Inspection on 02/04/07 for Castle Park Nursing Home

This inspection was carried out on 2nd April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Castle Park Nursing Home 31/01/06

Castle Park Nursing Home 20/09/05

Castle Park Nursing Home 23/11/04

Castle Park Nursing Home 11/06/04

Castle Park Nursing Home 05/03/04

Similar services:

Snydale Care Home

Staveley Birk Leas Nursing Home

Fairmount Nursing Home

Currergate Nursing Home

Brookfield

Castlethorpe Care Home

Elmleigh Convent

Woodlands Respite Care Centre

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

CARE HOME ADULTS 18-65 Castle Park Nursing Home Noddle Hill Way Sutton On Hull E Yorkshire HU7 4FG Lead Inspector Eileen Engelmann Key Unannounced Inspection 3rd April 2007 09:30 Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 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 Castle Park Nursing Home DS0000000927.V335451.R01.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 Adults 18-65. 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. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle Park Nursing Home Address Noddle Hill Way Sutton On Hull E Yorkshire HU7 4FG 01482 879334 01482 835651 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) www.barchester.com Barchester Healthcare Plc Mrs Janet Cooper Care Home 51 Category(ies) of Physical disability (51) registration, with number of places Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: Castle Park is part of the Barchester Healthcare group and is a single storey, purpose built home providing 51 placements for male and female service users over the age of eighteen, who have a physical disability or a terminal illness. Accommodation is mainly in single rooms (the home does have one double room), some with en-suite facilities. Service users have the choice of three lounges and a dining room for relaxing in with others; designated smoking areas are provided. The home has a garden and patio area, which is accessible to those in wheelchairs and with mobility problems. Activity programme workers are employed by the home to ensure service users have the opportunity to participate in a range of social and leisure activities and the home has a computer suite plus links to Hull College for those individuals who like to participate in communication and educational learning. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home, and copies are given to every new resident. The latest inspection report for the home is on display in the entrance hall and copies are available from the manager on request. Information given by the manager on 22/02/07 within the Pre-Inspection Questionnaire indicates the home charges fees from £368.50 to £1,490.00 per week depending on how much nursing input and 1-1 care is required for each prospective resident. Residents will pay additional costs for optional extras such as hairdressing, private chiropody treatment, toiletries and newspapers/magazines. Information on the specific charges for these is available in the service user guide, contract or from the manager. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit was carried out with the unit manager, staff, relatives and residents of Castle Park. The visit took place over 2 days and included a tour of the premises, examination of staff and resident files and records relating to the service. Three relatives and six of the residents were spoken to; their comments have been included in this report. Since the last visit in February 2006 relatives of the people living in the home have raised four concerns and three complaints with the Commission for Social Inspection and/or the Hull Social Service teams. The provider investigated one complaint and the Social service team looked at the other two. These were all resolved and where needed some changes to staff practice have been identified and actioned. Three safe-guarding of adults referrals have been made since the last visit (February 2006), these have been fully investigated and no further action was required. The manager and staff at Castle Park have worked hard to maintain high standards at the home and indeed have exceeded the expectations in a number of areas. There is a need for the management team to focus more on developing resident information into different formats so individuals understand what is written, and develop innovative ways that residents can take part in the decision making processes within the home. What the service does well: The home has an enthusiastic team of people working within the service, who like doing their jobs and learning more about how to do it well. The people working in the home want to make sure that the people who live in the home receive good care. People in the home said that the staff are ‘really great’, one individual said that ‘the people working in the home are friendly, helpful and always supportive’. Four people said that they ‘enjoy living at the home and that it has a very comfortable and pleasant atmosphere’. People are provided with a warm, safe and comfortable environment that is homely and welcoming. The home is clean and staff work hard to make sure the building is odour free. People said they are happy with their bedrooms and can bring in their own possessions, making it feel more like home. The person in charge of the home is very good at taking on new staff and making sure they are the right people with the right skills to look after the individuals living in the home. People working at the home are able to talk to the person in charge and are told if their work is okay or if they need to do different things. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The needs assessment process at the home is robust and thorough, enabling residents to be confident that their needs can be met by the service. EVIDENCE: The home has an up to date statement of purpose and service user guide, which is available in a clear print version or on videotape. Discussion with the unit manager indicated that the home is looking at ways in which residents can become more involved in the production of the documents and input their views and opinions of the service into the finished version. It was recommended that the unit manager consider how the information could be produced in a format suitable for the needs of those living in the home such as appropriate language, pictures, Braille. Four residents care and records were looked at as part of this visit, they each have been provided with a statement of terms and conditions/contract on admission and these are signed by the resident or their representative. These documents give clear information about fees and extra charges, which are reviewed and kept up to date. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 9 Each resident has their own individual file and four of those looked at had a full needs assessment completed within them. All assessments include input from outside sources such as family and state registered health professionals who are involved in the resident’s care. Any additional support the individual may need (such as 1-1 care) is clearly documented at this point and an agreement for funding arranged with the relevant funding authority. The information from the assessment process is used to formulate the individuals care plan. Discussion with three residents indicates that they are aware of what care they require and have input into how this takes place. Risk assessments are in place around activities of daily living and individuals spoken to are aware of these and understand why some may restrict their choice/freedom around the services/facilities available. Discussion with the unit manager indicated that she would visit all residents before they are admitted to the home to ensure they have received sufficient information about the home, and to introduce herself so there is someone they recognise when they come in. Those residents at the home who receive nursing care have undergone an assessment by a NHS registered nurse from the Health Authority, to determine the level of nursing input required by each individual. A copy of their assessment is kept within their care plan. It is recommended that the management team should make sure that there is a formal written process for confirming that the home can meet the assessed needs of an individual, and that the admission process is looked at as part of the quality assurance audits to determine the level of resident satisfaction with their experiences of these processes within the home. Staff members on duty were knowledgeable about the needs of each resident and had a good understanding of their specific problems/abilities and the care given on a daily basis. Discussion with the residents showed that they were satisfied with the care they receive and have a good relationship with the staff. One resident said ‘ the staff are really good, they look after us well and I love it here’, another individual commented that ‘ the staff look after my health and personal needs, but I am bored and don’t get enough social stimulation’. Three relatives said that ‘ the care our relatives receive is meeting their needs, we think the care home has a good nursing and care staff group’. The home employs fifteen staff from India, South Africa, Bulgaria and Uganda. These individuals offer staff an insight into different cultures and informal discussion with the staff indicates they work well together as a team. Residents are able to make a choice of staff gender when deciding who they would like to deliver their care, as the home has eight male care staff as well as the female members. The staff training files and the training matrix show that new staff go through an induction before starting work and that the home has a training programme in place. Information from the files and matrix indicates that the staff are up Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 10 to date with their basic mandatory safe working practice training, and there are a number of specialist subjects linked to the needs of the residents, which staff can attend training on and build their knowledge and skills in these areas. The employment records show that the manager is using a selective approach to recruitment; ensuring new staff have the right skills and attitude to meet the needs of the residents. Information from the Pre-Inspection Questionnaire and discussion with the residents indicates that the majority of the residents are of white/British nationality, and those from other ethnic groups have had their specific needs identified and these are being met. The home does accept residents with specific cultural or diverse needs and everyone is assessed on an individual basis. Discussion with the deputy manager indicated that the home looks after a number of people from the local community, although placements are open to individuals from all areas. The care plans show that residents receive input from specialist services including the Huntington’s specialist nurse, dieticians, physiotherapy, speech therapy, audiologist services, community psychiatric nurse, tissue viability nurse, and staff receive information and guidance from these experts as part of the multi-disciplinary team working within the home. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The health, personal and social care needs of the residents are clearly documented and are being met by the service and staff. Residents are encouraged to be independent within their daily lives using a risk assessment approach to care. EVIDENCE: Since the last visit in February 2006 the home has changed the format of its care plans, all documents have been up dated and reviewed and information transferred onto the new paperwork. Individual care plans are in place for all residents and the four examined set out the health, personal and social care needs identified for each person. Those residents requiring one-to-one input have a diary kept by the care worker detailing the resident’s needs throughout the day. The plans looked at have been evaluated on a monthly basis and any changes to the care being given is documented and implemented by the staff. Risk assessments were seen to cover pressure sores, nutrition, moving/handling and activities of daily living. Information about the resident’s social interests, Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 12 likes and dislikes, spiritual needs and wishes regarding death and dying are included within the