Inspection on 30/04/08 for Allerton Park

This inspection was carried out on 30th April 2008.

CSCI found this care home to be providing an Poor 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.

Other inspections for this house

Allerton Park 29/10/08

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Allerton Park 39-41 Oaks Lane Allerton Bradford BD15 7RT Lead Inspector Caroline Long Key Unannounced Inspection 09:00 30th April 2008 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 Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 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. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allerton Park Address 39-41 Oaks Lane Allerton Bradford BD15 7RT 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) 01274 496321 01274 782841 Park Homes (UK) Ltd Ruth Lumbwe Care Home 50 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (26), Old age, not falling within any other of places category (24) Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total of places for dementia care must not exceed 26 Date of last inspection 1st May 2007 Brief Description of the Service: 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 communal rooms of lounge and dining facilities. There is ramped access to the main door and a passenger lift ensures easy access to both floors. The home is situated three miles from Bradford city centre and can be accessed by public transport. Parking is provided within the grounds. The current weekly fees charged by the provider for residential care are from £341 to £378 and for nursing care from £522 to £575, however this is not always the cost to the person using the service. Their costs are dependent on local authority funding and benefit entitlement. Additional charges are made for hairdressing, private chiropody and newspapers. This information was provided to the us on the 12th May 2008. The contents of Inspection reports are discussed at staff, relative and residents meetings and are available upon request. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. Allerton Park is registered to provide nursing and residential care to people with dementia. Since the last inspection there have been issues raised about the quality of the care provided. The provider has worked with the District Nursing Team to improve the care in the home and progress has been made. However recently there has been a incident which showed further work needs to be carried out to make sure people are receiving prompt access to health care. This is what we used to write this report:• • • • We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assessment questionnaire (AQAA). We contacted relatives and advocates who visit the home to get their views. Two inspectors visited the home unannounced. This visit lasted over nine hours and included talking to the staff and the registered manager about their work and the training they have completed, and checking some of the records, policies and procedures the home has to keep. We spent time talking with people who live in the home and two relatives who were visiting. We looked at four people’s care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. • • • Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Before anyone moves into the home, the provider needs to be confident they can meet all their emotional, social and health needs. This will prevent people from the trauma of moving again to somewhere that is more suitable. People must be provided with a plan of their care, which they or their family have contributed to and made choices about. This plan should be written in a form which they can understand and contain their personal preferences. This plan, and the assessments of any risks involved, needs to be reviewed, as the person’s needs change. This means people are cared for and supported in the way they prefer and like. People’s health must be monitored and if they become unwell, staff must contact the appropriate health care professional promptly. Younger people have different social needs; they must be provided with imaginative and varied opportunities to develop and maintain their social, emotional, communication and independent living skills within their own age group. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 7 To protect people, the provider needs to make sure all the staff are fully aware of what constitutes restraint and restrictive practices and only use these in exceptional circumstance. To make the home a pleasant place to live and to prevent infections the home must improve its standards of cleanliness. 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. The summary of this inspection report can be made available in other formats on request. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 8 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 Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1, 3 and 4. Standard 6 is not applicable. People who use the service experience adequate quality outcomes in this area. Although people’s personal and health care needs are sufficiently assessed, people are being admitted when the home is unable provide the support and care people need. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Two people’s care records were looked at, who had been admitted to the home in the last year to see if the staff had properly assessed them. This is to make sure the home could meet their care needs and had the equipment necessary to care for them properly. Both had assessments of their personal and health Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 10 care needs, which had been carried out before the person moved into the home and both contained enough information. One person moved into the home so they could remain near to their relatives, and the relative explained how they were happy with this arrangement. However this person has specific personal, social and health needs and the home does not have the skills and environment necessary to provide them with a good quality of life. Staff also felt the environment was not suitable and they did not have the necessary skills to care for this person fully. The registered manager stressed people are no longer admitted to the home unless they have the correct equipment to enable the staff to meet their needs. The home does not offer intermediate care. