Inspection on 21/02/06 for Campania

This inspection was carried out on 21st February 2006.

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

Campania 04/09/07

Campania 27/07/06

Campania 12/07/05

Campania 20/12/04

Campania 07/07/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

Broadreach

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

CARE HOMES FOR OLDER PEOPLE Park View 18 - 20 Ellenborough Park South Weston Super Mare North Somerset BS23 1XN Lead Inspector Alison Murray Announced Inspection 21st February 2006 09:30 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 Park View DS0000020283.V277908.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. Park View DS0000020283.V277908.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Park View Address 18 - 20 Ellenborough Park South Weston Super Mare North Somerset BS23 1XN 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) 01934 626233 01934 420789 www.notarohomes.co.uk Notaro Homes Ltd Mrs Sarah Jane Emin Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Park View DS0000020283.V277908.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate 50 Patients aged 50 years and over requiring nursing care Staffing Notice dated 18/11/1999 applies Manager must be a RN on Parts 1 or 12 of the NMC register Date of last inspection 12/07/05 Brief Description of the Service: Park View provides nursing care for up to 50 older people. The home is an older property situated beside Ellenborough Park in Weston Super Mare. There are 44 single rooms and 3 that can be shared. Two passenger lifts ensure level access throughout the building. There is a secluded patio area to the rear of the building. Park View is approximately half a mile from the town centre, and a short walk from the sea front. The home is owned by N Notaro Homes Limited. Mr Notaro owns several other care homes in the town. They share a minibus and pool training resources for staff. Mrs Sarah Emin is the registered manager of Park View. Park View DS0000020283.V277908.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was Mrs Emin’s first inspection since she became registered manager of Park View. Because of this, a significant portion of the 8.5 hour announced inspection was spent in discussion with her, reviewing the management systems in the home. During the inspection, 13 of the 35 residents were consulted individually. Many others were observed in the communal areas of the home. Comment cards were received from 20 residents and 18 of their relatives. The inspector spoke with one of the trained nurses, and two care assistants. Other staff were observed as they went about their work. What the service does well: What has improved since the last inspection? Requirements and recommendations made at the last inspection were all met within the agreed timescales. Since the last inspection, the standard of care documentation has improved significantly. With one exception, care plans were in place to offer staff Park View DS0000020283.V277908.R01.S.doc Version 5.1 Page 6 guidance to meet assessed needs. This guidance was demonstrably based on good practice. Mrs Emin has settled well in her role as registered manager. Staff were enthusiastic about their work. They felt that they were working effectively as team, and were well supported by the management. 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. Park View DS0000020283.V277908.R01.S.doc Version 5.1 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 Park View DS0000020283.V277908.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, 3, 4 and 5. Standard 6 does not apply Residents’ needs are effectively assessed before they are admitted to the home. They are given good information about the range of services offered. EVIDENCE: Since the last inspection, the statement of purpose and service user guide have been amended to include Mrs Emin’s details. These documents are well presented and contain all the relevant information. Copies of the service user guide were seen in empty bedrooms. Mrs Emin said that she visits all prospective residents to assess their needs before admission to Park View. A copy of this assessment was seen in the records of recently admitted residents. At present, she does not formally write to confirm that these people’s assessed needs can be met within Park View. Mrs Emin said that she planned to do this in future. Park View DS0000020283.V277908.R01.S.doc Version 5.1 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 and 11 The health and personal care needs of the residents at Park View are well met, by an attentive and respectful staff team. Care and medication documentation is sound, but needs to be kept under review. EVIDENCE: Many of the current residents of Park View are very frail. Not all were able to initiate a conversation. Those who were, said that they were happy with the standard of care they received. All the residents consulted, or observed during the inspection were neatly dressed in appropriate clothing. Several residents were being nursed in bed. They looked comfortable, and staff were seen to check in on them regularly, to change their position, or offer drinks. There was evidence of a good rapport between staff and residents. One resident commented ‘they are lovely, and never make a fuss if I get into bother’. A relative stated ‘ Staff are very caring, understanding, polite, friendly and respectful’. Park View