individuals care plan. The funding authorities are carrying out yearly reviews of the care plans and the minutes of these meetings show that residents have input to this process (where possible), and family/representatives are also invited to the reviews with the resident’s permission. Residents or their representative have signed the care plans at the point of their being written to show they agree with the content, however there is little evidence that residents are consulted on a regular basis about their care, especially when staff are completing the monthly evaluations. This was discussed with the manager and she said she would look at how staff could use a variety of different and creative methods to help people using the service to contribute to their own care plan. Although residents are aware that they have a care plan, the current written format is not ideal for them to be able to understand the information in their plan, and they rely on staff telling them what is being put into the records. Certain individuals do have advocates who can help them with this process, but not everyone has this assistance. Some residents cannot read or write and the unit manager should consider what changes can be made to the current plan format to assist these individuals to understand what information is being written about them. Discussion with the residents clearly showed that they make a number of decisions and choices regarding their care, and staff respect these and are supportive towards helping individuals achieve independence wherever possible. Not everyone is happy that they are getting the assistance they need to be able to exercise their choice of activities. One resident commented that ‘ there is nothing for me to do. I sit and listen to the radio and my family have arranged for an advocate and additional social input, but there is not enough staff to give me the help I want to be independent’. The home has organised a specific staff member to carry out 1-1 activities with this individual, but this is only one day a week due to the number of people requiring this input. There are other social activities on offer, but this individual does not wish to join in or finds them too tiring to stay for long periods of time. Concerns raised by two relatives since the last visit in February 2006 have been around residents being put in front of televisions and left there for a long time, and individuals wandering around the home without being supervised. During this visit the inspector noted that three residents were sat in front of a television and the programme they were watching did not appear to be appropriate to their age group, however on talking to these individuals it became quite clear that they were listening to and interested in the contents of the programme. On both days of this unannounced visit it was observed that a member of staff, who was discretely following and attending to their needs, accompanied residents moving around the home. Resident meetings are available every month and the minutes of these demonstrate that individuals are able to voice opinions and viewpoints, which are listened to and action is taken by the staff where needed. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 13 Staff enable residents to take responsible risks in their every day lives and information within the care plans includes a number of risk assessments covering activities of daily living and individual ones linked to residents choices and wishes regarding their care. Talking to the residents showed that some individuals find it relatively easy to maintain their independence and are able to make their choices and decisions known without a lot of input from the staff. Others require a lot more from the staff because of communication difficulties, physical support and assistance and this was seen to be managed well on a day-to-day basis. One person asked to speak to the inspector and said that ‘ the staff are wonderful, my independence is very important to me and they help me manage my medical condition so I can enjoy my life and do what I want to’. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Links with the community are good and support and enrich resident’s social and educational opportunities. The arrangements for contact between residents and family/friends are good, and staff demonstrated a clear understanding of their role in supporting individuals to maintain these relationships. EVIDENCE: Discussion with the unit manager indicated that although there has been a lot of input from Hull College in the past, residents in the home currently are not using this service. This is being reviewed as the manager has identified individuals who could benefit from attending courses in life skills, numeracy and literacy. None of the residents have expressed an interest in finding Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 15 employment, although staff have contacts in the community if this should arise and is appropriate. Residents have access to Information Technology equipment such as computers (Castle Park has six within the home). Staff have use of a computer with internet access as part of their learning resources. This is situated in one of the resident lounges and the inspector queried if this was the most appropriate place as it could infringe on the residents personal space. The unit manager said she would look if it could be placed elsewhere. Residents are able to take part in different types of activities, both in-house and within the community. Information within the care plans and talking to the residents indicates that they are able to participate within the local community by having the freedom to come and go from the home as they choose. Some residents visit the local shops and access public transport independently. Three residents were enthusiastic about their participation in a community drama group. This takes place every Thursday and the group comes into the home and residents also go out into the community to take part in plays and workshops. Residents are encouraged to attend church services in the local community and individuals regularly go out to lunch, visit the shops and library. Staff have received training around Disability