Inspection on 23/06/05 for Alt Park

This inspection was carried out on 23rd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Alt Park 10/07/06

Alt Park 26/10/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Alt Park Parkstile Lane Gillmoss Liverpool L11 0BG Lead Inspector Jeanette Fielding Announced 23 June 2005 09.30 rd 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. Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Alt Park Address Parkstile Lane, Gillmoss, Liverpool, L11 0BG 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) 0151 546 5244 Tudor Bank Ltd Lorraine Jones - acting manager N Care Home with Nursing 35 Category(ies) of DE (E) Dementia 35 registration, with number of places Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 35 elderly persons who have dementia requiring nursing care 2. Up to 10 elderly persons who have dementia requiring personal care. 3. A maximum of 35 persons to be accommodated at the home. Date of last inspection N/A Brief Description of the Service: Alt Park has recently changed ownership and is now registered under the ownership of Tudor Bank Ltd, a company that has extensive experience of the care home business. The acting manager of the home is Lorraine Jones who is a qualified nurse and an experienced manager. An application to register the manager is currently being processed by CSCI. Alt park is registered to provide personal care and nursing care for elderly people who have dementia. It is registered for thirty-five service users, ten of whom may be accommodated for personal care. It is situated in the Gilmoss area of Liverpool. Accommodation is located on two floors with access to all areas of the home by a passenger lift. All bedrooms are for single occupancy, five of which have en-suite facilities. There are two lounges, a dining room and a conservatory. The home is surrounded by attractive and well kept gardens. Local shops and amenities can be found a short distance from the home. Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection of the home since the change in ownership and management. The inspection was conducted over a period of eight hours and the inspector spoke with staff, relatives and service users to give a broad picture of the home. Records relating to the care needs of service users were examined, together with information recorded regarding the individual care given. Staff records were examined to establish that appropriate checks have been made to ensure the safety of the service users. All areas of the home were inspected and health and safety was examined to make certain that the service users were provided with a comfortable and homely environment. A pre-inspection questionnaire was sent to the home to enable the inspector to evaluate information prior to the day of the inspection. Questionnaires were also sent to family members to give them the opportunity to express their views of the home. A good response was received from family members and all responses were positive. The manager has only been at the home for a few weeks and is currently working towards improving the existing documentation whilst developing other documentation relevant to the service users care needs. What the service does well: In the short space of time that the manager has been in post, a high number of improvements have been made within the home. This relates to both the physical improvements within the building, the care provided to service users and to the documentation held. All areas of the room are bright and welcoming and improvements have been made to the décor. Plans have been prepared for additional changes to be made within the home and have also been agreed with the staff. The staff team has been supportive of the manager, many of whom have worked at the home for several years with the previous owner. A good response was received from family members who were contacted prior to the inspection and were invited to make comment. Comments from family members include, “My relatives health and quality of life have increased tenfold from the previous home,” “The staff are kind, gentle and very thoughtful towards my relative and will do anything necessary to make them feel comfortable.” Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Alt Park F52 F02 S63172 Alt Park V226580 230605 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 Alt Park F52 F02 S63172 Alt Park V226580 230605 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, 2, 3, 4, 5 The manager has a clear development plan and vision for the home which she is effectively communicating to service users, staff and relatives. EVIDENCE: A Statement of Purpose has been prepared and gives information regarding the home. A copy of this is on display in the foyer and copies are available from the home on request. A Service User Guide has been prepared and a copy has been placed in each bedroom to give service users and their visitors the opportunity to read this at their leisure. Additional copies are available from the home on request. New contracts and statements of terms and conditions are now being issued to service users. The majority of service users are funded by the local authority who also provide contracts. The manager is currently preparing new files for service users. The information held on service users previously accommodated at the home does not include information regarding dementia and how this is displayed for each individual. A new format for assessments has been prepared and the manager Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 9 is reviewing the information gathered to enable a full plan of care to be prepared prior to the admission of the service user. Information is gathered from previous carers, doctors, hospital staff and family members. The manager also conducts her own assessment based on the facilities provided by the home to ensure that the identified care needs can be met. Daily reports on the care given by staff are detailed and informative. Information is recorded on the care