Inspection on 04/12/06 for April Park Nursing Home

This inspection was carried out on 4th December 2006.

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

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE April Park Nursing Home West Street Eckington Sheffield Derbyshire S21 4GA Lead Inspector Marie Bonynge Key Unannounced Inspection 10:30 4th December 2006 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 April Park Nursing Home DS0000066753.V318856.R02.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. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service April Park Nursing Home Address West Street Eckington Sheffield Derbyshire S21 4GA 0161 368 9099 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) Meridian Healthcare Ltd Mrs Marie M Spencer Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: April Park care home provides personal care with nursing for up to 40 older people. It is a purpose built building on two floors accessed via a passenger lift and stairs. The home is located in the village of Eckington close to a main bus route. A garden area is provided with seating and a patio area for residents use. Accommodation comprises of 37 single rooms with 3 of these having capacity to be used as double rooms for couples. 8 bedrooms offer en suite facilities. Each floor has a lounge and a separate lounge / dining area. A hairdressing room is also provided. A car park is to the side of the home. The fees for this home range from £345.05 to £461.72. There are additional variable charges for hairdressing, holistic therapy and newspapers. Chiropody charges are £9.25. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in December 2006. It is the first inspection of this service since the change of ownership and all of the key standards were examined on this visit. The visit lasted for approximately six and a half hours. Discussions were held with the covering manager, the deputy manager, 4 members of staff, 3 relatives and 5 residents. 2 completed CSCI resident surveys were received. Inspection methods used included the examination of care records, the case tracking of 4 residents to ascertain how the service works in practice for them and direct observation of care practices. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk What the service does well: What has improved since the last inspection? This is the first inspection of this service since it changed ownership and the requirements and recommendations made at the last inspection have been met. An extensive programme of refurbishment and redecoration has been completed with the addition of a hairdressing salon. A number of en suite facilities have been added. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the information they need to decide if this is the right place for them to live. Residents can be assured that they have their needs fully assessed before they move into the home and this informs the care to be provided. EVIDENCE: Discussions with residents, representatives and completed CSCI resident surveys indicate that enough information is received about the home before people move in so that they can decide if it is the right place for them. A service user guide and statement of purpose are in place from the new provider and are available in the reception area of the home. It is said that the service user guide is given to residents prior to their admission to the home although this is not evidenced in the files of residents. A recommendation is made in respect of this. Two residents commented that April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 9 they felt too poorly to look at any information before they came in but would appreciate someone going through this with them now. 2 completed resident surveys were received, 1 of which said that the resident had received a contract and 1 of which said the resident had not received a contract. 2 relatives were interviewed, both of whom did not deal with the finances of the resident and two residents were interviewed who did not deal with their own finances. Discussions with residents, their representatives and the manager indicated that the majority of residents did not deal with their own finances. A sample of contracts indicate that some residents have contracts from social services, some from the previous provider and some from the new provider, in two cases there was no contract on the file and these were awaited from social services. A statement of terms and conditions of residence is not in place although the provider did have one available. Assessments are in place in the 4 files examined for case tracking purposes that cover all aspects of the persons’ health and social care needs including a summary of their medication and any known allergies. Details are also included that are important to the person, such as how many pillows they like to have at night, and the help they require with nail and hair care. Thus helping to assist residents to settle in. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ experience of care is good, however the care plans and risk assessments do not always underpin the standard of care given placing residents at potential risk. EVIDENCE: Care plans were examined for 5 residents, 4 of which were looked at in detail and included 2 residents with nursing needs and 2 residents with personal and social care needs. Both of the care plans for the residents with nursing needs are comprehensive and outline in detail the action that needs to be taken by staff to carry out the residents’ care. These have been updated recently and include details of wound care, nutrition, eating and drinking and a falls risk assessment. However, the other 2 care plans are not comprehensive and do not cover key areas of need such as the mental state and cognition of a resident with dementia and anxiety. There is not sufficient detail to determine the care required to meet the needs of the person, it is almost solely reliant upon verbal information being passed on and the information contained within