Discrimination and residents rights, so are aware of resident’s rights to access public facilities. Residents are able to participate in council elections using postal votes or attending the local polling stations. The home is aware that the residents enjoy a wide range of activities, including those on an evening and weekend. The amount of social activity hours has been increased since the last visit in February 2006 and there are now four staff members who have 112 hours a week between them to deliver flexible social and leisure activities within the home. Information from the care plans and discussion with the residents indicates that popular activities within the home include, quiz nights, use of the cinema room, exercise sessions in the small gym with the physiotherapist (recreational and therapeutic), days out in the minibus and daily activities such as craft work and drawing in the dining room. Relatives said that ‘ the home tries to put on functions for everyone to enjoy and we are invited to take part in these’, ‘there is always a good atmosphere in the home between staff, relatives and residents’. It has been recognised by the inspector that for some specific individuals there is a wish not to participate in activities and it is seen that the staff respect this decision. Other people living in the home find it difficult to join in with the activities on offer due to their physical/mental conditions and although some 11 activity time has been allocated, this is limited due to the demands on this service. Discussions with the unit manager indicated she would review these individuals and assess what could be done to integrate them more into the community in the home. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 16 Contact arrangements between the residents and families/friends are clearly documented in the individual care plans and have been made using a risk assessment process that looks at vulnerability and risk of harm. Staff help the residents to maintain links to those relatives who find visiting difficult, by taking the individuals out to visit their families or by writing letters/cards and using telephone calls as a means of communication. The amount of contact with others depends on the wishes of the resident and the family; these choices are recorded in their plans. Some individuals see their families on a regular basis, whilst others choose to visit less often or not at all. Residents spoken to are very happy with the way that staff look after them, they felt that they are given choices in their everyday life and staff respected their privacy and dignity. Observations of the interaction between staff and residents showed that there is a good relationship between the two groups of people based on trust and friendship. In the last report (February 06) residents said they were bored with the menus and did not like the choice of foods offered. Since this time the home has completely reviewed its menus and included a range of food types and choices that are more appropriate to the residents age group. There is a list of snacks available at all times and residents are able to access these on request. The home has a rehabilitation kitchen, where residents are able to plan, shop for, cook and eat their own meals as part of their care activities. Dietician support is available for those who are identified as having a risk of nutrition deficiency and the kitchens provide a number of meals for those with diabetic, low-fat, pureed and soft food needs. Two relatives are concerned that their family members are not receiving sufficient support from the staff around cutting up of food and assistance at meal times. Information in the care plans clearly indicates that staff need to give this type of assistance and staff on duty are aware of this. Observation during the lunchtime meal showed that staff are not giving appropriate assistance to these residents. Observation showed partially sighted residents left with food in front of them and no explanation as to what was on their plate, cutlery was not given to them but left at the side where they could not see it and therefore they resorted to using their fingers to eat. The staff member stayed in the room but did not offer prompts to eat especially when residents were not aware that food was still on their plate. These concerns were discussed with the unit manager who said she would talk to the staff about this. Walking around the home it was seen that fluid charts in some residents rooms are not being completed correctly and this is not acceptable practice. Discussions with the manager indicated she would speak to staff and ensure that records were up to date and correct. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The health and personal care needs of the residents are clearly documented and are being met by the service and staff. EVIDENCE: Information, within the care plans looked at, shows that each resident has their own preferred daily routine including their choices and wishes regarding care giving. Comments from the resident and relative surveys indicate that staff have the necessary skills and knowledge to meet the needs of the residents, whilst giving sensitive, flexible and personal support. One relative had concerns that their family member was not getting to bed at their preferred time. It is clearly documented in the care plan what this individual’s preferences are and staff said that they are acting on the resident’s wishes if this is not always adhered to. The resident was not available to speak to at this visit. Other residents confirmed that staff do follow their preferred routines including times for getting up and going to bed. Equipment is available within the home to assist residents in maintaining their independence, this includes computers, possum systems, hoists, stand aids, electric wheelchairs, talking books, specialist beds and mattresses, personal Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 18 safety equipment (helmets) padded room furniture (bed rails and drawers) and input from a physiotherapist to maintain mobility and promote safety. Four residents said that they have good access to their GP’s, chiropody, dentist and optician services, with records