Inspection on 31/01/06 for Castle Park Nursing Home

This inspection was carried out on 31st January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 02/04/07

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 Unannounced Inspection 12:30 31 January 2006 st Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 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.V264022.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V264022.R01.S.doc Version 5.0 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) Barchester Healthcare Plc Mrs Janet Cooper Care Home 51 Category(ies) of Physical disability (51), Terminally ill (51) registration, with number of places Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th September 2005 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. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out with the nurse in charge, staff and residents of Castle Park Care Home. The inspection took 3 hours and included a tour of the premises, examination of staff and resident files and records relating to the service. Four residents were spoken to in an informal manner; their comments have been included in this report. All key standards have been looked at over the last year and information about these standards and their outcomes is written in the report for 20th September 2005 and this one. What the service does well: What has improved since the last inspection? What they could do better: Improvements must be made to the medication system to make sure staff use safe practices and better recording methods, to make sure the residents health is looked after and risk of harm is reduced. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 6 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. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 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.V264022.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. 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 continues to meet the criteria of Standard 2. Each resident has their own individual file and three 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. Four residents spoken to were able to give detailed information about their care needs and the input they required from the staff, service and outside professionals, and this was found to be accurately documented within their care plans. Discussion with the nurse in charge indicated that she or the unit manager 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. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 9 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. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6. The health, personal and social care needs of the residents are clearly documented and are being met by the service and staff. EVIDENCE: The home continues to produce and keep clear and well-written care plans for the residents. However, the recommendation made in the last report around updating the problem sheets still has to be implemented. Individual care plans are in place for all residents and clearly 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 service users needs throughout the day. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 11 Risk assessments were seen for moving and handling, pressure sores, activities of daily living and nutrition. These are reviewed regularly and the care plan amended as necessary. Risk management plans were seen in some care plans for challenging behaviour and handling of money. Three of the plans looked at have been evaluated on a regular basis and any changes to the care being given is documented and implemented by the staff. One recommendation made by the inspector was that the staff should take the time to rewrite the problem sheet section of the care plans. Although these are up to date they include information about old problems dating back to 2001 that are no longer relevant. The residents sign their own care plan and those individuals spoken to were aware of the plan content and had input to the way it was written. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14, 15 and 17. 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: Residents are able to participate in a number of projects and events taking place in the local community. Recently residents have been involved in a drama workshop run by ‘Artability’, which is a community group from Hull. There are organised trips out to the local pubs for meals and other facilities, and Hull College has teachers coming into the home once a week to offer service users access to their education and training facilities through the IT suite (Castle Park has an IT facility with six computers). 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 Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 13 to come and go from the home as they choose. Some residents visit the local shops and access public transport independently. At the last inspection some residents said that they were bored with the activities on offer. The inspector recommended that the viewpoints of the residents were obtained and feedback given to them about what can be offered. Since this time the home has developed one of the lounges into a cinema suite with a large screen plasma television mounted on the wall and DVD and video facilities also available. Discussion with the nurse in charge indicated that this has been very popular with the residents and plans are in place to develop the room further. 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. Discussion with the residents at the last inspection showed that some individuals were bored with the menu and meal choices on offer. The manager said that since the last visit the home has introduced ‘the Dining Experience’ where the manager sits and eats a meal with the residents once a week and comments are invited about the food and what the residents would like to see on the menu. Plans are still in place to introduce a ‘snack bar’, but no date for this has been given. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20. The system for medication must be improved as it contains practices that could potentially place the residents’ health and safety at risk. EVIDENCE: Discussion with the nurse in charge showed that she is aware of the changes to legislation around the disposal of medications from nursing homes, and that the home is organising a licensed waste management company to pick up any waste medicines on a monthly basis. The medication policy for the home says that individuals can self-medicate if they want to and after a risk assessment has been completed and agreed. Four of the residents spoken to prefer to have staff administer their medication and are happy with the way this is carried out. Checks of the system showed that staff are making errors in their medication practices. Action must be taken to improve the way in which staff are using the medication system to protect the health and safety of the residents and prevent the following errors happening again; ∗A number of staff have not signed on the MAR chart to indicate where they have administered medication to the resident. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 15 ∗Discrepancies were noted on three different entries for antibiotics, where there were either too few or too many signatures from staff administering the medication, for the amount of medication received and given to balance. ∗Staff need to ensure they sign every time for medication received from the pharmacy, to ensure there is no mishandling and the resident’s health is protected. The above are not acceptable practices and the registered manager should audit the medication system regularly to ensure they have been corrected and the risk of harm to the residents is reduced. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. 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: The home has a complaints procedure that residents and staff are aware of and are confident of using if needed. The complaints record shows that there have been some informal complaints around food since the last inspection. These have been investigated by the unit manager and resolved. There has been one Protection of Vulnerable Adults (POVA) referral made by the home since the last inspection. The POVA team investigated it, and no further action was needed. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. 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 different themes to capture the interest of the residents. Work is being done to convert the snoozelum 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. Another area undergoing change is the kitchen/servery, which is being developed into a rehabilitation kitchen with specialist equipment and worktops being fitted. This is due for completion by the end of February 2006. 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’. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 34. 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 of the 46 care staff employed at the home, 62.5 have achieved an NVQ 2 or 3 and 11others are going through the training. 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. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37. The manager is supported well by the senior staff in providing clear leadership throughout the home, with all staff demonstrating an awareness of their roles and responsibilities. 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 qualifications. The registered manager undertakes periodic` training and development’ to maintain her knowledge, skills and competence, whilst managing the home. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 4 X X X Standard No 22 23 Score 3 4 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 4 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Castle Park Nursing Home Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000000927.V264022.R01.S.doc Version 5.0 Page 21 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 YA20 Regulation 17 Requirement Accurate records must be kept of all medicines received, administered and leaving the home or disposed of to ensure there is no mishandling. Timescale for action 01/05/06 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 YA6 YA20 Good Practice Recommendations Staff should take the time to rewrite the problem sheet section of the care plans and file any old paperwork about problems no longer relevant to the individuals care. The registered manager should audit the medication system regularly to ensure the staff are using good practices and recording accurately. Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Castle Park Nursing Home DS0000000927.V264022.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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