April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 11 the daily records. A requirement is made in respect of this. Discussions with staff support that they know the needs of residents well and that verbal communications are central to the care of residents. Care plans are reviewed, although not always monthly and not always in line with the risk assessment for example regarding weight and nutrition. A requirement is made in respect of this. Daily records are clear and provide an overview of the persons care although this is not always underpinned by the care plan. A recent safeguarding adults referral had been initiated with reference to concerns about skin care and pressure ulcer management. An action plan has been agreed with the home through the Primary Care Trust and the Social Services Department that includes further training for staff regarding tissue viability. The manager and deputy manager have now accessed this training. The records viewed of a resident who had a pressure ulcer indicated that the relevant guidance is being followed in conjunction with the tissue viability nurse. Residents have access to professions allied to medicine such as chiropody, dental services and optician services. Medication systems are in place that are supported by the homes policies and procedures. A local pharmacist visits the home on a regular basis and provides advice and assistance regarding medicines used. A controlled drugs book is used for the recording of any such medicines, two signatures are required and the medication is usually administered by a trained member of staff and a care assistant. The care assistants do not normally administer medication in the home and as such do not receive any specific training, however it is considered good practice for the second person acting as the second signature to receive appropriate training. A recommendation is made in respect of this. Residents say that their privacy is maintained and that they feel they are treated with dignity. Staff are said to be ‘kind’ and ‘caring’. One resident said that ‘this home is excellent, as are the staff’. Care practices observed are carried out in a sensitive manner such as assisting people to walk and to eat and drink. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities and recreation are provided that generally meet with the expectations and preferences of residents. The meals are good and are taken in pleasant dining areas. EVIDENCE: 4 residents say that there is enough for them to do if they want to join in. One resident says that they choose not to go on some of the trips because of their particular health needs. Another resident says that they prefer to spend much of their time in their room reading, watching television and listening to music, which they are supported to do. Activities are provided throughout the week, although they had not gone ahead today due to unforeseen sickness. Some of these include art and craft, baking and music. Relatives are encouraged to visit the home at any time and say that they feel welcome. They also say that they are kept informed of any changes to the health and welfare of the person they are visiting. Residents say that they can get up and go to bed as they choose and that care is delivered in the way in which they prefer. Many of the residents in this home are frail and not able to April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 13 directly participate in the inspection visit. However, they appear well cared for and staff are observed to be attentive to their needs. The meals provided are said to be of good quality and are served in newly decorated and furnished dining areas. This provides for a pleasant environment for residents to eat in. However the menus do not indicate that a choice is available, although residents say that they can have an alternative if they want to. Residents do not know what meal is going to be served at lunch or tea on this visit and comment that a menu on display would help. Plans are in place to have a menu on each table and on display in each of the dining areas that identifies the choices available. A recommendation is made in respect of this. The menus are also in the process of being reviewed. Special diets are catered for such as soft diets, diabetic and homogenised diets. Although the different foods in the homogenised meals are being served mixed together and do not provide an appetising or attractive option. The use of food moulds was discussed as being good practice and a recommendation is made in respect of this. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place that assist in ensuring that the welfare of residents is safeguarded. Staff attitudes and awareness underpin these policies and procedures that results in residents feeling that their concerns are taken seriously and acted upon. EVIDENCE: A complaints procedure is in place that indicates that a response will be taken in the event of a complaint within given timescales. No complaints have been received by the CSCI and one complaint has been received by the home. The complaint has been responded to and recorded, with the outcome being communicated to the complainant. 2 relatives say that they know who to speak to if they are not satisfied with something or have any concerns although they are not aware of a formal complaints procedure. Residents also say that they would speak to the manager or a member of staff if they are not happy or have any concerns. They also say that they feel confident that they would be listened to and their concern would be acted upon. The manager has proposed to put a copy of the complaints procedure in each of the bedrooms for ease of reference for residents and representatives. A recommendation is made in respect of this. A copy of Derbyshires’ safeguarding adults policies and procedures are in place that assists in ensuring that the welfare of residents is safeguarded. A April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 15 safeguarding adults referral has been made regarding concerns about skin care and pressure ulcer care. Meetings have taken place with social services and the primary care trust with an action plan being agreed. The manager and deputy manager have completed tissue viability training and advise the CSCI that the service now meets the requirements of this action plan. A number of staff have accessed internal training regarding safeguarding adults and staff say that they are aware of what to do if they have concerns about a residents welfare. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 16 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): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is well decorated, comfortable and well maintained. EVIDENCE: Residents comment that they are pleased with their individual accommodation and say that the home is ‘comfortable’, ‘always clean’ and ‘furnished very nicely’. A refurbishment programme has been carried out that includes new furniture in the lounge and dining areas, the corridors, bathrooms and residents bedrooms. All the accommodation is single occupancy although there is capacity for 2 bedrooms to be used as a double room for example if a couple want to share. Seven of the bedrooms have been upgraded to provide en suite accommodation. The home is clean and free from offensive odours. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes recruitment practices generally assists in the safeguarding of residents. The home is committed to training that supports staff in the work they do. EVIDENCE: Staffing rotas provided indicate that the home is staffed in accordance with recommended guidance to meet with the assessed needs of residents. All of the residents spoken with say that staffing levels are generally satisfactory and there is a member of staff available if they need help with anything. There are 36 residents accommodated on this visit, with 17 residents being assessed as having nursing needs and 19 residents with personal and social care needs. Staff are said to be polite, helpful and caring with nothing being too much trouble. Staff are observed to be respectful and friendly in their interactions with residents and they also spend time with those residents who cannot participate in conversation. This results in residents saying that they are satisfied with the standard of care being provided. Staff files sampled indicate that the homes recruitment procedures are being followed in respect of CRB checks, 2 written references and an application form. Photographs are in the process of being obtained for all members of April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 18 staff however one staff file does not have a photographic proof of identity. A requirement is made in respect of this. A structured induction and foundation programme is in place with a comprehensive training plan put in place that includes moving and handling, care planning and risk assessment, pain assessment and disability awareness. There is a strong commitment to NVQ training with over 80 of staff having achieved NVQ level 2 or above. The home therefore exceeds standards in this area. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally well run in the interests of residents with a strong commitment to training. These assist in ensuring the health, safety and welfare of residents and staff. EVIDENCE: The registered manager is absent for a planned period of time and a parapatetic manager has been appointed to cover the absence. Key management responsibilities are allocated via way of discussing key management issues in meetings with an operations manager. There are handovers between trained staff, the deputy manager and senior carers. Communications are said to generally work well within this home. A quality assurance system is established with monthly monitoring visits being in place from the provider. The provider and manager were said to be approachable April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 20 and staff voiced confidence that their suggestions or concerns would be listened to. There is a positive approach to development and training. Residents are helped to take responsibility for managing their own money where possible although the majority of residents in this home have help from their families. Systems are in place for the maintenance of equipment, details of which were provided in the pre inspection information. An ongoing programme of training was in place to include moving and handling, infection control and fire training. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 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 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 22 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 15 1 2 Requirement Timescale for action 01/04/07 2. OP7 15 2 b 3. OP29 Sch 2 Care plans must be in place for all residents and cover all of the persons’ health, personal and social care needs. Care plans must be reviewed and 01/04/07 updated regularly in accordance with the risk assessment and recommended guidelines. Proof of identity must be kept for 01/04/07 all staff including a recent photograph. 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. 3. Refer to Standard OP1 OP9 OP15 Good Practice Recommendations It should be recorded in the residents file whether the service user guide has been given to the resident. Medicines training should be given to all staff who administer medication with reference to staff who act as a ‘witness’ to the administration of controlled drugs. Residents should be made aware of the choice that are DS0000066753.V318856.R02.S.doc Version 5.2 Page 23 April Park Nursing Home 4. 5. OP15 OP16 available via way of menus that are accessible to the needs of residents. Food moulds should be used when preparing and serving homogenised diets. A copy of the homes complaints procedure should be placed in every residents bedroom. April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 April Park Nursing Home DS0000066753.V318856.R02.S.doc Version 5.2 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. 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