DS0000020283.V277908.R01.S.doc Version 5.1 Page 10 The care records for 5 residents were reviewed. The standard of this documentation has improved since the last inspection. With one exception, care plans, and risk assessments were in place for each area of identified need. These were well written, and gave staff clear guidance to meet assessed needs. All care plans had been regularly reviewed. In one case, progress reports indicated that a resident had developed a pressure sore. In these notes, it was clear that staff were taking appropriate action to treat the wound, but there was no care plan in place to provide detailed advice. Staff have forged good links with the local GP. During the inspection, he visited a number of residents. The GP was keen to tell the inspector that in his opinion, staff meet the health needs of his patients very well. At the same time, the surgery Practice Nurse reviewed the diabetic residents with trained nurses in the home. This is good practice. A sample of medicine administration records (MAR sheets) was reviewed. These were generally well completed. In one case, a staff member had not signed a hand written amendment to the MAR sheet, but this was the exception rather than the rule. Mrs Emin said that Notaro Homes are working with the local hospice to introduce a new ‘care pathway’ for residents who require terminal care. She is enthusiastic about this, and feels that it will help to support residents, relatives and staff, whilst also improving communication systems. Park View DS0000020283.V277908.R01.S.doc Version 5.1 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 and 15 Residents are given the opportunity to take part in a good range of activities. Relatives and friends are encouraged to visit. The majority of residents enjoy the meals provided. EVIDENCE: It was clear that residents are given the opportunity to choose how to arrange their day. One person said that she regularly went out for a walk; another commented that he appreciated being able to attend services at his local church. One resident has enrolled on a creative writing course at the local college. He was keen to show the inspector a poem he had written, with the encouragement of staff in the home. Those residents, who were able, moved freely around the home. Staff were heard to ask less mobile residents if they would like to sit in one of the communal lounges, or in their own room. Residents were keen to praise the efforts of the activities organiser employed in the home. They said that they really enjoyed the sessions she organises, and were looking forward to trips in the home minibus once the weather improves. All planned activities are advertised in the home newsletter. This is Park View DS0000020283.V277908.R01.S.doc Version 5.1 Page 12 produced regularly. Recent copies were seen on display in the home, and in resident’s rooms. The majority of residents made positive comments about the standard of the food provided. One person said ‘its not how I used to cook, but it is very nice though’. Mrs Emin said that she planned to introduce a new menu in the near future. She intends to ask the residents their opinion of the proposed changes. The lunch served looked and smelt appetising. It was clear that a choice was available. Most of the more able residents chose to take their meal in the ground floor dining room. Staff assisted the less able residents in the first floor dining room. Both rooms were attractively decorated, with tables neatly set. Adapted cutlery and plate guards were provided where appropriate, to assist residents to eat independently. Park View DS0000020283.V277908.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): 16 and 18 The complaint procedure in the home is satisfactory. Staff demonstrate a good awareness of adult protection issues. EVIDENCE: The home has a clear and comprehensive complaint procedure. Residents and their relatives said that they would feel comfortable about raising any concerns should the need arise. Some relatives commented that they were unaware of the complaint procedure. This was clearly documented in the service user guide, and on the main notice board. A comments book was easily accessible in the main entrance area. Staff keep a record of concerns and complaints made. This demonstrated that issues raised were thoroughly investigated, and the complainant informed of the outcome of this investigation. A copy of ‘No Secrets in North Somerset’ was readily accessible to staff. Those consulted showed a good awareness of adult protection issues. Since the last inspection, one complaint has been received under adult protection procedures. On investigation, this complaint was found to be unsubstantiated. Other issues raised in this complaint were investigated during the course of the inspection, and reflected in the requirements and recommendations made. Park View DS0000020283.V277908.