given and how the service users needs and preferences are met. Visits to the home are welcomed and encouraged and the manager uses these visits as an additional opportunity to assess the service users abilities. The visits to the home are recorded and included in the assessment process. Alt Park F52 F02 S63172 Alt Park V226580 230605 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, 10, 11 The manager has prepared a new medication policy and is implementing this to ensure the protection of service users. EVIDENCE: Service users health, personal and social needs are now being incorporated in the individual care plans. The new files are informative and up to date and each are being reviewed on a frequent basis and the changing needs of the service users are identified. Information on service users dementia and mental health is being incorporated into the care files to give staff all the necessary information to enable them to provide a high level of care. Risk assessments have been prepared together with risk management strategies to reduce or remove any identified risks. Records are held of visits to the home by GP’s and other healthcare professionals. The district nursing service provides nursing care to service users who are accommodated for personal care and to offer advice and information to the manager and the staff team. One service user has a pressure sore and the advice of the district nurses has proved invaluable. Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 11 The manager has now had the opportunity to review the medications policy and procedure and has made improvements to the previous system. The Medication Administration Record sheets contain a few blank spaces where staff have failed to sign to indicate that medications have been administered. The manager has arranged for additional training to be given to the qualified nurses on the new procedure and has planned a training session with care staff to give them greater knowledge and understanding. All medications were seen to be ordered, stored, administered and disposed of in accordance with the reviewed policy and procedure. Personal care is given to service users in the privacy of their bedroom or in the bathroom as appropriate. Service users are free to meet with their visitors in the privacy of their bedroom, one of the lounge or dining areas, the conservatory or in the seating area of the foyer. Visitors are welcome at the home at any time and are encouraged to visit. A procedure to be followed in the event of the death of a service user has been prepared and information on local ministers who can be contacted is readily available. Alt Park F52 F02 S63172 Alt Park V226580 230605 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, 13, 14, 15 The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The routines within the home are flexible to meet the service users needs and preferences. The care files now include the service users preferences regarding the time they get up and go to bed. Links are now being developed within the local community and arrangements have been made for service users to be involved in social activities at the local church. A range of music is provided and service users were seen to be enjoying singing in the lounge. Most service users tend to watch television most of the day and are now being encouraged to participate in card games. Staff spend time with service users on a one-to-one basis to provide a more individual programme of activities. Choices are promoted by the staff team and service users are encouraged to make a selection from a range of opportunities. The hairdresser visits the home twice each week and service users are free to use this service or can be assisted by family to use a local service. Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 13 The menus have been reviewed following consultation with the service users and their families. A choice of meals is offered and mealtimes are flexible for each individual service user to give them the opportunity to choose when they eat. The chef makes all the cakes and pastries and prepares meals from fresh goods where possible. Bread and milk are delivered fresh to the home each day. The dining room is nicely set and service users are encouraged to take their meals there, but can have them in the lounge or in their bedroom if they wish. Special diets can be provided on request. Alt Park F52 F02 S63172 Alt Park V226580 230605 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, 17, 18 The home has a satisfactory complaints system with information on how to complain being readily accessible to service users and their families. EVIDENCE: A complaints procedure has been prepared and is on display on the notice board in the home. It is also included in the Statement of Purpose, the Service User Guide and in the individual contracts. No complaints have been received by the home since registration. Families deal with service users legal issues and all service users are included on the electoral register. The home has a policy and procedure to be followed in the event of abuse being suspected. These documents are fully accessible to all staff. Staff have been given training on the different types of abuse, how to identify it and the action to be taken. Evidence of this training is held on the staff files. One relative was spoken to and said that they would feel comfortable in approaching the manager to discuss any areas of concern and felt that appropriate action would be taken. Alt Park F52 F02 S63172 Alt Park V226580 230605 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) 19, 20, 21, 22, 23, 24, 25, 26 The standard of the environment within this home is good providing service users with an attractive and homely place to live. EVIDENCE: Improvements to the home have been planned. The home is decorated to a good standard although a programme of redecoration has been planned and prioritised. The furniture is in good condition and of domestic style. New armchairs and coffee tables have been ordered and their delivery is awaited. Bedrooms are personalised and are nicely decorated and furnished. A review of the safety within the building and appropriate measures put in place to protect service users. Sufficient toilets and bathrooms are provided and are suitably located throughout the building. Assisted bathing facilities are provided to assist service users who have mobility difficulties. Specialist equipment is provided for service users following assessment by the Occupational Therapist and Physiotherapist. Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 16 The flooring in the kitchen, laundry and staff room are damaged and should be prioritised for replacement within the programme of improvement of the home. Seating areas are provided within the lounge, dining room, conservatory or foyer to offer service users a choice of where they wish to spend their time. The manager requested advice from the fire officer with regard to safety of the service users and the proposed changes within the home. Information has been provided and improvements will be made following the advice given. All service users are accommodated in single bedrooms and it is evident that staff and family members have been involved in making the bedrooms as comfortable and homely as possible. The home is central heated and all bedrooms have windows that can be opened to provide natural light and ventilation. Thermostatic valves have been fitted to baths to ensure that service users are not put at risk of scalding. The gardens are large and extremely well maintained. The manager has identified a need for a fence to be put around the garden to avoid the risk of service users crossing the car park and getting on to the road. This will be included in the proposed improvements for the home. The home was found to be clean throughout and there were no offensive odours. Appropriate arrangements have been made for the disposal of waste. Alt Park F52 F02 S63172 Alt Park V226580 230605 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) 27, 28, 29, 30 The staff have a good understanding of the service users’ support needs. This is evident from the positive relationships which have been formed between the staff, the service users and the families. EVIDENCE: Many of the staff have worked at the home for many years, having been employed by the previous owner of the home. The home employs qualified nurses and care assistants to provide care for the service users. Staff have been enthusiastic about training that has recently been provided and those who have NVQ qualifications are looking to develop their knowledge and understanding in the different aspects of care. Two care staff are due to commence NVQ training in August 2005. A recruitment procedure has been prepared in accordance with equal opportunities. Prospective staff are required to complete an application form prior to attending for interview. A record of the questions and responses at the interview are held on the files of new staff. Two references are taken and checks are made with the Criminal Record Bureau and Protection of Vulnerable Adults lists to ensure the protection of service users. The staff have remained loyal to the service users through a long period of uncertainty when the home was up for sale and have demonstrated their commitment to high quality care. Training courses have been booked for staff on dementia care to enable them to provide the necessary level of care for the service users based on greater Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 18 knowledge and understanding. Information on the training undertaken by staff is held on their confidential files. The home employs sufficient staff to meet the care needs of the service users accommodated and additional staff will be employed when additional service users are admitted to the home. The staffing levels will be reviewed by the manager and based on service users needs and preferences. The home is currently recruiting care staff and qualified nurses who have mental health training. Alt Park F52 F02 S63172 Alt Park V226580 230605 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, 33, 34, 35, 36, 37, 38 The manager has a good understanding of the areas in which the home needs to improve. Planning was in place and set out how this improvement was going to be resourced and managed. EVIDENCE: The manager has been in post for only a few weeks. An application to register the manager is currently being processed by CSCI. She is a qualified nurse and an experienced manager who has the skills and experience to care for elderly people who have dementia. The manager has an open door policy and is available to speak with service users, family members and staff at all times. Staff meetings have been held to inform staff of her vision for the home and of the changes she intends to make. Staff spoken to said that the manager was approachable and they were Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 20 in support of all the proposed changes. They also confirmed that the home had improved since the recent changes. In the response to the questionnaire, families of service users gave positive comments and compliments about the manager and the recent improvements. Alt Park F52 F02 S63172 Alt Park V226580 230605 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 22 N/A 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 9 Regulation 13 Requirement The Registered Person must ensure that staff follow the procedure for the recording of medications administered. Timescale for action 22/7/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 19 Good Practice Recommendations The replacement of the flooring in the kitchen, laundry and staff room should now be considered. Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Liverpool Area Office 3rd Floor, 10 Duke Street Liverpool L1 5AS 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 Alt Park F52 F02 S63172 Alt Park V226580 230605 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!