of their visits being written into their care plans. They all have access to outpatient appointments at the hospital and records show that they have an escort from the home if wished. Responses to the surveys indicated that the residents and relatives are satisfied with the level of medical support given to the people living at the home. Entries in the care plan specify where individuals have dietary needs, including PEG feeds, supplement drinks and pureed diets. The staff weighs everyone on a regular basis and evidence in the plans show that dieticians are called out if the home has particular concerns about an individual. The nurses within the home carry out specialist tasks such as PEG tubes/feeding regimes and wound dressings. Pressure areas are monitored carefully and proactive measures include risk assessments and special mattresses and seat cushions. Information from the pre-inspection questionnaire and discussion with the unit manager indicates that currently there is one resident with pressure sores, their wounds are documented in their care plans and wound care is given as appropriate. Checks of the wound care records showed these were detailed around the type of dressings used and the progress of the wound. The staff ask the tissue viability nurse for advice, where required, and documented any changes as necessary. Relatives commented that they are kept informed of their relative’s wellbeing by the staff; they are regularly consulted (were appropriate) on their care and feel involved in their lives. Overall there is a good level of satisfaction with the care being given to the residents. In the last report (February 2006) a requirement was made for ‘accurate records to be kept of all medicines received, administered and leaving the home or disposed of to ensure there is no mishandling’. At this visit this requirement was met. Checks of the records and stock levels showed that these are up to date and correct. Controlled drugs are monitored and recorded in a controlled drug register and refrigerated medication is stored appropriately. One relative had concerns that their family member’s insulin had not been available at the home when they came to take them out for the day, this had occurred a week before this visit. The nurse in charge had already recognised that the insulin had not been delivered and had arranged for a new prescription. The unit manager is undertaking an investigation into how this was not picked up on when the new medications were delivered. Another relative expressed concerns that their family member did not receive their medication on time in a morning and this was important as it includes medication to control seizures. Discussion with the staff and checks of the medication records show that this is administered on time and staff are aware of the importance of it being given accurately. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home has a satisfactory complaints system with some evidence that residents feel that their views are listened to and acted upon. Staff and residents are confident about reporting any concerns and the unit manager acts quickly on any issues raised. EVIDENCE: Checks of the complaints record shows that the unit manager has dealt with 10 complaints since the last visit in February 2006. These have been investigated and resolved. There have been three other complaints received by the Commission and Social Services. These have also been looked at and actioned where needed. The home has a complaints policy and procedure that is found within the statement of purpose and service user guide. It is also on display within the home. Four residents showed a clear understanding about how to make their views and opinions heard and said ‘when I have made a complaint in the past it has been dealt with straight away’, ‘Elaine, the manager is very helpful to me’, ‘I have not got a lot of speech, but I can go to Elaine or Chris if I have problems’. One person said ‘ I cannot write, but there are forms to fill in and staff will do this for me’. All those spoken to are confident about using the procedure and certain that the home will take action to resolve their issues. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 20 It was recommended that the unit manager consider providing a simplified format for the complaints procedure as the one available is in clear print, and this is not appropriate for everyone in the home to understand. The staff on duty displayed a good understanding of the vulnerable adults procedure and three residents spoken to said they ‘felt safe at the home’. Staff training files show that safe-guarding of adults training has taken place and is an ongoing process, and information from the staff surveys indicates they are confident about the whistle blowing procedure and discussing any concerns with the management team. The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint, and management of resident’s money and financial affairs. Discussion with two residents indicated they had some concerns about the behaviour of another residents who had come into their room and frightened them. The unit manager is aware of the incident and assured the inspector that she is taking action to keep everyone safe and prevent the situation occurring again. There have been three safe-guarding of adults referrals made in the past 12 months, the home has been active in reporting two of these incidents. All have been investigated thoroughly by the police and social services and no further action has been necessary. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The standard of the environment within this home is good providing residents with a comfortable and homely place to live. EVIDENCE: There is an ongoing programme of refurbishment and renewal at the home. The décor is bright and cheerful with corridors decorated with a variety of pictures and artwork to capture the interest of the residents. Since the last visit in February 2006 the snoozelum has been converted into two different rooms with one being a smaller relaxation room and the other a mini-gym that the physiotherapist can use with the residents. The kitchen/servery has become a rehabilitation kitchen with specialist equipment and worktops fitted, and one lounge has become a cinema room complete with lighted signs and a wide, flat screen television mounted on the wall. The medication room has moved to the entrance hall, and feedback from the staff indicates the area is too small to house the dressing trolleys so these are kept temporarily in the relaxation room unless it is in use. