Inspection on 31/08/05 for Allerton Park

This inspection was carried out on 31st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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 30/04/08

Allerton Park 01/05/07

Allerton Park 09/05/06

Allerton Park 01/12/05

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Allerton Park 39-41 Oaks Lane Allerton Bradford BD15 7RT Lead Inspector Susan Knox Follow up visit 31/08/05 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 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 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Allerton Park Address 39-41 Oaks Lane, Allerton, Bradford, BD15 7RT 01274 496321 01274 782841 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Park Homes UK Ltd Care Home 50 Category(ies) of 24 OP Old age, 26 DE (E) Dementia-over 65, 6 registration, with number DE Dementia of places Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The total number of places for dementia care must not exceed 26 Date of last inspection 08/03/05 Brief Description of the Service: Allerton Park is part of Park Homes Limited, a registered company with several care homes in the area. The home is situated three miles from Bradford city centre and can be accessed by public transport. Parking is provided within the grounds.Allerton Park provides nursing and personal care for a maximum of fifty service users. 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 unit for dementia with nursing care and there is a 24 bedded unit for residential care. The suite is also registered to provide care for a small number with dementia who are under 65 years. Both are managed separately.Each unit provides accommodation in 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. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection is part of a number of monitoring visits made by the CSCI. It was unannounced and carried out by two inspectors, Susan Knox and Nadia Jejna starting at 10.00 am and finished at 5.00 pm. The person in charge was Ms B Hogan, training and development manager. The new acting manager was on sick leave. Most of the day was spent talking to service users, staff and management. A number of documents were inspected. These included care documentation, medication records, minutes of meetings and fire safety checks. A full building inspection was not carried out. Progress is being made but slowly. New care documentation is not fully implemented and all staff have not yet received dementia training. Information about the inspection findings was given to Mr J Sykes Operations Director. A list of requirements identified from this inspection can be found at the end of this report. What the service does well: What has improved since the last inspection? An activities coordinator has been employed. The number of activities and outings continue to improve. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 6 Regular staff meetings that provide the opportunity for open discussions. Some redecoration has been carried out to improve the environment for those with dementia. What they could do better: 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. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 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 standard(s) 1, 3, 4. Good information is available about the home. Additional information about the dementia unit would improve this. Dementia training has not been provided for all staff, therefore that not all the staff are effective in their approach to service users accommodated on the dementia unit. EVIDENCE: A folder containing copies of the statement of purpose and service user guide is in the reception area as well as a copy of an inspection report dated October 2004. When offered to interested parties the inspection report needs to be updated to the latest. The Statement of Purpose has been amended to incorporate the change in registration. Some details in the documentation need amending. For example one refers to 25 places in the dementia suite. A brochure has been produced for the dementia care suite. Information should be given about the types and severity of dementia that can be admitted. In addition, include the criteria for refusing admission e.g. aggressive behaviour, which may pose a risk to other residents and staff. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 9 The documentation states that staff are trained but this is not yet the case. Staff in the majority were kind and caring with residents, meeting their physical care needs but from observations during the visit more knowledge of the different types of dementia and how they affect individuals would better equip them to meet their needs. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 10 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 standard(s) 7, 8, 9 Care planning has improved but documents need more detail in line with person centred care. Staff need training about person centred care and challenging behaviour in order to fully meet the needs of service users. The recording of administration of medication and safe storage must be improved in order to safeguard the service users. EVIDENCE: The recently introduced care plan formats are being used for all new admissions to the home and are gradually replacing the previous documents used. Not all staff have received training in using the new format and person centred care yet. This was clear in the inconsistent ways that the care plans seen had been completed. Most of the residents needs had been identified but the detail as to how they would be met was not individual to them and did not fully explain how to meet them. In one case there was no information telling staff how to deal with a residents aggressive outbursts. For one residential client care planning was detailed especially with communication information. This was clearly person centred. Some documents were not completed. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 11 Staff also said that training and clear guidance on dealing with challenging behaviours had not been given. It appears that the issues relating to the employment of the acting manager has affected the full implementation of care documentation and staff training. Residents on the dementia care unit appeared to be settled and said that the staff were ‘nice girls’. Resident’s healthcare needs are assessed using appropriate risk assessment tools and care plans put in place where a need was identified. But the care plans lacked sufficient detail to fully inform staff about how to meet needs. For example a continence care plan did not fully state the reasons why this could be a problem and what type of pads were to be used. The care plan for an insulin dependant diabetic resident would have benefited from more detailed information on when to monitor blood sugar levels rather than say twice daily, where results were to be recorded and what action was to be taken if blood sugar levels were above or below certain levels. The advice of the diabetic nurse specialist should be sought. The policies relating to medication have been revised and updated. The operations director said that these have been implemented with staff. But the drugs trolley for the dementia unit was left in the dining room when not in use. The trolley was locked but not secured to a wall. Some medication was not stored safely. This is unsafe practice and the operations director was made aware. The medication administration record (MAR) was not fully completed and there were signature gaps for medicines that should have been given to residents. The charts were not fully completed and did not show what dates medicines had been received, how many or who by. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 12 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 standard(s) 12. A planned programme of activities is provided for service users including trips out. Care planning should also include social needs so that all needs, wishes and preferences can be met. EVIDENCE: A weekly activities record was on display in the main reception area. A trip to view Blackpool lights was planned. The home has done well to recruit an activities person who works with both units. This has been temporary work during college holidays but will continue at weekends. The operation director advised that an additional activities organiser is to be recruited. On the day of the visit she was assisting residents to bake. Activities are arranged for all residents in the home but comments from staff indicated that more appropriate activities are required for the service users with dementia. Training around dementia care would benefit the activities person to provide appropriate and meaningful activities for these residents. Good interactions were observed between staff and service users but it was evident that further training is required in order to meet the individual needs of those with dementia. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 13 The care plans seen did not contain individualised social and leisure histories leading to person centred social care plans. In one case the basic social care plan did not contain information that staff had told the inspector about a service user’s beloved cat being brought to the home weekly to visit them. This is good practice and should be evidenced. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 14 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 standard(s) 16, 18 An open forum is provided within the home for relatives to express their views to management and staff. The home protects the service users by following adult protection procedures. EVIDENCE: The complaints procedure is displayed in the main reception area and included in the Statement of Purpose. Regular relative meetings are held. The minutes of these meetings are displayed for visitors to see. These showed that open honest discussions are held especially relating to staffing problems and inspection requirements and recommendations. In the recent months staff and management have responded robustly to issues about adult protection. Correct policies and procedures have been followed. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 15 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 standard(s) 20 Work has been carried out to improve the environment for service users but has to be completed and the quality of the work improved. EVIDENCE: A full inspection was not carried out other than noting that the carpets in the dementia unit were uneven and there was wear and tear to carpets in the corridor. The operations director advised that new carpets are to be laid in the link corridor and lounges. The work started in the dementia unit to provide an environment of benefit to those with dementia such as colours and clear signage has not been fully completed. Corridors have been painted and some bedroom doors have been fitted with letterboxes to look like house doors to good effect. Other plans such as the use of part of the dining room as a kitchen has been carried out but the work is of a poor quality. A secure garden has been established since the last inspection with access, one ramped, from both units. The quality of the woodwork used for the Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 16 handrails is poor with a very rough finish. In addition the garden appears half finished. More plants garden ornaments and seating using guidance for stimulating the senses would improve this facility for service users. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29, 30 The home was unable to provide full evidence of robust recruitment checks thereby creating uncertainty about effective safeguarding of service users. Induction was in place for new staff but a lack of training calls into question the suitability of the person supervising the induction. Staff were enthusiastic about the planned training that will help them to meet the needs of service users. EVIDENCE: Staff confirmed that the numbers of carers had been increased in a morning in order to cope with the new admissions. A recruitment file was checked for a new member of staff. Application form was completed and two references obtained. This member of staff had previously been employed within the group of homes. There was evidence of previous 2004 CRB check and a CRB had been applied for. However, there was no evidence of a POVA first check. The operation director advised that this process is dealt with at the companies’ head office and the record would be there. It is a requirement that a record of recruitment including criminal checks is held within each home for inspection. Discussions were held with staff who were new to the home. They said that they liked working at the home. Supervision for new staff was by more Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 18 experienced care workers and a senior carer was providing an induction at the time of inspection. The senior carer had been shown how to provide induction training but had not yet received training themselves in mandatory areas of food hygiene, first aid and infection control but did say that dates for these were planned for the near future. Staff said that there have been problems with NVQ training providers but that they hoped to enrol on NVQ level 2 courses very soon. They were very enthusiastic about increasing their skills and knowledge. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 38 The stop, start employment of acting/clinical managers has affected the ability to put agreed action planning in place. Stability is required in order to complete the progress of the home to the required standard. Management ensure that regular meetings with service users, relatives and staff create an open forum within the home. The home is failing to safeguard people in the home by not ensuring regular fire testing and staff training. EVIDENCE: The acting manager is on sick leave and the training and development manager and the recently appointed clinical nurse manager are running the home. Promised actions have not yet been completed. The clinical nurse Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 20 manager said that action plans had been put in place, which included a staff training programme and reviewing, revising and implementing the homes policies and procedures. Staff said that the management team are approachable and supportive. They said that regular staff meetings are held and that they are an open forum for discussion. Residents and relatives meetings are held regularly and the minutes of the last meeting were displayed on the reception notice board, the next was due to be held that night. The fire alarm system tests were not up to date and had not been done weekly since the end of June 2005. The fire safety training records for staff were not up to date. It was clear from talking to staff that this important area of training must be updated. The last fire authority report was discussed with the operation director who agreed to put an action plan in place. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION x 2 x x x x x x STAFFING Standard No Score 27 x 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 x x x x x 2 Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 22 Are there any outstanding requirements from the last inspection? 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 7 Regulation 15 Requirement The provider to ensure that care plans provide sufficient detail to fully inform staff about individual needs and especially in dealing with aggression. Include person centred social/life history plans. The provider to ensure the advice of diabetic nurse specialist be sought. The provider to ensure that the record of administration improves and medication is safely stored. The provider to ensure that carpets are replaced in lounges and corridors. To improve the facilities in the garden The provider must ensure that full recruitment records are available on the premises. The provider must ensure that all staff are trained in dementia care, activities for those with dementia, challenging behaviour, fire training. The provider must ensure that fire systems are tested weekly as recommended by the FO. Timescale for action 1 November 2005 2. 3. 8 9 12 13, 17 30 September 2005 30 September 2005 1 November 2005 With immediate affect. 1 November 2005 With immediate affect. 4. 20 23 5. 6. 29 30 19 18 7. 38 13 Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 23 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. 2. Refer to Standard 1 19 Good Practice Recommendations Amend the Statement of Purpose and brochure. Work carried out needs to be of good quality and able to withstand the knocks of daily living. Allerton Park 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds, LS13 1HP National Enquiry Line: 0845 015 0120 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 20050831 S29131 V245774 Allerton Pk Follow up visit Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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