kept fresh and clean. There is a cleaning programme in place and general maintenance is ongoing but more needs to be done, such as freshening some of the paintwork, to improve the appearance of the home. The ceiling in one lounge/dining room was badly stained. On the day of the visit one of the bedrooms was being re-decorated and refurbished and we were told that more re-decorating was due to start the following week. The rooms are comfortably furnished and have a welcoming feel. There are sufficient, accessible toilets and bathrooms on both floors of the house. Staff are employed to help look after the maintenance of the house and grounds as well as keeping the gardens tidy. The home has effective infection control measures in place and follows the correct procedures if an outbreak of an infection does occur. Care Homes for Older People Page 20 of 28 Evidence: The gardens are attractive and there is seating for people to use in the better weather. We were told that some of the people who live at Allerton Park helped to plant the tubs. Staff said that people like to walk round the gardens and enjoy sitting out there in the fresh air. Care Homes for Older People Page 21 of 28 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. Sufficient staff are employed to meet peoples needs. People are protected by thorough recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Suitable training is provided to make sure staff have the skills and knowledge they require to be able to meet peoples needs. Evidence: The staff rotas, and peoples comments, confirmed our observations that there are enough staff on duty to meet peoples care, social and leisure needs. The staff confirmed that staffing levels are adjusted to meet peoples needs. People said there are always plenty of staff around and our observations confirmed this. Because of their high levels of dependency, some people were receiving additional attention from the staff. The home has appointed a Deputy Manager who was due to start in post in early November. All new staff complete an application form and provide two written references. Criminal Care Homes for Older People Page 22 of 28 Evidence: Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks are obtained and no new staff begin work until these checks have been completed satisfactorily. The members of staff we spoke to confirmed that the procedures are thorough. There is plenty of training available for staff. All the staff we spoke to said the training is good and keeps them up to date. The home keeps good records of staff training. Refresher training in Health and Safety, Food Hygiene, Moving and Handling and Fire Safety were all planned for the end of October 2008. All new care staff complete induction training which meets the Skills for Care criteria. This gives them good basic training to help them do their job effectively, and provides a sound basis for taking a National Vocational Qualification (NVQ) course. The nursing staff have had training updates including pressure area care and end of life care. More staff should take the first aid course, to try and make sure there is always a qualified first aider available. Most staff have had infection control training. One of the nurses has started a dementia care course and another has already passed one of the modules and has started the second dementia care module. One nurse is the homes link nurse for continence care and is taking additional training for this role. Another is the link nurse for end of life care and there is training planned for staff to help them in this area of care. Six of the twenty-three care staff have achieved an NVQ in care. Seven staff are enrolled on the level 2 course and two are taking the level 3 award. This means that currently less than 25 of the care staff have a recognised qualification. More staff need to enrol on an NVQ course, in order to make sure that the staff team have the training they need to do their job effectively. Care Homes for Older People Page 23 of 28 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 safe and well managed, in the best interests of the people who live there. Evidence: The manager has the necessary experience and qualifications to manage the home, in the best interests of the people who live there. The manager attends training to keep up her professional development. The records and the staff confirmed that all staff have regular one to one supervision meetings with their line manager. This supports staff to plan their personal and professional development and gives them the opportunity to discuss any areas of concern in a confidential setting. Peoples personal information is securely stored in locked cabinets when it is not being used. Care Homes for Older People Page 24 of 28 Evidence: Where the home helps people to manage their personal finances, accurate records are kept of all transactions and all monies are securely stored. The homes policies and procedures are kept up to date; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. These measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. The laundry is well organised and peoples personal clothing, as well as their bedding and towels, are properly cared for. The most recent Environmental Health Officers report for the kitchen awarded it a score of three stars out of a possible five. The manager said that most of the requirements of this report have now been dealt with. The home has a range of quality assurance systems in place, to help determine the quality of service the home offers. These include surveys for the people who live at the home and their relatives, meetings for people and their relatives that are held every six weeks and there are staff meetings. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 8 12 Any significant changes that affect peoples health and well-being must be rigorously followed up and action taken. This is in order to help people maintain their optimum health. 31/12/2008 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 1 28 More staff need to enrol on an NVQ course, in order to make sure that the staff team have the training they need to do their job effectively. Care Homes for Older People Page 27 of 28 Helpline: 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 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 28 of 28 - 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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