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 22 Walking around the premises there are a number of areas that need some attention and/or repairs, these include •Corridors 1 and 3 need the carpet replacing •Room 3 (Amy Johnson wing) needs a new carpet as the one in place is stained and badly fitted and could present a trip hazard. •The bath on Amy Johnson wing needs replacing, as it is badly stained and no longer in use. The manager should consider how the bathroom could be altered to provide a more suitable bathing facility. •The bedroom used as a sitting room by two residents needs deep cleaning. This was offered on the day of the visit and refused by the residents. The manager should negotiate with the residents the best time for this to be done. •The corridor paintwork throughout the home is damaged due to wheelchairs, and needs to be repainted. •The shower room on Maritime Wing requires a new shower hook fitting to ensure the showerhead is stored securely in an upright position. •The bath panel in the room on Maritime wing needs replacing/repairing. •There was no soap or towels available in a number of rooms during the morning, meaning staff and residents were left with nothing to wash and dry their hands on after giving or receiving care. This has been raised as a concern by two relatives. Discussion with the manager indicated new towels had arrived the morning of the visit and would be put out immediately. The home is clean, warm and comfortable and no malodours were present. Residents and visitors remarked that ‘ the domestic staff do a lovely job and make sure the home looks fresh and welcoming’. Comments from three relatives indicate that they feel that the laundry service within the home could be improved. One person said ‘clothes, socks etc disappear even though they are all well named. Clean laundry is not treated with enough respect; shirts are stuffed into drawers, not properly folded even though drawers are clearly marked for specific items. Other resident’s clothes are often misplaced and put into our relative’s drawers’. The laundry service for the home is sited in the grounds of the Castle Care Complex, it deals with the laundry for four homes and has a twenty-four hour turnaround on clothes and linen sent in daily. Each home has its own colour co-ordinated bags and there is a housekeeper on site who oversees the laundry work and care of the washing within the homes. Observation of the laundry operation shows that the system is efficient and effective, but the problems occur when the laundry goes back to the home. The unit manager should ensure care staff are putting laundry away in the correct rooms and taking time to hang or fold items appropriately. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The standards of recruitment, induction and training of staff are very good with appropriate checks being carried out and staff demonstrating a clear understanding of their roles, ensuring that residents are protected from risk and looked after by motivated and knowledgeable people. EVIDENCE: The company has achieved City and Guild training status and new staff members are undertaking their NVQ 2/3 with the homes training officer. At the moment 19/38 care staff employed at the home (50 ) have achieved an NVQ 2 or 3. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 24 The home has a separate recruitment department on site, which organises and monitors the recruitment/employment procedures as necessary. There is a comprehensive recruitment policy and procedure and the recruitment department follows the procedure, and ensures the interview process, police/CRB checks, written references, health checks and past work history are all obtained and satisfactory before the person starts work. Nurses at the home undergo regular registration audits with the Nursing and Midwifery Council to ensure they are able to practice. Checks of four staff files showed these are up to date and reviewed regularly. The home offers staff a wide range of training aimed at meeting the needs of the residents, in addition to a comprehensive induction and foundation programme, which meets the Skills for Care training targets. Staff receive in excess of three days paid training per year and the home has individual staff training plans that are discussed through supervision and appraisal. Four staff files were looked at and they contained evidence of a variety of training events attended over the past year, including Hoist training, customer care, first aid, safe-guarding of adults, epilepsy, Huntington’s disease, rehabilitation and mobility, as well as those pertaining to safe working practices. Staff said that ‘the home offers staff fantastic training opportunities and career structure’. Individuals receive regular supervision, both formal and informal and feel that this aspect of support is useful and offers them an opportunity to discuss their views and get feedback on their performance. Yearly appraisals are completed and staff receive advice and constructive criticism on their work performance. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 and 43. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The management of the home is satisfactory overall and the home regularly reviews aspects of its performance through a good programme of audits and consultations, which includes seeking the views of residents, staff and relatives. EVIDENCE: The registered manager has the qualifications, experience and competencies needed to run the home and meet its stated purpose, aims and objectives. The registered manager for the home manages three units on the same site, and each unit has its own unit manager. The registered manager has held this post for a number of years and has an up to date registration with the Nursing and Midwifery Council (NMC). She has also achieved suitable management Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 26 qualifications. The registered manager undertakes periodic` training and development’ to maintain her knowledge, skills and competence, whilst managing the home. The home has an up to date quality award from Investors in People, the local councils quality award (QDS) parts one and two and the local councils Heartbeat award. Continuous monitoring and assessment of the home and its practice/service by the various authorised bodies is an essential part of the process leading to the awards being reaffirmed year after year. Resident meetings are held on a regular basis and minutes are circulated to people living in the home. Staff have meetings with the manager and everyone is encouraged to join in with discussions and voice their opinions. Residents and staff agreed that they are able to express ideas; criticisms and concerns without prejudice and the management team will take action where necessary to bring about positive change. Policies and procedures within the home have been reviewed and updated to meet current legislation and good practice advice from the Department of Health, local/health authorities and specialist/professional organisations. The unit manager completes in-house audits of the home and its service on a monthly basis, and the registered individual does spot checks and completes the regulation 26 visits. A copy of the monthly visit is sent to the commission. The importance of the Commission’s document called Key Lines Of Regulatory Assessment (KLORA) was discussed with the unit manager, and how it is used in the inspection and report writing process. Maintenance certificates are in place and up to date for all the utilities and equipment within the building. Accident books are filled in appropriately and regulation 37 reports completed and sent on to the Commission where appropriate. Staff have received training in safe working practices; with designated persons appointed for fire warden duties, health and safety audits and safe working practices. The unit manager has completed generic risk assessments for a safe environment within the home and risk assessments were seen regarding fire, moving and handling, cot sides and pressure relieving equipment. Checks of the finance system for keeping of residents personal allowances showed that there are two systems in place. System 1 is kept by the administrator with computer held records and bank sheets, for each resident. This system is formally documented and individuals leaving money with the administrator receives a receipt and can have a copy of the computer printout on request. System 2 is money held in a safe in the home accessible by the trained nurses and with an account book kept for all monies deposited by family, visitors or Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 27 residents themselves. Staff do not give out receipts and the money is put into envelops with the residents name on. Checks of the systems showed that system 1 is up to date and accurate. System 2 showed a number of discrepancies in how money is being recorded, given out and receipted. Checks of the monies showed the balances were correct. System 2 had been set up to enable residents and relatives to access and leave money at the home when the manager and administrator was not on duty, such as evenings and weekends. However, it was clear from the records that the staff are not managing this appropriately. The unit manager was spoken to immediately about these concerns, she said she had already recognised the problems with system 2 and assured the inspector that she would stop the second system immediately and deposit all monies with the administrator. Confirmation this was done was e-mailed to the inspector on the second day of this visit. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 4 X X 3 3 Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 29 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA17 Regulation 12 (2)(4)(a) Requirement The registered person must make sure that residents who need help to eat are assisted appropriately, while maintaining their choice of when, where and what they eat. This is to help promote their nutritional health and protect their privacy and dignity. Timescale for action 01/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA1 Good Practice Recommendations The unit manager should consider how the statement of purpose and service user guide can be produced in different formats suitable for the needs of those living in the home. The management team should make sure that there is a formal written process for confirming that the home can meet the assessed needs of an individual, and that the admission process is looked at as part of the quality assurance audits to determine the level of resident satisfaction with their experiences of these processes DS0000000927.V335451.R01.S.doc Version 5.2 Page 30 2. YA2 Castle Park Nursing Home 3. 4. YA6 YA6 5. YA14 6. YA22 7. 8. YA24 YA30 within the home. The unit manager should consider how staff could use a variety of different and creative methods to help people using the service to contribute to their own care plan. The unit manager should make sure that the care plans are available in a language and format that the residents can understand (e.g. visual, graphic, simple printed English, deaf/blind manual, explanation, British sign language video. The unit manager must review those residents who are finding it difficult to participate in the social activities, and find more appropriate ways to involve them in community life within the home. The unit manager should consider providing a simplified format for the complaints procedure as the one available is in clear print, and this is not appropriate for everyone in the home to understand. The unit manager should ensure that all repairs as highlighted in this report are carried out. The unit manager should ensure care staff are putting laundry away in the correct rooms and taking time to hang or fold items appropriately. Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Castle Park Nursing Home DS0000000927.V335451.R01.S.doc Version 5.2 Page 32 - 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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