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. People who use the service experience poor quality outcomes in this area. People are not always receiving the health and personal care they need. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: We looked at four people’s care records in detail to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. Three were looked at on the nursing unit and one on the residential unit. All contained the information necessary and the actions that needed to be taken to meet people’s personal, social and welfare needs safely. These were supported by risk assessments for mobility, nutrition and pressure sores. Both the care plans and the risk assessments had been reviewed regularly. On the residential unit there was some evidence that people were involved in their plans, where people’s personal preference were described. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 12 However on the nursing unit the plans were very task orientated and did not include people’s likes and dislikes and there was no indication the person receiving the care or their representatives had agreed them. Examples of these were for personal hygiene it stated ‘staff to do a strip wash in a morning, comb hair and do oral if possible’ and ‘staff to do fingernails at least three weekly’. For one-person information recorded in the pre-assessment had not been put in the care plan, this could have resulted in the staff being unable to care for this person properly. When we visited and talked to health professionals we were able to see how people’s health care needs were not always being met. Examples of this are: • When we visited, a person who was displaying challenging behaviour was prevented from using the communal areas and this caused them considerable distress. They had also lost a lot of weight, but there was no evidence to show staff had recently contacted the dietician or mental health services for advice. A health professional said they were concerned about the home not recognising and acting upon acute illnesses, and they were able to give an example of when this had occurred and seriously affected the health of a person living in the home. There have been four complaints following the last inspection in May 2007 about the standard of the care people receive at Allerton Park, particularly about pressure area care and slow response to incidents. In response to these, more equipment has been purchased and the tissue viability nurse has provided staff with training and support. However the tissue viability nurse has explained how these issues continue to be unresolved, and gave an example of when staff had not responded speedily to equipment failure, which had resulted in the person not receiving the care they needed. • • When we visited, the registered manager was on duty and we saw the staff providing support in a kind and helpful manner and people were clean and dressed appropriately. A person living in the home said that the staff always protected their dignity and were respectful when they were providing personal care. There were positive responses from relatives about the general care people receive such as:‘From what I have seen whilst visiting very regularly everyone seems to be treated very well & with respect’. ‘Looks after my wife really well, offers valuable support, checks regularly on progress of my wife’. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 13 At the previous inspection a requirement was made asking for the staff to make sure medication was given at the time the doctor prescribed. When we visited we looked at the medication and found that people are not having their medication during meal times, but at regular intervals during the day. The staff said this makes sure people have their medicine when they need it and the staff have time to support people to take their medicine, if they need help. Medicines are offered individually and in a relaxed, unhurried manner. We looked at a sample of medication records and found them to be correct. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. People who use the service experience adequate quality outcomes in this area. People have access to activities but these are not offered with individual interests in mind, so some people’s social expectations are not met. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The people who live at Allerton Park are mostly older and for those who are able to take part there are activities available. For the morning’s activities a group of people had made some scones, which were taken to the kitchen to be baked for tea. A relative commented’. ‘Christine the activities co-ordinator is great & offers the residents various things to do.’ As well as baking, other activities offered were artwork, reading and group and individual conversations about subjects of interest to people. A member of staff confirmed that people go out to the local park or just for a walk in the garden. The home arranges trips out, including visiting gardens and to Blackpool to see Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 15 the illuminations. Two singers had been booked to visit later in the week. Only one visitor was seen in the home. We saw some people moving freely around the home, following their own choice of occupation. Interaction between the people who live at the home and staff was friendly and relaxed. Staff spent a lot of time with people, either just talking or assisting with activities. The televisions were not switched on in the lounges during the day and instead music was played, often of singers from the 1950s and 1960s. However two health professionals did say they do not see a lot of activities happening during their visits. For younger people and people with more complex health needs their social needs are not always met. A person with more complex health needs was restricted to their room, and provided with little to interest them for most of the day. At Allerton Park younger people are in the same communal environment as people who are considerably older and have different emotional and social needs. Younger people may have different social needs to older people, so they should be provided with imaginative and varied opportunities to develop and maintain their social, emotional, communication and independent living skills within their own age group. This means the home must provide the resources and staff skills necessary to make this lifestyle possible. All the dining tables were laid with ironed cloths, tablemats and cruet. At mealtimes everyone was given a cold drink with their meal and a hot drink afterwards. The food was hot and people said it was very nice. On the day of our visit the choice of main course was sausages or omelette, with vegetables including cauliflower cheese. There was trifle for dessert. Staff offered everyone a choice of main course. There was a variety of fresh fruit available at teatime. Drinks were available throughout the day. When people asked staff for a drink, they went to get it for them straight away. The menus are in need of a change. The manager said this was being done by the organisation and one of the company’s chefs was involved in the planning of suitable menus. A more varied choice of main courses needs to be available. The chef has recently resigned and the home has been recruiting for a replacement. The chef on duty when we visited had a good knowledge of special diets needed by some people. There was also information in the kitchen about people’s dietary requirements. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 People who use the service experience adequate quality outcomes in this area. People’s concerns, complaints and allegations are responded to, however no lessons are learnt from them about how to improve. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home has a complaints procedure, which is displayed in the entrance hall. Relatives said they felt confident that if they had concerns they would approach the manager. The home has had seventeen complaints since the previous inspection in April 2007, some involving the protection of vulnerable adults. These have been responded to by the provider or have been referred to appropriate external agencies to investigate. During our visit the operational manger explained all the complaints are put onto a computer database, where the issues are looked at for any patterns. When the operational manager visits they check the issues have been resolved. However for some of the complaints we looked at although the home had agreed with the complainant and apologised, the issues still remain unresolved and the home did not appear to have reviewed or improved upon their practices. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 17 Some of the people who live at Allerton Park may have difficulty in making their views, concerns and complaints known. The registered manager needs to make sure people have access to an independent advocacy service that can support them to make any complaints. Since the previous inspection in April 2007 we have received one complaint and referrals have been made to the safeguarding adults team at Bradford Social Services, these have been about poor health care practices, and incidents between people living in the home. The issues about poor health care practice has recently reoccurred and is being investigated by Bradford Adult Protection. When we visited we saw a person was being prevented from leaving their room, and they found this distressing. Preventing a person from leaving their bedroom is a type of restraint. When the interventions of staff restrict a person, this must only be in their best interests, and as part of their plan of care. It must be agreed with the person or their representatives, and carried out following the department of health and the mental capacity act guidance. We discussed this with the registered manager who agreed to review this person’s care. The training plan for staff indicated that most staff have attended training on safeguarding vulnerable adults. Two staff confirmed they would report to the manager any incidents that caused them concern regarding protecting people. However discussions with staff about the example above showed they were not aware of what could be environmental restraint. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. People who use the service experience adequate quality outcomes in this area. People live in comfortable surroundings, which are reasonably well maintained however this could be improved upon by a more rigorous cleaning programme. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Allerton Park is split into a residential and a nursing unit. Each has two lounges; some of the lounges have laminate floor, while others have carpeting. There is a small smoking room, but one of the unused upstairs bathrooms is to be converted into a lounge for people who like to smoke. On the walls in the nursing unit there is a selection of tactile pictures that have different textures. In other parts of the house there are pictures of old Bradford and pictures showing wartime scenes. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 19 There are ramps and handrails at the entrance and throughout the house, to assist people when they are moving about. Other adaptations are in place, such as seats that raise up to help people get into the bath. Also one bathroom did not have a soap dispenser at the wash hand basin. Two people showed us their bedrooms, which were nicely furnished and had personal items such as photographs. One also had a comfortable sofa and we were told their bed is comfortable. All the bedroom doors have locks and people have keys for their rooms, if they wish, and risk assessments for this are carried out. Some rooms on the nursing unit are kept locked, with keys readily available; the staff explained this is to make sure people do not go into someone else’s room by mistake. One area upstairs, where there are several bedrooms, has keypad locks on some of the doors. Where keypads are used it is good practice to look at who makes the decision as to whether people have the code or not and to make staff ware of the issues of capacity, and choice. The home has replaced the flooring in the rooms where it was in a poor condition and all the fire doors appear to fit properly. Rooms where cleaning materials and other chemicals are kept were safely locked. Throughout the home there were light bulbs that needed to be replaced. The gardens have recently been re-designed. They are accessible and have level pathways and plenty of benches to sit on. The gardeners are to return soon to replace with lawn some areas that are covered with wood bark. Other improvements to the original design are to be made, including more raised beds so that people can enjoy gardening if they wish. These and other points were raised at a recent meeting of the people who live at the home and relatives. Unfortunately the noisy kitchen extractor flue is sited on a wall in this enclosed garden, so it is not always such a peaceful place to sit in, as it should be. A relative told us ‘The home is always clean & fresh & renew things when needed.’ However there was an odour on walking into the home, which must be eliminated. The door handles were sticky to the touch and there were other signs that the cleaning programme needs to be more rigorous. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use the service experience adequate quality outcomes in this area. Despite the staff’s enthusiasm, people’s needs are not always met due to insufficient resources. Recruitment procedures need to be improved upon to make sure people are fully protected from abuse. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Forty people currently live at Allerton Park. When we visited the staff on duty were the registered manager and an activities co-ordinator, who was helping with the administration in the absence of an administrator. During the day and the evening there were three care staff on the residential unit, and one registered nurse and three care staff on the nursing unit. At night there is one nurse and three care staff on duty. Two weeks of staff rotas showed there are occasions when these numbers are lower and the registered manager is included in the rota. There was evidence to show that due to the environment and levels of help people need, this is not always enough to meet people’s needs fully. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 21 Staff agreed with this and said that the number of staff they needed depended upon how much personal care and support the people living in the home needed. The home has a multicultural staff group, who appear to understand the needs of the people. One member of staff was able to speak to a person living in the home in their first language. Generally there was a positive social rapport between people living in the home and staff. Four staff recruitment records were looked to make sure the necessary checks had been carried out so only suitable people were employed. These showed the home needs to be more vigilant, to make sure people are protected. Staff should not start work before all the necessary checks are completed and the home must make sure both references are from people who know the candidate. When a person has recently moved to the UK, a police check should be carried out in their country of origin. These issues were discussed with the operational and registered managers, who agreed to make sure systems were more robust in the future. During our visit we talked to the staff about their training. Those who had recently started confirmed they had an induction to the home and gave a list of the training courses they had attended. These were fire training, safeguarding adults, health and safety and mobility and assistance. The registered manager explained that the kitchen staff had now completed their food hygiene training and the care staff were to attend a food hygiene awareness course soon. There was also evidence that some of the care staff were to attend dementia awareness training at Park Lane College, Leeds and a nurse told us she was to attend the Dementia Course at Bradford University. The training records confirmed this, however the training matrix did not show that staff had any first aid or medication training and the poor response to people’s health care needs indicate further training is needed. The annual quality assessment questionnaire shows only six staff have completed their national vocational qualification (NVQ) level two in care. This qualification makes sure people have the necessary skills to care for people properly. The staff also told us they had regular staff meetings with the registered manager, and they felt fully supported by her in their work. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 37 and 38. People who use the service experience adequate quality outcomes in this area. Despite the registered manager’s best intentions, the home is not always managed in the best interests of people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Ms R Lumbwe, the Manager, has been in post for more than a year and has recently registered with us. She is a registered nurse, with experience of managing services for people with dementia. People with an interest in the service have expressed how very approachable and supportive she is and how she is focused on improving the services for the people who live at the home. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 23 However the outcomes in this report show the home is not always managed in the best interests of those who live there, and health professionals who visited the home felt the manager was not always supported in her role. All the sections of the annual quality assessment questionnaire were completed and the information gave us a reasonable picture of the current situation within the service. The evidence to support the comments made is satisfactory, although there are areas where more supporting evidence would have been useful to illustrate what the service has done in the last year. Some people ask the home to look after small sums of their money for them. There are records of all the transactions made on their behalf and receipts are kept. Each person’s money is individually stored and safely kept. Staff said their supervision was carried out regularly and they felt fully supported by the manager. Quality assurance surveys are now being sent to the relatives of the people who live at the home. The results of last year’s survey were analysed and a management report was written. There was evidence to show that one relative’s comments had been followed up and acted upon. The registered provider’s representative makes regular visits to the home and completes a report each month. The manager also holds regular meetings with the people who live at the home and their relatives. The manager said these were successful and a lot of useful suggestions have been made to help improve the services the home offers. The home’s maintenance records were looked at and those that were in the file were in order. The electrical wiring certificate showed that this five yearly check was carried out in August 2007; other certificates showed that health and safety inspections and servicing are carried out regularly. The passenger lift was repaired during our visit and is regularly serviced. The hot water temperatures in the home are now being checked each month and records are kept of the temperature of hot water from all the taps. These showed that the water from taps used by the people who live at the home is always at or around 43°C. This prevents people from possible scalding from the hot water. There is a set of risk assessments for the home but they are general company assessments and have not been adapted to meet the specific circumstances of Allerton Park. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 24 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 2 1 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 1 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 1 STAFFING Standard No Score 27 2 28 1 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 3 X X X 3 Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 OP4 Regulation 14 (1) Requirement Timescale for action 01/06/08 2 OP7 15 People must only be admitted when staff are able to meet their health, social and emotional needs. This is to make sure they can offer people a good and meaningful lifestyle. Everyone living in the home 01/07/08 must have an up to date written plan that includes all his or her personal and health care needs and their goals and aspirations. • The plan must include clear guidance to staff about the support that they have to provide to meet people’s needs. • People living in the home or their representatives must be involved in the development of, and agree with, the plan. • The plan must be kept under regular review and people living in the home or their representative made aware of any revisions. This is to make sure people are provided with a consistently good standard of care in the way DS0000029131.V363687.R01.S.doc Version 5.2 Allerton Park Page 26 3 OP8 12 (1) (a) 4 OP12 16 (2) (m) & (n) 5 OP18 12 6 OP27 18 (1) (a) they prefer. You must promote and maintain people’s health and make sure they have access to health care services. • You must make sure people are promptly referred to the appropriate health care professional if needed. • Any equipment used for the prevention of pressure sores must be in working order. In order to meet their different needs, people must be provided with imaginative and varied opportunities to develop and maintain their social, emotional, communication and independent living skills within their own age group. When the interventions of staff restrict a person, this must be the only practicable means of securing their welfare and it must be only be used in exceptional circumstances and comply with the guidelines issued by the department of health and the Mental Capacity Act. Staffing levels must be reviewed to make sure that there are sufficient staff on duty to meet the needs of people using the service at all times. 01/06/08 01/06/08 01/06/08 01/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Allerton Park Refer to Good Practice Recommendations DS0000029131.V363687.R01.S.doc Version 5.2 Page 27 1 2 Standard OP26 OP28 3 OP29 4 OP30 The cleaning programme should be more robust to keep the home a comfortable and pleasant place to live. To make sure staff have the necessary skills to care for people properly, the number of staff who have achieved their NVQ level 2 or equivalent in care should be increased to a minimum of 50 of the care staff. To protect people and to make sure only suitable people are employed, a more robust recruitment procedure should be followed and only employ people when all the safeguarding checks are completed. All staff should be provided with first aid and medication training. Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © 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 Allerton Park DS0000029131.V363687.R01.S.doc Version 5.2 Page 29 - 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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