CARE HOMES FOR OLDER PEOPLE
Argyle Park 9 Park Road Southport Merseyside PR9 9JB Lead Inspector
Mrs Joanne Revie Unannounced Inspection 17th February 10:00 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 Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 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. Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Argyle Park Address 9 Park Road Southport Merseyside PR9 9JB 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) 01704 539001 01704 539001 Mr Albert Marcel Zachariah Mrs Bernardine Sananes Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Service users to include up to 31 OP Service users to include 2 named clients under pensionable age The service should employ a suitably qualified and experienced Manager who is registered with the NCSC. 12th July 2005 Date of last inspection Brief Description of the Service: Argyle Park is a purpose built nursing home, which is situated close to Hesketh Park in Southport. The home was built 14 years ago and provides nursing care to 31 older people. All bedrooms are single and have ensuite toilets. The bedrooms are spread over three floors with a passenger lift, which takes wheelchairs for those who are less able. The home has a large combined Lounge and dining g area, hairdressing salon and well equipped bathrooms with aids to assist those who require help to bathe. Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The purpose of the visit was to assess the remaining core standards, which were not assessed during the visit in July 2005 and to check progress in meeting previous requirements. Therefore the reader should read both reports to get a full overview of the service. During the visit records and certificates were viewed. These are referred to in the evidence section of the report. Discussions were held with five clients. Their views are reflected in the summary section of the report. The visit was unannounced. What the service does well:
All clients spoken with confirmed that they felt they were well looked after and that staff were able to meet their needs. Comments made by clients included: “ Had an off day yesterday but I’m okay today- the staff looked after me very well” and “` Matron is lovely, staff are very kind- I don’t know what I would do without them”. Staff respond quickly to changes in the clients needs and make contact with the right health care professionals so that clients get the right advice about how to address any changes in their needs. One client stated, “ They’re very good at sorting things like that out”. Staff understand the importance of explaining all actions to a client when delivering care and requesting their permission. This is important as it promotes inclusion and encourages clients to feel as though they have control over what is happening. Three clients confirmed that they do feel in charge of their lives and that “ staff are very approachable so it’s easy”. All confirmed that they don’t have to join in activities if they don’t want to and that they are free to spend their time as they choose. This also helps to make clients feel in charge and can promote independence. Staff are respectful towards clients dignity and privacy. Two Clients confirmed that staff are respectful towards them and to their personal belongings that they keep in their bedrooms. One client commented, “ They are never rude and always ask if they want to move something”. Two clients were appreciative of the staff’s sensitivity towards them following recent traumas.
Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 6 The environment of the home presents generally as a clean well-maintained place to live. In particular each bedroom is decorated with a different colour scheme, which helps to make it feel homely. Clients are encouraged to bring personal items into the home, which helps to make the bedrooms feel more homely. There are no restrictions on visiting clients who live in the home. Visitors are welcome to visit when they please and clients are free to go out with them if they wish. One client stated “he’s always made welcome when he comes “ and “ I often go home with her on a Sunday”. What has improved since the last inspection? What they could do better:
Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 7 Some shortfalls were identified in staff training. The manager was aware of these and made plans to address them. In particular Staff have fallen behind with fire prevention and Food hygiene training. The manager must ensure she carries trough her intention to address this. Although staff are respectful towards the clients, dignity could be promoted further by supplying cloth tabards at meals times for those clients who are less independent rather than using disposable aprons. Although generally the home presents as a clean and comfortable place to live it was noted that one bedroom smelt unpleasant and that the ceiling to another bedroom required redecoration. This was discussed with the Manager who quickly identified the problem. The manager must carry through her intention to address this. The qualified staff manage wound care well. However this could be developed further by using accurate mapping tools or by taking photographs rather than making rough drawings of the wound. Staff implement Nutritional risk assessment records for any client who is loosing weight. Staff should assess all clients’ nutritional needs and record this information using this tool. This will mean that all clients will have their food intake assessed according to their health needs and staff will have proof that they have performed this action, which will prove good, practise. 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. Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards were assessed form this section on this occasion. EVIDENCE: Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 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 the following standard(s): 8, 10 Client’s health care needs are quickly addressed and met. Wound care is managed well but could be developed further. Staff respect the clients dignity and privacy. Protective clothing at mealtimes could enhance this further. EVIDENCE: Although standard 7 was not fully assessed during the visit, two care plans were viewed which showed that the service has complied with a requirement from the last inspection by developing Care Plan documentation. In particular staff are carrying out thorough reviews on a monthly basis. Two care plans were viewed and discussions were held with four clients and the manager. All clients commented positively on the staff’s ability to meet their needs. All confirmed that staff are quick to respond to any changes in their needs. Copies of multidisciplinary sheets were viewed which showed that doctors and other Health care professionals are regular visitors to the home. One client detailed on going health issues and the support that had been received from staff to address these.
Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 11 Wound Care records were viewed for two clients. These were detailed and appeared to be completed following each dressing change. Staff are recording all aspects of the wound and drawing rough diagrams. However staff are not accurately wound mapping or photographing wounds. The manager confirmed that a digital camera and computer system was available within the home. Copies of weight charts and recording of vital signs charts were viewed and evidenced that staff are being proactive by monitoring these on a monthly basis. Nutritional risk assessments are in place for those clients who have been identified as loosing weight only. Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 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 the following standard(s): 13,14 Visitors are welcome at the home. Clients feel in charge of their life. EVIDENCE: Discussions were held with three clients and the visitor’s book was viewed. The visitor’s book showed that people visit the home at various times during the day. All clients confirmed that their visitors are made to feel welcome and that they can visit when they choose. One stated that they go home to their families’ house most Sundays. All clients confirmed that they felt in charge of their lives. They also confirmed that simple choices such as clothing, choice of food, bedtimes etc were offered. Staff were overheard offering choice when delivering care. Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 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): No standards were assessed from this section on this occasion. EVIDENCE: Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 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, 24, 26 The home is safe and generally well maintained. Bedrooms are treated as the clients home however not all are as well maintained as they could be. The home appeared clean although an unpleasant smell was noted in one bedroom. EVIDENCE: A tour of the environment was undertaken and a discussion was held with the manager. All communal areas were viewed and a random selection of bedrooms was also viewed. Communal areas appeared comfortable, clean and tidy and were decorated and furnished to a good standard. Bedrooms were evidently the homes of the clients as all viewed contained many personal possessions. All bedrooms viewed had an individual colour scheme, which helped promote a homely atmosphere. Bedroom 30 had an unpleasant smell and bedroom 7 required the ceiling redecorating following
Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 15 what looked like a leak. The matron and the maintenance officer investigated this during the visit. The cause was found and the matron expressed her intention to rectify this. Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 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): No standards were assessed from this section on this occasion. EVIDENCE: Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 17 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, 38 The manager is “ fit” to manage the home. Staff require further training in some areas to fully protect the clients and their own Health safety and welfare. EVIDENCE: The manager’s file and the homes registration certificate was viewed. The manager is registered with CSCI. She acquired NVQ Level 4 in management prior to commencing her role. She is a qualified nurse who remains registered and a variety of certificates showed that she keep herself up to date through refresher training. A variety of certificates. Service contracts and records (including staff training) were viewed. A current gas safety and electrical certificate was available. Water temperatures are tested and results recorded regularly. The home has seven hoists available, which have all been serviced for safety.
Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 18 The fire alarm is tested on a weekly basis. A contract for servicing all fire equipment was viewed. Records showed that staff have not had refresher fire training or food hygiene training for some time. Fire drills have taken place but not three monthly. Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X 3 X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 20 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 OP24 Regulation 23(2)(d) 16(2)(k) Requirement The manager must ensure that she carries through her intention to resolve the unpleasant smell in bedroom 30 and to ensure the ceiling to bedroom 7 is redecorated. The manager must ensure that staff receive refresher fire training and food hygiene training without further delay. The manager must ensure fire drills are performed as a minimum of six monthly Timescale for action 31/03/06 2 OP38 23(4)(d) 12(1)(a) 23(4)(e) 31/03/06 3 OP38 31/03/06 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 OP8 OP8 Good Practice Recommendations The manager should consider supporting staff to photograph/ accurately map wound sizes rather than drawing rough diagrams. The manager should consider using nutritional risk assessment documentation for all clients.
DS0000017219.V280750.R01.S.doc Version 5.1 Page 21 Argyle Park 3 OP10 Client’s dignity could be further enhanced by using protective cloth tabards when eating rather than disposable aprons. Argyle Park DS0000017219.V280750.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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