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 and 26 Park View offers good all round accommodation. Residents and their relatives would like to see sustained improvements to the laundry service. EVIDENCE: Over recent years, Mr Notaro has invested heavily in the fabric and decoration of the home. The main work is now completed, with remaining resident bedrooms being decorated when they become available. Work was planned to start, to redecorate the first floor landing the week after the inspection. Two passenger lifts offer easy access to all areas. The home has a good range of patient hoists and specialist equipment. The standard of housekeeping was good. Residents confirmed that this was usually the case. Several residents and their relatives commented that the laundry service was variable. One person gave an example of another resident wearing her cardigan, whilst a relative said ‘my only criticism is the way clothes are treated’. Mrs Emin said that she was aware of these concerns, and Park View DS0000020283.V277908.R01.S.doc Version 5.1 Page 15 thought that things had improved over recent weeks. She plans to keep the situation under review. Park View DS0000020283.V277908.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): 27, 28, 29 and 30 Robust recruitment procedures ensure suitable staff are employed to work in the home. Concerns that staffing levels are insufficient to meet the needs of residents were not substantiated at inspection, but should be kept under review. EVIDENCE: Some relatives expressed concern that staffing levels were insufficient to meet the needs of the residents. One person said that the staff ‘appear extremely busy, and are often in a rush to complete tasks’. It was not possible to find evidence to support these concerns on the day of inspection. A review of the duty rota confirmed that staffing levels set by the former health authority are consistently met. Staff said that they were kept busy, but still had time to chat to the residents. Call bells were answered promptly. Residents said that this was generally the case. Mrs Emin said that she planned to keep staffing levels under review. She felt that some staff might be appearing to rush, in an attempt to ‘get everything done ’. She plans to discuss this with staff at individual supervision sessions. Records for 3 new staff members were reviewed. These were well organised, and demonstrated a robust recruitment procedure. These records contained evidence of a thorough induction programme. Park View DS0000020283.V277908.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, 32, 33, 35, 36, 37 and 38 The home is effectively and efficiently managed. Systems are in place to enable staff, residents and visitors to comment on the way the home is run. Some relatives feel that communication systems in the home need to be improved. EVIDENCE: Mrs Emin has been registered manager of Park View for less than a year. She holds regular meetings with staff, residents and their relatives. Minutes of these meetings were available for inspection. Staff and residents said that they appreciated her open management style. In particular, staff felt that they were working well together as a team. Park View DS0000020283.V277908.R01.S.doc Version 5.1 Page 18 Mrs Emin has enrolled on the Registered Managers Award course at the local college. She said that she receives good support from a more experienced manager who works at one of Mr Notaro’s other care homes. Some relatives commented that communication systems within the home could be improved. One person was not informed that a relative had fallen, whilst another said ‘I am not always informed of important matters’. Communication systems were also an issue in the complaint received under adult protection procedures. This was discussed at length with Mrs Emin. She and the inspector both felt that the staff training planned in conjunction with the local hospice would increase awareness of these issues. The same complaint raised concerns about staff awareness of safe manual handling procedures. Training records confirmed that staff have received appropriate manual handling updates. Mrs Emin is a qualified manual-handling trainer. She plans to follow up these concerns with the staff on duty at the time of the complaint. Records reviewed were well maintained and up to date. Procedures to safeguard residents’ money were seen to be effective. Park View DS0000020283.V277908.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 3 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 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 2 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 3 2 X 3 3 3 2 Park View DS0000020283.V277908.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 2 Standard OP7 OP33 Regulation 15.1 15.2 Requirement A specific care plan must be provided for each area of identified need. Communication systems must be reviewed, to ensure that relatives are informed of significant changes in a resident’s condition Timescale for action 21/03/06 21/03/06 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 3 4 5 Refer to Standard OP4 OP9 OP15 OP26 OP27 Good Practice Recommendations Mrs Emin should write to prospective residents or their representative to confirm that staff at Park View can meet their assessed needs. All staff should sign and date hand written entries in the medicine administration records. Mrs Emin should seek residents’ opinion of the new menus Mrs Emin should continue to review the performance of the laundry service. Staff levels should be kept under review, to ensure that they are appropriate to the needs of the residents. DS0000020283.V277908.R01.S.doc Version 5.1 Page 21 Park View 6 OP38 Mrs Emin should ensure that staff use appropriate manual handling techniques and equipment. Park View DS0000020283.V277908.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. 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