Inspection on 26/10/05 for Alt Park

This inspection was carried out on 26th October 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 23/06/05

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

CARE HOMES FOR OLDER PEOPLE Alt Park Alt Park Parkstile Lane Gillmoss Liverpool Merseyside L11 0BG Lead Inspector Jeanette Fielding Unannounced Inspection 26th October 2005 13:30 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 Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 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. Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alt Park Address Alt Park Parkstile Lane Gillmoss Liverpool Merseyside L11 0BG 0151 546 5244 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) Tudor Bank Ltd Care Home 35 Category(ies) of Dementia - over 65 years of age (35) registration, with number of places Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to 35 elderly persons who have dementia requiring nursing care Up to 10 elderly persons who have dementia requiring personal care A maximum of 35 persons to be accommodated at the home Date of last inspection 23rd June 2005 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 DS0000063172.V262221.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over a period of four and a half hours on one day. During the inspection, the files relating to the identified needs of the service users and the records relating to the actual care given were inspected. An inspection of the staff records was also undertaken to ensure that all checks had been made on staff to ensure the protection of the service users and to confirm that appropriate training had been given. An inspection of the building established that all areas were clean and that staff did all they could to provide a homely environment. Service users were not able to give their views of the home or of the care provided due to their mental condition. Five family members were spoken to, to gather their views and to obtain an objective aspect of the home. What the service does well: 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 DS0000063172.V262221.R01.S.doc Version 5.0 Page 6 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 Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 The new format for assessing prospective service users provides staff with information to enable them to meet the service users needs. EVIDENCE: The statement of purpose is now being updated to reflect the changes that have taken place since the takeover by the new owners and manager. It is expected that the new document will be available for prospective and current service users within the next few weeks. A copy of the updated document should be submitted to CSCI when it is completed. The manager of the home assesses prospective service users to ensure that the home can meet their individual needs. The new format used for assessing service users requires containing additional information regarding the service users dementia, how this is displayed and the specific care necessary. An assessment is undertaken by the social worker, CPN or other professional involved in the service users care, and the manager also gathers information from the service users family. Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 8 Visits to the home are welcomed and encouraged and the manager uses these visits as an additional opportunity to assess the service users mobility and abilities. The visits provide the service user or their family to meet with the staff and other service users and to view the room available. Records are held of visits made to the home by service users, their family or representative. Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. EVIDENCE: Service users health, personal and social needs are incorporated into individual care plans. Some additional information is required to be included into the care plans to give staff full information regarding the service users specific needs, particularly their dementia. The plans have been prepared by different staff and it is evident that a pro-forma care plan would benefit the staff to ensure that all are prepared to the same format. Risk assessments have been prepared for service user and risk management strategies have been implemented to remove or reduce any potential risks. Records are held of visits to and by GP’s and other healthcare professionals. The district nursing service provides nursing intervention to those service users who are accommodated for personal care, and will provide information and advice to the staff at any time. The Tissue Viability Nurse is contacted Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 10 regarding the treatment and care of any service user who is admitted with skin problems or pressure sores. The medications policy and procedure is now robust following improvements implemented by the manager. 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 which has recently been refurbished and provided with a television. Visitors are welcome at the home at any time and are encouraged to visit. Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: The routines within the home are flexible to meet the service users needs and preferences. The care files include the service users preferences regarding the time they get up and go to bed. Links have been developed with the local church and arrangements are in place for service users to attend services or social activities. A programme of activities has now been developed in line with service users preferences and abilities. The in house activities include card and board games, music, singing and dancing for the more able service users. Most service users enjoy watching television but some have only a short attention span and quickly get bored. Staff are aware of this and spend considerable time with service users on a one to one basis to provide stimulation. The staff were observed to promote independence through choice, offering service users a range of options. The hairdresser visit the home twice each week and service users are free to use this service or can be assisted by family to use a local hairdresser. Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 12 The menus in the home continue to be reviewed and amended according to service users tastes and preferences. A choice of meals is offered and mealtimes are flexible to enable each individual service user to choose when they eat within reasonable timeframes. 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 and fresh fruit and vegetables are used whenever possible. The tables in the dining room are attractively laid 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 or on the advice of the dietician or GP. Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 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 being updated to reflect the change of owner and manager of the home. It is displayed on the notice board within the home and is also included in the Statement of Purpose, the Service Users Guide and in the individual contracts. No complaints have been received by the home since the last inspection. 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. Three relatives 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 DS0000063172.V262221.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The standard of the environment within this home is good providing service users with an attractive and homely place to live. EVIDENCE: No major changes have taken place within the home since the last inspection. Plans are in place for new curtains to be fitted within the conservatory and it is hoped that air conditioning will be provided in this area before next summer to improve the seating area for the service users. The home is decorated to and furnished to a good standard and a number of new armchairs have been provided. The entrance area has now been improved to provide an additional seating area for service users and a television has been provided in this area. This has proved to be a popular area. It was planned that new coffee tables would be provided but these had not been put in place at the time of the inspection. A programme of Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 15 redecoration and improvements is due to commence and it is hoped that this work will be completed before Christmas. 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. Seating areas are provided within the lounge, dining room, conservatory or entrance area to offer service users a choice of where they wish to spend their time and to provide quieter areas for those who prefer this. 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 DS0000063172.V262221.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Detailed induction training programmes are now in effect to ensure that the service users needs are appropriately met. EVIDENCE: The home employs qualified nurses and care assistants to provide care for the service users. All staff are experienced, many of who have worked at Alt Park for a number of years. The homes 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. An induction training programme workbook is now used to ensure that all new staff are fully aware of the policies, procedures and practices within the home. Two staff have recently undertaken training on customer care and further training is planned for all staff. Dementia training is planned and courses on first aid and moving and handling have been booked. The manager is actively seeking training programmes to assist staff and further develop their knowledge and understanding. Information regarding the training courses undertaken by staff is held on their individual files. Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 17 Some of the qualified nurses who hold general nursing qualifications are now eager to undertaken additional training to obtain qualifications in dementia care. 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 DS0000063172.V262221.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38 EVIDENCE: An application to register the manager is currently being processed by CSCI. The manager is a qualified nurse and an experienced manager who has the skills, qualifications and experience to care for elderly people who have dementia. The manager is available in the home on a full time basis and is accessible to service users, their families and the staff during this time. Discussion took place with the Responsible Person, who was also present at the time of the inspection, with regard to the supernumerary hours worked by the manager. It was agreed that addition supernumerary hours would be available to the Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 19 manager to enable the care files to be reviewed and updated, and to allow additional time for the supervision and appraisal of staff. Staff meetings are held regularly and provide an opportunity to inform staff as well as providing a forum for general discussion. It is evident from the documentation held in the home that the health and safety of service users are given high priority. Family members were spoken to during the inspection and all agreed that the quality of care for their relatives had continually improved and that they felt confident that the service users were protected. Safety certificates were seen to be in place and up to date with the exception of the gas certificate which is now due to be inspected and a new certificate issued. All portable appliances have now been inspected and assessed as safe. Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 20 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 3 X 3 X X X X 3 Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 21 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 OP7 Regulation 14(2), 15(2) Requirement The Registered Person must ensure that all service users care needs are reviewed and their care plans updated to reflect their individual needs. Timescale for action 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alt Park DS0000063172.V262221.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 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 DS0000063172.V262221.R01.S.doc Version 5.0 Page 23 - 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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